U.S. patent application number 16/790831 was filed with the patent office on 2020-09-17 for flora treatment.
This patent application is currently assigned to OLYMPUS CORPORATION. The applicant listed for this patent is OLYMPUS CORPORATION. Invention is credited to Yumiko AWAU, Takeo SUZUKI.
Application Number | 20200289804 16/790831 |
Document ID | / |
Family ID | 1000004916005 |
Filed Date | 2020-09-17 |
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United States Patent
Application |
20200289804 |
Kind Code |
A1 |
AWAU; Yumiko ; et
al. |
September 17, 2020 |
FLORA TREATMENT
Abstract
A flora treatment of the invention includes a step (A) in which
an instrument is introduced into a lumen; a step (B) in which the
instrument is made to reach an intestinal cecum; a step (C) in
which an appendico is recognized; and a step (D) in which
probiotics is supplied to the appendico.
Inventors: |
AWAU; Yumiko; (Tokyo,
JP) ; SUZUKI; Takeo; (Tokyo, JP) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
OLYMPUS CORPORATION |
Tokyo |
|
JP |
|
|
Assignee: |
OLYMPUS CORPORATION
Tokyo
JP
|
Family ID: |
1000004916005 |
Appl. No.: |
16/790831 |
Filed: |
February 14, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62808365 |
Feb 21, 2019 |
|
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|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 1/015 20130101;
A61K 2035/115 20130101; A61B 1/31 20130101; A61K 35/741 20130101;
A61M 2210/1064 20130101; A61H 2201/105 20130101; A61H 21/00
20130101; A61M 31/00 20130101 |
International
Class: |
A61M 31/00 20060101
A61M031/00; A61K 35/741 20060101 A61K035/741; A61B 1/015 20060101
A61B001/015; A61B 1/31 20060101 A61B001/31; A61H 21/00 20060101
A61H021/00 |
Claims
1. A flora treatment comprising: a step (A) in which an instrument
is introduced into a lumen; a step (B) in which the instrument is
made to reach an intestinal cecum; a step (C) in which an appendico
is recognized; and a step (D) in which probiotics is supplied to
the appendico.
2. The flora treatment according to claim 1, wherein the instrument
is an endoscope, and an orifice of the appendico is recognized
using a field of view of the endoscope in the step (C).
3. The flora treatment according to claim 1, wherein the probiotics
is supplied into a mucus of the appendico in the step (D).
4. The flora treatment according to claim 3, further comprising,
before the step (D), a step (E) in which an inside of the appendico
is cleaned.
5. The flora treatment according to claim 3, further comprising,
before the step (D), a step (F) in which at least a part of the
mucus of the appendico is removed.
6. The flora treatment according to claim 5, further comprising,
before the step (F), a step (G) in which the mucus of the appendico
is dyed.
7. The flora treatment according to claim 3, wherein, in the step
(D), the probiotics is applied to a part where the mucus has been
removed in the step (F).
8. The flora treatment according to claim 1, further comprising,
after the step (D), a step (H) in which heat is applied to the
appendico for a predetermined time period, or comprising, after the
step (D), a step (I) in which vibration is applied to the appendico
for a predetermined time period.
9. The flora treatment according to claim 1, wherein an age of the
appendico is under 30 years.
Description
CROSS REFERENCE TO RELATED APPLICATION
[0001] This application is based upon and claims the benefit of
priority from the U.S. Provisional Patent Application No.
62/808,365 filed in the U.S.A. on Feb. 21, 2019, the entire
contents of which are incorporated herein by reference.
BACKGROUND OF THE INVENTION
1. Field of the Invention
[0002] The present invention relates to a flora treatment of
improving an intestinal environment by oral ingestion of
probiotics.
2. Description of the Related Art
[0003] A method of improving an intestinal environment by oral
ingestion of probiotics has been known. Such a method is disclosed
in US2018/0000875, for example.
[0004] In addition, a method of supplying probiotics into the
intestine through an endoscope is disclosed in Japanese Unexamined
Patent Application Publication No. 2013-505289.
SUMMARY OF THE INVENTION
[0005] Simply, a flora treatment according to the present invention
includes: a step (A) in which an instrument is introduced into a
lumen; a step (B) in which the instrument is made to reach an
intestinal cecum; a step (C) in which an appendico is recognized;
and a step (D) in which probiotics is supplied to the
appendico.
[0006] The above and other objects, features and advantages of the
invention will become more clearly understood from the following
description referring to the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0007] FIG. 1 is a diagram of a flow for supplying probiotics to an
appendico, which includes all embodiments and modified examples in
a flora treatment according to the present invention.
[0008] FIG. 2 illustrates the step (A) in FIG. 1.
[0009] FIG. 3 illustrates the step (B) in FIG. 1.
[0010] FIG. 4 illustrates the step (C) in FIG. 1.
[0011] FIG. 5 illustrates the step (D) in FIG. 1.
[0012] FIG. 6 illustrates the step (Q) in FIG. 1.
[0013] FIG. 7 is a partial perspective view illustrating, together
with an endoscope, a spoon-shaped mucus removal tool for removing
an appendico mucus.
[0014] FIG. 8 is a partial perspective view illustrating, together
with the endoscope, a stick-shaped mucus removal tool for removing
the appendico mucus.
[0015] FIG. 9 is a partial perspective view illustrating, together
with the endoscope, a spatula-shaped mucus removal tool for
removing the appendico mucus.
[0016] FIG. 10 is a partial perspective view illustrating, together
with the endoscope, a brush-shaped mucus removal tool for removing
the appendico mucus.
[0017] FIG. 11 is a partial perspective view illustrating, together
with the endoscope, a mucus removal fluffy tool for removing the
appendico mucus.
[0018] FIG. 12 illustrates a state where a thin-diameter endoscope
inserted into the endoscope channel in FIG. 2 is inserted in the
appendico.
