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Abstract
In drug-induced lupus (DIL), symptoms similar to those of systemic lupus erythematosus (SLE) usually resolve after discontinuation of the offending drug. A 41-year-old-woman with a history of ulcerative colitis presented with polyarthritis and myositis and was positive for anti-double stranded (ds) DNA IgG antibody. After discontinuation of mesalazine, the symptoms resolved, and the antibody titer decreased. The patient was diagnosed with DIL. Six months later, lupus myocarditis developed. After treatment with glucocorticoids, cyclophosphamide, intravenous immunoglobulin, and an intra-aortic balloon pump, she showed dramatic improvement. Patients with DIL and an immunological predisposition, such as anti-dsDNA antibodies, may have SLE and should be carefully monitored.
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Affiliation(s)
- Mai Yamashita
- Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan
| | - Keisuke Nishimura
- Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan
| | - Iku Shirasugi
- Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan
| | - Yoshihide Ichise
- Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan
| | - Yo Ueda
- Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan
| | - Jun Saegusa
- Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan
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Okano M, Yoneda K, Ichise Y, Kusuhara S, Muramae N, Mori K, Otsui K, Sakaguchi K. Glucocorticoid in Combination with a TNF-α Inhibitor: Treatment of Deep Vein Thrombosis in a Patient with Behçet's Disease. Intern Med 2022. [PMID: 36384897 PMCID: PMC10372286 DOI: 10.2169/internalmedicine.0209-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 38-year-old man with deep vein thrombosis associated with Behçet's disease (BD) was admitted to our hospital due to worsening symptoms despite the initiation of direct oral anticoagulants (DOACs). Administration of oral prednisolone and an intravenous anti-tumor necrosis factor-alpha (TNF-α) monoclonal antibody dramatically improved his symptoms. In addition, he was incidentally diagnosed with autosomal dominant polycystic kidney disease, which increases the risk of aortic aneurysms. BD also increases the risk of aortic aneurysms. This case suggests that immunosuppressive treatment is effective in patients with inflammation-related DOAC-refractory venous thrombosis who also suffer from BD.
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Affiliation(s)
- Mitsumasa Okano
- Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Katsuhiko Yoneda
- Department of Rheumatology and Clinical Immunology, Kobe University Hospital, Japan
| | - Yoshihide Ichise
- Department of Rheumatology and Clinical Immunology, Kobe University Hospital, Japan
| | - Sentaro Kusuhara
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Japan
| | - Naokazu Muramae
- Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Kenta Mori
- Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Kazunori Otsui
- Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Kazuhiko Sakaguchi
- Division of General Internal Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
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Ichise Y, Saegusa J, Tanaka-Natsui S, Naka I, Hayashi S, Kuroda R, Morinobu A. Soluble CD14 Induces Pro-inflammatory Cytokines in Rheumatoid Arthritis Fibroblast-Like Synovial Cells via Toll-Like Receptor 4. Cells 2020; 9:cells9071689. [PMID: 32674360 PMCID: PMC7408546 DOI: 10.3390/cells9071689] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/10/2020] [Accepted: 07/10/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives: Synovial fluids of rheumatoid arthritis (RA) patients commonly contain high concentrations of soluble CD14 (sCD14). To investigate its potential role in RA pathogenesis, we tested whether sCD14 binding transmits a signal to fibroblast-like synoviocytes from RA patients (RA-FLS). Methods: The induction of pro-inflammatory cytokines, chemokines, and mediators by sCD14 stimulation of RA-FLS was quantified by real-time PCR and ELISA. Cell proliferation was assessed by the BrdU assay. LPS-RS, a Toll-like receptor 4 (TLR-4) antagonist, was used to block TLR-4 signaling. Results: Soluble CD14 induced the expression of IL-6 mRNA and secretion of the protein. The expression of other pro-inflammatory cytokines and mediators, such as TNF-α, IL-8, intercellular adhesion molecule-1 (ICAM-1), MMP-3, and RANK ligand (RANKL), was also induced by sCD14. In addition, sCD14 stimulation promoted RA-FLS proliferation. LPS-RS abolished IL-6, IL-8, and ICAM-1 mRNA induction by sCD14 in RA-FLS. On the other hand, TNF-α and IL-17A increased TLR-4 expression by RA-FLS and amplified their sCD14-induced IL-6 expression. Conclusions: Soluble CD14 transmits inflammatory signals to RA-FLS via TLR-4. The effects of sCD14 may be augmented in inflammatory milieu. Our results suggest that sCD14 is involved in the pathogenesis of RA and may be a novel therapeutic target.
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Affiliation(s)
- Yoshihide Ichise
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (Y.I.); (S.T.-N.); (I.N.); (A.M.)
| | - Jun Saegusa
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (Y.I.); (S.T.-N.); (I.N.); (A.M.)
