Papers by R. Barreto-Zuñiga
Until recently the study of small bowel was limited to the radiographic approach. This paper desc... more Until recently the study of small bowel was limited to the radiographic approach. This paper describes experience with the first 86 procedures evaluated and treated with the new technique of double-balloon enteroscopy (DBE). Between August 2005 and September 2006, DBE was conducted in consecutive patients. The characteristics of the patients, indications for the procedures, procedural parameters, and diagnostic yield are described here. All conventional treatment options were available. All the patients had previously undergone esophagogastroduodenoscopy and colonoscopy. Eighty-six procedures in sixty-eight patients were carried out (41 women, 27 men; mean age 48.5 years, range 20-82). The most common indications were gastrointestinal bleeding (n = 40) and iron deficiency anemia (n = 7). The mean duration of the procedure was 63 (range 20-194) mins and 80 (range 20-150) minutes for the oral and anal routes, respectively. The mean depth of small-bowel insertion was 250 and 200 cm for the oral and anal routes, respectively. Impact in diagnosis and/or treatment was obtained in 50 patients (73.5%). The commonest findings in the 68 patients were angiodysplasia (n = 11), polyps (n = 8), nodular lymphoid hyperplasia (n = 5) and normal (n = 20). No major complications were observed. DBE is a useful tool for the diagnosis and treatment of patients with small-bowel pathology in whom traditional methods have not been effective. In almost two-thirds of patients DBE was clinically useful for diagnosis and treatment. The complication rate with the procedure was very low.
Revista de gastroenterología de México
We found that the seroprevalence in Cancer Institute of H. pylori infection was significantly mor... more We found that the seroprevalence in Cancer Institute of H. pylori infection was significantly more frequent in gastric cancer than in age- and gender-matched controls. This study suggested an epidemiological link between H. pylori infection and gastric cancer. H. pylori exhibits a complex system of enzymes which serve a range of functions. Toxic effects are produced by urease (UR), phospholipase (PL) and alcohol dehydrogenase (ADH). We embarked on an exploration of the enzyme activities of H. pylori infected patients using a TLC-autoradioluminography. This method has a wide dynamic range and could offer an analytical technique for studying a radioactive compound and its enzymes in H. pylori infected mucosa. Biopsies samples taken from 21 gastric cancer patients and 95 controls were studied. Although high activity of UR indicates well the presence of H. pylori impairment, activities of ADH and PL reflects more the chronicity of mucosal damage in both groups. Clearly, the enzyme profi...
Journal of Clinical Gastroenterology, 2007
Intraepithelial lymphocytes (IELs) phenotyping has emerged as a useful test in intestinal patholo... more Intraepithelial lymphocytes (IELs) phenotyping has emerged as a useful test in intestinal pathology. In celiac disease (CD), a permanent and marked increase of gammadelta+ IELs has been described. However, there is a lack of knowledge about this peculiar IELs population in other intestinal pathologies. To analyze the percentage of IELs, specifically gammadelta+ IELs subset, present in duodenal mucosa biopsies from patients with CD and compare it with those obtained from patients with small intestinal bacterial overgrowth (SIBO) or irritable bowel syndrome (IBS). Twelve patients with untreated CD, 8 patients with SIBO, and 10 patients with diarrhea-predominant IBS were evaluated. All subjects underwent upper endoscopy for mucosal biopsy and jejunal aspirate. From 2 small bowel biopsies, intraepithelial cells were isolated and labeled with the following monoclonal antibodies CD103-PE (phycoerythrin), CD3-FITC (fluoresecein isothio-cynate), CD-7R-PE, CD45RO-APC (allophycocyanin), and TcR gammadelta-FITC. Flow cytometry analysis was performed on a standard FACScan. Total and IELs subset counts were expressed as percentage. Mean total IELs percentage was 16.7+/-6% in IBS, 25.4+/-17% in SIBO, and 26+/-13% in CD patients (P=0.2). CD and SIBO patients, had significantly higher percentages of gammadelta+ IELs (15.7+/-13% and 14.6+/-8%) than IBS subjects (4.1+/-2.5%, P<0.05). There was no difference between CD and SIBO (P=0.6). An increased density of gammadelta+ IELs is typical, but not specific for CD. A similar increase was observed in subjects with SIBO. Our findings suggest that this unique T-cell population might have a key role against intestinal bacterial infections.
In order to develop an USB interface for E-Book that is one product of embedded system and then i... more In order to develop an USB interface for E-Book that is one product of embedded system and then implement communication between the E-Book and PC,the software development includes USB firework program,USB device driver program and USB communication program.On the base of finishing firework program and device driver program,the article introduces the design and implementation of USB communication program detailedly from two aspects,one is I/O interface with USB device driver program,and the other is USB communication on PC.Especially,the article introduces a sample testing program that to test bulk transfer.In the end,the article gives some reasons for error between USB practical transfer value and academic value.
