AIM:To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy. METHODS:We conducted a randomized,double-blind, placebo-controlled study with mosapride in addition to ...AIM:To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy. METHODS:We conducted a randomized,double-blind, placebo-controlled study with mosapride in addition to polyethylene glycol(PEG)-electrolyte solution.Of 250 patients undergoing colonoscopy,124 were randomized to receive 2 L PEG plus 15 mg of mosapride citrate (mosapride group),and 126 received 2 L PEG plus placebo(placebo group).Patients completed a questionnaire reporting the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed by colonoscopists using a 5-point scale based on Aronchick's criteria.The primary end point was optimal bowel preparation rates(scores of excellent/good/fair vs poor/inadequate). RESULTS:A total of 249 patients were included in the analysis.In the mosapride group,optimal bowel preparation rates were significantly higher in the left colon compared with the placebo group(78.2%vs 65.6%,P<0.05),but not in the right colon(76.5%vs 66.4%,P=0.08).After excluding patients with severe constipation,there was a significant difference in bowel preparation in both the left and right colon(82.4%vs 66.7%,80.8%vs 67.5%,P<0.05,P<0.01).The incidence of adverse events was similar in both groups. Among the subgroup who had previous colonoscopy experience,a significantly higher number of patients in the mosapride group felt that the current preparation was easier compared with patients in the placebo group(34/72 patients vs 24/74 patients,P<0.05). CONCLUSION:Mosapride citrate may be an effective and safe adjunct to PEG-electrolyte solution that leads to improved quality of bowel preparation,especially in patients without severe constipation.展开更多
AIM To investigate clinicopathological features of early stage gastric cancer with enteroblastic differentiation(GCED).METHODS We retrospectively investigated data on 6 cases of early stage GCED and 186 cases of early...AIM To investigate clinicopathological features of early stage gastric cancer with enteroblastic differentiation(GCED).METHODS We retrospectively investigated data on 6 cases of early stage GCED and 186 cases of early stage conventional gastric cancer(CGC: well or moderately differentiated adenocarcinoma) who underwent endoscopic submucosal dissection or endoscopic mucosal resection from September 2011 to February 2015 in our hospital.GCED was defined as a tumor having a primitive intestine-like structure composed of cuboidal or columnar cells with clear cytoplasm and immunohistochemical positivity for either alpha-fetoprotein, Glypican 3 or SALL4. The following were compared between GCED and CGC: age, gender, location and size of tumor, macroscopic type, ulceration, depth of invasion, lymphatic and venous invasion, positive horizontal and vertical margin, curative resection rate.RESULTS Six cases(5 males, 1 female; mean age 75.7 years; 6 lesions) of early gastric cancer with a GCED component and 186 cases(139 males, 47 females; mean age 72.7 years; 209 lesions) of early stage CGC were investigated. Mean tumor diameters were similar but rates of submucosal invasion, lymphatic invasion, venous invasion, and non-curative resection were higher in GCED than CGC(66.6% vs 11.4%, 33.3% vs 2.3%, 66.6% vs 0.4%, 83.3% vs 11% respectively, P < 0.01). Deep submucosal invasion was not revealed endoscopically or by preoperative biopsy. Histologically, in GCED the superficial mucosal layer was covered with a CGC component. The GCED component tended to exist in the deeper part of the mucosa to the submucosa by lymphatic and/or venous invasion, without severe stromal reaction. In addition, Glypican 3 was the most sensitive marker for GCED(positivity, 83.3%), immunohistochemically.CONCLUSION Even in the early stage GCED has high malignant potential, and preoperative diagnosis is considered difficult. Endoscopists and pathologists should know the clinicopathological features of this highly malignant type of cancer.展开更多
AIM: To evaluate the efficacy and safety of esomeprazole-based triple therapy compared with lansoprazole therapy as first-line eradication therapy for patients with Helicobacter pylori (H. pylori) in usual post-market...AIM: To evaluate the efficacy and safety of esomeprazole-based triple therapy compared with lansoprazole therapy as first-line eradication therapy for patients with Helicobacter pylori (H. pylori) in usual post-marketing use in Japan, where the clarithromycin (CAM) resistance rate is 30%.展开更多
Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate.The shortcomings of this method are the deficiencies of fixing the knife to the target... Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate.The shortcomings of this method are the deficiencies of fixing the knife to the target lesion,and of compressing it.These shortcomings can lead to major complications such as perforation and bleeding.To reduce the risk of complications related to ESD,we developed a new grasping type scissors forceps (Clutch Cutter,Fujifilm,Japan) which can grasp and incise the targeted tissue using an electrosurgical current.Esophagogastroduodenoscopy on a 59-year-old Japanese man revealed a 16mm esophageal submucosal nodule with central depression.Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement.The histologic diagnosis of the specimen obtained by biopsy was granular cell tumor.It was safely and accurately resected without unexpected incision by ESD using the CC.No delayed hemorrhage or perforation occurred.Histological examination confirmed that the granular cell tumor was completely excised with negative resection margin.We report herein a case of esophageal granular cell tumor successfully treated by an ESD technique using the CC.展开更多
