RESUMEN
BACKGROUND AND STUDY AIMS: Double-balloon endoscopy (DBE) is a new device that allows diagnosis and treatment throughout the entire small intestine. Although the originally described method requires two operators, we have recently developed a method to perform DBE by a single operator. We here assessed the clinical usefulness of this one-person method in comparison to the conventional two-person DBE. PATIENTS AND METHODS: One hundred sixty-two patients (102 men and 60 women, mean age 59 years) underwent 303 DBE procedures. Total observation time, completion rate of total intestinal and colonic observation, lesion-discovery rate, and complication rate were retrospectively compared between the one-person method and the conventional two-person method of DBE. The one-person method consists of the Grip and Pinch technique and Keep (or Hold) and Slide technique. RESULTS: The total observation times were 95.5 +/- 35.1 min and 96.7 +/- 47.5 min by one-person and two-person antegrade DBE, respectively, and 103 +/- 29.8 min and 111 +/- 30.1 min by one-person and two-person retrograde DBE, respectively. The completion rate for examination of the entire small intestine was 74.2% in one-person DBE and 76.5% in two-person DBE, respectively. The lesion-discovery rate was 69.0% in one-person DBE and 65.5% in two-person DBE, respectively. No significant differences between two methods were found in all measures. Also, no difference was observed in complication rate of the two methods. CONCLUSIONS: The single-operator method for DBE was as efficient as the dual-operator DBE without any higher risk of complications and, therefore, could replace the conventional dual-operator method in the future.
Asunto(s)
Cateterismo , Colonoscopía , Endoscopía del Sistema Digestivo/métodos , Técnicas Hemostáticas , Enfermedades Intestinales/patología , Enfermedades Intestinales/terapia , Intestino Delgado/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cateterismo/instrumentación , Competencia Clínica , Colonoscopía/efectos adversos , Endoscopía del Sistema Digestivo/efectos adversos , Endoscopía del Sistema Digestivo/instrumentación , Femenino , Técnicas Hemostáticas/efectos adversos , Técnicas Hemostáticas/instrumentación , Humanos , Masculino , Persona de Mediana Edad , Destreza Motora , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
Atoh1 plays a crucial role in intestinal cell differentiation. We have demonstrated that its human homolog Hath1 protein is targeted by the Wnt-GSK3 axis, resulting in the proteasomal degradation in human colon cancer. However, the contribution of Hath1 degradation to the undifferentiated state of colon cancer remains unknown. In this study, we demonstrated that both constitutive expression of mutant Hath1 and stabilization of Hath1 protein by a GSK3 inhibitor in colon cancer cells increased the expression of MUC2 known as a representative function of differentiated goblet cells. This means that Hath1 protein degradation may be required for maintaining the undifferentiated state of colon cancers, and that GSK3 inhibitors have potential for use in cancer therapy.
