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1.
Endoscopy ; 56(5): 376-383, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38191000

RESUMO

BACKGROUND: Adenoma detection rate (ADR) is an important indicator of colonoscopy quality and colorectal cancer incidence. Both linked-color imaging (LCI) with artificial intelligence (LCA) and LCI alone increase adenoma detection during colonoscopy, although it remains unclear whether one modality is superior. This study compared ADR between LCA and LCI alone, including according to endoscopists' experience (experts and trainees) and polyp size. METHODS: Patients undergoing colonoscopy for positive fecal immunochemical tests, follow-up of colon polyps, and abdominal symptoms at a single institution were randomly assigned to the LCA or LCI group. ADR, adenoma per colonoscopy (APC), cecal intubation time, withdrawal time, number of adenomas per location, and adenoma size were compared. RESULTS: The LCA (n=400) and LCI (n=400) groups showed comparable cecal intubation and withdrawal times. The LCA group showed a significantly higher ADR (58.8% vs. 43.5%; P<0.001) and mean (95%CI) APC (1.31 [1.15 to 1.47] vs. 0.94 [0.80 to 1.07]; P<0.001), particularly in the ascending colon (0.30 [0.24 to 0.36] vs. 0.20 [0.15 to 0.25]; P=0.02). Total number of nonpolypoid-type adenomas was also significantly higher in the LCA group (0.15 [0.09 to 0.20] vs. 0.08 [0.05 to 0.10]; P=0.02). Small polyps (≤5, 6-9mm) were detected significantly more frequently in the LCA group (0.75 [0.64 to 0.86] vs. 0.48 [0.40 to 0.57], P<0.001 and 0.34 [0.26 to 0.41] vs. 0.24 [0.18 to 0.29], P=0.04, respectively). In both groups, ADR was not significantly different between experts and trainees. CONCLUSIONS: LCA was significantly superior to LCI alone in terms of ADR.


Assuntos
Adenoma , Inteligência Artificial , Pólipos do Colo , Colonoscopia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adenoma/diagnóstico , Adenoma/diagnóstico por imagem , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/diagnóstico por imagem , Pólipos do Colo/diagnóstico , Pólipos do Colo/diagnóstico por imagem , Colonoscopia/métodos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/diagnóstico por imagem
2.
Clin J Gastroenterol ; 17(2): 271-275, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38042763

RESUMO

Revised idiopathic pulmonary fibrosis treatment guidelines were published in 2015, and nintedanib was conditionally recommended. Although diarrhea is reported to be a common major adverse event associated with nintedanib, there have been few reports on detailed endoscopic findings of nintedanib-associated enterocolitis. A 74-year-old woman was diagnosed with idiopathic pulmonary fibrosis 4 years ago in May. She was started on nintedanib (300 mg). Three months later, hepatic dysfunction was observed; therefore, the drug was temporarily discontinued and then resumed at a dose reduction of 200 mg. Five months later, the patient developed diarrhea, and the dose was reduced to 150 mg. However, no effect was noted; hence, colonoscopy was performed. Various inflammatory lesions, such as erythema and erosions, were observed continuously at the rectum, which resembled ulcerative colitis. No improvement was observed 2 months after follow-up colonoscopy, and nintedanib-related enterocolitis was suspected. The dose was further reduced to 100 mg. Since the endoscopic findings of nintedanib-associated enterocolitis are similar to those of ulcerative colitis, it is critical to consider patients with diarrhea who are taking nintedanib as having associated enterocolitis and attempt to reduce or discontinue the drug if diarrhea does not improve with antidiarrheal agents.


