Publications by authors named "Shiga H"
Background/aims: Radial incision and cutting (RIC) is an alternative dilation method for stenosis of the lower gastrointestinal tract. However, its safety and efficacy for the small intestine requiring balloon-assisted enteroscopy (BAE) remain limited. Therefore, this pilot study aimed to evaluate the safety and efficacy of RIC using BAE.
View Article and Find Full Text PDFAlthough endoscopic balloon dilation (EBD) is a common therapeutic approach for managing strictures associated with Crohn's disease (CD), the clinical application and complication rates of EBD remain unclear. We collected admission data for patients who underwent EBD using a nationwide database. We compared EBD outcomes between ileal and colonic strictures, CD and ulcerative colitis, and CD and anastomotic strictures arising from cancer-related surgery.
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- Radial incision and cutting (RIC) is explored as a new method for treating lower intestinal tract stenosis, aiming for high success rates and symptom relief, but patients often experience re-stenosis after the procedure.
- In a pilot study involving 20 patients, RIC was performed with the addition of triamcinolone acetonide (TA), and the safety and efficacy were assessed after two months, focusing on adverse events and symptom improvement.
- Results showed a delayed bleeding rate of 23.8%, but no perforations occurred; while symptoms improved, TA didn’t seem to significantly prevent re-stenosis, suggesting the need for further research.
Article Synopsis
- The study investigates the relationship between sleep disorders and inflammatory bowel disease (IBD) to determine if poor sleep causes increased disease activity.
- Researchers used the Pittsburgh Sleep Questionnaire to categorize participants into poor sleep and non-poor sleep groups, then tracked IBD relapse rates.
- Results showed a significantly higher relapse rate in the poor sleep group (28.3%) compared to those with better sleep (8.9%), indicating that chronic poor sleep may worsen IBD, especially ulcerative colitis.
The optimal immunosuppressive therapy for elderly patients with ulcerative colitis (UC) remains unclear. We aimed to evaluate clinical practice and prognosis in elderly patients with UC through comparing between those with elderly-onset UC (EOUC) and those with long-standing elderly UC (LEUC). In this retrospective single-center cohort study, we evaluated elderly patients with UC aged ≥ 60 in August 2022 through collecting medical record data from the time of diagnosis of UC until August 2022.
View Article and Find Full Text PDFBackground: It is crucial to pinpoint the metabolites that cause Crohn's disease (CD) and ulcerative colitis (UC) to comprehend their pathogenesis and identify possible targets for therapy. To achieve this goal, we performed the first metabolome-wide Mendelian randomization (MR) study of Japanese patients with CD and UC.
Methods: As exposure datasets, genetic instruments with blood-circulating metabolites were obtained from the Tohoku Medical Megabank Organization, which includes 204 metabolites from the genome-wide association study data of 7843 Japanese individuals.
Background/aims: During endoscopy, white spots (WS) are sometimes observed around benign or malignant colorectal tumors; however, few reports have investigated WS, and their significance remains unknown. Therefore, we investigated the significance of WS from clinical and pathological viewpoints and evaluated its usefulness in endoscopic diagnosis.
Methods: Clinical data of patients with lesions diagnosed as epithelial tumors from January 1, 2019, to December 31, 2020, were analyzed (n=3,869).
Article Synopsis
- The study compares clinical practices and outcomes between elderly patients with ulcerative colitis and those diagnosed at a younger age, noting an increase in older patients with the condition.
- Results showed that elderly-onset ulcerative colitis patients had a significantly lower rate of being free from systemic steroid use and a higher risk of death, whereas surgery and molecular targeting drug rates were similar across both groups.
- Conclusions suggest that while disease severity may be comparable, elderly-onset ulcerative colitis patients face higher mortality risk, highlighting the need for careful monitoring and timely surgical intervention.
Article Synopsis
- - The study aimed to evaluate the effectiveness of combining ustekinumab with budesonide versus using ustekinumab alone in treating Crohn's disease in 19 patients.
