The number of patients with nonalcoholic fatty liver diseases(NAFLD) including nonalcoholic steatohepatitis(NASH), has been increasing. NASH causes cirrhosis and hepatocellular carcinoma(HCC) and is one of the most se...The number of patients with nonalcoholic fatty liver diseases(NAFLD) including nonalcoholic steatohepatitis(NASH), has been increasing. NASH causes cirrhosis and hepatocellular carcinoma(HCC) and is one of the most serious health problems in the world. The mechanism through which NASH progresses is still largely unknown. Activation of caspases, Bcl-2 family proteins, and c-Jun N-terminal kinase-induced hepatocyte apoptosis plays a role in the activation of NAFLD/NASH. Apoptotic hepatocytes stimulate immune cells and hepatic stellate cells toward the progression of fibrosis in the liver through the production of inflammasomes and cytokines. Abnormalities in glucose and lipid metabolism as well as microbiota accelerate these processes. The production of reactive oxygen species, oxidative stress, and endoplasmic reticulum stress is also involved. Cell death, including apoptosis, seems very important in the progression of NAFLD and NASH. Recently, inhibitors of apoptosis have been developed as drugs for the treatment of NASH and may prevent cirrhosis and HCC. Increased hepatocyte apoptosis may distinguish NASH from NAFLD, and the improvement of apoptosis could play a role in controlling the development of NASH. In this review, the association between apoptosis and NAFLD/NASH are discussed. This review could provide their knowledge, which plays a role in seeing the patients with NAFLD/NASH in daily clinical practice.展开更多
AIM： To clarify the risk factors for bleeding after endoscopic mucosal resection （EMR）. METHODS： A total of 297 consecutive patients who underwent EMR were enrolled. Some of the patients had multiple lesions. Blee...AIM： To clarify the risk factors for bleeding after endoscopic mucosal resection （EMR）. METHODS： A total of 297 consecutive patients who underwent EMR were enrolled. Some of the patients had multiple lesions. Bleeding requiring endoscopic treatment was defined as bleeding after EMR. Odds ratios （OR） with 95% confidence intervals （CI）, calculated by logistic regression with multivariate adjustments for covariates, were the measures of association. RESULTS： Of the 297 patients, 57 （19.2%） patients with bleeding after EMR were confirmed. With multivariate adjustment, the cutting method of EMR, diameter, and endoscopic pattern of the tumor were associated with the risk of bleeding after EMR. The multivariate-adjusted OR for bleeding after EMR using endoscopic aspiration mucosectomy was 3.07 （95%CI, 1.59-5.92） compared with strip biopsy. The multiple-adjusted OR for bleeding after EMR for the highest quartile （16-50 mm） of tumor diameter was 5.63 （95%CI, 1.84-17.23） compared with that for the lowest （4-7 mm）. The multiple-adjusted OR for bleeding after EMR for depressed type of tumor was 4.21 （95%CI, 1.75-10.10） compared with elevated type. CONCLUSION： It is important to take tumor charactedstics （tumor size and endoscopic pattern） and cutting method of EMR into consideration in predicting bleeding after EMR.展开更多
AIM: To investigate an association between N -acetyltransferase 2 (NAT2 )-haplotypes/diplotypes and adverse effects in Japanese pulmonary tuberculosis patients. METHODS: We studied 100 patients with pulmonary TB treat...AIM: To investigate an association between N -acetyltransferase 2 (NAT2 )-haplotypes/diplotypes and adverse effects in Japanese pulmonary tuberculosis patients. METHODS: We studied 100 patients with pulmonary TB treated with anti-TB drugs including INH. The frequencies and distributions of single nucleotide polymorphisms, haplotypes, and diplotypes of NAT2 were determined by the PCR-restriction fragment length polymorphism method, and the results were compared between TB patients with and without adverse effect, using multivariate logistic regression analysis.RESULTS: Statistical analysis revealed that the frequency of a variant haplotype, NAT2*6A , was signifi cantly increased in TB patients with hepatotoxicity, compared with those without hepatotoxicity [P = 0.001, odds ratio (OR) = 3.535]. By contrast, the frequency of a wild-type (major) haplotype, "NAT2*4", was signif icantly lower in TB patients with hepatotoxicity than those without hepatotoxicity (P < 0.001, OR = 0.265). There was no association between NAT2-haplotypes and skin rash or eosinophilia. CONCLUSION: The present study shows that NAT2 is one of the determinants of anti-TB drug-induced hepatotoxicity. Moreover, the haplotypes, NAT2*4 and NAT2*6A, are useful new biomarkers for predicting anti- TB drug-induced hepatotoxicity.展开更多
Due to the limitations in autogenous nerve grafting or Schwann cell transplantation,large gap peripheral nerve injuries require a bridging strategy supported by nerve conduit.Cell based therapies provide a novel treat...Due to the limitations in autogenous nerve grafting or Schwann cell transplantation,large gap peripheral nerve injuries require a bridging strategy supported by nerve conduit.Cell based therapies provide a novel treatment for peripheral nerve injuries.In this study,we first experimented an optimal scaffold material synthesis protocol,from where we selected the 10%GFD formula(10%GelMA hydrogel,recombinant human basic fibroblast growth factor and dental pulp stem cells(DPSCs))to fill a cellulose/soy protein isolate composite membrane(CSM)tube to construct a third generation of nerve regeneration conduit,CSM-GFD.Then this CSM-GFD conduit was applied to repair a 15-mm long defect of sciatic nerve in a rat model.After 12 week post implant surgery,at histologic level,we found CSM-GFD conduit could regenerate nerve tissue like neuron and Schwann like nerve cells and myelinated nerve fibers.At physical level,CSM-GFD achieved functional recovery assessed by a sciatic functional index study.In both levels,CSM-GFD performed like what gold standard,the nerve autograft,could do.Further,we unveiled that almost all newly formed nerve tissue at defect site was originated from the direct differentiation of exogeneous DPSCs in CSM-GFD.In conclusion,we claimed that this third-generation nerve regeneration conduit,CSM-GFD,could be a promising tissue engineering approach to replace the conventional nerve autograft to treat the large gap defect in peripheral nerve injuries.展开更多