Assuntos
Colite Ulcerativa , Enterocolite , Fibrose Pulmonar Idiopática , Indóis , Feminino , Humanos , Idoso , Fibrose Pulmonar Idiopática/diagnóstico , Fibrose Pulmonar Idiopática/tratamento farmacológico , Diarreia/induzido quimicamente , Resultado do Tratamento
3.
Clin J Gastroenterol ; 16(3): 344-348, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36867353

RESUMO

The pathologic diagnosis of duodenal tumors is a developing field; however, its overview remains unclear. We describe a rare case of a duodenal gastric-type neoplasm in a 50-year-old woman. She visited her primary care doctor with complaints of upper abdominal pain, tarry stools, and shortness of breath on exertion. She was admitted owing to a stalked polyp with erosion and hemorrhage in the descending part of the duodenum. Endoscopic mucosal resection (EMR) was performed on the polyp. Histologically, the resected polyp was a lipomatous lesion in the submucosal layer, composed of mature adipose tissues. Scattered irregular lobules of Brunner's gland-like structures with well-preserved construction but mildly enlarged nuclei and occasional conspicuous nucleoli of the constituent cells were observed. The resection margin was negative. EMR findings of the duodenal polyp showed a gastric epithelial tumor within a lipoma, a rare histological type that has not been reported previously. This tumor may be classified as a "neoplasm with uncertain malignant potential" in a lipoma, an intermediate category between adenoma and invasive adenocarcinoma. There is no consensus on treatment, and careful follow-up is recommended. This is the first report of a duodenal gastric-type neoplasm with uncertain malignant potential in a lipoma.


Assuntos
Glândulas Duodenais , Duodenopatias , Neoplasias Duodenais , Lipoma , Neoplasias Gástricas , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Duodenais/diagnóstico por imagem , Neoplasias Duodenais/cirurgia , Neoplasias Duodenais/patologia , Glândulas Duodenais/patologia , Duodeno/cirurgia , Duodeno/patologia , Duodenopatias/patologia , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia
4.
J Gastroenterol Hepatol ; 37(4): 766-772, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35174541

RESUMO

BACKGROUND AND AIM: This study aimed to compare the mean number of adenomas in patients undergoing Endo-wing-assisted colonoscopy (EAC) and transparent hood-assisted colonoscopy (TAC). METHODS: Patients undergoing colonoscopy for positive fecal immunochemical tests, colon polyp surveillance, and evaluation of abdominal symptoms at a single institution were randomly assigned to the EAC or TAC group. The mean number of adenomas per patient, adenoma detection rate, cecal intubation time, withdrawal time, mean number of adenomas per location, and adenoma size were compared. RESULTS: Overall, 800 patients were enrolled. The EAC and TAC groups comprised 372 and 393 patients, respectively. The groups did not significantly differ with respect to cecal intubation and withdrawal times. The mean number of adenomas per patient was significantly higher in the EAC group (1.13 vs 0.90, P = 0.04), particularly in the sigmoid colon (0.54 [201/372] vs 0.38 [149/393], P = 0.04). The adenoma detection rates were 48.1% and 45.0% in the EAC and TAC groups, respectively, albeit without significant difference between the two groups (P = 0.393). The total number of sessile-type adenomas (0.73 [270/372] vs 0.47 [183/393], P < 0.0001) and small polyps (≤ 5 mm) (0.53 [198/372] vs 0.41 [159/393], P = 0.016) was significantly higher in the EAC group. CONCLUSION: Endo-wing-assisted colonoscopy is significantly superior to TAC in terms of the mean number of adenomas per patient.


Assuntos
Adenoma , Pólipos do Colo , Neoplasias Colorretais , Adenoma/diagnóstico , Ceco , Pólipos do Colo/diagnóstico , Colonoscopia/métodos , Neoplasias Colorretais/diagnóstico , Humanos
5.
J Gastroenterol Hepatol ; 36(10): 2778-2784, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33973300

