Comparison of two fluoroscopic images to ensure efficient scope insertion for biliary intervention in patients with Roux-en-Y hepaticojejunostomy

Endoscopy ◽  
2017 ◽  
Vol 49 (12) ◽  
pp. 1256-1261 ◽  
Author(s):  
Koichiro Tsutsumi ◽  
Hironari Kato ◽  
Ken Hirao ◽  
Sho Mizukawa ◽  
Shinichiro Muro ◽  
...  
Keyword(s):  
Medical Information ◽  
Standard Procedure ◽  
University Hospital ◽  
Information Network ◽  
Imaging Method ◽  
Anastomotic Site ◽  
Biliary Disease ◽  
Endoscopic Retrograde ◽  
Time Required ◽  
Clinical Trials Registry

Abstract Background and study aims No standard procedure for endoscopic retrograde cholangiopancreatography is available for patients with Roux-en-Y hepaticojejunostomy (RYHJ) with side-to-end hepaticojejunostomy. We therefore explored methods of efficient scope insertion at a hepaticojejunostomy site. Patients and methods Patients with suspected biliary disease were prospectively enrolled. Based on two fluoroscopic images obtained on scope insertion into each lumen of a two-pronged Roux-en-Y anastomosis, we selected the lumen in which the distal end of the scope progressed toward the patient’s liver or head. The accuracy of this method for selecting the correct lumen leading to the hepaticojejunostomy site was investigated. Results Of the 33 included patients, successful insertion to the hepaticojejunostomy site was achieved in 32 (97 %), 26 (81 %) of whom had undergone the imaging method. The accuracy of the method was 88 % (23/26). The time required for insertion between the anastomotic site and the hepaticojejunostomy site was shorter when the lumen selection had been correct (13 minutes [7 – 30] (n = 23) vs. 18 minutes [8 – 28] (n = 9); P = 0.95). Conclusion This method based on two fluoroscopic images was useful for achieving efficient scope insertion in patients with RYHJ.Trial registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN000014183).

Transpancreatic precut papillotomy versus double-guidewire technique in difficult biliary cannulation: prospective randomized study

Endoscopy ◽  
2017 ◽  
Author(s):  
Harutoshi Sugiyama ◽  
Toshio Tsuyuguchi ◽  
Yuji Sakai ◽  
Rintaro Mikata ◽  
Shin Yasui ◽  
...  
Keyword(s):  
Success Rate ◽  
Pancreatic Duct ◽  
Medical Information ◽  
Randomized Study ◽  
University Hospital ◽  
Information Network ◽  
Endoscopic Retrograde ◽  
Biliary Cannulation ◽  
Significant Difference ◽  
Difficult Biliary Cannulation

Abstract Background and study aims Difficult biliary cannulation and unintentional pancreatic duct cannulation are thought to be important contributors to pancreatitis occurring after endoscopic retrograde cholangiopancreatography. Our aim was to compare and evaluate the rates of success and complications of transpancreatic precut papillotomy (TPPP) and the double-guidewire technique (DGT), both with prophylactic pancreatic stenting. Patients and methods From April 2011 to March 2014, patients with difficult biliary cannulation, in whom we planned to first position a guidewire in the pancreatic duct, were enrolled, and 68 patients were prospectively randomly allocated to two groups (TPPP 34, DGT 34). We evaluated the rates of success and complications for each group. Results TPPP had a significantly higher success rate (94.1 %) than DGT (58.8 %). The rate of post-ERCP pancreatitis was 2.9 % in both groups. There was no significant difference between the two groups in the overall rate of complications related to cannulation. Conclusion If biliary cannulation cannot be achieved, TPPP should be selected first after unintentional pancreatic duct cannulation.University Hospital Medical Information Network identifier: UMIN000008200

scholarly journals Attribution of non-ClinicalTrials.gov registries among WHO International Clinical Trials Registry Platform-registered trials from 2014 to 2018: A protocol for a meta-epidemiological study

2018 ◽  
Author(s):  
Masahiro Banno ◽  
Yasushi Tsujimoto ◽  
Yuki Kataoka
Keyword(s):  
Clinical Trials ◽  
Epidemiological Study ◽  
Medical Information ◽  
University Hospital ◽  
World Health ◽  
Study Phase ◽  
Target Sample Size ◽  
Registration Number ◽  
Health Organization ◽  
Clinical Trials Registry