[0019] FIG. 13 illustrates a state where the mucus removal fluffy
tool is inserted from the endoscope channel into the appendico.
[0020] FIG. 14 illustrates a state where the probiotics is jetted
(applied) to the appendico, with a position of the endoscope fixed
by inflating the balloon in FIG. 6.
[0021] FIG. 15 illustrates the step (J) in FIG. 1.
[0022] FIG. 16 illustrates a configuration of the step (J) in FIG.
1, which is different from the configuration of the step (J) in
FIG. 15.
[0023] FIG. 17 illustrates an example in which the probiotics is
supplied to the appendico through a catheter inserted into the
endoscope channel in FIG. 2.
[0024] FIG. 18 illustrates a funnel-shaped indwelling body.
[0025] FIG. 19 illustrates a tuft-like indwelling body.
[0026] FIG. 20 illustrates a thread-like indwelling body.
[0027] FIG. 21 illustrates a fluff impregnated with the probiotics
and a bar holding the fluff, as an example of a treatment
instrument to be used in the step (L) in FIG. 1.
[0028] FIG. 22 illustrates a state where an incision is made on a
part of the intestinal cecum.
[0029] FIG. 23 illustrates forming of the appendico by suturing the
incision in FIG. 22.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT(S)
[0030] Hereinafter, embodiments of the present invention will be
described with reference to drawings.
[0031] Note that, in the present invention, probiotics indicates at
least one kind of microorganism that provides a beneficial effect
to a living body. The beneficial effect here includes, for example,
improvement of an intestinal bacterial flora, an effect to an
intestinal immune, and the like.
[0032] Even if bacteria, as a simple substance, are called as bad
bacteria or opportunistic bacteria, the bacteria that provide a
beneficial effect is included in the probiotics.
[0033] Furthermore, the probiotics is not specifically limited, but
includes the bacteria that belong to Bacteroidetes phylum,
Firmicutes phylum, Actinobacteria phylum, Proteobacteria phylum,
and the like.
[0034] When using the above-described bacteria, the bacteria may be
used as a simple substance as described above, or a plurality of
kinds of bacteria may be used.
[0035] When a plurality of kinds of bacteria are used, the kinds,
amounts, and ratio of the bacteria can be appropriately selected
depending on purposes for production, storage, and treatment.
[0036] There is a possibility that a colonization ratio of main
purpose bacteria to a subject can be increased by adding symbiotic
bacteria capable of producing mucus decomposing enzyme to the main
purpose bacteria, for example.
[0037] Bacteria that produce the mucus decomposing enzyme include,
for example, B. bifidum, C. perfringens, B. longum subsp. Longum,
and B. breve, etc.
[0038] Note that artificially-cultured bacteria have such a benefit
that impurities are not likely to be included.
First Embodiment
[0039] FIG. 1 is a diagram of a flow for supplying probiotics to
the appendico, which includes all embodiments and modified examples
in a flora treatment according to the present invention, FIG. 2
illustrates the step (A) in FIG. 1, FIG. 3 illustrates the step (B)
in FIG. 1, FIG. 4 illustrates the step (C) in FIG. 1, and FIG. 5
illustrates the step (D) in FIG. 1.
[0040] As illustrated in FIG. 1, when probiotics 100 (see FIG. 5)
is supplied to an appendico 19, the procedure is performed as
follows: the steps (A).fwdarw.(B).fwdarw.(C).fwdarw.(D).fwdarw.(M)
in the present embodiment.
[0041] Note that it is needless to say that the flow in FIG. 1
shown below is not performed in the alphabetical order.
[0042] First, in the step (A), an endoscope 1, as an instrument, is
introduced into a lumen, as illustrated in FIG. 2.
[0043] Note that, as illustrated in FIG. 2, a large intestine 10 to
which the endoscope 1 reaches through the lumen is generally
composed of, in the following order from the anus 11: the lower
rectum 12; the upper rectum 13; the sigmoid colon 14, the
descending colon 15, the transverse colon 16; the ascending colon
17; the intestinal cecum 18, the appendico 19, and the ileum
20.
(Step (A): With Regard to Introduction of Endoscope 1 Into
Lumen)
[0044] In the present invention, the route for introducing the
endoscope 1 into a body may be oral or transanal (through anus 11)
as illustrated in FIGS. 2 to 5.
[0045] In addition, the endoscope 1 may be a flexible endoscope or
a capsule endoscope in the present invention.
[0046] The flexible endoscope may be an endoscope for the upper
digestive tract or an endoscope for the lower digestive tract. In
addition, the diameter of the flexible endoscope may be
appropriately selected depending on a subject.
[0047] Although details will be described in the modified examples
shown below, the endoscope 1 may be used individually, a sheath and
an endoscope 1 insertable into a channel of the sheath may be used
in combination, or a mother endoscope and a baby endoscope
configured to be insertable into a channel of the mother endoscope
may be used in combination.
[0048] In addition, the endoscope 1 and a treatment instrument
configured to be insertable into a channel 2 of the endoscope 1 may
be used in combination, or the endoscope 1 and a treatment
instrument configured to be fittable to the distal end of the
endoscope 1 may be used in combination.
[0049] Furthermore, when a capsule endoscope is used, a guiding
apparatus configured to control the movement and indwelling of the
capsule endoscope from outside the body may be used with the
capsule endoscope.
[0050] Next, in the step (B), the endoscope 1 is made to reach the
intestinal cecum 18, as illustrated in FIG. 3.
(Step (B): With Regard to Reaching to the Intestinal Cecum 18)
[0051] Confirmation is made that the endoscope 1 has reached the
intestinal cecum 18, with the illumination light being supplied
from an illumination portion 4, for example, by using the field of
view of an observation portion 3 of the endoscope 1.