- - Results showed no significant difference in clinical remission rates or mucosal healing between the combination therapy and ustekinumab monotherapy after 8 and 32 weeks.
- - The most common side effect observed was an exacerbation of Crohn's disease, but safety profiles were comparable for both treatment groups.
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- This study assessed the effectiveness of NUDT15 codon 139 genotyping to improve thiopurine treatment for inflammatory bowel disease (IBD) among 4628 patients in Japan.
- Retrospective analysis showed that while genotyping did not significantly change thiopurine induction rates, it led to customized dosing that reduced adverse events (AEs) and improved treatment retention.
- Findings indicated that starting doses and genotype-based adjustments can minimize risks, with specific genotypes correlating to different reactions to thiopurine treatments—providing a basis for more tailored treatment strategies.
Background And Aim: Inflammatory bowel disease (IBD) frequently affects younger patients and poses various challenges concerning pregnancy and childbirth. Maintaining good disease control throughout pregnancy is crucial, but expectant and pregnant patients may worry about the fetal impact of medications, leading to treatment discontinuation due to uncertainty about this issue. This study investigated the real-world drug-prescribing practices for pregnant patients with IBD in Japan and their potential connection to major congenital malformations (MCMs).
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- Vedolizumab (VDZ) is an agent for treating inflammatory bowel diseases (IBD) that has a good safety record, and researchers wanted to see if patients could safely switch to it from other therapies while also getting live vaccines.
- The study involved 107 unimmunized IBD patients, where a group either continued VDZ during vaccination or switched to it before vaccination, finding that most maintained their health and had positive vaccine responses.
- The results suggest that live-attenuated vaccines can be safely administered during VDZ treatment without causing infections, indicating a viable option for unimmunized patients on immunosuppressive therapy.
Objective: Periglomerular and granule cells in the adult mammalian olfactory bulb modulate olfactory signal transmission. These cells originate from the subventricular zone, migrate to the olfactory bulb via the Rostral Migratory Stream (RMS), and differentiate into mature cells within the olfactory bulb throughout postnatal life. While the regulation of neuroblast development is known to be affected by external stimuli, there is a lack of information concerning changes that occur during the recovery process after injury caused by external stimuli.
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- - The study focuses on a new treatment method called radial incision and cutting (RIC) for lower gastrointestinal tract stenosis, which has advantages over traditional treatments like surgery and endoscopic balloon dilation (EBD), but still faces issues with restenosis.
- - Researchers are conducting a phase II trial involving 20 participants aged 20-80, comparing the safety of administering triamcinolone acetonide (TA) post-RIC, assessing both the safety and effectiveness of this approach.
- - Key outcomes include monitoring adverse events, the technical success of the RIC procedure, improvements in symptoms, and length of hospital stay, with the goal of providing data that could inform future studies on this treatment.
Article Synopsis
- - The study investigates the usage and prevalence of generic drugs and biosimilars for treating ulcerative colitis (UC) in Japan, leveraging data from a national medical claims database involving over 30,000 cases.
- - Findings indicate a notable increase in the prescription rate for generic mesalazine from 10% in 2015 to over 30% in 2021, while generic molecular targeting drugs saw a smaller increase, from 0.15% to 2.5% during the same period.
- - Despite some growth, the overall penetration rates for generics and biosimilars remain low compared to other treatments, highlighting the need for strategies to enhance their use for more cost-effective healthcare in Japan. *
Background And Purpose: Colorectal cancer progression from adenoma to cancer is a time-intensive process; however, the interaction between normal fibroblasts (NFs) with early colorectal tumors, such as adenomas, remains unclear. Here, we analyzed the response of the microenvironment during early tumorigenesis using co-cultures of organoids and NFs.
Materials And Methods: Colon normal epithelium, adenoma, cancer organoid, and NFs were established and co-cultured using Transwell inserts.
Background: Hospitalization for ulcerative colitis (UC) is potentially life-threatening. Severe disease in the Japanese criteria which modifies the Truelove-Witts' criteria might encompass more fulminant cases than the definition for acute severe UC. However, few studies have investigated the predictive factors for clinical remission (CR) after medical treatments for severe hospitalized patients by Japanese criteria.
