1.Propiverine Hydrochloride as a Treatment for Fecal Incontinence
Yasue IREI ; Shota TAKANO ; Kazutaka YAMADA
Annals of Coloproctology 2020;36(2):88-93
Propiverine hydrochloride (PH) is widely used for the treatment of urinary incontinence (UI) due to bladder overactivity. Moreover, the comorbidity of UI with fecal incontinence (FI) is known to be due to the relationship of both to nervous system disorders and dysfunction or weakening of the pelvic floor muscles. The aim of this single-arm prospective study was to evaluate the therapeutic value of PH for FI.Methods: Patients (n = 24) who were diagnosed as having both FI and UI from April 2015 to November 2016 were included in the study and administered a dosage of 10–20 mg PH every day for 1 month. The primary endpoint was to create a reduction in the frequency of FI per week. An evaluation criterion of ≥50% reduction in frequency was determined as effective. The percentage of the patients who achieved the ≥50% endpoint (responders) was also calculated.Results: The frequency of FI per week was 6.0 ± 8.2 (0.25–30) at baseline and reduced to 1.6 ± 2.1 (0–7) at the posttherapeutic state (P = 0.005). A reduction of ≥50% was seen in 14 of the patients (58.3%).Conclusion: PH reduced the frequency of FI in patients with both FI and UI. This study introduces a possible therapeutic option for the pharmacological treatment of FI.
2.Primary Mediastinal Large B-cell Lymphoma Presenting as a Bulky Anterior Mediastinal Tumor: A Case Report
Toshiaki ASANO ; Kazutaka OZEKI ; Nobuyuki HAYASHI ; Yoshitaka HIBINO ; Ryuichi FUKUYAMA ; Yoshiyuki YAMADA
Journal of the Japanese Association of Rural Medicine 2017;66(1):86-90
A 38-year-old woman was examined at our hospital because of cough, night sweats, and facial edema. Computed tomography of the chest revealed a large mass in the anterior mediastinum measuring 8.2×12.2 cm, with multiple nodules on both lungs. Bronchoscopy revealed multiple nodules parallel to the tracheal rings and obstruction of the anterior segmental bronchus of the right lung. The histopathological features were diagnostic of primary mediastinal large B-cell lymphoma. She underwent chemotherapy followed by radiation therapy to the mediastinal mass. After 8 months, she developed right cerebellar metastasis. Eventually, she received peripheral stem cell transplantation after 17 months.
3.Role of interleukin-6 in orthodontically induced inflammatory root resorption in humans.
Ryuichi KUNII ; Masaru YAMAGUCHI ; Yasuhiro TANIMOTO ; Masaki ASANO ; Kunihiko YAMADA ; Takemi GOSEKI ; Kazutaka KASAI
The Korean Journal of Orthodontics 2013;43(6):294-301
OBJECTIVE: To determine the interleukin (IL)-6 levels in gingival crevicular fluid (GCF) of patients with severe root resorption after orthodontic treatment and investigate the effects of different static compressive forces (CFs) on IL-6 production by human periodontal ligament (hPDL) cells and the influence of IL-6 on osteoclastic activation from human osteoclastic precursor (hOCP) cells in vitro. METHODS: IL-6 levels in GCF samples collected from 20 patients (15 and 5 subjects without and with radiographic evidence of severe root resorption, respectively) who had undergone orthodontic treatment were measured by ELISA. The levels of IL-6 mRNA in hPDL cells and IL-6 protein in conditioned medium after the application of different uniform CFs (0, 1.0, 2.0, or 4.0 g/cm2 for up to 72 h) were measured by real-time PCR and ELISA, respectively. Finally, the influence of IL-6 on mature osteoclasts was investigated by using hOCP cells on dentin slices in a pit-formation assay. RESULTS: Clinically, the IL-6 levels were significantly higher in the resorption group than in the control group. In vitro, IL-6 mRNA expression significantly increased with increasing CF. IL-6 protein secretion also increased in a time- and magnitude-dependent manner. Resorbed areas on dentin slices were significantly greater in the recombinant human IL-6-treated group and group cultured in hPDL cell-conditioned medium with CF application (4.0 g/cm2) than in the group cultured in hPDL cell-conditioned medium without CF application. CONCLUSIONS: IL-6 may play an important role in inducing or facilitating orthodontically induced inflammatory root resorption.