RESUMO

BACKGROUND AND AIM: The adenoma detection rate is an important indicator of colonoscopy quality and colorectal cancer incidence. We compared the adenoma detection rates between white light imaging (WLI) and linked color imaging (LCI) colonoscopy. METHODS: Patients undergoing colonoscopy for positive fecal immunochemical tests, follow-up of colon polyps, and abdominal symptoms at three institutions were randomly assigned to the LCI or WLI groups. Mean adenoma number per patient (including based on endoscopists' experience), adenoma detection rate, cecal intubation time, withdrawal time, mean adenoma number per location, and adenoma size were compared. RESULTS: The LCI and WLI groups comprised 494 and 501 patients, respectively. No significant differences in the cecal intubation rate (LCI vs WLI: 99.5% vs 99.4%), cecal intubation time, and withdrawal time were noted between groups. The mean adenoma number per patient was significantly higher in the LCI group than in the WLI group (1.07 vs 0.88, P = 0.04), particularly in the descending [0.12 (58/494) vs 0.07 (35/501), P = 0.01] and sigmoid colon [0.41 (201/494) vs 0.30 (149/501), P ≤ 0.001]. However, the adenoma detection rate was 47.1% in the LCI group and 46.9% in the WLI group, with no significant difference (P = 0.93). The total number of sessile-type adenomas was significantly higher in the LCI group than in the WLI group (346/494 vs 278/501, P = 0.04). As for polyp size, small polyps (≤ 5 mm) were detected at a significantly higher rate in the LCI group (271/494 vs 336/501, P = 0.04). CONCLUSION: Linked color imaging is significantly superior to WLI in terms of mean adenoma number per patient.


Assuntos
Adenoma , Pólipos do Colo , Neoplasias Colorretais , Adenoma/diagnóstico por imagem , Ceco/diagnóstico por imagem , Colonoscopia , Cor , Neoplasias Colorretais/diagnóstico por imagem , Humanos
6.
Intern Med ; 60(5): 731-738, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33642561

RESUMO

Rituximab (RTX) is effective for treating cancer, but reports of RTX-associated enterocolitis are limited. We herein report the case of a 65-year-old man who developed RTX-induced ileocolitis. He was diagnosed with gastric mucosa-associated lymphoid tissue lymphoma (MALToma) and treated with RTX. He complained of bloody diarrhea after RTX. Mucosal inflammation on colonoscopy indicated RTX-induced ileocolitis. He was treated with corticosteroids, and his symptoms improved. We reviewed the RTX-associated gastrointestinal adverse events and classified the features into ulcerative colitis, Crohn's disease, microscopic colitis, and ileocolitis. To our knowledge, this is the first case of a Japanese patient who developed RTX-induced ileocolitis.


Assuntos
Colite Ulcerativa , Doença de Crohn , Linfoma de Zona Marginal Tipo Células B , Idoso , Colite Ulcerativa/induzido quimicamente , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/tratamento farmacológico , Colonoscopia , Humanos , Linfoma de Zona Marginal Tipo Células B/induzido quimicamente , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Linfoma de Zona Marginal Tipo Células B/tratamento farmacológico , Masculino , Rituximab/efeitos adversos
7.
J Gastroenterol Hepatol ; 36(6): 1642-1648, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33125743

RESUMO

BACKGROUND AND AIMS: Laser endoscopy involves blue laser imaging in bright mode (BLI-bright). Linked color imaging (LCI) is superior to white light imaging (WLI) for detecting gastric cancers. This study aimed to detect gastric cancers on screening endoscopy using not only WLI but also BLI-bright and LCI in patients with atrophic gastritis. PATIENTS AND METHODS: A total of 500 patients with atrophic gastritis undergoing screening esophagogastroduodenoscopy were included. The gastric lumen was observed in the WLI mode, followed by the LCI and BLI-bright modes. When gastric neoplasms were suspected, the mode was changed to WLI, and we sprayed indigo carmine. Finally, biopsy specimens were taken for those lesions and pathological diagnosis was made. We compared the size, morphology, and color of gastric neoplasms found by the first WLI mode and those detected by only the LCI mode or BLI-bright mode. RESULTS: We detected 16 gastric neoplasms (3.2%), of which 13 were early gastric cancers (EGCs) and three were gastric adenomas. Ten EGCs and two gastric adenomas (75%) were detected by the first WLI mode; three EGCs and one gastric adenoma (25%) were missed by the first WLI mode and were detected by the LCI mode or BLI-bright mode. All were less than 1 cm in diameter and were reddish. Mean diameter of the lesions was significantly less for LCI-detected or BLI-bright-detected lesions than for WLI-detected lesions (7.8 vs 21.2 mm). CONCLUSIONS: Laser endoscopy is useful for detecting EGCs by LCI for patients with atrophic gastritis.