Plant metabolomics developed as a powerful tool to examine gene functions and to gain deeper insight into the physiology of the plant cell. In this study, we screened Arabidopsis lines overexpressing rice full-length ...Plant metabolomics developed as a powerful tool to examine gene functions and to gain deeper insight into the physiology of the plant cell. In this study, we screened Arabidopsis lines overexpressing rice full-length （FL） cDNAs （rice FOX Arabidopsis lines） using a gas chromatography-time-of-flight mass spectrometry （GC-TOF/MS）-based technique to identify rice genes that caused metabolic changes. This screening system allows fast and reliable identification of candi- date lines showing altered metabolite profiles. We performed metabolomic and transcriptomic analysis of a rice FOX Ara- bidopsis line that harbored the FL cDNA of the rice ortholog of the Lateral Organ Boundaries （LOB） Domain （LBD）/ Asymmetric Leaves2-1ike （ASL） gene of Arabidopsis, At-LBD37/ASL39. The investigated rice FOX Arabidopsis line showed prominent changes in the levels of metabolites related to nitrogen metabolism. The transcriptomic data as well as the results from the metabolite analysis of the Arabidopsis At-LBD37/ASL39-overexpressor plants were consistent with these findings. Furthermore, the metabolomic and transcriptomic analysis of the Os-LBD37/ASL39-overexpressing rice plants indicated that Os-LBD37/ASL39 is associated with processes related to nitrogen metabolism in rice. Thus, the combination of a metabolomics-based screening method and a gain-of-function approach is useful for rapid characterization of novel genes in both Arabidopsis and rice.展开更多
A 58-year-old Japanese man had tarry stool and severe anemia. Neither upper nor lower gastrointestinal （GI） endoscopy showed any localized lesions. Thus, the source of his GI bleeding was suspected to be in the smal...A 58-year-old Japanese man had tarry stool and severe anemia. Neither upper nor lower gastrointestinal （GI） endoscopy showed any localized lesions. Thus, the source of his GI bleeding was suspected to be in the small intestine, and he underwent peroral double-balloon enteroscopy （DBE） using EN-450T5 （Fujinon-Toshiba ES System Co., Tokyo, Japan）. There were no lesions considered to be the source of GI bleeding. After the procedure, the patient began to experience abdominal pain. Laboratory tests revealed hyperamylasemia and abdominal computed tomography revealed an inflammation of the pancreas and the peripancreas. He was thus diagnosed to have acute pancreatitis. Conservative treatments resulted in both clinical and laboratory amelioration. He had no history of alcohol ingestion, gallstone disease or pancreatitis. Magnetic resonance cholangiopancreatography demonstrated no structural alterations and no stones in the pancreatobiliary ductal system. As his abdominal pain started after the procedure, his acute pancreatitis was thus thought to have been related to the peroral DBE. This is the first reported case of acute pancreatitis probably associated with peroral DBE.展开更多
Approximately 80%-95%of gastrointestinal stromal tumors(GISTs)show positive staining for KIT,while the other 5%-20%show negative staining.If the tumor is negative for KIT,but is positive for CD34,a histological diagno...Approximately 80%-95%of gastrointestinal stromal tumors(GISTs)show positive staining for KIT,while the other 5%-20%show negative staining.If the tumor is negative for KIT,but is positive for CD34,a histological diagnosis is possible.However,if the tumor is negative for KIT,CD34,S-100,and SMA,a definitive diagnosis is often challenging.Recently,Discovered on GIST-1(DOG1)has received considerable attention as a useful molecule for the diagnosis of GIST.DOG1,a membrane channel protein,is known to be overexpressed in GIST.Because the sensitivity and specificity of DOG1 are higher than those of KIT,positive staining for DOG1has been reported,even in KIT-negative GISTs.KITnegative GISTs most commonly arise in the stomach and are mainly characterized by epithelioid features histologically.We describe our experience with a rare case of a KIT-negative GIST of the stomach that was diagnosed by positive immunohistochemical staining for DOG1 in a patient who presented with severe anemia.Our findings suggest that immunohistochemical staining for DOG1,in addition to gene analysis,is useful for the diagnosis of KIT-negative tumors that are suspected to be GISTs.展开更多
AIM:To evaluate the effectiveness of our proposed bowel preparation method for colon capsule endoscopy.METHODS:A pilot,multicenter,randomized controlled trial compared our proposed "reduced volume method"(gr...AIM:To evaluate the effectiveness of our proposed bowel preparation method for colon capsule endoscopy.METHODS:A pilot,multicenter,randomized controlled trial compared our proposed "reduced volume method"(group A) with the "conventional volume method"(group B) preparation regimens.Group A did not drink polyethylene glycol electrolyte lavage solution(PEGELS) the day before the capsule procedure,while group B drank 2 L.During the procedure day,groups A and B drank 2 L and 1 L of PEG-ELS,respectively,and swallowed the colon capsule(PillCam COLON capsule).Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups,and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that time.Capsule videos were reviewed for grading of cleansing level,RESULTS:Sixty-four subjects were enrolled,with results from 60 analyzed.Groups A and B included 31 and 29 subjects,respectively.Twenty-nine(94%) subjects in group A and 25(86%) subjects in group B had adequate bowel preparation(ns).Twenty-two(71%) of the 31 subjects in group A excreted the capsule within its battery life compared to 16(55%) of the 29 subjects in group B(ns).Of the remaining 22 subjects whose capsules were not excreted within the battery life,all of the capsules reached the left side colon before they stopped functioning.A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS,due to ingesting the PEG-ELS faster than recommended.CONCLUSION:Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method.展开更多