Culture Media, Conditioned
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Dentin
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Enzyme-Linked Immunosorbent Assay
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Gingival Crevicular Fluid
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Humans*
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Interleukin-6*
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Interleukins
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Osteoclasts
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Periodontal Ligament
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Real-Time Polymerase Chain Reaction
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RNA, Messenger
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Root Resorption*
4.The relationship between the size of caudolateral curvilinear osteophyte of the canine femoral neck and the radiographic view.
Miori KISHIMOTO ; Sa Hun PAE ; Naoyoshi MUROYA ; Hirokazu WATARAI ; Hiroshi ANZAI ; Ki Ja LEE ; Junichiro SHIMIZU ; Motoki SASAKI ; Kazutaka YAMADA
Journal of Veterinary Science 2010;11(1):89-91
Caudolateral curvilinear osteophyte (CCO), an osteophyte at the site of joint capsule attachment on the caudal aspect of the femoral neck, has been advocated as a radiographic criterion for coxofemoral subluxation. The correlation between the presence of CCO on radiographs (radiographic-CCO), the size of the CCO (CCO index) on three-dimensional computed tomographic (CT) images, and hip evaluation using transverse CT images was assessed in 22 Border Collies. CCOs were detected on the radiographs and CT images of 32% and 100% femurs, respectively. The CCO index correlated significantly with radiographic-CCO, but a large CCO index did not necessarily imply that the CCO was visible on radiographs. Hence, radiographic-CCO findings should be used cautiously in hip evaluation of Border Collies.
Animals
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Dog Diseases/*physiopathology/radiography
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Dogs
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Female
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Hip Dysplasia, Canine/*physiopathology/radiography
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Image Processing, Computer-Assisted
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Male
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Osteophyte/*physiopathology/radiography
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Tomography, X-Ray Computed/veterinary
5.Symptom analysis of 537 patients with neurogenic intrapelvic syndrome.
Takano MASAHIRO ; Ogata SHUNJI ; Nozaki RYOICHI ; Hisano SABURO ; Saiki YASUMITSU ; Fukunaga MITSUKO ; Takano SHOTA ; Tanaka MASAFUMI ; Magata SHINICHIRO ; Nakamura YASUSHI ; Sakata GENTARO ; Yamada KAZUTAKA
Chinese Journal of Gastrointestinal Surgery 2010;13(12):921-923
OBJECTIVETo characterize the symptoms of neurogenic intrapelvic syndrome and the pathogenic mechanisms.
METHODSA total of 537 patients with neurogenic intrapelvic syndrome were treated in the Takano Hospital between 2001 and 2005. Clinical data were analyzed retrospectively.
RESULTSThe mean age was 58.5 years old. There were 205 males and 332 females. There were 80 patients(14.9%) who presented with only one symptom with anorectal pain being the most common one (43.8%, 35/80). One hundred and fifty-six(29.1%) patients had two symptoms with anorectal pain and difficult evacuation being the most common combination (26.3%, 41/156). There were 144 patients (26.8%) complained of 3 symptoms and the most common combination was anorectal pain, difficult evacuation, and abdominal discomfort (30.0%, 43/144). A combination of 4 symptoms was reported in 105 patients(19.6%) with the combination of anorectal pain, incontinence, abdominal discomfort, and lumbar discomfort being the most often(65.7%, 69/105). In addition, there were 52 patients(9.7%) who had above 5 symptoms simultaneously. The frequencies of the 5 symptoms were 73.6% for anorectal pain, 27.9% for incontinence, 69.6% for difficult evacuation, 55.3% for abdominal discomfort, and 53.6% for lumbar discomfort.
CONCLUSIONSSymptomatology of neurogenic intrapelvic syndrome is complicated. The pathogenic mechanism may be related to concurrent dysfunction of sacral nerve and pelvic splanchnic nerve.
Encopresis ; etiology ; Female ; Humans ; Male ; Middle Aged ; Pelvic Pain ; etiology ; Retrospective Studies ; Syndrome