Lubiprostone Decreases the Small Bowel Transit Time by Capsule Endoscopy: An Exploratory, Randomised, Double-Blind, Placebo-Controlled 3-Way Crossover Study

The aim of this study was to investigate the usefulness of lubiprostone for bowel preparation and as a propulsive agent in small bowel endoscopy. Six healthy male volunteers participated in this randomized, 3-way crossover study. The subjects received a 24 μg tablet of lubiprostone 60 minutes prior to the capsule ingestion for capsule endoscopy (CE) and a placebo tablet 30 minutes before the capsule ingestion (L-P regimen), a placebo tablet 60 minutes prior to CE and a 24 μg tablet of lubiprostone 30 minutes prior to CE (P-L regimen), or a placebo tablet 60 minutes prior to r CE and a placebo tablet again 30 minutes prior to CE (P-P regimen). The quality of the capsule endoscopic images and the amount of water in the small bowel were assessed on 5-point scale. The median SBTT was 178.5 (117–407) minutes in the P-P regimen, 122.5 (27–282) minutes in the L-P regimen, and 110.5 (11–331) minutes in the P-L regimen (P=0.042). This study showed that the use of lubiprostone significantly decreased the SBTT. We also confirmed that lubiprostone was effective for inducing water secretion into the small bowel during CE

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

Measurement of keV-neutron capture cross sections and capture gamma-ray spectra of Cs-133 and I-127

The neutron capture cross sections and the capture gamma-ray spectra of 127I and 133Cs at incident neutron energies from 15 to 100 keV have been measured by the time-of-flight method. Capture gamma-rays were detected with an anti-Compton NaI(Tl) spectrometer, and the pulse-height weighting technique was applied to derive capture yields. The capture cross sections of 127I and 133Cs were determined using the standard capture cross section of 197Au. The total errors of the cross sections were 3.8-5.1%. The obtained cross sections were compared with evaluated values in JENDL-4.0 and ENDF/B-VII.1. For 127I, the energy dependence is different between the present results and the evaluations. For 133Cs, the evaluated values in JENDL-4.0 agree with the present results but the evaluated values in ENDF/B-VII.1 are smaller than the present results by 14%–18%. The capture gamma-ray spectra of 133Cs and 127I were derived by unfolding the pulse height spectra with detector response functions

Measurement of keV-neutron capture cross sections and capture gamma-ray spectra of Cs-133 and I-127

The neutron capture cross sections and the capture gamma-ray spectra of 127I and 133Cs at incident neutron energies from 15 to 100 keV have been measured by the time-of-flight method. Capture gamma-rays were detected with an anti-Compton NaI(Tl) spectrometer, and the pulse-height weighting technique was applied to derive capture yields. The capture cross sections of 127I and 133Cs were determined using the standard capture cross section of 197Au. The total errors of the cross sections were 3.8-5.1%. The obtained cross sections were compared with evaluated values in JENDL-4.0 and ENDF/B-VII.1. For 127I, the energy dependence is different between the present results and the evaluations. For 133Cs, the evaluated values in JENDL-4.0 agree with the present results but the evaluated values in ENDF/B-VII.1 are smaller than the present results by 14%–18%. The capture gamma-ray spectra of 133Cs and 127I were derived by unfolding the pulse height spectra with detector response functions