Assuntos
Adenoma/diagnóstico por imagem , Cor , Diagnóstico por Imagem/métodos , Detecção Precoce de Câncer/métodos , Diagnóstico Precoce , Endoscopia do Sistema Digestório , Mucosa Gástrica/diagnóstico por imagem , Gastrite Atrófica/diagnóstico por imagem , Lasers , Luz , Neoplasias Gástricas/diagnóstico por imagem , Adenoma/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/patologia , Adulto Jovem
8.
Intern Med ; 59(24): 3147-3154, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33328413

RESUMO

A 49-year-old man complained of chronic palpitation and shortness of breath, which had recently become exacerbated. A blood examination indicated severe refractory anemia and hypoproteinemia. Physical examinations revealed anemia, a systolic murmur, and spoon nails. Multiple nonspecific ileal ulcers were observed. A pathological examination indicated a small granuloma with CD68-positive histiocytes. He had a deeply wrinkled forehead, chiseled face, and clubbed fingers. Radiography revealed periostosis of the fingers and long bones in the limb. He was diagnosed with pachydermoperiostosis. SLCO2A1 demonstrated a c.1807C>T homo-mutation. He was also diagnosed with SLCO2A1-associated chronic enteropathy and thus was treated with 5-aminosalicylic acid, which temporarily improved the ileal ulcers, anemia, and hypoalbuminemia.


Assuntos
Doenças Inflamatórias Intestinais , Transportadores de Ânions Orgânicos , Osteoartropatia Hipertrófica Primária , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Transportadores de Ânions Orgânicos/genética , Osteoartropatia Hipertrófica Primária/diagnóstico , Osteoartropatia Hipertrófica Primária/genética , Úlcera
9.
J Gastroenterol Hepatol ; 34(9): 1492-1496, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31254485

RESUMO

BACKGROUND AND AIM: Transparent hood-assisted colonoscopy (TAC) has been reported to improve the cecal insertion rate and adenoma detection rate (ADR). An endoscopic cap (Endocuff) with two rows of soft wings was recently developed to improve ADR, by flattening the mucosal folds during withdrawal. This randomized prospective control study aimed to compare ADR between Endocuff-assisted colonoscopy (EAC) and TAC. METHODS: A total of 513 patients undergoing colon adenoma screening were included. EAC was performed in 256 patients and TAC in 260 patients. Cecal intubation rate, cecal intubation time, ADR, and mean adenoma number per patient (MAP) were investigated in both groups (clinical trial registration: UMIN000016278). RESULTS: We excluded six patients in the EAC group and two patients in the TAC group because of colonic stenosis due to colonic adenocarcinomas. Finally, 250 patients (151 men/99 women, median age 62.1 years) were assigned to EAC and 258 patients (165 men/93 women, median age 64.3 years) were assigned to TAC. There were no significant differences in cecal intubation rate, intubation time, withdrawal time, and cleanliness score between groups. The ADR was 50.8% in EAC and 52.7% in TAC, with no significant difference (P = 0.666). The MAP was 1.35 in EAC and 1.20 in TAC, with no significant difference (P = 0.126). However, The MAP of diminutive adenomas (< 5 mm) tended to be higher in EAC than in TAC (P = 0.077). There was no significant difference in MAP in each segment between groups. CONCLUSIONS: Endocuff-assisted colonoscopy might be equivalent to TAC in cecal intubation time, ADR, and MAP.


Assuntos
Adenoma/patologia , Colo/patologia , Neoplasias do Colo/patologia , Colonoscópios , Colonoscopia/instrumentação , Mucosa Intestinal/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Desenho de Equipamento , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes
10.
Intern Med ; 58(15): 2167-2171, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30996166

RESUMO

No specific endoscopic features for eosinophilic gastroenteritis (EGE) have been reported previously. This study therefore evaluated the endoscopic findings of six patients with EGE. The diagnosis was confirmed based on gastrointestinal symptoms, pathological findings on biopsy, and the absence of other diseases. The site of the lesion was identified based on eosinophilic infiltration with ≥20 cells per high-power field during a pathological specimen analysis. Flattening of the small intestinal villi was observed in four patients; we speculate that this may be a specific feature in the diagnosis of EGE.