AIM:To evaluate the possibility of reducing the volume of polyethylene glycol(PEG)-electrolyte solution using adjunctive mosapride citrate for colonoscopy preparation. METHODS:This was a single-center,prospective, ran...AIM:To evaluate the possibility of reducing the volume of polyethylene glycol(PEG)-electrolyte solution using adjunctive mosapride citrate for colonoscopy preparation. METHODS:This was a single-center,prospective, randomized,investigator-blinded,non-inferiority study involving 252 patients of both sexes,aged from 20 to 80 years,scheduled for screening or diagnostic colonoscopy in our department.A total of 126 patients was randomized to receive 1.5 L PEG-electrolyte solution plus 15 mg of mosapride(1.5 L group),and 126 received 2 L PEG-electrolyte solution plus 15 mg of mosapride(2 L group).Patients completed a questionnaire on the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed using a 5-point scale based on the Aronchick scale.The primary end point was adequate bowel preparation rates(score of excellent/good/fair) vs(poor/inadequate).Acceptability and tolerability,as well as disease detection,were secondary end points. RESULTS:A total of 244 patients was included in the analysis.There were no significant differences between the 2 L and 1.5 L groups in age,sex,body mass index, number of previous colonoscopies,and the preparation method used previously.The adequate bowel preparation rates were 88.5%in the 2 L group and 82.8%in the 1.5 L group[95%lower confidence limit(LCL)for the difference=-14.5%,non-inferiority P=0.019]in the right colon.In the left colon,the adequate bowel preparation rates were 89.3%in the 2 L group and 81.1%in the 1.5 L group(95%LCL=-17.0%,non-inferiority P=0.066).Compliance,defined as complete (100%)intake of the PEG solution,was significantly higher in the 1.5 L group than in the 2 L group(96.8% vs 85.7%,P=0.002).The proportion of abdominal distension(none/mild/moderate/severe)was significantly lower in the 1.5 L group than in the 2 L group (36/65/22/3 vs 58/48/18/2,P=0.040).Within the subgroup who had undergone colonoscopy previously, a significantly higher number of patients in the 1.5 L group than in the 2 L group felt that t展开更多
Numerous cellular and molecular events have been described in development of gastric cancer. In this artide, we overviewed roles of Helicobacter pylori （H pylori） infection on some of the important events in gastric...Numerous cellular and molecular events have been described in development of gastric cancer. In this artide, we overviewed roles of Helicobacter pylori （H pylori） infection on some of the important events in gastric carcinogenesis and discussed whether these cellular and molecular events are reversible after cure of the infection. There are several bacterial components affecting gastric epithelial kinetics and promotion of gastric carcinogenesis. The bacterium also increases risks of genetic instability and mutations due to NO and other reactive oxygen species. Epigenetic silencing of tumor suppressor genes such as RUNX3 may alter the frequency of phenotype change of gastric glands to those with intestinal metaplasia. Host factors such as increased expression of growth factors, cytokines and COX-2 have been also reported in non-cancerous tissue in Hpylori-positive subjects. It is noteworthy that most of the above phenomena are reversed after the cure of the infection. However, some of them including overexpression of COX-2 continue to exist and may increase risks for carcinogenesis in metaplastic or dysplastic mucosa even after successful H pylori eradication. Thus, H pylori eradication may not completely abolish the risk for gastric carcinogenesis. Efficiency of the cure of the infection in suppressing gastric cancer depends on the timing and the target population, and warrant further investigation.展开更多
AIM To determine the prognostic factors associated with mortality in patients with gastric fundal variceal (GFV) bleeding.METHODS In total, 42 patients were endoscopically diagnosed with GFV bleeding from January 2000...AIM To determine the prognostic factors associated with mortality in patients with gastric fundal variceal (GFV) bleeding.METHODS In total, 42 patients were endoscopically diagnosed with GFV bleeding from January 2000 to March 2014. We retrospectively reviewed the patients' medical records and assessed their history, etiology of liver cirrhosis, disease conditions, treatment options for GFV bleeding, medications administered before and after onset of GFV bleeding, blood test results(hemoglobin, albumin, and bilirubin concentrations), and imaging results(including computed tomography and abdominal ultrasonography). We