AIM: To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy. METHODS: Between Septem...AIM: To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy. METHODS: Between September 2006 and April 2011, 47 procedures of DB-ERCP were performed in 28 patients with a Roux-en-Y total gastrectomy (n = 11), Billroth Ⅱ gastrectomy (n = 15), or Roux-en-Y anastomosis with hepaticojejunostomy (n = 2). DB-ERCP was performed using a short-type DBE combined with several technical innovations such as using an endoscope attachment, marking by submucosal tattooing,selectively applying contrast medium, and CO2 insufflations. RESULTS: The papilla of Vater or hepaticojejunostomy site was reached in its entirety with a 96% success rate (45/47 procedures). There were no significant differences in the success rate of reaching the blind end with a DBE among Roux-en-Y total gastrectomy (96%), Billroth Ⅱ reconstruction (94%), or pancreatoduodenectomy (100%), respectively (P = 0.91). The total successful rate of cannulation and contrast enhancement of the target bile duct in patients whom the blind end was reached with a DBE was 40/45 procedures (89%). Again, there were no significant differences in the success rate of cannulation and contrast enhancement of the target bile duct with a DBE among Roux-en-Y total gastrectomy (88 %), Billroth Ⅱ reconstruction (89%), or pancreatoduodenectomy (100%), respectively (P = 0.67). Treatment was achieved in all 40 procedures (100%) in patients whom the contrast enhancement of the bile duct was successful. Common endoscopic treatments were endoscopic biliary drainage (24 procedures) and extraction of stones (14 procedures). Biliary drainage was done by placement of plastic stents. Stones extraction was done by lithotomy with the mechanical lithotripter followed by extraction with a basket or by the balloon pull-through method. Endoscopic sphincterotomy was performed in 14 procedures with a needle precutting knife using a guidewire. The mean total duration o展开更多
In this study, the temporal structure of the variation of North Atlantic Oscillation （NAO） and its impact on regional climate variability are analyzed using various datasets. The results show that blocking formation...In this study, the temporal structure of the variation of North Atlantic Oscillation （NAO） and its impact on regional climate variability are analyzed using various datasets. The results show that blocking formations in the Atlantic region are sensitive to the phase of the NAO. Sixty-seven percent more winter blocking days are observed during the negative phase compared to the positive phase of the NAO. The average length of blocking during the negative phase is about 11 days, which is nearly twice as long as the 6-day length observed during the positive phase of the NAO. The NAO-related differences in blocking frequency and persistence are associated with changes in the distribution of the surface air temperature anomaly, which, to a large extent, is determined by the phase of the NAO. The distribution of regional cloud amount is also sensitive to the phase of the NAO. For the negative phase, the cloud amounts are significant, positive anomalies in the convective zone in the Tropics and much less cloudiness in the mid latitudes. But for the positive phase of the NAO, the cloud amount is much higher in the mid-latitude storm track region. In the whole Atlantic region, the cloud amount shows a decrease with the increase of surface air temperature. These results suggest that there may be a negative feedback between the cloud amount and the surface air t.emperature in the Atlantic region.展开更多
Attention constitutes a fundamental psychological feature guiding our mental effort toward specific objects, concurrent with processes such as memory, reasoning, and imagination. Visual attention, crucial for selectin...Attention constitutes a fundamental psychological feature guiding our mental effort toward specific objects, concurrent with processes such as memory, reasoning, and imagination. Visual attention, crucial for selecting surrounding information, often decreases in older adults and patients with cerebrovascular disorders. Effective methods to enhance attention are scarce. Here, we investigated whether color information influences visual attention and brain activity during task performance, utilizing EEG. We examined 13 healthy young adults (seven women and six men;mean age: 21.2 ± 0.58 years) using 19-electrode electroencephalograms to assess the impact of color information on visual attention. The Clinical Assessment for Attention cancellation test was conducted under the black, red, and blue color conditions. Wilcoxon’s signed-rank test was used to assess differences in task performance (task time and error) between conditions. Spearman’s rank correlation was utilized to examine the correlation in power levels between task performance and color conditions. Significant variations in total task errors were observed among color conditions. The black condition exhibited the highest error frequency (0.7 ± 0.9 times), followed by the red condition (0.5 ± 0.8 times), with the lowest error frequency occurring in the blue (0.2 ± 0.4 times) condition (black vs. red: P = 0.03;black vs. blue: P = 0.00;red vs. blue: P = 0.032). No time difference was observed. The black condition showed negative delta and high-gamma correlations in the central electrodes. The red condition revealed positive alpha and low-gamma correlations in the frontal and occipital areas. Although no correlations were observed in the blue condition, it enhanced attentional performance. Positive alpha and low-gamma waves might be crucial for spotting attentional errors in key areas. Our findings provide insights into the effects of color information on visual attention and potential neural correlates associated with attentional processes. In conclusi展开更多
