1.Comparison of 19-gauge conventional and Franseen needles for the diagnosis of lymphadenopathy and classification of malignant lymphoma using endoscopic ultrasound fine-needle aspiration
Mitsuru OKUNO ; Keisuke IWATA ; Tsuyoshi MUKAI ; Yusuke KITO ; Takuji TANAKA ; Naoki WATANABE ; Senji KASAHARA ; Yuhei IWASA ; Akihiko SUGIYAMA ; Youichi NISHIGAKI ; Yuhei SHIBATA ; Junichi KITAGAWA ; Takuji IWASHITA ; Eiichi TOMITA ; Masahito SHIMIZU
Clinical Endoscopy 2024;57(3):364-374
Background/Aims:
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) using a 19-gauge needle is an efficient sampling method for the diagnosis of lymphadenopathy. This study compared 19-gauge conventional and Franseen needles for the diagnosis of lymphadenopathy and classification of malignant lymphoma (ML).
Methods:
Patient characteristics, number of needle passes, puncture route, sensitivity, specificity, and accuracy of cytology/histology for lymphadenopathy were analyzed in patients diagnosed with lymphadenopathy by EUS-FNA using conventional or Franseen needles.
Results:
Between 2012 and 2022, 146 patients met the inclusion criteria (conventional [n=70] and Franseen [n=76]). The median number of needle passes was significantly lower in the conventional group than in the Franseen group (3 [1–6] vs. 4 [1–6], p=0.023). There were no significant differences in cytological/histological diagnoses between the two groups. For ML, the immunohistochemical evaluation rate, sensitivity of flow cytometry, and cytogenetic assessment were not significantly different in either group. Bleeding as adverse events (AEs) were observed in three patients in the Franseen group.
Conclusions
Both the 19-gauge conventional and Franseen needles showed high accuracy in lymphadenopathy and ML classification. Considering sufficient tissue collection and the avoidance of AEs, the use of 19-gauge conventional needles seems to be a good option for the diagnosis of lymphadenopathy.
2.One-year clinical efficacy and safety of indigo naturalis for active ulcerative colitis: a real-world prospective study
Yuichi MATSUNO ; Takehiro TORISU ; Junji UMENO ; Hiroki SHIBATA ; Atsushi HIRANO ; Yuta FUYUNO ; Yasuharu OKAMOTO ; Shin FUJIOKA ; Keisuke KAWASAKI ; Tomohiko MORIYAMA ; Tomohiro NAGASUE ; Keizo ZEZE ; Yoichiro HIRAKAWA ; Shinichiro KAWATOKO ; Yutaka KOGA ; Yoshinao ODA ; Motohiro ESAKI ; Takanari KITAZONO
Intestinal Research 2022;20(2):260-268
Background/Aims:
Recent studies suggested a favorable effect of indigo naturalis (IN) in inducing remission for refractory ulcerative colitis (UC), however, the maintenance effect of IN for patients with UC remains unknown. Therefore, we conducted a prospective uncontrolled open-label study to analyze the efficacy and safety of IN for patients with UC.
Methods:
Patients with moderate to severe active UC (clinical activity index [CAI] ≥ 8) took 2 g/day of IN for 52 weeks. CAI at weeks 0, 4, 8, and 52 and Mayo endoscopic subscore (MES) and Geboes score (GS) at weeks 0, 4, and 52 were assessed. Clinical remission (CAI ≤ 4), mucosal healing (MES ≤ 1), and histological healing (GS ≤ 1) rates at each assessment were evaluated. Overall adverse events (AEs) during study period were also evaluated. The impact of IN on mucosal microbial composition was assessed using 16S ribosomal RNA gene sequences.
Results:
Thirty-three patients were enrolled. The rates of clinical remission at weeks 4, 8, and 52 were 67%, 76%, and 73%, respectively. The rates of mucosal healing at weeks 4 and 52 were 48% and 70%, respectively. AEs occurred in 17 patients (51.5%) during follow-up. Four patients (12.1%) showed severe AEs, among whom 3 manifested acute colitis. No significant alteration in the mucosal microbial composition was observed with IN treatment.
Conclusions
One-year treatment of moderate to severe UC with IN was effective. IN might be a promising therapeutic option for maintaining remission in UC, although the relatively high rate of AEs should be considered.