Background. The attribution of non-ClinicalTrials.gov registries among registered trials of the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) had increased until 2013. However, the attribution after 2013 is unknown. Moreover, no study has investigated the usage of non-ClinicalTrials.gov registries after 2015 or compared the characteristics of trials under non-ClinicalTrials.gov and ClinicalTrials.gov registries. Methods. This will be a meta-epidemiological study. It will include all trials registered on the ICTRP from January 1, 2014, to December 31, 2018. First, we will describe the total attribution of non-ClinicalTrials.gov registries among the ICTRP-registered trials for each year and each registry worldwide. Second, we will compare the recruitment status, target sample size, study type, study design, countries, prospective registration, funding, and study phase of the trials on ClinicalTrials.gov and other registries from 2014 to 2018. Third, we will report on the distribution of primary registries of trials from the top five countries in order of the quantity of registered trials on the ICTRP. Ethics & Dissemination. Ethics approval is not required for this study. This protocol has been registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR). The findings will be published in a peer-reviewed journal and may be presented at conferences. Trial Registration Number. UMIN000034401

scholarly journals A novel telerehabilitation with educational program for caregivers using telelecture is a feasible procedure for fall prevention in elderly people – A pilot study

2020 ◽  
Author(s):  
Kentaro Moriichi ◽  
Mikihiro Fujiya ◽  
Takanori Ro ◽  
Tetsuo Ota ◽  
Hitomi Nishimiya ◽  
...  
Keyword(s):  
Elderly People ◽  
Fall Prevention ◽  
Educational Program ◽  
Medical Information ◽  
The Elderly ◽  
Berg Balance Scale ◽  
University Hospital ◽  
Telemedicine System ◽  
Before And After ◽  
Clinical Trials Registry

Abstract Background: The importance of fall prevention rehabilitations has been well recognized. Recently, telerehabilitation was developed, however, there have been no reports on the use of telerehabilitation with direct support from specialists for fall prevention among the elderly. We herein reported telerehabilitation by carers educated by our novel educational program.Methods: Nine elderly people in two nursing homes were enrolled using our original criteria. Carers are educated with our educational program using telelecture system. Telerehabilitation was performed by carers following the instruction from rehabilitation specialists in Asahikawa Medical University using the telemedicine system every 2-4 weeks for three months. Carers were assessed with our original questionnaire before and after the telelecture. Berg Balance Scale (BBS), Timed Up & Go test (TUG test), Hand-held dynamometer (HHD) and Mini-Mental State Examination (MMSE) were assessed before and after telerehabilitation.Results: The average number of times to perform telerehabilitation in all institutes was 4.7. Levels of understanding of carers were significantly increased after the telelecture. No adverse event occurred during the study period. Median BBSs before and three months after telerehabilitation were 43 and 49, respectively. Those of TUG test, right and left HHD and MMSE were 17.89 and 18.53, 7.95 and 11.55, 9.85 and 13.20, and 16 and 19, respectively. All results were improved after telerehabilitation.Conclusions: Our telerehabilitation program exhibited significant effects in elderly people as well as levels of understanding rehabilitation of caregivers in the facilities for the elderly people safely.Trial registration: University Hospital Medical Information Network Clinical Trials Registry（UMIN-CTR）UMIN000041439, August 17th, 2020

scholarly journals Attribution of non-ClinicalTrials.gov registries among WHO International Clinical Trials Registry Platform-registered trials from 2014 to 2018: A protocol for a meta-epidemiological study

2019 ◽  
Author(s):  
Masahiro Banno ◽  
Yasushi Tsujimoto ◽  
Yuki Kataoka
Keyword(s):  
Clinical Trials ◽  
Epidemiological Study ◽  
Medical Information ◽  
University Hospital ◽  
World Health ◽  
Study Phase ◽  
Cross Sectional ◽  
Data Set ◽  
Study Type ◽  
Clinical Trials Registry