Introduction: Computed tomography (CT) measurements of bone mineral attenuation may be a useful means to identify older women who should be prioritized for bone mineral density screening. Methods: We compared bone min...Introduction: Computed tomography (CT) measurements of bone mineral attenuation may be a useful means to identify older women who should be prioritized for bone mineral density screening. Methods: We compared bone mineral attenuation as measured in the L1 vertebra of CT studies to the results of dual-energy x-ray absorptiometry (DEXA) studies to determine what CT attenuation thresholds might yield a reasonable combination of sensitivity and specificity for the detection of osteoporosis. The study was limited to women between the ages of 65 and 75 years who had a DEXA study and a CT that included the L1 or adjacent vertebra performed within 3 years of the DEXA study. Results: There were 1226 women in this study, of whom 452 (38%) had osteoporosis based on a T-score ≤ −2.5 by DEXA. There were 830 CT studies performed with contrast and 396 studies which were performed without contrast. There was a statistically significant difference in the mean HU of those studies performed without contrast compared to those with contrast (unenhanced mean 103 HU versus 125 HU, p < 0.001). Different CT attenuation thresholds provided the most appropriate combination of sensitivity and specificity for the detection of osteoporosis when comparing CT studies performed without or with IV contrast and when all the CT data were used in aggregate. Conclusion: Different thresholds appear necessary when using the mean CT vertebral attenuation to identify older women for preferential referral for DEXA studies.展开更多
Attentional issues may affect acquiring new information, task performance, and learning. Cortical network activities change during different functional brain states, including the default mode network (DMN) and attent...Attentional issues may affect acquiring new information, task performance, and learning. Cortical network activities change during different functional brain states, including the default mode network (DMN) and attention network. We investigated the neural mechanisms underlying attentional functions and correlations between DMN connectivity and attentional function using the Trail-Making Test (TMT)-A and -B. Electroencephalography recordings were performed by placing 19 scalp electrodes per the 10 - 20 system. The mean power level was calculated for each rest and task condition. Non-parametric Spearman’s rank correlation was used to examine the correlation in power levels between the rest and TMT conditions. The most significant correlations during TMT-A were observed in the high gamma wave, followed by theta and beta waves, indicating that most correlations were in the parietal lobe, followed by the frontal, central, and temporal lobes. The most significant correlations during TMT-B were observed in the beta wave, followed by the high and low gamma waves, indicating that most correlations were in the temporal lobe, followed by the parietal, frontal, and central lobes. Frontoparietal beta and gamma waves in the DMN may represent attentional functions.展开更多
AIM: To evaluate the 5-lipoxygenases (Loxs) expression level in human colorectal cancer specimens in order to determine its clinicopathologic significance in human tumorigenesis. METHODS: The relative quantity of 5-Lo...AIM: To evaluate the 5-lipoxygenases (Loxs) expression level in human colorectal cancer specimens in order to determine its clinicopathologic significance in human tumorigenesis. METHODS: The relative quantity of 5-Lox mRNA in paired 91 colorectal tumor and adjacent normal mucosa samples was determined by real time quantitative PCR. Additionally, the expression of 5-Lox and cyclooxygenase (Cox)-2 proteins was also examined using immunohistochemical staining methods. RESULTS: There was a marked increase in 5-Lox mRNA levels in the tumor compared with paired normal mucosa samples (P < 0.0001). Sixty six (72.5%) tumors showed high 5-Lox mRNA levels. The positivity rate of 5-Lox and Cox-2 protein expression was 68.7% and 79.1% respectively. There was a significant association between tumoral 5-Lox mRNA level and tumor size (Rho = 0.392, P = 0.0002), depth or vessel invasion. CONCLUSION: These results suggest that 5-Lox is up-regulated in colorectal cancer and that inhibition of its expression might be valuable in the prevention and treatment of colorectal cancer.展开更多
The Alkyl Polyglucoside（APG） is a nonionic surfactant with no toxicity and with high biodegradability, its drag-reduction behavior in a circular pipe flow is measured, and the rheological characteristics are investi...The Alkyl Polyglucoside（APG） is a nonionic surfactant with no toxicity and with high biodegradability, its drag-reduction behavior in a circular pipe flow is measured, and the rheological characteristics are investigated with a rheometer with a cone-plate flow cell. From the measured results, the APG is shown to have a high drag-reduction capacity, whose shear viscosity is shear-ratedependent at high concentrations, while its solution at concentrations with drag-reduction effects is non-viscoelastic as verified by zero relaxation time in the relaxation process of the shear stress, which contradicts the general viewpoint that there is a correlation between the viscoselastic characteristics and the turbulent drag reduction for the drag-reduction surfactant. However, the APG solution is birefringent as observed through a birefringent test, which indicates that there are rod-shaped micelles in the solution under the shearing flow. The higher extensional viscosity inferred from the extensional phenomenon observed in the measurements of the shear viscosity could be responsible for the drag reduction property of this nonionic surfactant.展开更多