also assessed the prognostic factors associated with short-term mortality(up to 90 d) and long-term mortality in all patients.RESULTS Multivariate analysis showed that prophylactic administration of antibiotics was an independent prognostic factor associated with decreases in short-term mortality (OR = 0.08, 95%CI: 0.01-0.52) and longterm mortality (OR = 0.27, 95%CI: 0.08-0.91) in patients with GFV bleeding. In contrast, concurrent hepatocellular carcinoma (HCC) and regular use of proton pump inhibitors (PPI) were independent prognostic factors associated with increases in shortterm mortality(HCC: OR = 15.4, 95%CI: 2.08-114.75; PPI: OR = 12.76, 95%CI: 2.13-76.52) and long-term mortality (HCC: OR = 7.89, 95%CI: 1.98-31.58; PPI: OR = 10.91, 95%CI: 2.86-41.65) in patients with GFV bleeding. The long-term overall survival rate was significantly lower in patients who regularly used PPI than in those who did not use PPI(P = 0.0074).CONCLUSION Administration of antibiotics is associated with decreased short- and long-term mortality, while concurrent HCC and regular PPI administration are associated with increased short- and long-term mortality.展开更多
Fenofibrate is a member of such fibrate class agents as bezafibrate and it work as a ligand of PPARα, and also shows a potent triglyceride-lowering effect. The elevation of aminotransferase levels has been frequently...Fenofibrate is a member of such fibrate class agents as bezafibrate and it work as a ligand of PPARα, and also shows a potent triglyceride-lowering effect. The elevation of aminotransferase levels has been frequently observed after the administration of fenofibrate and this phenomenon is considered to be non-pathological because fenofibrate activates the gene expression of the aminotransferases. Recently, fenofibrate has been used not only for hypercholesterolemia but also for primary biliary cirrhosis （PBC）. However, the occurrence of liver injury induced by fenofibrate has not yet been reported written in the English literature. We herein report a rare case of liver injury due to the oral use of this drug.展开更多
While pneumatosis cystoides intestinalis （PCI） is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal f...While pneumatosis cystoides intestinalis （PCI） is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical importance of PCI that mimics perforated peritonitis, which requires emergency surgery. Preoperative imaging modalities and diagnostic laparoscopy are useful to make an accurate diagnosis.展开更多
Nickel electroplating has been used practically for decades, is easy to plate, but there is an unknown interest in it. Nickel electroplating as a basis of surface treatment is shown practically from basics to the appl...Nickel electroplating has been used practically for decades, is easy to plate, but there is an unknown interest in it. Nickel electroplating as a basis of surface treatment is shown practically from basics to the applied electronics use. At first the basics of nickel electroplating, for example, purpose, use, merit & demerit, nickel plating solution, current efficiency, limiting current density, additional agents and their behaviors are surveyed. And the points of nickel deposition already practically used such as decorative nickel plating, satin nickel plating and functional nickel plating, which has very high throwing power and has been used for electronics, are described in detail.展开更多
There is a long history of studies on the bad influence of smoking on our bodies, with many study results accumulated to date indicating a decline in the smoking rate. However, the smoking rate in Japan is still highe...There is a long history of studies on the bad influence of smoking on our bodies, with many study results accumulated to date indicating a decline in the smoking rate. However, the smoking rate in Japan is still higher than that in other countries. In order to reveal the various influences due to smoking, we examined the changes in lifestyle and vitality prior to and the following smoking, targeting college students who are at the early age of starting to smoke. The subjects were 213 college students (83 men and 130 women). Smoking frequency as well as sleeping, eating habits, exercise, and vitality as a lifestyle were surveyed through a questionnaire survey. As a result of comparing smoking and lifestyle between the smoking group and non-smoking group, in terms of sleep, the bedtime and wake-up time tended to be late in the smoking group. Regarding eating habits, there was a tendency for the smoking group to have a high rate of skipping breakfast and a high intake rate of midnight snacks. Regarding exercise, the number of people exercising on a daily basis was small in both the smoking group and the non-smoking group, with no significant difference observed. Therefore, this study revealed that smoking has a negative influence on some aspects of lifestyle. There was no significant relationship in terms of the effects of smoking on vitality. Going forward, it will be necessary to clarify the negative effects of smoking on mental health.展开更多