[0052] When the endoscope 1 is advanced in the lumen from the mouth
or the anus 11 to the intestinal cecum 18, a gas may be introduced
into the lumen, to expand the lumen.
[0053] In addition, when anaerobic bacteria are used as the
probiotics 100, it is preferable to use a non-oxygen gas, as the
gas, to purge the atmosphere with the non-oxygen gas at the latest
immediately before the supply of the probiotics 100 to the
appendico 19. Note that the non-oxygen gas includes a carbon
dioxide gas, a nitrogen gas, or a noble gas.
[0054] At the stage of inserting the endoscope 1 from the anus 11
to advance the endoscope 1 to the intestinal cecum 18, an
oxygen-containing gas or the non-oxygen gas may be used.
[0055] Using the oxygen-containing gas has such an advantage that
the number of indigenous bacteria in the large intestine 10 can be
reduced. The oxygen-containing gas includes air. Using the
non-oxygen gas has such an advantage that there is no need for
switching the kinds of gases.
[0056] Next, in the step (C), an orifice 19i of the appendico 19
(hereinafter, referred to as the appendico orifice 19i) is
recognized, as illustrated in FIG. 4.
(Step (C): With Regard to Recognition of the Appendico Orifice
19i)
[0057] The position of the appendico orifice 19i is confirmed by
using the field of view of the observation portion 3 of the
endoscope 1.
[0058] After that, in the step (D), the probiotics 100 is supplied
to the appendico 19, as illustrated in FIG. 5. Specifically, in the
step (S), the probiotics 100 is jetted to the appendico orifice
19i. Note that the probiotics 100 is supplied into a mucus 64 of
the appendico 19 (see FIG. 15).
(Step (D): With Regard to Supply of the Probiotics 100 to the
Appendico 19/Step (S): With Regard to Jetting of the Probiotics 100
Toward the Appendico Orifice 19i)
[0059] FIG. 5 illustrates the step (S): jetting of the probiotics
100 toward the appendico orifice 19i as a specific example of the
step (D): supply of the probiotics 100 to the appendico 19.
[0060] The jetting of the probiotics 100 may be performed with an
air/water feeding conduit of the endoscope 1, with the endoscope
channel 2, or with a channel of a sheath, when the sheath is used
in combination with the endoscope 1.
[0061] When the endoscope 1 is used in combination with a baby
endoscope or a treatment instrument, the step (R) in FIG. 1:
leading out from the channel, which will be described later, may be
performed to jet the probiotics 100 from the treatment instrument
or tube inserted in the endoscope channel 2.
[0062] Note that the strength of the jetting may be appropriately
selected depending on the closing state of the appendico orifice
19i.
[0063] The probiotics 100 to be jetted is preferably a powder or a
fluid. The powder includes the freeze-dried probiotics 100. The
fluid includes the culture solution of the probiotics 100, a liquid
in which the probiotics 100 is mixed, or liposome having at least a
single layer containing the probiotics 100.
[0064] Furthermore, the viscosity of the fluid can be appropriately
set. The liquid includes degassed water, carbonic water, mucin,
collagen, or hyaluronic acid.
[0065] When the step (F): removal of the appendico mucus in FIG. 1,
to be described later, is performed in advance, it is preferable to
use mucin as the liquid for supplementing the removed mucus.
[0066] Furthermore, the powder or the fluid may contain components
for growing the probiotics 100. The components include bacteria,
iron, dietary fiber, or oligosaccharide. The bacteria as the
components for growing the probiotics 100 may be live bacteria or
dead bacteria.
[0067] Lastly, in the step (M), the endoscope 1 is extracted from
the inside of the body.
(Step (M): With Regard to Extraction from Inside of Body)
[0068] When a flexible endoscope is used, the endoscope 1 is
extracted from the inside of the body by being pulled out.
[0069] When the capsule endoscope is used, the capsule endoscope
may be excreted by spontaneous passage, or may be guided to the
colon, the rectum, or the anus by using the guiding apparatus
located outside the body.
[0070] By using such a method, the probiotics 100 is surely
supplied to the mucus 64 of the appendico 19, which improves the
colonization of the probiotics 100 in the mucus 64.
FIRST MODIFIED EXAMPLE OF THE FIRST EMBODIMENT
[0071] In addition to a series of flow including the steps (A),
(B), (C), (D/S), and (M) in FIG. 1 according to the present
embodiment, at least one of the steps (Q), (R), (E), or (F) may be
performed. When the step (F) is performed, step (G) may be further
performed.
(Step (Q): With Regard to P ositioning)
[0072] FIG. 6 illustrates the step (Q) in FIG. 1.
[0073] At the stage when the appendico orifice 19i is recognized
with the endoscope 1 in the step (C), the endoscope 1 may be
positioned in the step (Q) as illustrated in FIG. 6.
[0074] As exemplified in FIG. 6, the positioning is performed by
inflating a balloon 8 provided to a sliding tube 7, to thereby
enable the distance between the endoscope 1 and the appendico 19 to
be stabilized.
[0075] Another method for the positioning includes a method of
discharging the gas in the lumen to bring the inside of the lumen
into a negative pressure state, to thereby cause the endoscope 1 to
stick to the intestinal tract. When the gas in the intestine is
discharged, the gas can be discharged by using the air/water
feeding conduit of the endoscope 1, for example.
(Step (E): With Regard to Cleaning of the Inside of the Appendico
19)
[0076] Before the step (D): supply of the probiotics 100 to the
appendico 19, cleaning of the inside of the appendico 19 in the
step (E) may be performed.
[0077] The cleaning of the inside of the appendico 19 is performed
by supplying a fluid to the inside of the appendico 19. When gas is
used as the fluid, if the bacteria inside the appendico, which are
desired to be removed, are anaerobic, it is preferable to supply
oxygen-containing gas. When a liquid is used as the fluid, it is
preferable to use normal saline or mucin.
