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Kazuhiro Watanabe,
Hitoshi Ogawa,
Chikashi Shibata,
Koh Miura,
Takeshi Naitoh,
Masayuki Kakyo,
Makoto Kinouchi,
Toshinori Ando,
Nobuki Yazaki,
Naoki Tanaka,
Sho Haneda, Manabu Sato,
Iwao Sasaki
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ABSTRACT: Tacrolimus, a 23-member macrolide lactone discovered in 1984 from the actinomycete Streptomyces tsukubaensis, was the first macrolide immunosuppressant agent. Tacrolimus was first used for patients after liver transplantation to reduce the activity of the patient's immune system and the risk of organ rejection. Oral tacrolimus was recently approved for use in steroid-refractory moderate-to-severe ulcerative colitis in Japan. This review focuses on the clinical efficacy and safety data of tacrolimus in moderate-to-severe refractory ulcerative colitis.
Clinical Medicine Reviews in Therapeutics. 11/2010;
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ABSTRACT: The aim of this study was to investigate the effects of intracolonic capsaicin on colonic motility and defecation.
The effects of capsaicin (1, 2, 5, and 10 mg) administrated into the proximal colon on ileocolonic motility and defecation were studied in neurally intact dogs with or without various antagonists (atropine, hexamethonium, ondansetron, propranolol, and FK224), dogs with extrinsic denervation of an ileocolonic segment, and dogs with enterically isolated ileocolonic loops equipped with strain gauge force transducers.
Capsaicin at 5 and 10 mg evoked giant migrating contractions in a dose-independent manner, and it induced defecations with more than 90% probability in neurally intact dogs. These effects of capsaicin were abolished by atropine and hexamethonium. Ondansetron inhibited the capsaicin-induced increase in colonic motility but did not affect the induction of defecation. The other antagonists had no effect. In dogs with extrinsic denervation, capsaicin did not evoke giant migrating contractions in the colon but still induced defecation in 30-40% of experiments. In dogs with ileocolonic loops, capsaicin did not stimulate colonic motility nor induce defecation.
These results indicate that intracolonic capsaicin causes giant migrating contractions and defecation. Intact extrinsic innervation, continuity of the colon, and intraluminal contents were considered necessary for this effect.
Surgery 06/2010; 147(6):789-97. · 3.10 Impact Factor
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Manabu Sato,
Hitoshi Ogawa,
Chikashi Shibata,
Koh Miura,
Toshinori Ando,
Fumito Saijo,
Sho Haneda,
Masayuki Kakyo,
Makoto Kinouchi,
Kohei Fukushima,
Yuji Funayama,
Kenichi Takahashi,
Iwao Sasaki
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ABSTRACT: Infliximab is effective in the treatment of steroid-resistant Crohn disease. However, there is clinical concern about a possible correlation between an increased risk of anorectal cancer and infliximab treatment. We report a case of anorectal cancer in long-standing perianal Crohn disease. A 34-year-old patient with a long-standing perianal lesion of Crohn disease underwent 3 sessions of infliximab therapy. After therapy, the concentration of plasma CEA was 36.5ng/ml and rose to 91.4ng/ml. We suspected anorectal cancer, so abdominoperineal resection was performed. The histological findings indicated mucinous adenocarcinoma. Monitoring of patients with long-standing perianal Crohn disease is considered essential for early diagnosis of anal cancer after obtaining biopsy samples from perianal lesions. Additionally, when infliximab is started for perianal Crohn disease, thorough examination for perianal lesion should be performed.
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 06/2010; 107(6):885-92.
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ABSTRACT: The aim of the present study was to investigate the effects of diversion of biliary and pancreatic juices on upper gut motility and hormone secretion.
We used dogs equipped with strain gauge force transducers to measure upper gut motility. Dogs were divided into 5 groups: control, sham operation, biliary diversion (BD), pancreatic juice diversion (PJD), and biliopancreatic juice diversion (BPD). Postprandial plasma concentrations of insulin, gastric inhibitory polypeptide (GIP), and peptide YY (PYY) were also measured.
Occurrence and migration velocity of the migrating motor complex in the jejunum in the interdigestive state were decreased in the BD and BPD groups compared with the other 3 groups (P < .05). In the BD and BPD groups, areas of postprandial contractile curves in the upper gut were decreased, and the duration of the postprandial contractions in the proximal jejunum, which a previous study showed to correlate with gastric emptying, were less compared with the other 3 groups (P < .05). Plasma insulin levels did not differ among the 5 groups. Plasma concentrations of GIP suppressed in the PJD and BPD groups (P < .05), whereas plasma PYY level was increased in the BD group (P < .05).
Bile diversion seems to inhibit interdigestive and postprandial upper gut contractions in association with an increase of plasma PYY. Pancreatic juice was considered to play a role in the secretion of GIP.
Surgery 04/2010; 148(5):1012-9. · 3.10 Impact Factor
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Manabu Sato,
Chikashi Shibata,
Daisuke Kikuchi,
Fumie Ikezawa,
Hirofumi Imoto,
Masayuki Kakyo,
Makoto Kinouchi,
Naoki Tanaka,
Koh Miura,
Takeshi Naitoh,
Hitoshi Ogawa,
Iwao Sasaki
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ABSTRACT: Our aim was to study the effect of the viscosity of enteral nutrient solutions on upper gut motility and gut hormone secretion.
We used 5 beagle dogs equipped with strain gauge force transducers to measure upper gastrointestinal motility. Upper gut motility and gut hormone secretion were compared across 6 experimental conditions; control (oral solid meal), liquid-120, liquid-5 (liquid enteral nutrients administered for 120 and 5 min, respectively), low, middle, and high viscosity conditions.
The magnitude of receptive relaxation was decreased in the liquid-120 compared to control, but this decrease was reversed with the increase of viscosity. The duration of the postprandial contractions in the proximal jejunum was decreased in the liquid-5 compared to the control, but this decrease was reversed in the middle and high viscosity conditions (p < 0.05). Rapid increase in plasma concentrations of gastric inhibitory polypeptide observed in the liquid-5 compared to the control was reversed in the low, middle, and high viscosity conditions.
Although patterns of upper gut motility and gut hormone secretion after liquid enteral nutrients were considerably altered compared to those after solid meal ingestion, increasing the viscosity of liquid enteral nutrients reversed those altered patterns.
Hepato-gastroenterology 58(105):36-41. · 0.66 Impact Factor