Assuntos
Duodeno/fisiopatologia , Endoscopia/métodos , Enterite/diagnóstico , Enterite/fisiopatologia , Eosinofilia/diagnóstico , Eosinofilia/fisiopatologia , Gastrite/diagnóstico , Gastrite/fisiopatologia , Mucosa Intestinal/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Técnicas e Procedimentos Diagnósticos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
11.
World J Gastroenterol ; 22(42): 9394-9399, 2016 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-27895427

RESUMO

AIM: To evaluate the morphology of the colon in patients with irritable bowel syndrome (IBS) by using computed tomography colonography (CTC). METHODS: Twelve patients with diarrhea type IBS (IBS-D), 13 patients with constipation type IBS (IBS-C), 12 patients with functional constipation (FC) and 14 control patients underwent colonoscopy following CTC. The lengths of the rectosigmoid colon, transverse colon and the total colon were measured. The diameters of the rectum, sigmoid colon, descending colon, transverse colon, and ascending colon were measured. RESULTS: The mean length of the total colon was 156.5 cm in group C, 158.9 cm in group IBS-D, 172.0 cm in group IBS-C, and 188.8 cm in group FC. The total colon in group FC was significantly longer than that in group C (P < 0.05). The mean length of the rectosigmoid colon was 56.2 cm, 55.9 cm, 63.6cm, and 77.4 cm (NS). The mean length of the transverse colon was 49.9 cm, 43.1 cm, 57.0 cm, and 55.0 cm. The transverse colon in group IBS-D was significantly shorter than that in group IBS-C (P < 0.01) and that in group FC (P = 0.02). The mean diameter of the sigmoid colon was 4.0 cm, 3.3 cm, 4.2 cm, and 4.3 cm (NS). The mean diameter of the descending colon was 3.6 cm, 3.1 cm, 3.8 cm, and 4.3 cm. The descending colon diameter in group IBS-D was significantly less than that in group IBS-C (P = 0.03) and that in group FC (P < 0.001). The descending colon diameter in group FC was significantly greater than that in group C (P = 0.04). The mean diameter of the transverse colon was 4.4 cm, 3.3 cm, 4.2 cm, and 5.0 cm (NS). CONCLUSION: CT colonography might contribute the clarification of subtypes of IBS.


Assuntos
Colo/diagnóstico por imagem , Colonografia Tomográfica Computadorizada , Síndrome do Intestino Irritável/diagnóstico por imagem , Idoso , Constipação Intestinal/etiologia , Diarreia/etiologia , Feminino , Humanos , Síndrome do Intestino Irritável/classificação , Síndrome do Intestino Irritável/complicações , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Reto/diagnóstico por imagem , Estudos Retrospectivos
12.
Allergol Int ; 65 Suppl: S6-S10, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27118436

RESUMO

BACKGROUND: Eosinophilic esophagitis (EoE) is related to allergic diseases such as bronchial asthma (BA), atopic dermatitis, and allergic rhinitis. The aim of this study was to examine the eosinophil infiltration in the upper gastrointestinal (GI) tract in patients with BA using esophagogastroduodenoscopy. METHODS: Patients with BA who had upper GI tract symptoms were enrolled. Patients who received systemically administered steroids were excluded. Eosinophil infiltrations in the esophagus, stomach, and duodenum were examined with regard to the endoscopic findings and pathological findings of biopsy specimens (UMIN000010132). RESULTS: Ninety patients were enrolled from October in 2012 to September in 2014. Thirty-six were male, 54 were female, and the mean age was 57.5 years. Eighty-one (90%) used inhaled corticosteroids. Fourteen patients (15.6%) had reflux esophagitis, 8 of whom had grade A and 6 had grade B. No patient with EoE was observed. One female patient who had marked eosinophil infiltration in the esophagus, stomach, and duodenum was diagnosed as having eosinophilic gastroenteritis, but endoscopy showed only mucosal edema in the antrum. Another female patient who had marked eosinophil infiltration in the esophagus, stomach, and duodenum was diagnosed as having eosinophilic granulomatosis with polyangiitis, and endoscopy showed erosions in the antrum and the duodenum. Three patients had eosinophil infiltration in the stomach, but none of them had severe symptoms. CONCLUSIONS: Patients with asthma who had upper gastrointestinal symptoms rarely had eosinophilic gastrointestinal disorders. Biopsy specimens are of high importance in the diagnosis of eosinophilic gastrointestinal disorders even if there is no remarkable endoscopic finding.


