[Show abstract][Hide abstract] ABSTRACT: The prevalence of inflammatory bowel disease (IBD) is increasing. Since patients usually need long-term treatment and suffer from reduced quality of life, there is a need to develop new therapeutic strategy. The aim of this study was to investigate the therapeutic potential of erythropoietin (EPO) for the treatment of IBD.
Murine colitis was induced by 3.0% Dextran Sulfate Sodium (DSS). Recombinant human EPO (rhEPO) was given to evaluate the anti-inflammatory and regenerative effects on intestinal inflammation. The effect of rhEPO on human colon epithelial cells was also evaluated. Immunohistochemical analysis of EPO receptor was performed in human IBD tissues.
While about 62% of control mice with severe colitis induced by 5-day DSS died, 85% of mice treated with rhEPO survived. Histological analysis confirmed that EPO treatment reduced the colonic inflammation. Furthermore, EPO treatment significantly downregulated the local expressions of IFN-γ, TNF-α and E-selectin in the colon, suggesting that the effect was associated with inhibiting local immune activation. In a 4-day DSS-induced colitis model, rhEPO significantly improved the recovery of body weight loss compared to controls. Furthermore, proliferating cell nuclear antigen expression was significantly upregulated in the colon tissue from mice treated with rhEPO compared to controls. In addition, rhEPO increased the growth of cultured human colon epithelial cells in a dose-dependent manner. Furthermore, EPO-receptor expression was confirmed in human IBD colon tissues.
Three major functions of EPO, hematopoiesis, anti-inflammation and regeneration, may produce significant effects on intestinal inflammation, therefore suggesting that rhEPO might be useful for IBD.
[Show abstract][Hide abstract] ABSTRACT: To clarify the incidence and clinical features of perianal lesions in patients with UC, we retrospectively analyzed data from 4,678 patients who underwent surgery for perianal diseases between 2001 and 2010 and data from 773 patients with UC. Perianal lesions occurred in 21 patients (2.7%) with UC including 13 with total colitis, 5 with left-side colitis and 3 with proctitis. On the spectrum of perianal lesions, the percentages of fistula/abscess and hemorrhoid/fissure were 76.2% and 14.3%, respectively, in UC patients, compared with 25.2% and 55.7%, respectively, in common anal disease patients, showing a significant difference (p<0.001). We classified the perianal lesions in UC patients into four categories according to Hughes' classification. Eight of 10 cases with incidental fistula/abscess succeeded with local surgical treatment. There were no lesions similar to the primary lesions of Crohn's disease. Three of 6 cases with secondary fistula/abscess and 2 cases with post-operative anastomotic fistulas failed with local surgical treatment, and required total proctocolectomy or ileostomy. Our conclusions were as follows. The majority of perianal lesions in UC patients were fistula/abscess. The classification of perianal lesions according to Hughes' classification reflected the responsiveness to treatment and the prognosis. It is important to recognize the existence of perianal lesions in the clinical management of patients with ulcerative colitis.
[Show abstract][Hide abstract] ABSTRACT: In 2010, a newly-created medical fee was established for "Cancer Patient Rehabilitation." We acquired the facility criteria for cancer rehabilitation in August 2011. In December 2005, we started a preventive rehabilitation program to provide comprehensive respiratory physical therapy. Maintenance rehabilitation, palliative rehabilitation and home visiting rehabilitation have been increasing recently. All our staff hope to provide safer, improved skills cancer medical care for all patients by using better rehabilitation skills.
No preview · Article · Feb 2013 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: A 48-year-old male was admitted to our hospital for high fever, abdominal pain and back pain. He had Crohn's disease and resulting stenosis of the ileum. He had been treated with IFX nine times. A bacterial culture test showed Klebsiella pneumonia and we diagnosed sepsis from the stenotic lesion of the ileum. Antibiotic therapy was not effective, so we operated on his stenotic ileum. After the operation, chest CT examination showed an extradural compression and we diagnosed pyogenic spondylitis. Rest and antibiotic therapy continued for about one month and his pyogenic spondylitis was healed. IFX treatment of the stenotic lesion of Crohn's disease predisposes the patient to sepsis and pyogenic spondylitis. Therefore, we may consider operating on the stenotic lesion first, and then using IFX.