AIM: To evaluate the usefulness and safety of argon plasma coagulation (APC) for superficial esophageal squamous-cell carcinoma (SESC) in high-risk patients. METHODS: We studied 17 patients (15 men and 2 women, 21 les...AIM: To evaluate the usefulness and safety of argon plasma coagulation (APC) for superficial esophageal squamous-cell carcinoma (SESC) in high-risk patients. METHODS: We studied 17 patients (15 men and 2 women, 21 lesions) with SESC in whom endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and open surgery were contraindicated from March 1999 through February 2009. None of the patients could tolerate prolonged EMR/ESD or open surgery because of severe concomitant disease (e.g., liver cirrhosis, cerebral infarction, or ischemic heart disease) or scar formation after EMR/ESD and chemoradiotherapy. After conventional endoscopy, an iodine stain was sprayed on the esophageal mucosa to determine the lesion margins. The lesion was then ablated by APC. We retrospectively studied the treatment time, number of APC sessions per site, complications, presence or absence of recurrence, and time to recurrence.RESULTS: The median duration of follow-up was 36 mo (range: 6-120 mo). All of the tumors were macroscopically classified as superficial and slightly depressed type (0-Ⅱc). The preoperative depth of invasion was clinical T1a (mucosal cancer) for 19 lesions and clinical T1b (submucosal cancer) for 2. The median treatment time was 15 min (range: 10-36 min). The median number of treatment sessions per site was 2 (range: 1-4). The median hospital stay was 14 d (range: 5-68 d). Among the 17 patients (21 lesions), 2 (9.5%) had recurrence and underwent additional APC with no subsequent evidence of recurrence. There were no treatment-related complications, such as bleeding or perforation. CONCLUSION: APC is considered to be safe and effective for the management of SESC that cannot be resected endoscopically because of underlying disease, as well as for the control of recurrence after EMR and local recurrence after chemoradiotherapy.展开更多
文摘The number of patients with nonalcoholic fatty liver diseases(NAFLD) including nonalcoholic steatohepatitis(NASH), has been increasing. NASH causes cirrhosis and hepatocellular carcinoma(HCC) and is one of the most serious health problems in the world. The mechanism through which NASH progresses is still largely unknown. Activation of caspases, Bcl-2 family proteins, and c-Jun N-terminal kinase-induced hepatocyte apoptosis plays a role in the activation of NAFLD/NASH. Apoptotic hepatocytes stimulate immune cells and hepatic stellate cells toward the progression of fibrosis in the liver through the production of inflammasomes and cytokines. Abnormalities in glucose and lipid metabolism as well as microbiota accelerate these processes. The production of reactive oxygen species, oxidative stress, and endoplasmic reticulum stress is also involved. Cell death, including apoptosis, seems very important in the progression of NAFLD and NASH. Recently, inhibitors of apoptosis have been developed as drugs for the treatment of NASH and may prevent cirrhosis and HCC. Increased hepatocyte apoptosis may distinguish NASH from NAFLD, and the improvement of apoptosis could play a role in controlling the development of NASH. In this review, the association between apoptosis and NAFLD/NASH are discussed. This review could provide their knowledge, which plays a role in seeing the patients with NAFLD/NASH in daily clinical practice.
文摘AIM： To clarify the risk factors for bleeding after endoscopic mucosal resection （EMR）. METHODS： A total of 297 consecutive patients who underwent EMR were enrolled. Some of the patients had multiple lesions. Bleeding requiring endoscopic treatment was defined as bleeding after EMR. Odds ratios （OR） with 95% confidence intervals （CI）, calculated by logistic regression with multivariate adjustments for covariates, were the measures of association. RESULTS： Of the 297 patients, 57 （19.2%） patients with bleeding after EMR were confirmed. With multivariate adjustment, the cutting method of EMR, diameter, and endoscopic pattern of the tumor were associated with the risk of bleeding after EMR. The multivariate-adjusted OR for bleeding after EMR using endoscopic aspiration mucosectomy was 3.07 （95%CI, 1.59-5.92） compared with strip biopsy. The multiple-adjusted OR for bleeding after EMR for the highest quartile （16-50 mm） of tumor diameter was 5.63 （95%CI, 1.84-17.23） compared with that for the lowest （4-7 mm）. The multiple-adjusted OR for bleeding after EMR for depressed type of tumor was 4.21 （95%CI, 1.75-10.10） compared with elevated type. CONCLUSION： It is important to take tumor charactedstics （tumor size and endoscopic pattern） and cutting method of EMR into consideration in predicting bleeding after EMR.
基金by Grant-in-Aid for Scientif ic Research (Category B, No. 18390168) for K Tsukamoto by the Ministry of Education, Culture, Sports, Science and Technology of Japan
文摘AIM: To investigate an association between N -acetyltransferase 2 (NAT2 )-haplotypes/diplotypes and adverse effects in Japanese pulmonary tuberculosis patients. METHODS: We studied 100 patients with pulmonary TB treated with anti-TB drugs including INH. The frequencies and distributions of single nucleotide polymorphisms, haplotypes, and diplotypes of NAT2 were determined by the PCR-restriction fragment length polymorphism method, and the results were compared between TB patients with and without adverse effect, using multivariate logistic regression analysis.RESULTS: Statistical analysis revealed that the frequency of a variant haplotype, NAT2*6A , was signifi cantly increased in TB patients with hepatotoxicity, compared with those without hepatotoxicity [P = 0.001, odds ratio (OR) = 3.535]. By contrast, the frequency of a wild-type (major) haplotype, "NAT2*4", was signif icantly lower in TB patients with hepatotoxicity than those without hepatotoxicity (P < 0.001, OR = 0.265). There was no association between NAT2-haplotypes and skin rash or eosinophilia. CONCLUSION: The present study shows that NAT2 is one of the determinants of anti-TB drug-induced hepatotoxicity. Moreover, the haplotypes, NAT2*4 and NAT2*6A, are useful new biomarkers for predicting anti- TB drug-induced hepatotoxicity.
基金supported by the National Natural Science Funding of China(81701032,81871503)the Wenzhou Science and Technology Association Project,the Wenzhou Major Scientific and Technological Innovation Key Medical and Health Project(ZY2019010)+4 种基金the Wenzhou Medical University grant(QTJ16026)Wenzhou Science and Technology Association Project,Wenzhou Basic Research Project(Y20180131)Zhejiang Province Program of the Medical and Health Science and Technology(2018KY537)Zhejiang Natural Science Foundation(LGF18C100002)Zhejiang Xinmiao Talents Program(2018R413186).