[0078] In addition, as the method of supplying the fluid, similarly
as in the step (S) in FIG. 1, the fluid may be supplied through the
air/water feeding conduit of the endoscope 1 or the endoscope
channel 2. When a sheath is used in combination with the endoscope
1, the fluid may be supplied from the channel of the sheath. Or,
the fluid may be supplied from the treatment instrument or the tube
inserted into the endoscope channel 2, or from a catheter inserted
independently from the endoscope 1.
(Step (F): With Regard to Removal of the Mucus of the Appendico
19)
[0079] Before the step (D): supply of the probiotics 100 to the
appendico 19, the removal of the mucus 64 of the appendico 19
(hereinafter, referred to as the appendico mucus 64) in the step
(F) may be performed.
[0080] The removal of the mucus 64 in the step (F) may be performed
on the entirety or only a part of the appendico 19.
[0081] In addition, both an outer mucus layer 61 and an inner mucus
layer 62 (for both, see FIG. 15) of the appendico mucus 64 may be
removed, but more preferably, the outer mucus layer 61 is removed
with the inner mucus layer 62 remained.
[0082] FIG. 7 is a partial perspective view illustrating, together
with the endoscope, a spoon-shaped mucus removal tool for removing
the appendico mucus. FIG. 8 is a partial perspective view
illustrating, together with the endoscope, a stick-shaped mucus
removal tool for removing the appendico mucus. FIG. 9 is a partial
perspective view illustrating, together with the endoscope, a
spatula-shaped mucus removal tool for removing the appendico mucus.
FIG. 10 is a partial perspective view illustrating, together with
the endoscope, a brush-shaped mucus removal tool for removing the
appendico mucus. FIG. 11 is a partial perspective view
illustrating, together with the endoscope, a mucus removal fluffy
tool for removing the appendico mucus.
[0083] The removal of the appendico mucus 64 may be performed with
a mucolytic agent, a normal saline containing an abrasive, an
abrasive, laser, or water pressure. Alternatively, mucus removal
tools 31 to 35 such as a spoon, a stick, a spatula, a brush, or a
fluffy member, as illustrated in FIGS. 7 to 11 may be used.
[0084] These agents and tools can be used in combination. For
example, a sharp curette, a brush, a spatula, or a fluffy member,
each of which includes an abrasive disposed on the surface thereof,
can be used. Alternatively, a brush, a spatula, or a fluff, each of
which impregnates a mucolytic agent, can be used.
[0085] In the case where only the outer mucus layer 61 of the
appendico mucus 64 is removed, each of the sharp curette, the
brush, the spatula, and the fluffy member is preferably made of a
member which is more flexible than the inner mucus layer 62 and
harder than the outer mucus layer 61.
[0086] When only the outer mucus layer 61 of the appendico mucus 64
is removed, it is preferable that roughness, which has a thickness
thinner than the thickness of the outer mucus layer 61, is formed
on the surface of the spatula, as illustrated in FIG. 9. The
thickness of the roughness is preferably equal to or smaller than 1
mm, or more preferably equal to or less than 0.7 mm.
[0087] When only the outer mucus layer 61 of the appendico mucus 64
is removed, the length of the bristles of the brush as illustrated
in FIG. 10 is smaller than the thickness of the outer mucus layer
61. The length of the bristles is preferably equal to or less than
1 mm, or more preferably equal to or less than 0.7 mm.
[0088] The step (F): removal of the appendico mucus 64 may be
performed in combination with the step (E): cleaning of the inside
of the appendico 19.
[0089] The order of the steps in this case is not specifically
limited, but can be appropriately selected depending on the state
of the appendico 19 of a patient. In addition, at least one of the
steps may be performed plurality of times. For example, the steps
may be performed as follows: the step (E).fwdarw.the step
(F).fwdarw.the step (E), for example.
[0090] FIG. 12 illustrates a state where a thin-diameter endoscope
inserted into the endoscope channel in FIG. 2 is inserted into the
appendico.
[0091] As illustrated in FIG. 12, after a thin-diameter endoscope
40 is inserted into the appendico 19 in advance to observe the
inside of the appendico 19 in step (R) and the thin-diameter
endoscope 40 is extracted from the appendico 19 and the endoscope
1, cleaning of the inside of the appendico 19 in the step (F) or
the removal of the appendico mucus 64 in the step (F) may be
performed. Furthermore, before inserting the thin-diameter
endoscope 40 into the appendico 19 in the step (R), the positioning
of the endoscope 1 in the step (Q) may be performed.
[0092] The appendico 19 differs in the shape, the thickness, and
the length depending on a living body. Therefore, only the
observation of the appendico orifice 19i with the observation
portion 3 is not sufficient for accurately recognizing the shape
and the depth of the appendico 19. Using the thin-diameter
endoscope 40 makes it easier to perform the cleaning of the inside
of the appendico 19 in the step (E) and the removal of the
appendico mucus 64 in the step (F).
[0093] FIG. 6, and FIGS. 12 to 14 exemplify the flow of the step
(Q).fwdarw.the step (R).fwdarw.the step (O).fwdarw.the step
(F).fwdarw.the step (D)/(S). FIG. 13 illustrates a state where the
mucus removal fluffy tool is inserted from the endoscope channel
into the appendico, and FIG. 14 illustrates a state where the
probiotics is jetted (applied) to the appendico, with the position
of the endoscope fixed by inflating the balloon in FIG. 6.
(Step (G): With Regard to Dyeing of the Appendico Mucosa)
[0094] Before the removal of the appendico mucus 64 in the step (F)
illustrated in FIG. 13, dyeing of the appendico mucus 64 in step G
may be performed. Dyeing of the mucus 64 makes it easier to confirm
the thickness of the mucus 64 and the removed amount of the mucus
64.