- Department of Clinical Laboratory, Kobe University Hospital, Kobe 650-0017, Japan
- Correspondence: ; Tel.: +81-78-382-6197; Fax: +81-78-382-6209
| | - Shino Tanaka-Natsui
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (Y.I.); (S.T.-N.); (I.N.); (A.M.)
| | - Ikuko Naka
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (Y.I.); (S.T.-N.); (I.N.); (A.M.)
| | - Shinya Hayashi
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (S.H.); (R.K.)
| | - Ryosuke Kuroda
- Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (S.H.); (R.K.)
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan; (Y.I.); (S.T.-N.); (I.N.); (A.M.)
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Naka I, Saegusa J, Uto K, Yamamoto Y, Ichise Y, Yamada H, Akashi K, Ueda Y, Onishi A, Okano T, Takahashi S, Sendo S, Morinobu A. SAT0011 COMBINED INHIBITION OF AUTOPHAGY AND GLUTAMINE METABOLISM SUPPRESSES CELL GROWTH OF RA SYNOVIOCYTES AND AMELIORATES ARTHRITIS IN SKG MICE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Immunometabolism is now recognaized to be crucial in the pathogenesis of rheumatoid arthritis (RA). We have recently shown that the expression of glutaminase 1 (GLS1), a key enzyme in glutaminolysis, is upregulated in fibroblast-like synoviocytes from RA patients (RA-FLS) and that GLS1 inhibition suppresses RA-FLS proliferation (1). However, glutaminolysis has been known to suppress autophagy by activating mTORC1 or counteracting ROS production (2). Given the possibility of autophagy upregulation following glutamiolysis inhibition, therapies targeting both autophagy and glutaminolysis may be more effective in suppressing cell growth of RA-FLS, yet the relation between glutaminolysis and autophagy in RA-FLS has not been investigated.Objectives:To examine the effects of inhibiting both glutaminolysis and autophagy on RA-FLS and autoimmune arthritis in SKG mice.Methods:GLS1 inhibitor, compound 968 (C968), was used to suppress glutaminolysis, and Chloroquine (CQ) was used to inhibit autophagy. To detect autophagy, the expression of ATG5 and LC3B was measured by real-time PCR and the production of LC3-II was analyzed by Western blotting. The formation of autophagic vacuoles was identified by immunfluorescense. Cell growth was evaluated by BrdU assay. Apoptosis was analyzed by flow cytometry staining with Annexin V-FITC and PI. C968 and CQ were administered subcutaneously to Zymosan A-injected SKG mice.Results:C968 upregulated the expression of ATG5 and LC3B, and increased the protein level of LC3-II in RA-FLS. C968 also facilitated autophagosome formation. These results suggested that inhibition of glutaminolysis promoted autophagy in RA-FLS. The combined treatment with C968 and CQ significantly suppressed cell proliferation of RA-FLS more strongly than did C968 or CQ alone. In addition, C968 combined with CQ increased the apoptosis rate, whereas either C968 or CQ alone did not. Furthermore, combination of C968 and CQ significantly attenuated the degree of arthritis in SKG mice, while C968 or CQ monotherapy did not (Figure).Conclusion:The GLS1 inhibitor C968 promotes autophagy in RA-FLS. C968 in combination with CQ reduces proliferation and enhances apoptosis in RA-FLS, and ameliorates the arthritis in SKG mice. Suppressing C968-induced autophagy may be a promising therapy for arthritis.References:[1] Takahashi S., et al. Arthritis Res Ther. 2017 Apr 11;19(1):76.[2] Villar VH., et al. Autophagy. 2015;11(8):1198-208.Acknowledgments :NoneDisclosure of Interests:None declared
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Tsuji S, Horiuchi A, Tamaki M, Ichise Y, Kajiyama M, Tanaka N. Effectiveness and safety of a new regimen of polyethylene glycol plus ascorbic acid for same-day bowel cleansing in constipated patients. Acta Gastroenterol Belg 2018; 81:485-489. [PMID: 30645916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND STUDY AIMS In an exploratory study we compared a new regimen of low-volume polyethylene glycol plus ascorbic acid (PEG-Asc) with the standard regimen for same-day bowel cleansing in constipated patients. PATIENTS AND METHODS Between January and June 2015 we studied consecutive patients with constipation (Rome III constipation criteria) scheduled for colonoscopy. The initial group received the standard regimen of PEG-Asc. The subsequent group received the new regimen. The new regimen involved ingestion of 10 mL of sodium picosulfate and 50g of magnesium citrate dissolved in 0.2 L of water followed by 0.2 L of PEG-Asc +0.2 L of water given 6 or 7 times over 3 hours. Bowel cleansing was prospectively evaluated using the Boston bowel preparation scale (BBPS). Bowel cleansing, adenoma detection rates and adverse events were reviewed using electronic medical records and endoscopic filing system. RESULTS Sixty-two patients used the standard regimen and sixty used the new regimen. The basic characteristics of the two groups were similar. The mean volume of PEG-Asc and total liquid intake was less with the new regimen compared to the standard regimen (1.3 L vs. 2.0 L, P<0.001; 2.6 L vs. 3.0 L, P<0.001). The proportion of patients with a BBPS score ≥ 6 was significantly greater with the new than the standard regimen (93% vs. 76%, P=0.008). Nausea and/or vomiting was also significantly less frequent than with the standard regimen (5% vs. 16%, P=0.046). CONCLUSIONS The new regimen of PEG-Asc gave improved same-day bowel cleansing for colonoscopy in constipated patients.