Hepato-Gastroenterology
In Japan, gastric cancer is still the leading cause of death, although the mortality rate has rec... more In Japan, gastric cancer is still the leading cause of death, although the mortality rate has recently been decreasing and early gastric cancer comprised half of all resected cancers. Recently, some interesting problems of early gastric cancer have been raised in Western literature. However, they seem to be different from Japanese experience or to include misconceptions of early gastric cancer in Japan. The purpose of this article is to mainly provide Western readers with the Japanese experience in early gastric cancer which may assist them in understanding its diversity.
Hepato-gastroenterology, 2001
In Japan, gastric cancer is still the leading cause of death, although the mortality rate has rec... more In Japan, gastric cancer is still the leading cause of death, although the mortality rate has recently been decreasing and early gastric cancer comprised half of all resected cancers. Recently, some interesting problems of early gastric cancer have been raised in Western literature. However, they seem to be different from Japanese experience or to include misconceptions of early gastric cancer in Japan. The purpose of this article is to mainly provide Western readers with the Japanese experience in early gastric cancer which may assist them in understanding its diversity.
Journal of gastroenterology, 1997
We conducted a case-control study to examine the association of Helicobacter pylori infection as ... more We conducted a case-control study to examine the association of Helicobacter pylori infection as a risk factor in gastric cancer in the Japanese population. Serum IgG antibodies for Helicobacter pylori were determined in 55 consecutive patients with gastric cancer and in 75 age- and sex-matched mass survey subjects and 57 age- and sex-matched cancer-free patients with conditions considered at a high risk for development of gastric cancer (precancerous condition). We examined the histology in all subjects and particular focus was placed on the extent of Helicobacter pylori-associated gastritis. The seroprevalence of Helicobacter pylori in gastric cancer patients (82%) and those with a precancerous condition (89%) was significantly higher (P < 0.005) than that in the mass survey subjects (60%). Positive relative risk associations were found for patients with gastric cancer (odds ratio, 3, with 95% confidence intervals of 1.69-5.33) and those with a precancerous condition (odds rati...
Revista Espanola De Enfermedades Digestivas, 2017
Mujer de 54 años de edad referida a colonoscopia para cribado de cáncer de colon. Durante la colo... more Mujer de 54 años de edad referida a colonoscopia para cribado de cáncer de colon. Durante la colonoscopia se documentaron múltiples quistes en sigma, el mayor de ellos de 4 cm de diámetro. Se tomaron biopsias de uno de ellos, observando la pared del quiste y posteriormente la liberación de gas y el colapso del mismo (Figs. 1 y 2). La tomografía computarizada de abdomen confirmó el diagnóstico (Fig. 3).
Revista de Gastroenterología de México (English Edition)
Revista de Gastroenterología de México (English Edition)
Revista de Gastroenterología de México
Revista de Gastroenterología de México
Hepato-gastroenterology
In Japan, gastric cancer is still the leading cause of death, although the mortality rate has rec... more In Japan, gastric cancer is still the leading cause of death, although the mortality rate has recently been decreasing and early gastric cancer comprised half of all resected cancers. Recently, some interesting problems of early gastric cancer have been raised in Western literature. However, they seem to be different from Japanese experience or to include misconceptions of early gastric cancer in Japan. The purpose of this article is to mainly provide Western readers with the Japanese experience in early gastric cancer which may assist them in understanding its diversity.
Histopathology, 1978
Details of 13 new cases of inflammatory fibroid polyp of the gastrointestinal tract and of 76 pat... more Details of 13 new cases of inflammatory fibroid polyp of the gastrointestinal tract and of 76 patients recorded in the literature (total 89) are described and analysed. The lesion is always benign, may occur at any age but is commonest in the sixth and seventh decades, and involves the stomach most frequently. Abdominal pain, often related to obstruction, is the principal symptom. Eosinophilia of the peripheral blood does not occur. The lesions are sessile or polypoidal, originate in the gut submucosa, vary greatly in cellularity, and have a wide range of tissue eosinophilia. Some are very vascular, many of the larger vessels having a notably broad zone of connective tissue about them. The aetiology of the condition is discussed and reasons for distinguishing it from eosinophilic gastroenteritis, with which it is frequently confused, are given. The precise nature and aetiology of the inflammatory fibroid polyp remains undetermined.