[0095] The mucus dyeing agent is not specifically limited, but
includes Alcian blue, for example.
[0096] As the dyeing method of the appendico mucus 64, dyeing may
be performed with the mucus dyeing agent carried by the mucus
removal tool, or the mucus dyeing agent may be sprayed using the
channel of the mucus removal tool, the endoscope channel 2, and the
channel of the sheath.
SECOND MODIFIED EXAMPLE OF THE FIRST EMBODIMENT
[0097] In addition to a series of flow including the steps (A),
(B), (C), (D/S), and (M) in FIG. 1 according to the present
embodiment, the flow of step (P) may be performed. Or, at least one
of the steps (Q), (R), (E), or (F) shown in the first modified
example of the first embodiment may be performed.
(Step (P): With Regard to Capturing of the Probiotics in a
Protective Form)
[0098] In step (f) to be described later, the probiotics 100 in the
protective form, which have been orally ingested in advance and
reached inside the lumen, are captured with the endoscope 1, the
sheath of the endoscope, or the treatment instrument in the step
(R).
[0099] After that, the probiotics 100 is discharged from the
protective form of the probiotics, when the appendico orifice 19i
is recognized in the step (C), or the endo scope 1 or the like
contacts the appendico 19 in the step (O).
[0100] The method of capturing can be appropriately selected
depending on the tool to be used and the protective form. The
method includes a suction by bringing the channel into the negative
pressure state, or capturing with a grasping forceps, for
example.
[0101] The method of discharging can be appropriately selected
depending on the protective form. For example, the protective form
is a capsule and the probiotics is contained in the capsule, the
method of discharging the probiotics includes opening of the
capsule or dissolution of the capsule.
[0102] When the protective form is a tablet surface coating and the
probiotics is in the form of tablet, for example, the method of
discharging the probiotics includes dissolution or cutting of the
coating, or crushing of the tablet. When the protective form is a
bag, for example, the method of discharging the probiotics includes
dissolution, cutting, puncturing, or pressing of the bag.
Second Embodiment
[0103] As illustrated in FIG. 1, when the probiotics 100 is
supplied to the appendico 19, the procedure is performed as
follows: steps
(A).fwdarw.(B).fwdarw.(C).fwdarw.(O).fwdarw.(D)/(J).fwdarw.(M) in
the present embodiment.
[0104] Note that the steps (A), (B), (C), and (M) are the same as
those recited in the first embodiment.
(Step (O): With regard to contact with the appendico 19)
[0105] When a flexible endoscope is used, the distal end of the
endoscope 1 is brought into contact with the appendico orifice 19i
or the distal end of the endoscope 1 is inserted into the lumen of
the appendico 19.
[0106] When a treatment instrument is used, the distal end of the
treatment instrument is brought into contact with the appendico
orifice 19i, the distal end of the treatment instrument is inserted
into the lumen of the appendico 19, or the distal end of the
treatment instrument is separated and inserted into the lumen of
the appendico 19.
[0107] When a capsule endoscope is used, the surface of the capsule
endoscope is brought into contact with the appendico orifice 19i, a
part of the capsule endoscope is inserted into the lumen of the
appendico 19, or the entirety of the capsule endoscope is inserted
into the lumen of the appendico 19.
[0108] When the capsule endoscope is used, the capsule endoscope
may be indwelled inside the body to enable the probiotics to be
supplied periodically from the capsule endoscope for a
predetermined period.
(Step (J): With Regard to Introduction of the Probiotics 100 Into
the Mucus 64)
[0109] FIG. 15 illustrates the step (J) in FIG. 1, and FIG. 16
illustrates a configuration of the step (J) in FIG. 1, which is
different from the configuration illustrated in FIG. 15.
[0110] When the probiotics 100 is introduced into the mucus 64 on a
cross section of the appendico 19 including the mucus 64 and the
mucosa 63, the probiotics 100 may be introduced into the inside of
the outer mucus layer 61, may be introduced between the outer mucus
layer 61 and the inner mucus layer 62, may be introduced into the
inside of the inner mucus layer 62, or may be introduced between
the inner mucus layer 62 and the epithelial cells. Alternatively,
the introduction may be performed in combination of these.
[0111] Note that "introduction" in the present embodiment means
disposing the probiotics 100 directly on the mucus 64.
[0112] The probiotics 100 to be introduced is the same as described
above (Step (S): Jetting of the probiotics 100 toward the appendico
orifice 19i).
[0113] The treatment instrument for introducing the probiotics 100
into the mucus 64 can be appropriately selected depending on the
form of the probiotics 100 to be introduced and the introducing
position.
[0114] When a tubular treatment instrument 42 including inside
thereof a flow path 42k as illustrated in FIG. 15 is used, for
example, a hole 42h may be open on a side surface of the tube.
Forming the hole on the side surface of the tube makes it easier to
introduce the probiotics 100 into the mucus 64 located at the
position apart from the sensitive mucosa 63.
[0115] Thus, in the present embodiment, the probiotics 100 is
introduced into the mucus 64, which improves the colonization of
the probiotics 100 in the mucus 64.
FIRST MODIFIED EXAMPLE OF THE SECOND EMBODIMENT
[0116] In addition to the second embodiment, similarly as in the
first modified example of the first embodiment, at least one of the
steps (Q), (R), (E), or (F) may be performed.
[0117] When the step (F) is performed, as illustrated in FIG. 16, a
spoon-shaped treatment instrument 44 for removing the appendico
mucus, which is used in the step (F), is used, for example, and the
probiotics 100 may be introduced into the mucus 64 in the step
(J).
[0118] In this case, the treatment instrument for removing the
appendico mucus may include a channel for supplying the probiotics
or a structure for carrying the probiotics. Such a configuration
enables the number of inserting and extracting the treatment
instrument into and from the channel to be reduced.