文摘Due to the limitations in autogenous nerve grafting or Schwann cell transplantation,large gap peripheral nerve injuries require a bridging strategy supported by nerve conduit.Cell based therapies provide a novel treatment for peripheral nerve injuries.In this study,we first experimented an optimal scaffold material synthesis protocol,from where we selected the 10%GFD formula(10%GelMA hydrogel,recombinant human basic fibroblast growth factor and dental pulp stem cells(DPSCs))to fill a cellulose/soy protein isolate composite membrane(CSM)tube to construct a third generation of nerve regeneration conduit,CSM-GFD.Then this CSM-GFD conduit was applied to repair a 15-mm long defect of sciatic nerve in a rat model.After 12 week post implant surgery,at histologic level,we found CSM-GFD conduit could regenerate nerve tissue like neuron and Schwann like nerve cells and myelinated nerve fibers.At physical level,CSM-GFD achieved functional recovery assessed by a sciatic functional index study.In both levels,CSM-GFD performed like what gold standard,the nerve autograft,could do.Further,we unveiled that almost all newly formed nerve tissue at defect site was originated from the direct differentiation of exogeneous DPSCs in CSM-GFD.In conclusion,we claimed that this third-generation nerve regeneration conduit,CSM-GFD,could be a promising tissue engineering approach to replace the conventional nerve autograft to treat the large gap defect in peripheral nerve injuries.
文摘Plant metabolomics developed as a powerful tool to examine gene functions and to gain deeper insight into the physiology of the plant cell. In this study, we screened Arabidopsis lines overexpressing rice full-length （FL） cDNAs （rice FOX Arabidopsis lines） using a gas chromatography-time-of-flight mass spectrometry （GC-TOF/MS）-based technique to identify rice genes that caused metabolic changes. This screening system allows fast and reliable identification of candi- date lines showing altered metabolite profiles. We performed metabolomic and transcriptomic analysis of a rice FOX Ara- bidopsis line that harbored the FL cDNA of the rice ortholog of the Lateral Organ Boundaries （LOB） Domain （LBD）/ Asymmetric Leaves2-1ike （ASL） gene of Arabidopsis, At-LBD37/ASL39. The investigated rice FOX Arabidopsis line showed prominent changes in the levels of metabolites related to nitrogen metabolism. The transcriptomic data as well as the results from the metabolite analysis of the Arabidopsis At-LBD37/ASL39-overexpressor plants were consistent with these findings. Furthermore, the metabolomic and transcriptomic analysis of the Os-LBD37/ASL39-overexpressing rice plants indicated that Os-LBD37/ASL39 is associated with processes related to nitrogen metabolism in rice. Thus, the combination of a metabolomics-based screening method and a gain-of-function approach is useful for rapid characterization of novel genes in both Arabidopsis and rice.
文摘A 58-year-old Japanese man had tarry stool and severe anemia. Neither upper nor lower gastrointestinal （GI） endoscopy showed any localized lesions. Thus, the source of his GI bleeding was suspected to be in the small intestine, and he underwent peroral double-balloon enteroscopy （DBE） using EN-450T5 （Fujinon-Toshiba ES System Co., Tokyo, Japan）. There were no lesions considered to be the source of GI bleeding. After the procedure, the patient began to experience abdominal pain. Laboratory tests revealed hyperamylasemia and abdominal computed tomography revealed an inflammation of the pancreas and the peripancreas. He was thus diagnosed to have acute pancreatitis. Conservative treatments resulted in both clinical and laboratory amelioration. He had no history of alcohol ingestion, gallstone disease or pancreatitis. Magnetic resonance cholangiopancreatography demonstrated no structural alterations and no stones in the pancreatobiliary ductal system. As his abdominal pain started after the procedure, his acute pancreatitis was thus thought to have been related to the peroral DBE. This is the first reported case of acute pancreatitis probably associated with peroral DBE.
文摘Approximately 80%-95%of gastrointestinal stromal tumors(GISTs)show positive staining for KIT,while the other 5%-20%show negative staining.If the tumor is negative for KIT,but is positive for CD34,a histological diagnosis is possible.However,if the tumor is negative for KIT,CD34,S-100,and SMA,a definitive diagnosis is often challenging.Recently,Discovered on GIST-1(DOG1)has received considerable attention as a useful molecule for the diagnosis of GIST.DOG1,a membrane channel protein,is known to be overexpressed in GIST.Because the sensitivity and specificity of DOG1 are higher than those of KIT,positive staining for DOG1has been reported,even in KIT-negative GISTs.KITnegative GISTs most commonly arise in the stomach and are mainly characterized by epithelioid features histologically.We describe our experience with a rare case of a KIT-negative GIST of the stomach that was diagnosed by positive immunohistochemical staining for DOG1 in a patient who presented with severe anemia.Our findings suggest that immunohistochemical staining for DOG1,in addition to gene analysis,is useful for the diagnosis of KIT-negative tumors that are suspected to be GISTs.