In the Large Helical Device （LHD）, two different divertor configurations, i.e. helical divertor （HD） and local island divertor （LID）, are utilized to control the edge plasma. The HD with two X-points is an intri...In the Large Helical Device （LHD）, two different divertor configurations, i.e. helical divertor （HD） and local island divertor （LID）, are utilized to control the edge plasma. The HD with two X-points is an intrinsic divertor for heliotron devices, accompanied with a relatively thick ergodic layer outside the confinement region. Edge and divertor plasma behavior from low density to high density regimes is presented, referring to the divertor detachment. The effect of the ergodic layer on the edge transport is also discussed. On the other hand, the LID is an advanced divertor concept which realizes a high pumping efficiency by the combination of an externally induced magnetic island and a closed pumping system. Experimental results to confirm the fundamental divertor performance of the LID are presented.展开更多
Hyperuricemia(HUA)mainly occurs because of purine metabolism disorders.We recently proposed that limonin from Simiao pill may have therapeutic effects on nitric oxide synthase 3(NOS3)that is related to HUA.Concurrentl...Hyperuricemia(HUA)mainly occurs because of purine metabolism disorders.We recently proposed that limonin from Simiao pill may have therapeutic effects on nitric oxide synthase 3(NOS3)that is related to HUA.Concurrently,our previous work employed a new method,structure-based multi-ligand molecular modeling,to identify potential agents from a herbal formula that may produce synergistic effects and may have the potential to develop combination drugs.Therefore,we employed multi-ligand modeling to seek compounds with potential synergistic effects with limonin against NOS3.We obtained 403 multi-ligand docking results between 403 compounds and the limonin-NOS3 complex(average affinity–8.297 kcal/mol).Then we selected the top 10 highest binding affinity compounds for virtual pharmacokinetic and toxicity screening and we found that only obacunone passed all filters.We further subjected obacunone,bound to limonin and NOS3,to molecular dynamics simulations.We found that the NOS3-limonin-obacunone complex was more stable than the NOS3-limonin complex,based on the root mean square deviation of backbone Cαatoms and root mean square fluctuation,which suggests that synergistic effects may exist between limonin and obacunone.Further cell and animal experimental research is required to verify our results.展开更多
A long-pulse plasma discharge for more than 30 min. was achieved on the Large Helical Device （LHD）. A plasma of ne = 0.8 × 10^19 m^-3 and T10 = 2.0 keV was sustained with PICH = 0.52 MW, PECH = 0.1 MW and avera...A long-pulse plasma discharge for more than 30 min. was achieved on the Large Helical Device （LHD）. A plasma of ne = 0.8 × 10^19 m^-3 and T10 = 2.0 keV was sustained with PICH = 0.52 MW, PECH = 0.1 MW and averaged PNBI = 0.067 MW. Total injected heating energy was 1.3 G J, which was a quarter of the prepared RF heating energy. One of the keys to the success of the experiment was a dispersion of the local plasma heat load to divertors, accomplished by shifting the magnetic axis inward and outward.展开更多
The fibre-reinforced structure in synovial articular cartilage plays an important role in enhancing the fluid load support in the biphasic lubrication mechanism.Poly(vinyl alcohol)(PVA)hydrogel is a potential biomimet...The fibre-reinforced structure in synovial articular cartilage plays an important role in enhancing the fluid load support in the biphasic lubrication mechanism.Poly(vinyl alcohol)(PVA)hydrogel is a potential biomimetic articular cartilage material.In this study,PVA hydrogel was reinforced with PVA fibres to improve its frictional properties.By computational analysis,the position of the PVA fibre layer was examined with a migrating contact condition to reduce the friction coefficient.To improve the fibre reinforcement,a method for fibre placement was developed to retain the initial strain of the fibre in the hydrogel matrix.The experimental results showed that the fibre-reinforced PVA hydrogel with a surface fibre layer had a low friction coefficient of 0.031 in pure water.The fibre-reinforced PVA hydrogel successfully reduced friction coefficient.展开更多
Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mese...Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mesenterioaxial intrathoracic gastric volvulus, which was successfully treated with laparoscopic repair of the diaphragmatic hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication. A 70-year-old Japanese woman was admitted to our hospital because of sudden onset of upper abdominal pain. An upper gastrointestinal series revealed an incarcerated intrathoracic mesenterioaxial volvulus of the distal portion of the stomach and the duodenum. The complete laparoscopic approach was used to repair the volvulus. The laparoscopic procedures involved the repair of the hiatal hernia using polytetrafluoroethylene mesh and Toupet fundoplication. This case highlights the feasibility and effectiveness of the laparoscopic procedure, and laparoscopic repair of the hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication may be useful for preventing postoperative recurrence of hiatal her-nia, volvulus, and gastroesophageal reflux.展开更多