[0119] FIG. 16 exemplifies the treatment instrument 44 for removing
the appendico mucus, as described above. The treatment instrument
44 includes, in the spoon, a flow path 44k and a hole 44h that are
used for supplying the probiotics.
SECOND MODIFIED EXAMPLE OF THE SECOND EMBODIMENT
[0120] Instead of the introduction of probiotics 100 into the mucus
64 in the step (J), introduction of the probiotics 100 into the
lumen of the appendico 19 in the step (K) or application of the
probiotics 100 to a removed part of the mucus 64 in the step (L)
may be performed as illustrated in FIG. 14. Alternatively, at least
two of the steps (J), (K), and (L) may be performed.
(Step (K): With Regard to Introduction of the Probiotics 100 Into
the Lumen of the Appendico 19)
[0121] FIG. 17 illustrates an example in which the probiotics is
supplied to the appendico through a catheter inserted into the
endoscope channel in FIG. 2.
[0122] When the probiotics 100 to be introduced is in a fluid form,
the introduction is performed toward the appendico orifice 19i in
the step (K) in the same way as the jetting of the probiotics in
the step (S).
[0123] Note that, when the endoscope 1 and the appendico 19 are
apart from each other, as illustrated in FIG. 17, the step (K) may
be performed with the distal end of the endoscope 1 being brought
into contact with the appendico 19 in the step (O).
[0124] An indwelling body for indwelling the probiotics 100 in the
appendico 19 may be used in combination with the endoscope 1.
[0125] The indwelling body may be a capsule containing the
probiotics 100, or a tablet made by solidifying the probiotics 100
by an excipient, or a thread, a sheet, a fluff, or a sponge, each
of which is impregnated with or containing the probiotics 100.
[0126] When the sheet containing the probiotics 100 is used, the
shape of the sheet may be flat or three-dimensional. FIG. 18
illustrates a funnel-shaped indwelling body, FIG. 19 illustrates a
tuft-like indwelling body, and FIG. 20 illustrates a thread-like
indwelling body. The three-dimensional sheet such as the
funnel-shaped indwelling body 17 as illustrated in FIG. 18, the
tuft-like indwelling body 72 as illustrated in FIG. 19, and the
string-like indwelling body 73 as illustrated in FIG. 20 may be
used.
[0127] The material of the indwelling body is not specifically
limited. However, the material is preferably decomposed or absorbed
in the body, or excreted outside the body, and the material
includes starch, collagen, mucin, bioabsorbable polymer, or human
hair, a botanical thread, or an animal thread, for example.
[0128] The botanical thread includes a cotton thread or a hemp
thread. The animal thread includes a silk thread, a wool thread, or
a spider's thread. The time until the indwelling body is
decomposed, the time until the indwelling body is absorbed in the
living body, and the time until the indwelling body is excreted
outside the body are appropriately determined.
[0129] When the thread, sheet, or fluff, each containing the
probiotics 100, is used, a part of the thread or the like may be
exposed to the intestinal cecum, the colon, or the ileum. FIGS. 18
to 20 exemplify the three-dimensional sheets exposed to the outside
the appendico.
[0130] When the capsule endoscope is used, a thread, a sheet, a
fluff, a sponge, a powder, or a gel, each of which contains the
probiotics, may be arranged on the outer surface of the capsule
endoscope.
(Step (L): With Regard to Application of the Probiotics 100 to the
Removed Part)
[0131] The method of removing the mucus 64 and the treatment
instrument for removing the mucus 64 are the same as recited in the
above-described step (F).
[0132] The treatment instrument for applying the probiotics 100 to
the part where the mucus 64 is removed may be any instrument as
long as the instrument can be impregnated with the probiotics 100.
For example, the treatment instrument includes a brush, a non-woven
cloth, a fluff, a sponge, or a solid substance including a surface
on which roughness is formed.
[0133] FIG. 21 illustrates a fluff impregnated with the probiotics
and a bar holding the fluff, as an example of a treatment
instrument to be used in the step (L) in FIG. 1. Specifically, a
treatment instrument 47 includes at the distal end thereof a fluff
and a fluff 47w, and includes inside thereof a conduit 47k for
supplying the probiotics 100 to the fluff and the fluff 47w.
[0134] The probiotics 100 may be impregnated to the fluff before
the treatment instrument is inserted into the endoscope channel 2,
or the bar is provided with a tube and a hole for supplying the
probiotics 100 in the liquid form. The bar can be combined with the
brush, the non-woven cloth, the sponge, and the solid
substance.
Third Embodiment
[0135] When the probiotics 100 is supplied to the appendico 19 as
illustrated in FIG. 1, the procedure is performed as follows: steps
(A).fwdarw.(B).fwdarw.(C).fwdarw.(O).fwdarw.(E).fwdarw.(M) in the
present embodiment.
[0136] The flow according to the present embodiment is a flow for
removing the bacteria harmful to a living body from the
appendico.
[0137] The steps (A), (B), (C), (O), (E), and (M) are the same as
those recited in the first and second embodiments and the modified
examples of the embodiments.
[0138] With also such a method, the same effects as those of the
first and second embodiments described above can be obtained.
MODIFIED EXAMPLE OF THE THIRD EMBODIMENT
[0139] Instead of the cleaning of the inside of the appendico 19 in
the step (E), the removal of the appendico mucus 64 in the step (F)
may be performed.
[0140] The removal of the appendico mucus 64 in the step (F) is the
same as described in the first modified example of the first
embodiment.
[0141] Both of the cleaning of the inside of the appendico 19 in
the step (E) and the removal of the appendico mucus 64 in the step
(F) may be performed.
[0142] The order of the steps in this case is not specifically
limited, but can be appropriately selected depending on the state
of the appendico of a patient. In addition, the number of times of
performing each of the steps is not limited, and at least one of
the steps (E) or (F) may be performed plural times in such an order
of (E).fwdarw.(F).fwdarw.(E), for example.