基金Supported by Foundation for Promotion of Cancer Research by Ministry of Health,Labor and Welfare in Japan
文摘AIM:To evaluate the effectiveness of our proposed bowel preparation method for colon capsule endoscopy.METHODS:A pilot,multicenter,randomized controlled trial compared our proposed "reduced volume method"(group A) with the "conventional volume method"(group B) preparation regimens.Group A did not drink polyethylene glycol electrolyte lavage solution(PEGELS) the day before the capsule procedure,while group B drank 2 L.During the procedure day,groups A and B drank 2 L and 1 L of PEG-ELS,respectively,and swallowed the colon capsule(PillCam COLON capsule).Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups,and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that time.Capsule videos were reviewed for grading of cleansing level,RESULTS:Sixty-four subjects were enrolled,with results from 60 analyzed.Groups A and B included 31 and 29 subjects,respectively.Twenty-nine(94%) subjects in group A and 25(86%) subjects in group B had adequate bowel preparation(ns).Twenty-two(71%) of the 31 subjects in group A excreted the capsule within its battery life compared to 16(55%) of the 29 subjects in group B(ns).Of the remaining 22 subjects whose capsules were not excreted within the battery life,all of the capsules reached the left side colon before they stopped functioning.A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS,due to ingesting the PEG-ELS faster than recommended.CONCLUSION:Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method.
文摘AIM: To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy. METHODS: Between September 2006 and April 2011, 47 procedures of DB-ERCP were performed in 28 patients with a Roux-en-Y total gastrectomy (n = 11), Billroth Ⅱ gastrectomy (n = 15), or Roux-en-Y anastomosis with hepaticojejunostomy (n = 2). DB-ERCP was performed using a short-type DBE combined with several technical innovations such as using an endoscope attachment, marking by submucosal tattooing,selectively applying contrast medium, and CO2 insufflations. RESULTS: The papilla of Vater or hepaticojejunostomy site was reached in its entirety with a 96% success rate (45/47 procedures). There were no significant differences in the success rate of reaching the blind end with a DBE among Roux-en-Y total gastrectomy (96%), Billroth Ⅱ reconstruction (94%), or pancreatoduodenectomy (100%), respectively (P = 0.91). The total successful rate of cannulation and contrast enhancement of the target bile duct in patients whom the blind end was reached with a DBE was 40/45 procedures (89%). Again, there were no significant differences in the success rate of cannulation and contrast enhancement of the target bile duct with a DBE among Roux-en-Y total gastrectomy (88 %), Billroth Ⅱ reconstruction (89%), or pancreatoduodenectomy (100%), respectively (P = 0.67). Treatment was achieved in all 40 procedures (100%) in patients whom the contrast enhancement of the bile duct was successful. Common endoscopic treatments were endoscopic biliary drainage (24 procedures) and extraction of stones (14 procedures). Biliary drainage was done by placement of plastic stents. Stones extraction was done by lithotomy with the mechanical lithotripter followed by extraction with a basket or by the balloon pull-through method. Endoscopic sphincterotomy was performed in 14 procedures with a needle precutting knife using a guidewire. The mean total duration o
文摘In this study, the temporal structure of the variation of North Atlantic Oscillation （NAO） and its impact on regional climate variability are analyzed using various datasets. The results show that blocking formations in the Atlantic region are sensitive to the phase of the NAO. Sixty-seven percent more winter blocking days are observed during the negative phase compared to the positive phase of the NAO. The average length of blocking during the negative phase is about 11 days, which is nearly twice as long as the 6-day length observed during the positive phase of the NAO. The NAO-related differences in blocking frequency and persistence are associated with changes in the distribution of the surface air temperature anomaly, which, to a large extent, is determined by the phase of the NAO. The distribution of regional cloud amount is also sensitive to the phase of the NAO. For the negative phase, the cloud amounts are significant, positive anomalies in the convective zone in the Tropics and much less cloudiness in the mid latitudes. But for the positive phase of the NAO, the cloud amount is much higher in the mid-latitude storm track region. In the whole Atlantic region, the cloud amount shows a decrease with the increase of surface air temperature. These results suggest that there may be a negative feedback between the cloud amount and the surface air t.emperature in the Atlantic region.
文摘Attention constitutes a fundamental psychological feature guiding our mental effort toward specific objects, concurrent with processes such as memory, reasoning, and imagination. Visual attention, crucial for selecting surrounding information, often decreases in older adults and patients with cerebrovascular disorders. Effective methods to enhance attention are scarce. Here, we investigated whether color information influences visual attention and brain activity during task performance, utilizing EEG. We examined 13 healthy young adults (seven women and six men;mean age: 21.2 ± 0.58 years) using 19-electrode electroencephalograms to assess the impact of color information on visual attention. The Clinical Assessment for Attention cancellation test was conducted under the black, red, and blue color conditions. Wilcoxon’s signed-rank test was used to assess differences in task performance (task time and error) between conditions. Spearman’s rank correlation was utilized to examine the correlation in power levels between task performance and color conditions. Significant variations in total task errors were observed among color conditions. The black condition exhibited the highest error frequency (0.7 ± 0.9 times), followed by the red condition (0.5 ± 0.8 times), with the lowest error frequency occurring in the blue (0.2 ± 0.4 times) condition (black vs. red: P = 0.03;black vs. blue: P = 0.00;red vs. blue: P = 0.032). No time difference was observed. The black condition showed negative delta and high-gamma correlations in the central electrodes. The red condition revealed positive alpha and low-gamma correlations in the frontal and occipital areas. Although no correlations were observed in the blue condition, it enhanced attentional performance. Positive alpha and low-gamma waves might be crucial for spotting attentional errors in key areas. Our findings provide insights into the effects of color information on visual attention and potential neural correlates associated with attentional processes. In conclusi
文摘Introduction: Computed tomography (CT) measurements of bone mineral attenuation may be a useful means to identify older women who should be prioritized for bone mineral density screening. Methods: We compared bone mineral attenuation as measured in the L1 vertebra of CT studies to the results of dual-energy x-ray absorptiometry (DEXA) studies to determine what CT attenuation thresholds might yield a reasonable combination of sensitivity and specificity for the detection of osteoporosis. The study was limited to women between the ages of 65 and 75 years who had a DEXA study and a CT that included the L1 or adjacent vertebra performed within 3 years of the DEXA study. Results: There were 1226 women in this study, of whom 452 (38%) had osteoporosis based on a T-score ≤ −2.5 by DEXA. There were 830 CT studies performed with contrast and 396 studies which were performed without contrast. There was a statistically significant difference in the mean HU of those studies performed without contrast compared to those with contrast (unenhanced mean 103 HU versus 125 HU, p < 0.001). Different CT attenuation thresholds provided the most appropriate combination of sensitivity and specificity for the detection of osteoporosis when comparing CT studies performed without or with IV contrast and when all the CT data were used in aggregate. Conclusion: Different thresholds appear necessary when using the mean CT vertebral attenuation to identify older women for preferential referral for DEXA studies.