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Affiliation(s)
- S Tsuji
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
| | - A Horiuchi
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
| | - M Tamaki
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
| | - Y Ichise
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
| | - M Kajiyama
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
| | - N Tanaka
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
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Kageyama G, Onishi A, Ueda Y, Kamei Y, Yamada H, Ichise Y, Waki D, Naka I, Tsuda K, Okano T, Takahashi S, Nishida M, Akashi K, Nishimura K, Sendo S, Kogata Y, Saegusa J, Morinobu A. THU0611 Subjective Well-Being of Japanese RA Patients Who Reach Treatment Target Is Higher than The Japanese Average. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kageyama G, Onishi A, Ueda Y, Kamei Y, Yamada H, Ichise Y, Waki D, Naka I, Tsuda K, Okano T, Takahashi S, Nishida M, Akashi K, Nishimura K, Sendo S, Kogata Y, Saegusa J, Morinobu A. AB0192 Some of The Painful RA Patients Underrate Global Health VAS at Hospitals. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Uemura Y, Hayashi H, Takahashi T, Saitho T, Umeda R, Ichise Y, Sendo S, Tsuji G, Kumagai S. [MMP-3 as a Biomarker of Disease Activity of Rheumatoid Arthritis]. Rinsho Byori 2015; 63:1357-1364. [PMID: 27089651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of this study was to confirm the clinical significance of serum MMP-3 measurement in the evalua- tion of disease activity and effectiveness of treatment in patients with rheumatoid arthritis (RA). MMP-3 was measured for 206 outpatients with RA during a period of 4 months, and also serially measured for RA patients treated with methotrexate(MTX) alone or together with infliximab (IFX). Serum MMP-3 was significantly correlated with CRP, SAA, and ESR. Significant correlation of serum MMP-3 was found not only with DAS28 (CRP) in female and male patients (p <0.0001 and p < 0.0051, respectively) but also with the EULAR classification criteria for the disease activity of RA. Among the items of DAS28(CRP), the strongest association of MMP-3 was found with swollen joint counts. Furthermore, MMP-3 levels increased with advances in Stage and Class of RA. MMP-3 levels gradually decreased 12 and 24 weeks after successful treatment with MTX (p=0.0188 and p=0.0179, respectively). Extent of the decrease was more prominent in patients with better response to MTX than in those with poor response. MMP-3 levels significantly decreased 6 weeks after IFX treatment and continued to decrease until 48 weeks. Significant decrease of MMP-3 level from before treatment was shown only in the good response group to IFX after 48 weeks of treatment. MMP-3 level was shown to be useful as a disease activity marker in RA patients. In addition, serial measurement of MMP-3 maybe helpful to evaluate the effect of treatments with MTX and IFX.
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Kumagai S, Tsuji G, Ichise Y, Umeda R, Muta A, Abe K, Izumi M, Uemura Y, Uga H, Kurata H, Misaki K, Onishi A. THU0190 The Prediction Model for Methotrexate Efficacy Consisting of 9 SNPS Selected by Dmet Microarray Profiling in Japanese RA Patients. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kumagai S, Tsuji G, Ichise Y, Umeda R, Uemura Y, Hagiwawa Y, Uga H, Kurata H, Misaki K. OP0153 Validation Study of the Prediction Model for Methotrexate Hepatotoxicity Composed of 13 SNPS Selected by DMET Microarray Profiling in Japanese RA Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sendo S, Tsuji G, Umeda R, Ichise Y, Kumagai S, Suzuki Y. Granulomatosis with polyangiitis (Wegener's granulomatosis) diagnosed by transbronchial biopsy from stenotic portion of mainstem bronchus. Mod Rheumatol 2013; 25:649-52. [PMID: 24251995 DOI: 10.3109/14397595.2013.844305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This report concerns a case of granulomatosis with polyangiitis (GPA) (Wegener's granulomatosis (WG)) with bronchus narrowing. Although nasal biopsy had been performed three times, no positive histology for GPA (WG) could be obtained. Flexible bronchoscopy revealed diffuse erythema, edema of the mucosa and stenosis of the right mainstem bronchus. Transbronchial biopsy identified granuloma with giant cells. These findings led to a diagnosis of GPA (WG). This case suggests that biopsy from the bronchus is useful for diagnosis of GPA (WG).