(Execution Scenes of the First to Third Embodiments)
[0143] The first to third embodiments may be performed singly, in
combination with an endoscopic examination, or in combination with
an endoscopic treatment such as polyp resection.
(Post-Treatment of the First to Third Embodiments)
[0144] (Step (H): With Regard to Warming of the Appendico from a
Body Surface and Step (I): Application of Vibration to the
Appendico from the Body Surface)
[0145] After the supply of the probiotics 100 to the appendico 19
in the step (D), the warming of the appendico 19 from the body
surface in the step (H) or the application of vibration to the
appendico 19 from the body surface in the step (I) may be
performed.
[0146] The step (H) or the step (I) may be performed before or
after the extraction of the endoscope 1 from the inside of the body
in step (M).
[0147] As the method of warming the appendico 19 from the body
surface in the step (H), a known method of warming the entirety or
a part of the body can be employed. For example, the known method
includes bathing, warming with a compress, a hot-water bottle, a
hot stone, far infrared irradiation, or hyperthermia.
[0148] As the method of vibrating the appendico 19 from the body
surface in the step (I), a known method can be employed. For
example, the known method includes hyperthermia, a massager, or a
jet bath.
[0149] There is a possibility that the probiotics 100 is diffused
in the appendico 19 or permeates in the mucus 64 by performing the
step (H) or the step (I).
(Step Z: Ingestion of Probiotics 100 or Probiotic Nourishment)
[0150] It is preferable to perform the step (Z): the ingestion of
the probiotics 100 after performing the step (M), (H), or (I).
[0151] Ingestion of the probiotics 100 in the state where the
existing number of the bacteria in the appendico 19 is decreased
will increase the possibility that flora formulated with the
probiotics 100 is formed in the appendico 19.
[0152] Note that the step (Z) may be performed orally or through a
suppository.
[0153] In the step (Z), the ingesting form of the probiotics 100
includes a powder including the probiotics 100, a tablet including
the probiotics 100, and a capsule containing the probiotics 100, or
a fluid including the probiotics 100. The fluid includes degassed
water, carbonic water, mucin, collagen, hyaluronic acid, yogurt,
milk, or a juice.
[0154] The nourishment of the probiotics 100 includes a chemical
compound such as ferrous sulfate, manganese sulphate, magnesium
sulfate, sodium acetate, ammonium citrate, potassium
dihydrogenphosphate, glucose, or tripton, or yeast, lactic acid
bacteria, butyrate-producing bacteria, Bifidobacteria, or the like.
When the yeast, lactic acid bacteria, butyrate-producing bacteria,
or Bifidobacteria is used, it is preferable to use dead bacteria,
or live bacteria weaker than the probiotics 100 which is desired to
be colonized in the appendico, or weakened live bacteria.
(Step (V): With Regard to Intestinal Environment Restoration
Process)
[0155] After the execution of the first to third embodiments, the
intestinal environment restoration treatment for restoring the
intestinal environment to the environment before the execution of
the first to third embodiments.
[0156] For example, as described later in the section of the
execution target of the present invention, it can be considered
that absorption rate of nutrition is increased in a healthy body to
withstand a harsh living environment, and thereafter in accordance
with a change in the living environment, the intestinal environment
restoration process in the step (V) is performed.
[0157] As a specific method of the intestinal environment
restoration process in the step (V) includes dietary restriction,
medicinal agent ingestion, intestine cleaning, or intestinal mucus
removal. These specific methods are the same as pre-treatment steps
(b), (c), (d), and (e) to be described later.
[0158] As another specific method of the intestinal environment
restoration process in the step (V) includes fecal transplantation
of intestinal substances of a near relative or a housemate of a
subject, or the intestinal substances of the subject himself or
herself collected before the execution of the first to third
embodiments. The fecal transplantation may be performed in
combination with the dietary restriction, the medicinal agent
ingestion, the intestine cleaning, or the intestinal mucus
removal.
(Pre-Treatment of the First to Third Embodiments)
(Step (a): With Regard to Appendico Forming)
[0159] A plastic surgery of appendico for forming the appendico 19
may be performed on a person whose appendico 19 has been removed
due to appendico hypoplasia or appendicitis or a person with
aging-related weakened immune system of the appendico 19, prior to
the execution of the first to third embodiments.
[0160] FIG. 22 illustrates a state where an incision is made on a
part of the intestinal cecum, and FIG. 23 illustrates forming of
the appendico by suturing the incision in FIG. 22.
[0161] The forming of the appendico may be performed by abdominal
operation or using a laparoscope.
[0162] The method of forming the appendico 19 is not specifically
limited, but as exemplified in FIGS. 21, 22, the method includes "a
method of forming the appendico 19' by making an incision 18c on a
part of the intestinal cecum 18 to suture the cut surface", "a
method of transplanting a diverticulum formed in the intestinal
tract", "a method of excising a part of the jejunum and closing one
end of the excised part and then transplanting the excised part to
the intestinal cecum", "a method of indwelling an appendico forming
instrument in the intestinal cecum 18 to make the appendico 19
gradually grow in the body", or "a method of transplanting the
intestine including at least the appendico 19". As the appendico
forming instrument, an instrument to be used in the tissue expander
method may be applied, for example.
[0163] In the method of making the incision 18c on a part of the
intestinal cecum 18 and suturing the cut surface 18n, or the method
of transplanting a part of the jejunum, the muscle layer may be
partially removed. In the case where suturing is performed in the
forming of the appendico, the suturing may be performed with a
needle and a thread, with a clip, with a stapler, or with heat
sealing, or suturing may be performed with a combination of heat
sealing and ultrasound vibration.
