[Clinical study of sigmoid volvulus at eleven core hospitals in the Kagawa Prefecture].

We analyzed the clinical features of 157 patients admitted to 11 institutions in the Kagawa Prefecture for volvulus of the sigmoid colon. The following were the background information of the patients:median age, 79.0 years;male-to-female ratio, 102:55;median body mass index, 20.0kg/m2;and the proportion of patients with performance status ≥3, 43.9%. Abdominal bloating and pain were the chief complaints. During hospitalization, endoscopy and endoscopic detorsion were performed 157 and 100 times, respectively. An accidental complication was observed in 3 cases, all of which were intestinal perforations. Surgery, which was indicated for ischemia, was performed in 62 of the 157 cases. Endoscopy is useful in the diagnosis of ischemia, which can be treated following an early diagnosis. Of the 157 patients, 19 died, whereas the rest were discharged. The risk factors for death were age ≥80 years and creatinine kinase level ≥200IU/L.

Efficacy of probiotic treatment with Bifidobacterium longum 536 for induction of remission in active ulcerative colitis: A randomized, double-blinded, placebo-controlled multicenter trial.

BACKGROUND AND AIM: We conducted a randomized, double-blinded, placebo-controlled trial to investigate the efficacy of Bifidobacterium longum 536 (BB536) supplementation for induction of remission in Japanese patients with active ulcerative colitis (UC). METHODS: Fifty-six patients with mild to moderate UC were enrolled. Three patients had pancolitis, 36 had left-sided colitis, and 17 had proctitis. Patients were randomly treated with 2-3 × 10(11) freeze-dried viable BB536 (28 patients) or placebo (28 patients) for 8 weeks. RESULTS: In total, 63% of patients receiving BB536 showed clinical remission (UC disease activity index [UCDAI] ≤2) at week 8 compared to 52% of those receiving placebo (P = 0.395). We observed a significant decrease of UCDAI scores (3.8 ± 0.4 at baseline to 2.6 ± 0.4 at week 8) in the BB536 group (P < 0.01), whereas there was no significant decrease in the placebo group (P = 0.88). There was also a significant decrease in the Rachmilewitz endoscopic index (EI) and the Mayo subscore at week 8 in the BB536 group, whereas there was no significant decrease in the placebo group. A single patient in the BB536 group complained of a mild side-effect, but no other adverse effects were observed. CONCLUSION: Supplementation with BB536 was well tolerated and reduced UCDAI scores, EI and Mayo subscores after 8 weeks in Japanese patients with mild to moderately active UC.

Virtual sonography for novice sonographers: usefulness of SYNAPSE VINCENT® with pre-check imaging of tumor location.

PURPOSE: To evaluate the usefulness of a virtual ultrasound (US) imaging device as a tool to assist novice sonographers. MATERIALS AND METHODS: A prospective blinded pilot study was conducted involving patients with liver lesions. Two sonographers and 2 medical doctors with less than 5 years of experience performed US examinations. The time needed to detect liver lesions on US and the success rate for detecting liver lesions with and without using the virtual US imaging device SYNAPSE VINCENT® (Fujifilm Medical Co., Tokyo, Japan) before US examination were evaluated. RESULTS: Thirty-two patients with the following 42 liver lesions were included: liver cyst (n = 24), hemangioma (n = 8), hepatocellular carcinoma (n = 6), and liver metastasis (n = 4). The maximal diameter of these lesions ranged from 0.3 to 1.5 cm (mean ± SD, 0.8 ± 0.4). The average time for detecting liver lesions on US was 47.8 s (range, 7-113) with VINCENT and 112.9 s (range, 14-313) without VINCENT before US examination. There were significant differences in the duration of US examination with and without VINCENT (p = 0.0002, Student's t test). The rates for accurately detecting liver lesions were 100 and 76.2% (16/21) in US beginners with and without VINCENT, respectively. Significantly higher detection rates were found in the US beginners who used VINCENT compared to those who did not use VINCENT (p = 0.047, Fisher's exact test). CONCLUSION: Before US examination, a reference with VINCENT could contribute to the successful detection of liver lesions and could be time-saving for US beginners.