No preview · Article · Jan 2013 · Nippon Daicho Komonbyo Gakkai Zasshi
[Show abstract][Hide abstract] ABSTRACT: The current treatment plan for squamous cell anal canal carcinoma using chemoradiotherapy (CRT) is becoming more standardized. We use CRT rather than surgery to select the appropriate treatment. We experienced 4 patients treated with abdominoperineal resection(APR), of which 1 underwent adjuvant CRT. We also experienced 3 patients treated with radiotherapy(RT) and 2 treated with CRT. A patient treated with RT underwent APR because of radiation colitis. RT and CRT are advantageous for quality of life and are expected to be effective for controlling the disease. We hope that the standard treatment plan for anal cancer in Japan will be determined on the basis of histological features.
No preview · Article · Nov 2012 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: Cases of colorectal cancer resembling a submucosal tumor are rare and among them, tumors of less than 1 cm in diameter occur very rarely. We report on a case of advanced transverse colon cancer 7 mm in diameter resembling a submucosal tumor with reference to the tumor's clinicopathological features, development and progression. A woman in her 60's was referred to our hospital because of a positive fecal occult blood test. Colonoscopy showed a cancerous lesion resembling a submucosal tumor of the transverse colon. Laparoscopic right hemicolectomy with dissection of group 3 lymph node was performed. The histological diagnosis and pathological stage was moderately differentiated adenocarcinoma, 7 X 6mm in diameter, pSS, pN0(0/19), sP0, sH0, cM0, and fStage II.
No preview · Article · Sep 2011 · Gastroenterological Endoscopy
[Show abstract][Hide abstract] ABSTRACT: In patients with longstanding ulcerative colitis (UC), the risk of developing colorectal cancer (CRC) increases steadily and cancer surveillance is widely recommended. We herein report on four cases of early CRC associated with UC, and in every case we could detect the lesions endoscopically and perform the operation successfully. The type IV like pit pattern, called the neoplastic pit pattern of ulcerative colitis (NPUC), was a particularly important indicator to recognize CRC and dysplasia. However, in many cases, to detect flat neoplastic lesions is still difficult in spite of remarkable progress in endoscopic techniques : therefore, further studies are necessary for accurate diagnosis of the lesions. In surveillance colonoscopy, when we can acquire an exact method of finding the lesions, surveillance by targeted biopsies will be more efficient than by non-targeted random biopsies.
No preview · Article · Apr 2011 · Gastroenterological Endoscopy
[Show abstract][Hide abstract] ABSTRACT: A man in his early seventies underwent low anterior resection and partial resection of the liver for the rectal cancer and liver metastasis. However, 4 months after the surgery, he was found to have a liver tumor at S5 and S7 by abdominal CT scan. Then, he underwent chemotherapy (mFOLFOX6), but the metastatic tumor was progressive. We selected FOLFIRI + cetuximab regimen for second-line therapy to resect the metastatic tumor. As the metastatic lesion was become smaller after 4-course of the regimen including cetuximab, we decided to perform a radical resection. We conducted a right lobectomy of the liver, and the tumor was completely resected.
No preview · Article · Nov 2010 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: A woman in her fifties underwent a right hemicolectomy (D3) for cancer of the ascending colon in October 2007, definitively and pathologically diagnosed as papillary adenocarcinoma invading to the subserosa, and no metastasis was detected to lymph node. But 13 months after the surgery, she was found to have a mass near the anastomosis by an abdominal CT scan. Colonoscopy showed an evaluating lesion with ulcer in the anal side of the anastomosis. We tried to resect the metastasis, but it was not resectable because of the invasion to the pancreas. The mFOLFOX regimen was effective. After the chemotherapy (6 courses), we decided to perform a radical resection. We conducted pancreatoduodenectomy in May 2009. She is still alive 12 months after surgery.
No preview · Article · Nov 2010 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: Our hospital fights against a clinical study clearly. However, our hospital did not participate in a clinical study here. When I widened a clinical study in cooperation with the staff, I make a progress report. I started a clinical study only with a doctor first. Therefore it was recognized many problems happened and to promote a clinical study without cooperation of the work of many kinds. I studied with the staff to promote a clinical study and deepened understanding. Thereafter the clinical study was led by a nurse of the chemotherapy room; , in addition, was able to get various cooperation from a skiagrapher. When OGSG0603 began, the nurse and the pharmacist served to become the key than a doctor. I was able to promote a clinical study by cooperation of much staff. In addition, I was able to carry out the system improvement of each section by performing a clinical study.
No preview · Article · Apr 2009 · Gan to kagaku ryoho. Cancer & chemotherapy