Aim： To identify proteins induced by androgen in Sertoli cells during spermatogenesis. Methods： We analyzed protein profiles in TM4 Sertoli cells treated with dihydrotestosterone （DHT） using surface enhanced laser...Aim： To identify proteins induced by androgen in Sertoli cells during spermatogenesis. Methods： We analyzed protein profiles in TM4 Sertoli cells treated with dihydrotestosterone （DHT） using surface enhanced laser desorption ionization time-of-flight mass spectrometry （SELDI-TOF-MS）. Results： We found increases in the expression of a 5.0-kDa protein at 15 min, an 11.3-kDa protein at 24 h and 4.3 kDa, 5.7 kDa, 5.8 kDa, 9.95 kDa and 9.98 kDa proteins at 48 h after the treatment. In contrast, the expression of 6.3 kDa and 8.6 kDa proteins decreased at 30 min, and 4.9 kDa, 5.0 kDa, 12.4 kDa and 19.8 kDa proteins at 48 h after the treatment. The ll.3-kDa protein was identified as macrophage migration inhibitory factor （MIF） known to having various functions. The 9.98-kDa protein was identified as calgizzarin related to calcium channels. The timing of their expression suggests that MIF and calgizzarin are involved in late regulation of spermatogenesis in Sertoli cells by androgen. Conclusion： MIF and calgizzarin are two important androgen-responsive proteins produced by Sertoli cells and they might play a role in regulating spermatogenesis.展开更多
Background: The reports of clinical outcomes of patients treated with chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma are rare. We report our results of chemoradiotherapy for primary thyroid non-Hodgkin...Background: The reports of clinical outcomes of patients treated with chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma are rare. We report our results of chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma. Materials and Methods: The subjects were 67 patients with thyroid non-Hodgkin’s lymphoma among 269 patients with malignant lymphoma who received radiotherapy in our hospital during a period between May 1990 and June 2005. The patients included 16 men and 51 women, with a mean age of 66.2 ± 10.7 years (30 - 84 years). The disease stage was stage I in 42 patients, stage II in 24, and unclear in 1. The histologic type was B-cell lymphoma in 66 patients, MALT in 9, diffuse type in 52, follicular type in 5, and diffuse and follicular type in 1. CHOP chemotherapy regimen for malignant lymphoma patients was as follows. Intravenous drip infusion of cyclophosphamide 750 mg/m<sup>2</sup>, (drip) infusion of doxorubicin 50 mg/m<sup>2</sup>, and intravenous injection of vincristine 1.4 mg/m<sup>2</sup> were administered on day 1, followed by 5 consecutive days of oral prednisolone 100 mg/m<sup>2</sup>. This regimen was repeated every 3 weeks (21 days) in 6 to 8 courses. Modified CHOP chemotherapy regimen was as follows. Intravenous drip infusion of cyclophosphamide 600 mg/m<sup>2</sup>, intravenous (drip) infusion of doxorubicin 40 mg/m<sup>2</sup>, intravenous infusion of vindesine 3 mg/m<sup>2</sup>, and intravenous drip infusion of prednisolone 60 mg/body were administered on day 1, and intravenous prednisolone was changed to oral prednisolone with the dose tapered gradually. After completing one course of this regimen, two courses of radiotherapy (a total of 36 Gy) were performed, followed by 6 courses of the chemotherapy regimen at lower doses (80% of the initial doses) repeated once a month. Results: Results of chemoradiotherapy in all patients were excellent. The 15-year survival rate was over 80%. Although there were no significant differences in the results of chemoradiotherapy among d展开更多
文摘AIM:To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy. METHODS:We conducted a randomized,double-blind, placebo-controlled study with mosapride in addition to polyethylene glycol(PEG)-electrolyte solution.Of 250 patients undergoing colonoscopy,124 were randomized to receive 2 L PEG plus 15 mg of mosapride citrate (mosapride group),and 126 received 2 L PEG plus placebo(placebo group).Patients completed a questionnaire reporting the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed by colonoscopists using a 5-point scale based on Aronchick's criteria.The primary end point was optimal bowel preparation rates(scores of excellent/good/fair vs poor/inadequate). RESULTS:A total of 249 patients were included in the analysis.In the mosapride group,optimal bowel preparation rates were significantly higher in the left colon compared with the placebo group(78.2%vs 65.6%,P<0.05),but not in the right colon(76.5%vs 66.4%,P=0.08).After excluding patients with severe constipation,there was a significant difference in bowel preparation in both the left and right colon(82.4%vs 66.7%,80.8%vs 67.5%,P<0.05,P<0.01).The incidence of adverse events was similar in both groups. Among the subgroup who had previous colonoscopy experience,a significantly higher number of patients in the mosapride group felt that the current preparation was easier compared with patients in the placebo group(34/72 patients vs 24/74 patients,P<0.05). CONCLUSION:Mosapride citrate may be an effective and safe adjunct to PEG-electrolyte solution that leads to improved quality of bowel preparation,especially in patients without severe constipation.