文摘Attentional issues may affect acquiring new information, task performance, and learning. Cortical network activities change during different functional brain states, including the default mode network (DMN) and attention network. We investigated the neural mechanisms underlying attentional functions and correlations between DMN connectivity and attentional function using the Trail-Making Test (TMT)-A and -B. Electroencephalography recordings were performed by placing 19 scalp electrodes per the 10 - 20 system. The mean power level was calculated for each rest and task condition. Non-parametric Spearman’s rank correlation was used to examine the correlation in power levels between the rest and TMT conditions. The most significant correlations during TMT-A were observed in the high gamma wave, followed by theta and beta waves, indicating that most correlations were in the parietal lobe, followed by the frontal, central, and temporal lobes. The most significant correlations during TMT-B were observed in the beta wave, followed by the high and low gamma waves, indicating that most correlations were in the temporal lobe, followed by the parietal, frontal, and central lobes. Frontoparietal beta and gamma waves in the DMN may represent attentional functions.
文摘AIM: To evaluate the 5-lipoxygenases (Loxs) expression level in human colorectal cancer specimens in order to determine its clinicopathologic significance in human tumorigenesis. METHODS: The relative quantity of 5-Lox mRNA in paired 91 colorectal tumor and adjacent normal mucosa samples was determined by real time quantitative PCR. Additionally, the expression of 5-Lox and cyclooxygenase (Cox)-2 proteins was also examined using immunohistochemical staining methods. RESULTS: There was a marked increase in 5-Lox mRNA levels in the tumor compared with paired normal mucosa samples (P < 0.0001). Sixty six (72.5%) tumors showed high 5-Lox mRNA levels. The positivity rate of 5-Lox and Cox-2 protein expression was 68.7% and 79.1% respectively. There was a significant association between tumoral 5-Lox mRNA level and tumor size (Rho = 0.392, P = 0.0002), depth or vessel invasion. CONCLUSION: These results suggest that 5-Lox is up-regulated in colorectal cancer and that inhibition of its expression might be valuable in the prevention and treatment of colorectal cancer.
基金supported by the Natural Science Foundation of Hunan Province and Zhuzhou City(Grant No.13JJ9032)
文摘The Alkyl Polyglucoside（APG） is a nonionic surfactant with no toxicity and with high biodegradability, its drag-reduction behavior in a circular pipe flow is measured, and the rheological characteristics are investigated with a rheometer with a cone-plate flow cell. From the measured results, the APG is shown to have a high drag-reduction capacity, whose shear viscosity is shear-ratedependent at high concentrations, while its solution at concentrations with drag-reduction effects is non-viscoelastic as verified by zero relaxation time in the relaxation process of the shear stress, which contradicts the general viewpoint that there is a correlation between the viscoselastic characteristics and the turbulent drag reduction for the drag-reduction surfactant. However, the APG solution is birefringent as observed through a birefringent test, which indicates that there are rod-shaped micelles in the solution under the shearing flow. The higher extensional viscosity inferred from the extensional phenomenon observed in the measurements of the shear viscosity could be responsible for the drag reduction property of this nonionic surfactant.
文摘AIM: To evaluate the usefulness and safety of argon plasma coagulation (APC) for superficial esophageal squamous-cell carcinoma (SESC) in high-risk patients. METHODS: We studied 17 patients (15 men and 2 women, 21 lesions) with SESC in whom endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and open surgery were contraindicated from March 1999 through February 2009. None of the patients could tolerate prolonged EMR/ESD or open surgery because of severe concomitant disease (e.g., liver cirrhosis, cerebral infarction, or ischemic heart disease) or scar formation after EMR/ESD and chemoradiotherapy. After conventional endoscopy, an iodine stain was sprayed on the esophageal mucosa to determine the lesion margins. The lesion was then ablated by APC. We retrospectively studied the treatment time, number of APC sessions per site, complications, presence or absence of recurrence, and time to recurrence.RESULTS: The median duration of follow-up was 36 mo (range: 6-120 mo). All of the tumors were macroscopically classified as superficial and slightly depressed type (0-Ⅱc). The preoperative depth of invasion was clinical T1a (mucosal cancer) for 19 lesions and clinical T1b (submucosal cancer) for 2. The median treatment time was 15 min (range: 10-36 min). The median number of treatment sessions per site was 2 (range: 1-4). The median hospital stay was 14 d (range: 5-68 d). Among the 17 patients (21 lesions), 2 (9.5%) had recurrence and underwent additional APC with no subsequent evidence of recurrence. There were no treatment-related complications, such as bleeding or perforation. CONCLUSION: APC is considered to be safe and effective for the management of SESC that cannot be resected endoscopically because of underlying disease, as well as for the control of recurrence after EMR and local recurrence after chemoradiotherapy.