Journal of Crohn's and Colitis, 2013
Poster presentations indexes of treatment response. Aim of this study was to evaluate the use of ... more Poster presentations indexes of treatment response. Aim of this study was to evaluate the use of soluble transferrin receptor/log10 ferritin index (sTfR-F) as a predictor of the effectiveness of intravenous iron in IBD-associated anemia. Methods: 54 patients with IBD were included in this study (30 men, 22 ulcerative colitis, 32 Crohn's disease). Intravenous ferric carboxymaltose was administered at a maximum dose of 15 mg/kg or 1000 mg within 15 min. Anemia was defined as hemoglobin Hb <13 g/dl in men and Hb <12 g/dl in women. Several laboratory and clinical parameters were analyzed including sTfR-F index at week 0 and week 4. Results: Ferric carboxymaltose was administered at a mean dose of 1290±329 mg. Hemopoietic response (increase of Hb >2 g/dl) was observed in 66.7% of the patients. Mean CRP and ESR values were not statistically significant different between the two phases of the study and no significant correlation between CRP and sTfR-F index was found. Intravenous ferric carboxymaltose infusion had as a result a significant reduction of sTfR-F index at week 4 compared to week 0 (p < 0.0001). Patients with hemopoietic response after treatment had significantly higher baseline sTfR-F (5.2±3.6) compared to those without response (1.5±0.8). Baseline sTfR-F >1.4 had a sensitivity of 91.8% and specificity of 94.4% in the prediction of the hemopoietic response. Conclusions: sTfR-F index is a highly reliable predictive index of the effectiveness of intravenous ferric carboxymaltose infusion in IBD-associated anemia. P124 Use of interferon-gamma release assay (IGRA) and tuberculin skin test (TST) for tuberculosis screening in patients candidates for anti-TNF terapy in inflammatory bowel disease (IBD)
Endoscopy, 2011
There have been reports, mainly retrospective, of pancreatitis and hyperamylasemia after anterogr... more There have been reports, mainly retrospective, of pancreatitis and hyperamylasemia after anterograde double-balloon enteroscopy (DBE). Our aim was to report the incidence of pancreatitis and hyperamylasemia after DBE and investigate possible risk factors associated with its occurrence. In this single-center prospective cohort study, serum samples were taken for amylase and lipase before and 3 hours after anterograde DBE in consecutive patients. Multiple variables were recorded, including total procedure time, insertion depth, and number of passes. Patients were evaluated to 24 hours later for signs of pancreatitis. The main outcome measures were the occurrence of hyperamylasemia and pancreatitis. 92 patients were included in the analysis (58 women, 34 men; mean age 54 years, range 18-89). The mean total procedure time was 62 minutes (range 30-120). The mean post-procedure amylase and lipase levels were significantly higher in comparison with the baseline levels (165 U/L vs. 69 U/L and 144 U/L vs. 28 U/L respectively, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.05); 36 patients (39%) showed hyperamylasemia after the procedure and three patients developed acute mild pancreatitis. Hyperamylasemia was associated more frequently with procedure duration greater than 60 minutes ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001) and insertion depth greater than 25 cm ( P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.013). The incidence of hyperamylasemia after anterograde DBE is common and particularly associated with longer procedure time and insertion depth. The cumulative incidence of pancreatitis was 3%. We recommend the avoidance of both unnecessarily lengthy procedures and deep insertion distances in patients who undergo anterograde DBE.
Digestive Endoscopy, 1993
... Yoshihiro KOHLI, Takuji KATO, Shigeji ITO, Makoto IWAKI, Kunio SUZUKI, Takashi UEDA, Yoshimic... more ... Yoshihiro KOHLI, Takuji KATO, Shigeji ITO, Makoto IWAKI, Kunio SUZUKI, Takashi UEDA, Yoshimichi ABE and Kunihisa ... of Internal Medicine, Fukui Medical School, 23-3 Shimoaizuki, Matsuoka-cho, Yoshida-gun, Fukui 910-11, Japan. ... Kohli Y, Hata M, Yamazaki Y et al. ...
Journal of Crohn's and Colitis
Journal of Clinical Gastroenterology, 2007
Intraepithelial lymphocytes (IELs) phenotyping has emerged as a useful test in intestinal patholo... more Intraepithelial lymphocytes (IELs) phenotyping has emerged as a useful test in intestinal pathology. In celiac disease (CD), a permanent and marked increase of gammadelta+ IELs has been described. However, there is a lack of knowledge about this peculiar IELs population in other intestinal pathologies. To analyze the percentage of IELs, specifically gammadelta+ IELs subset, present in duodenal mucosa biopsies from patients with CD and compare it with those obtained from patients with small intestinal bacterial overgrowth (SIBO) or irritable bowel syndrome (IBS). Twelve patients with untreated CD, 8 patients with SIBO, and 10 patients with diarrhea-predominant IBS were evaluated. All subjects underwent upper endoscopy for mucosal biopsy and jejunal aspirate. From 2 small bowel biopsies, intraepithelial cells were isolated and labeled with the following monoclonal antibodies CD103-PE (phycoerythrin), CD3-FITC (fluoresecein isothio-cynate), CD-7R-PE, CD45RO-APC (allophycocyanin), and TcR gammadelta-FITC. Flow cytometry analysis was performed on a standard FACScan. Total and IELs subset counts were expressed as percentage. Mean total IELs percentage was 16.7+/-6% in IBS, 25.4+/-17% in SIBO, and 26+/-13% in CD patients (P=0.2). CD and SIBO patients, had significantly higher percentages of gammadelta+ IELs (15.7+/-13% and 14.6+/-8%) than IBS subjects (4.1+/-2.5%, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). There was no difference between CD and SIBO (P=0.6). An increased density of gammadelta+ IELs is typical, but not specific for CD. A similar increase was observed in subjects with SIBO. Our findings suggest that this unique T-cell population might have a key role against intestinal bacterial infections.
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Papers by R. Barreto-Zuñiga