文摘AIM To investigate clinicopathological features of early stage gastric cancer with enteroblastic differentiation(GCED).METHODS We retrospectively investigated data on 6 cases of early stage GCED and 186 cases of early stage conventional gastric cancer(CGC: well or moderately differentiated adenocarcinoma) who underwent endoscopic submucosal dissection or endoscopic mucosal resection from September 2011 to February 2015 in our hospital.GCED was defined as a tumor having a primitive intestine-like structure composed of cuboidal or columnar cells with clear cytoplasm and immunohistochemical positivity for either alpha-fetoprotein, Glypican 3 or SALL4. The following were compared between GCED and CGC: age, gender, location and size of tumor, macroscopic type, ulceration, depth of invasion, lymphatic and venous invasion, positive horizontal and vertical margin, curative resection rate.RESULTS Six cases(5 males, 1 female; mean age 75.7 years; 6 lesions) of early gastric cancer with a GCED component and 186 cases(139 males, 47 females; mean age 72.7 years; 209 lesions) of early stage CGC were investigated. Mean tumor diameters were similar but rates of submucosal invasion, lymphatic invasion, venous invasion, and non-curative resection were higher in GCED than CGC(66.6% vs 11.4%, 33.3% vs 2.3%, 66.6% vs 0.4%, 83.3% vs 11% respectively, P < 0.01). Deep submucosal invasion was not revealed endoscopically or by preoperative biopsy. Histologically, in GCED the superficial mucosal layer was covered with a CGC component. The GCED component tended to exist in the deeper part of the mucosa to the submucosa by lymphatic and/or venous invasion, without severe stromal reaction. In addition, Glypican 3 was the most sensitive marker for GCED(positivity, 83.3%), immunohistochemically.CONCLUSION Even in the early stage GCED has high malignant potential, and preoperative diagnosis is considered difficult. Endoscopists and pathologists should know the clinicopathological features of this highly malignant type of cancer.
文摘AIM: To evaluate the efficacy and safety of esomeprazole-based triple therapy compared with lansoprazole therapy as first-line eradication therapy for patients with Helicobacter pylori (H. pylori) in usual post-marketing use in Japan, where the clarithromycin (CAM) resistance rate is 30%.
文摘 Endoscopic submucosal dissection (ESD) with a knife is a technically demanding procedure associated with a high complication rate.The shortcomings of this method are the deficiencies of fixing the knife to the target lesion,and of compressing it.These shortcomings can lead to major complications such as perforation and bleeding.To reduce the risk of complications related to ESD,we developed a new grasping type scissors forceps (Clutch Cutter,Fujifilm,Japan) which can grasp and incise the targeted tissue using an electrosurgical current.Esophagogastroduodenoscopy on a 59-year-old Japanese man revealed a 16mm esophageal submucosal nodule with central depression.Endoscopic ultrasonography demonstrated a hypoechoic solid tumor limited to the submucosa without lymph node involvement.The histologic diagnosis of the specimen obtained by biopsy was granular cell tumor.It was safely and accurately resected without unexpected incision by ESD using the CC.No delayed hemorrhage or perforation occurred.Histological examination confirmed that the granular cell tumor was completely excised with negative resection margin.We report herein a case of esophageal granular cell tumor successfully treated by an ESD technique using the CC.
文摘AIM:To evaluate the possibility of reducing the volume of polyethylene glycol(PEG)-electrolyte solution using adjunctive mosapride citrate for colonoscopy preparation. METHODS:This was a single-center,prospective, randomized,investigator-blinded,non-inferiority study involving 252 patients of both sexes,aged from 20 to 80 years,scheduled for screening or diagnostic colonoscopy in our department.A total of 126 patients was randomized to receive 1.5 L PEG-electrolyte solution plus 15 mg of mosapride(1.5 L group),and 126 received 2 L PEG-electrolyte solution plus 15 mg of mosapride(2 L group).Patients completed a questionnaire on the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed using a 5-point scale based on the Aronchick scale.The primary end point was adequate bowel preparation rates(score of excellent/good/fair) vs(poor/inadequate).Acceptability and tolerability,as well as disease detection,were secondary end points. RESULTS:A total of 244 patients was included in the analysis.There were no significant differences between the 2 L and 1.5 L groups in age,sex,body mass index, number of previous colonoscopies,and the preparation method used previously.The adequate bowel preparation rates were 88.5%in the 2 L group and 82.8%in the 1.5 L group[95%lower confidence limit(LCL)for the difference=-14.5%,non-inferiority P=0.019]in the right colon.In the left colon,the adequate bowel preparation rates were 89.3%in the 2 L group and 81.1%in the 1.5 L group(95%LCL=-17.0%,non-inferiority P=0.066).Compliance,defined as complete (100%)intake of the PEG solution,was significantly higher in the 1.5 L group than in the 2 L group(96.8% vs 85.7%,P=0.002).The proportion of abdominal distension(none/mild/moderate/severe)was significantly lower in the 1.5 L group than in the 2 L group (36/65/22/3 vs 58/48/18/2,P=0.040).Within the subgroup who had undergone colonoscopy previously, a significantly higher number of patients in the 1.5 L group than in the 2 L group felt that t
文摘Numerous cellular and molecular events have been described in development of gastric cancer. In this artide, we overviewed roles of Helicobacter pylori （H pylori） infection on some of the important events in gastric carcinogenesis and discussed whether these cellular and molecular events are reversible after cure of the infection. There are several bacterial components affecting gastric epithelial kinetics and promotion of gastric carcinogenesis. The bacterium also increases risks of genetic instability and mutations due to NO and other reactive oxygen species. Epigenetic silencing of tumor suppressor genes such as RUNX3 may alter the frequency of phenotype change of gastric glands to those with intestinal metaplasia. Host factors such as increased expression of growth factors, cytokines and COX-2 have been also reported in non-cancerous tissue in Hpylori-positive subjects. It is noteworthy that most of the above phenomena are reversed after the cure of the infection. However, some of them including overexpression of COX-2 continue to exist and may increase risks for carcinogenesis in metaplastic or dysplastic mucosa even after successful H pylori eradication. Thus, H pylori eradication may not completely abolish the risk for gastric carcinogenesis. Efficiency of the cure of the infection in suppressing gastric cancer depends on the timing and the target population, and warrant further investigation.