Background. The attribution of non-ClinicalTrials.gov registries among registered trials of the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) had increased until 2013. However, the attribution after 2013 is unknown. Moreover, no study has investigated the usage of non-ClinicalTrials.gov registries after 2015 or compared the characteristics of trials under non-ClinicalTrials.gov and ClinicalTrials.gov registries. Methods. This will be a meta-epidemiological study. It will include all trials registered on the ICTRP from January 1, 2014, to December 31, 2018. First, we will describe the total attribution of non-ClinicalTrials.gov registries among the ICTRP-registered trials for each year and each registry worldwide. Second, we will compare the recruitment status, target sample size, study type, countries, retrospective registration, funding, and study phase of the trials on ClinicalTrials.gov and other registries from 2014 to 2018. Third, we will report on the distribution of primary registries of trials from the top five countries in order of the quantity of registered trials on the ICTRP. We will separately report the results from interventional and other studies. Inclusion criteria for interventional studies will be studies that include the word “intervention” or “interventional” in “study type” of the data set. Other studies will refer to studies other than interventional studies such as cohort, case-control, and cross-sectional studies. Ethics & Dissemination. Ethics approval is not required for this study. This protocol has been registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR). The findings will be published in a peer-reviewed journal and may be presented at conferences. Trial Registration Number. UMIN000034401

Stapled Versus Hand-Sewn Anastomosis in Colorectal Cancer Surgery : A comparative study

2013 ◽  
Vol 12 (3) ◽  
pp. 56-61 ◽  
Author(s):  
Jawhar Lal Singha ◽  
Zahidul Haq ◽  
MA Majid
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Treatment Plan ◽  
Colorectal Anastomosis ◽  
Cancer Surgery ◽  
University Hospital ◽  
Anastomotic Site ◽  
Colon And Rectal Cancer ◽  
Significant Difference ◽  
Time Required

Introduction: In spite of long journey of intestinal anastomotic techniques surgeons still are not free from doubt about the leakage after colorectal anastomosis. In distal rectal anastomosis after cancer surgery it poses more risk due to poor colonic vascularity and reduced remaining tissue to nourish the anastomotic site. Exploration of surgical staplers has provided some procedural advantages and sense of security to surgeons as well as to patients in respect to sphincter saving and thereby improving quality of life. However, outcome measures of these devices should be made to see its efficacy over conventional hand-sewn technique because their cost play role in treatment plan. The result of such comparative study may help surgeons to counsel the patients. Objectives: To find out whether stapled anastomosis is safer than hand-sewn anastomosis in colon and rectal cancer surgery. methods: The quasi-experimental study was undertaken in the department of general and colorectal surgery, Bangabandu Sheikh Mujib Medical University hospital during Feb 2005 to June 2008. Total 100 patients were selected. 48 patients underwent ‘Stapled’ and 52 underwent ‘Hand-sewn’ anastomosis. The patients were treated and postoperatively managed by same colorectal surgeon. The outcome variables were ‘time required for anastomoses, ‘postoperative hospital stay’ and early and late ‘complications’ in postoperative and follow-up period. Result and observation: The age, sex, socioeconomic status or co-morbidities did not show any statistical difference between two groups as in the hospital stay (p=.821). The time required for anastomosis showed strongly significant difference (18.17 min and 26.85 min; p=.000) in favor of stapling group. The hemorrhage from anastomotic line (p=1.00), anastomotic leakage (p=.413), ileus/ obstruction (p=.640) and wound dehiscence (p=.640) were much less in stapled group though they lack statistical power. All others except anastomotic stenosis (p=.514) showed almost similar results. Conclusion: Considering user perspective, time requirement and postoperative complications stapling technique appear to be safer and superior to hand-sewn technique though it demands statistical strengthening on large scale study. Chattagram Maa-O-Shishu Hospital Medical College Journal Volume 12, Issue 3, September 2013: 56-61

scholarly journals Adipose most abundant 2 protein is a predictive marker for cisplatin sensitivity in cancers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kenya Kamimura ◽  
Takeshi Suda ◽  
Yasuo Fukuhara ◽  
Shujiro Okuda ◽  
Yu Watanabe ◽  
...  
Keyword(s):  
Medical Information ◽  
Excision Repair ◽  
Predictive Marker ◽  
University Hospital ◽  
Cisplatin Sensitivity ◽  
High Doses ◽  
Clinical Trials Registry ◽  
The University

