A nationwide, multi-center, retrospective study of symptomatic small bowel stricture in patients with Crohn\u27s disease.

BACKGROUND:Small bowel stricture is one of the most common complications in patients with Crohn\u27s disease (CD). Endoscopic balloon dilatation (EBD) is a minimally invasive treatment intended to avoid surgery; however, whether EBD prevents subsequent surgery remains unclear. We aimed to reveal the factors contributing to surgery in patients with small bowel stricture and the factors associated with subsequent surgery after initial EBD.METHODS:Data were retrospectively collected from surgically untreated CD patients who developed symptomatic small bowel stricture after 2008 when the use of balloon-assisted enteroscopy and maintenance therapy with anti-tumor necrosis factor (TNF) became available.RESULTS:A total of 305 cases from 32 tertiary referral centers were enrolled. Cumulative surgery-free survival was 74.0% at 1 year, 54.4% at 5 years, and 44.3% at 10 years. The factors associated with avoiding surgery were non-stricturing, non-penetrating disease at onset, mild severity of symptoms, successful EBD, stricture length < 2 cm, and immunomodulator or anti-TNF added after onset of obstructive symptoms. In 95 cases with successful initial EBD, longer EBD interval was associated with lower risk of surgery. Receiver operating characteristic analysis revealed that an EBD interval of ≤ 446 days predicted subsequent surgery, and the proportion of smokers was significantly high in patients who required frequent dilatation.CONCLUSIONS:In CD patients with symptomatic small bowel stricture, addition of immunomodulator or anti-TNF and smoking cessation may improve the outcome of symptomatic small bowel stricture, by avoiding frequent EBD and subsequent surgery after initial EBD

海洋観測の現場で経験した作業の一例

海洋研究の一環として海の構造や生物環境を明らかにするために、定期的に乗船し、研究対象海域において様々な観測機器を使用した海洋観測を行っている。自身は、海洋観測に従事した経験がなかったため、先生や先輩職員から事前に機器の取扱い方法や使用手順などの説明を受けた。その後、数回にわたって海洋観測に参加し、現場作業を経験することで、観測にかかる一連の作業手順について学んだ。本稿では、経験した様々な観測作業を踏まえた上で、海洋観測の現場で行っている作業の一例について紹介するとともに、今後の現場作業を円滑に行っていくために必要であることを記す

GNSSアンテナ設置用器材の製作と観測船での設置作業について

応用力学研究所海洋環境物理分野・市川香准教授による研究の一環で、海洋研究開発機構（JAMSTEC）が所有する地球深部探査船「ちきゅう」にて、計測用のGNSS アンテナ2 台を長期間設置することになった。そのため、アンテナ器材一式（固定用金具およびPC 等の各種機器の収納箱など）の準備を行った後、佐世保港に停泊中の同船にて、研究協力者とともに金具の固定、各種機器の動作確認および機器周辺の環境整備を行った。また、事前対応の一つとして、研究所技術職員と協働して固定用金具の製作および各種機器収納箱の加工を行ったため、アンテナ設置作業の詳細とともに紹介する

大型船へのGNSSアンテナ設置について

地球環境力学部門海洋リモートセンシング分野・市川准教授による研究の一環で、大型船にGNSS（Global Navigation Satellite System, 全球測位衛星システム）アンテナを設置することになった。2017 年から2019 年まで大型の探査船に設置して計測を行っていたが、今回は別の大型船へアンテナを設置することになり、設置する船の条件に合わせてアンテナを取り付ける金具の設計や機器類の設置方法を変更したので、以下に紹介する

Evaluation of Serum Leucine-Rich Alpha-2 Glycoprotein as a New Inflammatory Biomarker of Inflammatory Bowel Disease

Studies on serum leucine-rich alpha-2 glycoprotein (LRG) in inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), are scarce; the methods for estimating disease activity are less established, particularly for CD. This study is aimed at evaluating the utility of serum LRG as a potential inflammatory marker for IBD and to investigate the LRG gene expression in peripheral blood mononuclear cells (PBMCs) as a possible source of serum LRG. Overall, 98 patients with UC and 96 patients with CD were prospectively enrolled and clinically evaluated; 92 age-matched individuals served as the healthy controls. The blood samples were analyzed for serum LRG levels and routine laboratory parameters. Disease activity was assessed clinically and endoscopically. Finally, LRG gene expression in the PBMCs from a different cohort (41 patients with UC, 34 patients with CD, and 30 healthy controls) was examined. The serum LRG levels were higher during active disease than during inactive disease; additionally, serum LRG levels were positively correlated with clinical disease activity, C-reactive protein (CRP) levels, and other laboratory parameters in patients with UC and CD and with endoscopic disease activity in UC. UC and CD showed comparable areas under the curve (AUC) values for determining clinical remission and differentiating between endoscopic remission associated with LRG and CRP. The levels of LRG mRNA were also increased in PBMCs from patients with UC and CD and reflected disease activity. These data suggest that serum LRG, originated partially from PBMCs, is an inflammatory marker in UC and CD. A large-scale well-designed study should be conducted in the future to more accurately reveal the clinical significance of LRG in patients with IBD