文摘AIM To determine the prognostic factors associated with mortality in patients with gastric fundal variceal (GFV) bleeding.METHODS In total, 42 patients were endoscopically diagnosed with GFV bleeding from January 2000 to March 2014. We retrospectively reviewed the patients' medical records and assessed their history, etiology of liver cirrhosis, disease conditions, treatment options for GFV bleeding, medications administered before and after onset of GFV bleeding, blood test results(hemoglobin, albumin, and bilirubin concentrations), and imaging results(including computed tomography and abdominal ultrasonography). We also assessed the prognostic factors associated with short-term mortality(up to 90 d) and long-term mortality in all patients.RESULTS Multivariate analysis showed that prophylactic administration of antibiotics was an independent prognostic factor associated with decreases in short-term mortality (OR = 0.08, 95%CI: 0.01-0.52) and longterm mortality (OR = 0.27, 95%CI: 0.08-0.91) in patients with GFV bleeding. In contrast, concurrent hepatocellular carcinoma (HCC) and regular use of proton pump inhibitors (PPI) were independent prognostic factors associated with increases in shortterm mortality(HCC: OR = 15.4, 95%CI: 2.08-114.75; PPI: OR = 12.76, 95%CI: 2.13-76.52) and long-term mortality (HCC: OR = 7.89, 95%CI: 1.98-31.58; PPI: OR = 10.91, 95%CI: 2.86-41.65) in patients with GFV bleeding. The long-term overall survival rate was significantly lower in patients who regularly used PPI than in those who did not use PPI(P = 0.0074).CONCLUSION Administration of antibiotics is associated with decreased short- and long-term mortality, while concurrent HCC and regular PPI administration are associated with increased short- and long-term mortality.
文摘Fenofibrate is a member of such fibrate class agents as bezafibrate and it work as a ligand of PPARα, and also shows a potent triglyceride-lowering effect. The elevation of aminotransferase levels has been frequently observed after the administration of fenofibrate and this phenomenon is considered to be non-pathological because fenofibrate activates the gene expression of the aminotransferases. Recently, fenofibrate has been used not only for hypercholesterolemia but also for primary biliary cirrhosis （PBC）. However, the occurrence of liver injury induced by fenofibrate has not yet been reported written in the English literature. We herein report a rare case of liver injury due to the oral use of this drug.
文摘While pneumatosis cystoides intestinalis （PCI） is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical importance of PCI that mimics perforated peritonitis, which requires emergency surgery. Preoperative imaging modalities and diagnostic laparoscopy are useful to make an accurate diagnosis.
文摘Nickel electroplating has been used practically for decades, is easy to plate, but there is an unknown interest in it. Nickel electroplating as a basis of surface treatment is shown practically from basics to the applied electronics use. At first the basics of nickel electroplating, for example, purpose, use, merit & demerit, nickel plating solution, current efficiency, limiting current density, additional agents and their behaviors are surveyed. And the points of nickel deposition already practically used such as decorative nickel plating, satin nickel plating and functional nickel plating, which has very high throwing power and has been used for electronics, are described in detail.
文摘There is a long history of studies on the bad influence of smoking on our bodies, with many study results accumulated to date indicating a decline in the smoking rate. However, the smoking rate in Japan is still higher than that in other countries. In order to reveal the various influences due to smoking, we examined the changes in lifestyle and vitality prior to and the following smoking, targeting college students who are at the early age of starting to smoke. The subjects were 213 college students (83 men and 130 women). Smoking frequency as well as sleeping, eating habits, exercise, and vitality as a lifestyle were surveyed through a questionnaire survey. As a result of comparing smoking and lifestyle between the smoking group and non-smoking group, in terms of sleep, the bedtime and wake-up time tended to be late in the smoking group. Regarding eating habits, there was a tendency for the smoking group to have a high rate of skipping breakfast and a high intake rate of midnight snacks. Regarding exercise, the number of people exercising on a daily basis was small in both the smoking group and the non-smoking group, with no significant difference observed. Therefore, this study revealed that smoking has a negative influence on some aspects of lifestyle. There was no significant relationship in terms of the effects of smoking on vitality. Going forward, it will be necessary to clarify the negative effects of smoking on mental health.
