RESUMO
BACKGROUND AND AIM: Balloon endoscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) is an emerging procedure for pancreatobiliary diseases in patients with surgically altered anatomy. However, data on BE-ERCP for hepatolithiasis after hepaticojejunostomy (HJS) are still limited. METHODS: Stone removal success, adverse events and recurrence were retrospectively studied in consecutive patients who underwent BE-ERCP for hepatolithiasis after HJS between January 2011 and October 2022. Subgroup analysis was performed to compare clinical outcomes between patients who had undergone HJS over 10 years before (past HJS group) and within 10 years (recent HJS group). RESULTS: A total of 131 patients were included; 39% had undergone HJS for malignancy and 32% for congenital biliary dilation. Scope insertion and complete stone removal were successful in 89% and 73%, respectively. Early adverse events were observed in 9.9%. Four patients (3.1%) developed gastrointestinal perforation but could be managed conservatively. Hepatolithiasis recurrence rate was 17%, 20% and 31% in 1-year, 3-year, and 5-year after complete stone removal. The past HJS group was the only risk factor for failed stone removal (odds ratio 10.4, 95% confidence interval 2.99-36.5) in the multivariable analysis. Failed scope insertion (20%) and failed guidewire or device insertion to the bile duct (22%) were two major reasons for failed stone removal in the past HJS group. CONCLUSIONS: BE-ERCP for hepatolithiasis was effective and safe in cases with HJS but the complete stone removal rate was low in the past HJS group. Recurrent hepatolithiasis was common and careful follow up study is needed even after complete stone removal.
Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Litíase , Hepatopatias , Humanos , Masculino , Feminino , Estudos Retrospectivos , Colangiopancreatografia Retrógrada Endoscópica/métodos , Pessoa de Meia-Idade , Idoso , Hepatopatias/cirurgia , Litíase/cirurgia , Adulto , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Recidiva , Jejunostomia/métodos , Idoso de 80 Anos ou mais , Resultado do TratamentoRESUMO
As a help of the mechanism elucidation of alcoholism, we studied the relationship between glycogen synthase kinase 3-beta (GSK3B) -50T/C and -1727A/T polymorphisms, which are reported to relate to bipolar disorder. We genotyped the two polymorphisms in GSK3B gene using a polymerase chain reaction (PCR) in 71 health controls and 47 alcoholics. In this study, there was no significant difference in the frequency of GSK3B -50T/C and -1727A/T polymorphisms between alcoholics and controls. We suggested that there was no significant association of GSK3B -50T/C and -1727A/T polymorphisms with alcoholism.
Assuntos
Alcoolismo/genética , Quinase 3 da Glicogênio Sintase/genética , Polimorfismo Genético , Feminino , Glicogênio Sintase Quinase 3 beta , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da PolimeraseRESUMO
As a help of the relationship between bipolar disorder and alcoholism, we studied the relationship between GSK-3 beta -50T/C polymorphism, which is reported to the relationship for bipolar disorder, and Japanese alcoholics. And we investigated the relationship between GSK-3 beta -50T/C polymorphism and DBI +529A/T polymorphisms, which is reported to one of the risk factor for alcoholism. We analyzed the GSK-3 beta genotype using a polymerase chain reaction (PCR), and DBI genotype using PCR with confronting two-pair novel primers (PCR-CTPP) in 75 health controls and 64 alcoholics. In this study, there was no significant difference in the frequency of GSK-3 beta -50T/C polymorphism between alcoholics and controls (p = 0.883), and there was no significant difference in the frequency of DBI +529A/T polymorphism (p = 0.131). Also, there was no relationship between GSK-3 beta -50T/C polymorphism and DBI +529A/T allele in alcoholism (p = 0.907). We suggested that bipolar disorder may not be one of the pathogenesis of alcoholism, and that there was no relationship between GSK-3 beta -50T/C polymorphism and DBI +529A/T polymorphism.
Assuntos
Alcoólicos , Alcoolismo/genética , Inibidor da Ligação a Diazepam , Quinase 3 da Glicogênio Sintase/genética , Polimorfismo Genético , Alelos , Povo Asiático , Transtorno Bipolar/genética , Feminino , Glicogênio Sintase Quinase 3 beta , Humanos , Masculino , Fatores de RiscoRESUMO
During daycare programs of animal assisted therapy (AAT), we collected data on the brain function of two affective disorder patients who received psychotropic drug therapy with fNIRS, after written informed consent was obtained. A male patient at first showed a bloodstream drop, seen in the lower inside part of frontal lobe. In both patients, at least a slight activation of the function of the frontal lobe was seen during the therapy. Therefore, an activation effect of AAT was seen at least objectively by fNIRS.