View Article and Find Full Text PDFPurpose: This study aimed to elucidate the relationship between diurnal masseter muscle activity and awareness of diurnal awake bruxism (d-AB) by conducting a comparative analysis of electromyographic (EMG) data from individuals with and without awareness of diurnal awake bruxism (d-AB), utilizing EMG data gathered from multiple subjects.
Methods: Unilateral masseter electromyography (EMG) recordings were performed during the daytime using an ultraminiature wearable EMG device. A total of 119 participants (59 with awareness of diurnal tooth clenching [d-TC] and 60 without awareness of d-TC) were included.
Article Synopsis
- The study aimed to assess how the length of the membranous septum (MS) changes throughout the cardiac cycle using CT images in patients preparing for transcatheter aortic valve replacement (TAVR).
- Three different measurement techniques (coronal, stretched, and reformatted coronal views) were applied to 34 patients' CT images across various phases of the cardiac cycle, revealing differences in MS lengths.
- Results showed that the measurement methods produced varying MS lengths, with notable correlations between some methods and significant differences in lengths at specific points in the cardiac cycle, emphasizing the need for careful measurement during diastole for accurate evaluations.
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- The study examines long-term outcomes for patients with new-onset ulcerative colitis (UC) in the age of biologic treatments, using data from 6,689 cases.
- Findings show high rates of being surgery-free (98.5%) and relatively moderate rates for being systemic steroid-free (61.0%) and molecular targeting drug-free (88.7%) five years post-diagnosis.
- The study highlights that younger patients have better surgery-free outcomes, while prescription rates for various treatments have increased significantly from 2014 to 2021, suggesting a potential improvement in long-term UC prognosis.
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- The study assesses the effectiveness of antibiotics in treating uncomplicated diverticulitis, which is still debated among healthcare professionals.
- A nationwide database was analyzed, comparing outcomes of patients receiving antibiotics versus those who did not within two days of admission, focusing on surgery rates, death, and medical costs.
- Results showed that the antibiotic group had significantly lower rates of surgery, but higher medical costs, suggesting that early antibiotic treatment may help reduce severe complications in patients with diverticulitis.
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- This study looked at how effective advanced therapies (AT) are for hospitalized patients with acute severe ulcerative colitis (ASUC), comparing their results with those receiving corticosteroids (CS).
- Out of 221 patients, those given CS had a higher clinical remission rate than those on AT, particularly on Day 14 of treatment.
- While first-line ATs showed some effectiveness, second-use ATs yielded limited benefits, suggesting that switching therapies may be more beneficial for some patients.
The usefulness of NUDT15 genotyping as a pharmacogenomic test for thiopurine has been established. The first such test developed to date, NUDT15 genotyping was approved for reimbursement in Japan in February 2019 for all indicated patients. We retrospectively examined claims data in Japan and confirmed that the proportion of patients who undergo genotyping before initiating a new thiopurine regimen has increased; furthermore, genotyping has improved the rate of treatment continuation and reduced on-treatment hospitalization.
View Article and Find Full Text PDFIntroduction: Cyclosporine or infliximab (IFX) have been used to avoid surgery in patients with severe refractory ulcerative colitis (UC). Tacrolimus (Tac) is occasionally used as an alternative to cyclosporine; however, the comparative efficacy of Tac and IFX has not been reported. We aimed to compare the effectiveness of Tac and IFX in hospitalized patients with UC.
View Article and Find Full Text PDFBackground: Olfactory dysfunctions (OD) and taste dysfunctions (TD) are widely recognized as characteristic symptoms of COVID-19; however, the frequency and mode of occurrence has varied depending on the viral mutation. The prevalence and characteristics of OD/TD in Japan have not been definitively investigated. The purpose of this study is to assess the prevalence of OD/TD in Japan during the Alpha variant epidemic, and measure symptom prolongation at 6 months and 1 year later following initial infection.
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