Assuntos
Asma/patologia , Eosinófilos/patologia , Trato Gastrointestinal Superior/patologia , Adolescente , Adulto , Idoso , Asma/complicações , Edema/patologia , Endoscopia Gastrointestinal , Enterite/complicações , Enterite/patologia , Eosinofilia/complicações , Eosinofilia/patologia , Esofagite Eosinofílica/complicações , Esofagite Eosinofílica/patologia , Feminino , Gastrite/complicações , Gastrite/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa/patologia , Adulto Jovem
13.
Intern Med ; 53(18): 2057-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25224187

RESUMO

A pyogenic granuloma (PG) is a capillary hemangioma that usually occurs on the skin or in the oral cavity; it is rarely observed in the gastrointestinal tract. We herein describe a case of a 86-year-old woman who presented with anemia. Esophagogastroduodenoscopy and colonoscopy did not reveal any significant bleeding focus, but capsule endoscopy revealed a bleeding focus in the small intestine. We performed double-balloon enteroscopy and identified a 7-mm-diameter, reddish, subpedunculated, hemispheric polyp with a smooth surface in the small intestine, approximately 100 cm from the ileocecal valve. The polyp was surgically removed, and the histological findings were consistent with a diagnosis of PG.


Assuntos
Enteroscopia de Duplo Balão/métodos , Granuloma Piogênico/diagnóstico , Doenças do Íleo/diagnóstico , Íleo/patologia , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos
14.
J Occup Health ; 48(3): 198-206, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16788281

RESUMO

We examined whether serum gammaGTP activity (gammaGTP) is associated with Breslow's lifestyle index and whether it could be used as a tool to detect subjects with unhealthy lifestyles. To that effect, 724 male Japanese workers excluding patients suffering from hepatitis virus infection, autoimmune liver diseases and apparently active bile duct diseases were cross-sectionally examined. gammaGTP was inversely associated with the total score of Breslow's index for all subjects (lambda=30.643) and in subjects aged 40 or more (lambda=37.073). The association was consistent even after adjustments of subjects' ages and levels of triglycerides, total cholesterol and uric acid (p=0.0001). Among the seven lifestyle factors comprising Breslow's index, improper habits of drinking (p<0.0001), smoking (p=0.0204), exercise (p=0.0189) and body weight control (p<0.0001), were associated with increased gammaGTP. Even in a survey in which subjects who had proper habits of drinking and body weight control were selectively examined, improper habits of smoking and exercise still tended to be associated with increased gammaGTP. Receiver operating characteristic curves indicated that gammaGTP was beneficial for detecting subjects who scored two or less on Breslow's index, at least in subjects aged 40 or more. gammaGTP was associated with insulin resistance level estimated by the homeostasis model assessment (p<0.0001), which was inversely associated with Breslow's index (p=0.0040). gammaGTP could be used as an objective substitute of Breslow's index, allowing us to identify subjects with low scores on Breslow's index, at least after sorting subjects properly. Such screening would enable interventions to correct subjects' unhealthy lifestyles, helping to solve lifestyle-related disease issues.