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Kumagai S, Tsuji G, Sendo S, Ichise Y, Umeda R, Hagihara Y, Uga H, Kurata H. THU0220 Establishment of a Prediction Model for Hepatotoxicity of Methotrexate by Using Dmet Microarray Profiling in Japanese Patients with Rheumatoid Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Horiuchi A, Nakayama Y, Kajiyama M, Kato N, Kamijima T, Ichise Y, Tanaka N. Colonoscopic enema as rescue for inadequate bowel preparation before colonoscopy: a prospective, observational study. Colorectal Dis 2012; 14:e735-9. [PMID: 22630138 DOI: 10.1111/j.1463-1318.2012.03107.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIM Colonoscopy may need to be rescheduled because of inadequate bowel preparation. We evaluated the effectiveness of colonoscopic enema as rescue for an inadequate 1-day bowel preparation before colonoscopy. METHOD Patients referred for afternoon colonoscopy were prospectively enrolled in the study during a 1-year period. Patients took bowel preparation (polyethylene glycol) solution on the morning of the endoscopy. If during colonoscopy the bowel preparation was poor, an enema of polyethylene glycol solution (500 ml) was instilled into the colon at the level of the hepatic flexure via the biopsy channel of the colonoscope which was then removed. The patient was allowed to recover from the propofol sedation and used the bathroom to evacuate the enema. The colonoscope was then introduced and the examination continued. RESULTS Of 504 patients undergoing colonoscopy, 26 (4.9%) received an enema. The median age was 59 (29-79) years and 19 (73%) were female. A subsequent successful colonoscopy was achieved in 25/26 (96%). There were no complications. The mean time spent for the entire colonoscopy from the initial preparation to the end of the examination including the enema was 7.6± 1.1h (5.4 h preparation, 0.2h first colonoscopy+enema, 0.66h waiting in the lavatory, 0.33h second colonoscopy and 1 h for recovery). CONCLUSION Colonoscopic enema was highly successful as rescue for patients with inadequate bowel preparation and avoided postponement of the procedure.
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Affiliation(s)
- A Horiuchi
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
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Horiuchi A, Nakayama Y, Kajiyama M, Kamijima T, Kato N, Ichise Y, Tanaka N. Endoscopic decompression of benign large bowel obstruction using a transanal drainage tube. Colorectal Dis 2012; 14:623-7. [PMID: 21689313 DOI: 10.1111/j.1463-1318.2011.02624.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM Endoscopic decompression of malignant colorectal obstruction is often dealt with using expandable metallic stents. Endoscopic decompression of benign large bowel obstruction is more difficult. We report the technique and outcome of transanal endoscopic decompression for benign large bowel obstruction. METHOD From January 2001 to June 2010, endoscopic decompression using a transanal drainage tube placement was attempted in consecutive patients with benign large bowel obstruction. The clinical features, technical success, complications, treatment after the tube placement and clinical success were retrospectively evaluated. RESULTS There were 13 patients (seven males, age 47-87, mean 69 years). The sites of obstruction were transverse colon [5 (38%)], sigmoid colon [3 (23%)], ileocecal valve [2 (15%)], splenic flexure [1 (8%)], descending colon [1 (8%)] and rectum [1 (8%)]. The most common cause of obstruction was anastomotic stricture [9 (69%)]. In 12 (92%) patients transanal decompression was technically successful with one perforation. An overtube, the reinsertion of colonoscope along the decompression tube, or the use of a small-diameter endoscope was required for the tube placement in seven (54%). In seven (54%) patients tube placement alone resulted in relief of bowel obstruction without operation. CONCLUSION Endoscopic decompression using a transanal drainage tube is effective for the management of benign large bowel obstruction.
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Affiliation(s)
- A Horiuchi
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan.
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Abstract
We report the case of a video capsule endoscope lodged within a Zenker diverticulum. The system that was equipped with a real-time viewer showed an unchanging image unlike esophageal or gastric mucosa, suggesting that the capsule was elsewhere. The presence of cervical discomfort suggested video capsule retention in a Zenker diverticulum. The capsule was removed endoscopically and reinserted using a hood-assisted endoscope and the procedure was completed.
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Affiliation(s)
- A Horiuchi
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Shinshu University Graduate School of Medicine, Matsumoto, Japan
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Yano T, Fukuyama Y, Yokoyama H, Takai E, Tanaka Y, Ichise Y. [Advantages and disadvantages of lymph node dissection in surgery of non-small-cell carcinoma of the lung--with special reference to a study of cases of N0-pathologic N2]. Nihon Kyobu Geka Gakkai Zasshi 1997; 45:363-4. [PMID: 9235339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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