1.The incidence and risk factors of venous thromboembolism in Japanese inpatients with inflammatory bowel disease: a retrospective cohort study.
Katsuyoshi ANDO ; Mikihiro FUJIYA ; Yoshiki NOMURA ; Yuhei INABA ; Yuuya SUGIYAMA ; Takuya IWAMA ; Masami IJIRI ; Keitaro TAKAHASHI ; Kazuyuki TANAKA ; Aki SAKATANI ; Nobuhiro UENO ; Shin KASHIMA ; Kentaro MORIICHI ; Yusuke MIZUKAMI ; Toshikatsu OKUMURA
Intestinal Research 2018;16(3):416-425
BACKGROUND/AIMS: Venous thromboembolism (VTE) is a major extraintestinal manifestation in inflammatory bowel disease (IBD), regarded as an independent risk factor for VTE according to reports from Western countries. However, the incidence and risk factors of VTE in Asian IBD patients are not fully understood. We aimed to reveal the incidence and risk factors of VTE in Japanese IBD inpatients. METHODS: The incidence of VTE in inpatients with IBD (n=340), gastrointestinal cancers (n=557), and other gastrointestinal diseases (n=569) treated at our hospital from 2009 to 2013 was retrospectively investigated. The characteristics and laboratory data of IBD inpatients with and without VTE were compared in univariate and multivariate analyses. Clinical courses of VTE in IBD were surveyed. RESULTS: VTE was detected in 7.1% of IBD inpatients, significantly higher than in gastrointestinal cancer inpatients (2.5%) and inpatients with other gastrointestinal diseases (0.88%). The incidence of VTE in ulcerative colitis (UC) patients (16.7%) was much higher than that in those with Crohn's disease (3.6%). In the univariate analysis, the risk factors were an older age, central venous catheter, prednisolone, surgery, low serum albumin, high serum C-reactive protein and D-dimer. According to a multivariate analysis, >50 years of age and surgery were the only risk factors. The in-hospital mortality rate of IBD inpatients with VTE was 4.2%. CONCLUSIONS: The incidence of VTE with IBD, especially UC, was found to be high compared with other digestive disease, which was almost equivalent to that of Western countries. The efficacy of prophylaxis needs to be investigated in Asian IBD patients.
Asian Continental Ancestry Group*
;
C-Reactive Protein
;
Central Venous Catheters
;
Cohort Studies*
;
Colitis, Ulcerative
;
Crohn Disease
;
Gastrointestinal Diseases
;
Gastrointestinal Neoplasms
;
Hospital Mortality
;
Humans
;
Incidence*
;
Inflammatory Bowel Diseases*
;
Inpatients*
;
Multivariate Analysis
;
Prednisolone
;
Retrospective Studies*
;
Risk Factors*
;
Serum Albumin
;
Venous Thromboembolism*
2.Long-term Observation of Gastric Adenocarcinoma of Fundic Gland Mucosa Type before and after Helicobacter pylori Eradication: a Case Report
Keitaro TAKAHASHI ; Nobuhiro UENO ; Takahiro SASAKI ; Yu KOBAYASHI ; Yuya SUGIYAMA ; Yuki MURAKAMI ; Takehito KUNOGI ; Katsuyoshi ANDO ; Shin KASHIMA ; Kentaro MORIICHI ; Hiroki TANABE ; Yuki KAMIKOKURA ; Sayaka YUZAWA ; Mishie TANINO ; Toshikatsu OKUMURA ; Mikihiro FUJIYA
Journal of Gastric Cancer 2021;21(1):103-109
Gastric adenocarcinoma of the fundic gland mucosa type (GA-FGM) was proposed as a new variant of gastric adenocarcinoma of the fundic gland type (GA-FG). However, at present, the influence of Helicobacter pylori and the speed of progression and degree of malignancy in GA-FGM remain unclear. Herein, we report the first case of intramucosal GA-FGM that was endoscopically observed before and after H. pylori eradication over 15 years. The lesion showed the same tumor size with no submucosal invasion and a low MIB-1 labeling index 15 years after its detection using endoscopy. The endoscopic morphology changed from 0-IIa before H. pylori eradication to 0-IIa+IIc and then 0-I after H. pylori eradication. These findings suggest that the unaltered tumor size reflects low-grade malignancy and slow growth, and that the endoscopic morphology is influenced by H. pylori eradication.