Assuntos
Estilo de Vida , Programas de Rastreamento/métodos , Assunção de Riscos , gama-Glutamiltransferase/sangue , Adulto , Idoso , Consumo de Bebidas Alcoólicas , Análise de Variância , Estudos Transversais , Exercício Físico , Inquéritos Epidemiológicos , Humanos , Japão , Pessoa de Meia-Idade , Sobrepeso , Curva ROC , Análise de Regressão , Fumar , Estatística como Assunto , Inquéritos e Questionários , Local de Trabalho , gama-Glutamiltransferase/fisiologia
15.
J Gastroenterol Hepatol ; 19(10): 1155-62, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15377293

RESUMO

BACKGROUND AND AIM: The mechanisms involved in the beneficial effect of gadolinium chloride against endotoxin-induced liver damage were studied. METHODS: Superoxide anions released into the hepatic sinusoids were examined in a liver perfusion model using the cytochrome C method. RESULTS: Gadolinium chloride treatment fully depleted ED2-positive cells from the liver and significantly attenuated superoxide anion release after a lipopolysaccharide or tumor necrosis factor-alpha (TNF-alpha) challenge. Moreover, gadolinium chloride treatment resulted in a significant decline in endothelial cell damage in the hepatic sinusoids as assessed by the purine nucleoside phosphorylase/glutamic-pyruvic transaminase ratio in the liver perfusate. Although gadolinium chloride treatment did not affect the level of serum TNF-alpha, it significantly reduced that of interleukin (IL)-8 and neutrophil migration in the hepatic sinusoids after the lipopolysaccharide challenge. CONCLUSION: These data suggest that a reduction of the superoxide anion level in the hepatic sinusoids in acute endotoxemia and subsequent reduction of neutrophil migration into the liver may indicate that gadolinium chloride treatment suppresses the progression of liver damage in acute endotoxemia.


Assuntos
Antioxidantes/farmacologia , Gadolínio/farmacologia , Células de Kupffer/efeitos dos fármacos , Lipopolissacarídeos/efeitos adversos , Hepatopatias/etiologia , Superóxidos/metabolismo , Animais , Endotoxemia/metabolismo , Células de Kupffer/metabolismo , Fígado/metabolismo , Masculino , Modelos Animais , Estresse Oxidativo/efeitos dos fármacos , Perfusão , Ratos , Ratos Wistar
16.
J Hepatol ; 41(1): 19-24, 2004 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15246202

RESUMO

BACKGROUND/AIMS: Since a novel polypeptide named adiponectin was shown to prevent the development of steatosis and steatohepatitis in animal models, we studied whether it was also possible in a clinical situation. METHODS: Associations between serum adiponectin levels and serum transaminase activities were studied in 791 Japanese males who were not heavy drinkers, and had no autoimmune or HBV- or HCV-induced liver diseases. RESULTS: Various markers of metabolic diseases including levels of body mass index (BMI), serum triglyceride, total cholesterol, and insulin resistance assessed by the homeostasis model were significantly higher in subjects with increased transaminase activities when compared to those with normal activities. Single regression analyses demonstrated that the logarithmic serum adiponectin level was inversely correlated with the levels of logarithmic serum AST (r=-0.229, P<0.0001), ALT (r=-0.305, P<0.0001), and gammaGTP (r=-0.278, P<0.0001). Even in multiple regression analyses in which subjects' age and levels of BMI, serum triglyceride, total cholesterol, and insulin resistance were adjusted, the inverse correlations were significant (P=0.0426, 0.0332, and 0.0011, respectively). CONCLUSIONS: Hypoadiponectinemia may worsen liver diseases associated with metabolic diseases in clinical cases. In addition to aggravation of insulin resistance and hyperlipidemia, some hypoadiponectinemia specific mechanisms may stand behind the association.


Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Fígado Gorduroso/sangue , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Adiponectina , Adulto , Idoso , Fígado Gorduroso/fisiopatologia , Humanos , Hiperlipidemias/sangue , Hiperlipidemias/fisiopatologia , Resistência à Insulina , Japão , Masculino , Pessoa de Meia-Idade , Análise de Regressão , gama-Glutamiltransferase/sangue
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