3.Effects of pre-exercise ingestion of different amounts of carbohydrate at three hours after feeding breakfast on exercise-induced hypoglycemia
Sanako HATTA ; Iori FUJIE ; Masanari TOGO ; Keisuke SHIBATA ; Nobuya KIMURA ; Kazuki TAKIZAWA ; Isao KAMBAYASHI ; Taichi YAMAGUCHI
Japanese Journal of Physical Fitness and Sports Medicine 2021;70(4):247-256
The purpose of this study was to compare effects of different amounts of carbohydrate (CHO) in beverage on plasma glucose (GLU) concentration during exercise after feeding breakfast. Seven healthy Japanese male subjects performed 30-min cycling at an intensity on the 75% of maximal load at 3-h after feeding breakfast under 3 types of CHO (0 g, 30 g and 150 g) beverage conditions. The subjects ingested 500 mL of beverage dissolved each amount of glucose at 30-min before the exercise. The GLU concentrations were measured at 35- and 10-min before the exercise and every 5-min during the exercise. The minimum GLU concentrations under the 30 g condition for all subjects were lower than a criterion for hypoglycemic (72 mg / dL). The mean value also fell below the criterion at from 10- to 20-min during exercise. The minimum GLU concentration under the 150 g condition of only one subject was lower than the criterion, but the mean value did not fall below the criterion. Significant negative correlations were found between the subjects’ maximum oxygen uptake (VO2max) and the decreases in GLU concentration from maximum to minimum under both the 30 g (r = -0.947, p < 0.01) and 150 g conditions (r = -0.884, p < 0.01). This study clarified that feeding breakfast at 3-h before the exercise followed by the 30 g CHO beverage ingestion at 30 min before the exercise induced exercise-induced hypoglycemia, and that the subjects with higher VO2max had the greater decreases in GLU concentration.
4.Intra-individual variations of organophosphate pesticide metabolite concentrations in repeatedly collected urine samples from pregnant women in Japan.
Keisuke HIOKI ; Yuki ITO ; Naoko OYA ; Shoji F NAKAYAMA ; Tomohiko ISOBE ; Takeshi EBARA ; Kanemitsu SHIBATA ; Naomi NISHIKAWA ; Kunihiko NAKAI ; Tomota KAMIDA ; Jun UEYAMA ; Mayumi SUGIURA-OGASAWARA ; Michihiro KAMIJIMA
Environmental Health and Preventive Medicine 2019;24(1):7-7
BACKGROUND:
Low-dose exposure to organophosphate (OP) insecticides during pregnancy may adversely affect neurodevelopment in children. To evaluate the OP exposure levels, single urine sampling is commonly adopted to measure the levels of dialkylphosphates (DAPs), common OP metabolites. However, the inter-day variations of urinary DAP concentrations within subjects are supposed to be large due to the short biological half-lives of the metabolites, and it is thus considered difficult to accurately assess OP exposure during pregnancy with single sampling. This study aimed to assess intra-individual variations of DAP concentrations and the reproducibility of the exposure dose categorization of OPs according to DAP concentration ranges in pregnant women in Japan.
METHODS:
Urine samples were collected from 62 non-smoking pregnant women (12-22 weeks of gestation) living in Aichi Prefecture, Japan. First morning void (FMV) and spot urine samples taken between lunch and dinner on the same day were collected on five different days during 2 weeks. The concentrations of DAP and creatinine in urine samples were measured using an ultra performance liquid chromatography with tandem mass spectrometry. Creatinine-adjusted and unadjusted concentrations were used for the intraclass correlation coefficient (ICC) calculations and surrogate category analyses.
RESULTS:
For all DAP metabolites, the creatinine-adjusted single ICCs exceeded 0.4, indicating moderate reliability. Overall, ICCs of spot urine samples taken in the afternoon were better than those taken as FMV. Surrogate category analyses showed that participants were categorized accurately into four exposure dose groups according to the quartile points.
CONCLUSION
This study indicated that a single urine sample taken in the afternoon may be useful in assessing OP exposure as long as the exposure is categorized into quartiles when conducting epidemiological studies in early to mid-pregnant women in Japan.
Adult
;
Chromatography, Liquid
;
Creatinine
;
urine
;
Environmental Exposure
;
analysis
;
Environmental Monitoring
;
methods
;
Environmental Pollutants
;
urine
;
Female
;
Humans
;
Japan
;
Mass Spectrometry
;
Organophosphates
;
urine
;
Pesticides
;
urine
;
Pregnancy
;
Pregnant Women
;
Young Adult