AbstractCisplatin (CDDP) is one of the chemotherapeutic drugs being used to treat various cancers. Although effective in many cases, as high doses of CDDP cause cytotoxic effects that may worsen patients’ condition, therefore, a marker of sensitivity to CDDP is necessary to enhance the safety and efficiency of CDDP administration. This study focused on adipose most abundant 2 (APM2) to examine its potential as a marker of CDDP sensitivity. The relationship of APM2 expression with the mechanisms of CDDP resistance was examined in vitro and in vivo using hepatocellular carcinoma (HCC) cells, tissues and serum of HCC patients (n = 71) treated initially with intrahepatic arterial infusion of CDDP followed by surgical resection. The predictability of serum APM2 for CDDP sensitivity was assessed in additional 54 HCC patients and 14 gastric cancer (GC) patients. APM2 expression in CDDP-resistant HCC was significantly higher both in serum and the tissue. Bioinformatic analyses and histological analyses demonstrated upregulation of ERCC6L (DNA excision repair protein ERCC6-like) by APM2, which accounts for the degree of APM2 expression. The serum APM2 level and chemosensitivity for CDDP were assessed and cut-off value of serum APM2 for predicting the sensitivity to CDDP was determined to be 18.7 µg/mL. The value was assessed in HCC (n = 54) and GC (n = 14) patients for its predictability of CDDP sensitivity, resulted in predictive value of 77.3% and 100%, respectively. Our study demonstrated that APM2 expression is related to CDDP sensitivity and serum APM2 can be an effective biomarker of HCC and GC for determining the sensitivity to CDDP.Trial registration: This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000028487).

scholarly journals Evenly Distributed Protein Intake over 3 Meals Augments Resistance Exercise–Induced Muscle Hypertrophy in Healthy Young Men

2020 ◽  
Vol 150 (7) ◽  
pp. 1845-1851 ◽  
Author(s):  
Jun Yasuda ◽  
Toshiki Tomita ◽  
Takuma Arimitsu ◽  
Satoshi Fujita
Keyword(s):  
Protein Intake ◽  
Muscle Hypertrophy ◽  
Medical Information ◽  
Young Men ◽  
University Hospital ◽  
Outcome Variable ◽  
Tissue Mass ◽  
Parallel Group ◽  
Exercise Induced ◽  
Clinical Trials Registry

ABSTRACT Background Although daily protein intake (PI) has been reported to be essential for regulating muscle mass, the distribution of daily PI in individuals is typically the lowest at breakfast and skewed toward dinner. Skewed protein intake patterns and inadequate PI at breakfast were reported to be negative factors for muscle maintenance. Objectives This study examined whether a protein-enriched meal at breakfast is more effective for muscle accretion compared with the typical skewed PI pattern. Methods This 12-wk, parallel-group, randomized clinical trial included 26 men (means ± SEs; age: 20.8 ± 0.4 y; BMI: 21.8 ± 0.4 kg/m2). The “high breakfast” (HBR) group (n = 12) consumed a protein-enriched meal at breakfast providing a PI of 0.33 g/kg body weight (BW); their PI at lunch (0.46 g/kg BW) and dinner (0.48 g/kg BW) provided an adequate overall daily PI (1.30 g/kg BW/d). The “low breakfast” (LBR) group (n = 14) consumed 0.12 g protein/kg BW at breakfast; intakes at lunch (0.45 g/kg BW) and dinner (0.83 g/kg BW) yielded the same daily PI as in the HBR group. The participants performed supervised resistance training (RT) 3 times per week (75–80% 1-repetition maximum; 3 sets × 10 repetitions). DXA was used to measure the primary outcome variable, that is, total lean soft tissue mass (LTM). Results The total LTM at baseline did not differ between the HBR (52.4 ± 1.3 kg) and LBR (53.4 ± 1.2 kg) groups. After the intervention, increases in total LTM were significant in both groups, with that in the HBR group (2.5 ± 0.3 kg) tending to be greater than that in the LBR group (1.8 ± 0.3 kg) (P = 0.06), with a large effect size (Cohen d = 0.795). Conclusions For RT-induced muscle hypertrophy in healthy young men, consuming a protein-enriched meal at breakfast and less protein at dinner while achieving an adequate overall PI is more effective than consuming more protein at dinner. This study was registered at University hospital Medical Information Network (UMIN) Clinical Trials Registry as UMIN000037583 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042763).