[0164] A flexible endoscope may be inserted into a body prior to
the forming of the appendico, to confirm the site suitable for
forming the appendico. In this case, locations where the Peyer's
patches are present in the intestine may be confirmed, for example,
and the site including a predetermined percentage of the Peyer's
patches may be a candidate for the site at which the appendico is
formed.
(Step (b): With Regard to Dietary Restriction)
[0165] The number of bacteria in the intestine may be decreased by
dietary restriction prior to the execution of the first to third
embodiments.
[0166] The period of the dietary restriction can be appropriately
set.
[0167] The dietary restriction may be performed by starvation,
restriction of caloric intake, or intake of food which is less
likely to be the nutrition for the bacteria.
(Step (c): With Regard to Medicinal Agent Ingestion)
[0168] Prior to the execution of the first to third embodiments,
ingestion of a medicinal agent for reducing the number of bacteria
in the intestine may be performed.
[0169] The medicinal agent inoculation may be performed by
hypodermic injection, oral ingestion, a suppository, or inhalation
through the bronchi.
[0170] The medicinal agent may be an antibiotic or allicin that
acts directly on the bacteria, or a purgative that acts on the
intestine.
(Step (d): With Regard to Intestinal Cleaning)
[0171] Prior to the execution of the first to third embodiments,
intestinal cleaning may be performed by introducing a liquid from
the anus 11.
[0172] The liquid to be used for the intestinal cleaning is not
specifically limited, but includes normal saline, oxygenated water,
or degassed water, for example. The liquid may include a medicinal
agent for reducing the number of bacteria in the intestine.
[0173] The intestinal cleaning may be performed by using a
plurality of kinds of liquids. For example, after the cleaning
using the liquid including the medicinal agent for reducing the
number of bacteria, rinsing and cleaning may be performed with
normal saline, for example.
(Step (e): With Regard to Intestinal Mucus Removal)
[0174] Prior to the execution of the first to third embodiments, at
least a part of the mucus of the large intestine 10 or the mucus of
the small intestine may be removed.
[0175] The removal of the appendico mucus in the step (H) is
diverted to the method of removing the mucus.
(Step (f): With Regard to Oral Ingestion of the Probiotics 100 in
Protective Form)
[0176] Prior to the execution of the first to third embodiments,
the probiotics 100 in a protective form may be orally ingested.
[0177] The protective form referred to here indicates protecting
and housing the probiotics 100 so as not to be killed by the
digestive juice until the probiotics 100 reaches the intestinal
tract.
[0178] The protective form includes, for example, a capsule, a
tablet coating, or a bag with which the probiotics 100 are
protected. With regard to the probiotics 100 referred to here, the
ingestion of the probiotics 100 in the above-described step (Z) can
be diverted.
[0179] The timing of the oral ingestion of the probiotics 100 in
the protective form is not specifically limited, and the timing of
the oral ingestion is any timing as long as the probiotics 100 in
the protective form reaches the intestinal tract when the procedure
using the endoscope 1 is performed. The timing of the oral
ingestion can be appropriately selected depending on the protective
form, the body condition, the body size, the age, the type of
procedure, the timing of performing the procedure, or the like.
[0180] The ingestion quantity and the number of ingestions of the
probiotics 100 in the protective form are not specifically limited,
but can be appropriately selected depending on the protective form,
the body condition, the body size, the age, the type of procedure,
the timing of performing the procedure, or the like.
[0181] The above-described steps (b), (c), (d), (e), and (f) may be
performed in combination.
(Other Pre-Treatment)
[0182] Prior to the execution of the first to third embodiments,
indigenous bacteria in the intestine may be collected, cultured,
and analyzed. Based on the result of the analysis, insufficient
bacteria or bacteria that are good match with the indigenous
bacteria may be selected, and the selected bacteria may be used as
the probiotics in the present invention.
(With Regard to Execution Target of the Present Invention)
[0183] The flora treatment according to the present invention is
applicable to all ages, but the age of the appendico 19 is
preferably under 30 years.
[0184] Since fibrosis has not progressed in the appendico 19 under
30 years, and lymphocytes in the appendico 19 are active, the
treatment is likely to take effect. In addition, the age of the
intestinal tract including the appendico 19 is 10 years or
older.
[0185] The intestinal tract of 10 years or older has a sufficient
tissue strength, which makes it easier for endoscope 1 to reach the
intestinal cecum 18.
[0186] The present invention can be applied to allergy treatment.
The allergy includes a hay fever, an atopic dermatitis, an animal
allergy, a food allergy, a sick house syndrome, an ulcerative
enteritis, or a Crohn disease.
[0187] The present invention can be applied to treatment of
drug-induced enterocolitis. In addition, the present invention can
be applied to immunity reinforcement before endoscopic examination
and endoscopic treatment.
[0188] The present invention can be applied to health care. The
health care includes an obesity treatment, cholesterol lowering, or
metabolic rate enhancement.
[0189] The present invention can be applied to an inborn error of
metabolism. Furthermore, the present invention can be applied to
malabsorption syndrome treatment, improvement of absorption rate of
nutrition in a healthy body. The malabsorption syndrome includes a
postgastrectomy syndrome, a short bowel syndrome, a celiac disease,
or an amyloidosis.
[0190] The present invention can be applied to enhancement of the
absorption rate of nutrition in a healthy body. People having
healthy body that requires such treatment includes people withstand
harsh living environments such as athletes, alpinists, or people in
military service.
[0191] Note that the present invention is not limited only to the
above-described embodiments and modified examples of each of the
embodiments, but various modifications can be made within a range
without departing from the gist of the invention.
[0192] Having described the preferred embodiments of the invention
referring to the accompanying drawings, it should be understood
that the present invention is not limited to those precise
embodiments and various changes and modifications thereof could be
made by one skilled in the art without departing from the spirit or
scope of the invention as defined in the appended claims.
* * * * *