scholarly journals Furosemide versus mannitol in patients who received cisplatin-based chemotherapy using short hydration: study protocol for a randomized controlled trial

2018 ◽  
Author(s):  
Eriko Murakami ◽  
Hiroaki Akamatsu ◽  
Toshio Shimokawa ◽  
Kiyoko Wada ◽  
Nobuyuki Yamamoto
Keyword(s):  
Renal Dysfunction ◽  
Phase Ii ◽  
Medical Information ◽  
Controlled Trial ◽  
University Hospital ◽  
Open Label ◽  
Open Label Phase ◽  
Secondary Endpoints ◽  
Clinical Trials Registry ◽  
Thoracic Malignancies

Abstract Background: Cisplatin (CDDP) is a key drug for various thoracic malignancies. To avoid renal toxicity of CDDP, mannitol is routinely used, but it reportedly causes phlebitis. Furosemide is another widely-used option for diuresis, but to date, it has not been assessed in comparison with mannitol. We therefore undertake a randomized phase II comparative study of furosemide and mannitol in CDDP-based chemotherapy using short hydration. Methods: This study is designed as a two-arm, prospective, randomized, single-center, open-label phase II study. The primary endpoint is set as the proportion of patients who experienced any grade renal dysfunction, defined as elevation in creatinine using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0, during the first cycle. Secondary endpoints are: the proportion of patients who experienced ≥ grade 2 renal dysfunction during the first cycle, any grade and ≥ grade 2 renal dysfunction after the completion of forth cycle, and the proportion of patients who had phlebitis. A total of 105 patients will be enrolled in this trial. Discussion: The results of this study will suggest that furosemide can be better choice than mannitol regarding convenience and in reduction of phlebitis. Trial registration: University Hospital Medical Information Network Clinical Trials Registry, ID: UMIN000031910(http://www.umin.ac.jp/ctr/index.htm). Registered on 1 April 2018.

scholarly journals An open-label, randomized controlled trial of sulfamethoxazole–trimethoprim for Pneumocystis prophylaxis: results of 52-week follow-up

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Masako Utsunomiya ◽  
Hiroaki Dobashi ◽  
Toshio Odani ◽  
Kazuyoshi Saito ◽  
Naoto Yokogawa ◽  
...  
Keyword(s):  
Adverse Events ◽  
Medical Information ◽  
Controlled Trial ◽  
Pneumocystis Pneumonia ◽  
University Hospital ◽  
Discontinuation Rate ◽  
Open Label ◽  
Strength Group ◽  
Drug Retention ◽  
Clinical Trials Registry

Abstract Objectives The aim was to investigate the long-term prophylactic efficacy, drug retention and safety of low-dose sulfamethoxazole–trimethoprim (SMX/TMP) prophylaxis against Pneumocystis pneumonia (PCP). Methods Adult patients with rheumatic diseases receiving prednisolone ≥0.6 mg/kg/day were randomized into the single-strength group (SS; SMX/TMP 400/80 mg daily), the half-strength group (HS; 200/40 mg daily) or the escalation group (ES; starting at 40/8 mg and increasing incrementally to 200/40 mg daily) and treated for 24 weeks, then observed for 52 weeks. The primary endpoint, the PCP non-incidence rate (non-IR) at week 24, has been reported previously. The secondary endpoints were the PCP non-IR at week 52, treatment discontinuation rate and adverse events. Results Fifty-eight, 59 and 55 patients in the SS, HS and ES, respectively, received SMX/TMP. PCP did not develop in any of the patients by week 52. The estimated PCP non-IR in patients receiving SMX/TMP 200/40 mg daily (HS and ES) was 96.8–100%. Throughout the 52-week observation period, the overall discontinuation rate was significantly lower in HS than in SS (22.7 vs 47.2%, P = 0.004). The discontinuation rates attributable to adverse events were significantly lower in HS (19.1%, P = 0.007) and ES (20.3%, P = 0.007) than in SS (41.8%). The IRs of adverse events requiring SMX/TMP dose reduction before week 52 differed among the three groups, with a significantly higher IR in SS than in HS or ES (P = 0.007). Conclusion SMX/TMP 200/40 mg had a high PCP prevention rate and was superior to SMX/TMP 400/80 mg in terms of drug retention and safety. Trial registration University Hospital Medical Information Network Clinical Trials Registry, UMIN000007727.

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