基金supported by NIFS under Grant(No.NIFS05ULPP506)in part by the JSPS-CAS Core-University Program in the field of Plasma and Nuclear Fusion
文摘In the Large Helical Device （LHD）, two different divertor configurations, i.e. helical divertor （HD） and local island divertor （LID）, are utilized to control the edge plasma. The HD with two X-points is an intrinsic divertor for heliotron devices, accompanied with a relatively thick ergodic layer outside the confinement region. Edge and divertor plasma behavior from low density to high density regimes is presented, referring to the divertor detachment. The effect of the ergodic layer on the edge transport is also discussed. On the other hand, the LID is an advanced divertor concept which realizes a high pumping efficiency by the combination of an externally induced magnetic island and a closed pumping system. Experimental results to confirm the fundamental divertor performance of the LID are presented.
基金This work was funded by the Key Project of National Natural Science Foundation of China[grant number 81830117]Joint Funds of National Natural Science Foundation of China[grant number U22A20365]+3 种基金National Natural Science Foundation of China[grant numbers 8220140209,82274499]Guangdong Basic and Applied Basic Research Foundation[grant number 2021A1515110082]China Postdoctoral Science Foundation[grant number 2022M711534]Science&Technical Plan of Guangzhou,Guangdong,China[grant number 201903010069].
文摘Hyperuricemia(HUA)mainly occurs because of purine metabolism disorders.We recently proposed that limonin from Simiao pill may have therapeutic effects on nitric oxide synthase 3(NOS3)that is related to HUA.Concurrently,our previous work employed a new method,structure-based multi-ligand molecular modeling,to identify potential agents from a herbal formula that may produce synergistic effects and may have the potential to develop combination drugs.Therefore,we employed multi-ligand modeling to seek compounds with potential synergistic effects with limonin against NOS3.We obtained 403 multi-ligand docking results between 403 compounds and the limonin-NOS3 complex(average affinity–8.297 kcal/mol).Then we selected the top 10 highest binding affinity compounds for virtual pharmacokinetic and toxicity screening and we found that only obacunone passed all filters.We further subjected obacunone,bound to limonin and NOS3,to molecular dynamics simulations.We found that the NOS3-limonin-obacunone complex was more stable than the NOS3-limonin complex,based on the root mean square deviation of backbone Cαatoms and root mean square fluctuation,which suggests that synergistic effects may exist between limonin and obacunone.Further cell and animal experimental research is required to verify our results.
基金supported in part by the JSPS-CAS Core-University Program in the field of Plasma and Nuclear Fusion
文摘A long-pulse plasma discharge for more than 30 min. was achieved on the Large Helical Device （LHD）. A plasma of ne = 0.8 × 10^19 m^-3 and T10 = 2.0 keV was sustained with PICH = 0.52 MW, PECH = 0.1 MW and averaged PNBI = 0.067 MW. Total injected heating energy was 1.3 G J, which was a quarter of the prepared RF heating energy. One of the keys to the success of the experiment was a dispersion of the local plasma heat load to divertors, accomplished by shifting the magnetic axis inward and outward.
基金the Grant-in-Aid for Specially Promoted Research of Japan Society for the Promotion of Science(JSPS)(KAKENHI:23000011)the Grant-in-Aid for Science Research of JSPS(KAKENHI:16H03170).
文摘The fibre-reinforced structure in synovial articular cartilage plays an important role in enhancing the fluid load support in the biphasic lubrication mechanism.Poly(vinyl alcohol)(PVA)hydrogel is a potential biomimetic articular cartilage material.In this study,PVA hydrogel was reinforced with PVA fibres to improve its frictional properties.By computational analysis,the position of the PVA fibre layer was examined with a migrating contact condition to reduce the friction coefficient.To improve the fibre reinforcement,a method for fibre placement was developed to retain the initial strain of the fibre in the hydrogel matrix.The experimental results showed that the fibre-reinforced PVA hydrogel with a surface fibre layer had a low friction coefficient of 0.031 in pure water.The fibre-reinforced PVA hydrogel successfully reduced friction coefficient.
基金Supported by The Department of Surgery Fujita Health University School of Medicine and University Hospital
文摘Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mesenterioaxial intrathoracic gastric volvulus, which was successfully treated with laparoscopic repair of the diaphragmatic hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication. A 70-year-old Japanese woman was admitted to our hospital because of sudden onset of upper abdominal pain. An upper gastrointestinal series revealed an incarcerated intrathoracic mesenterioaxial volvulus of the distal portion of the stomach and the duodenum. The complete laparoscopic approach was used to repair the volvulus. The laparoscopic procedures involved the repair of the hiatal hernia using polytetrafluoroethylene mesh and Toupet fundoplication. This case highlights the feasibility and effectiveness of the laparoscopic procedure, and laparoscopic repair of the hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication may be useful for preventing postoperative recurrence of hiatal her-nia, volvulus, and gastroesophageal reflux.
文摘Aim： To identify proteins induced by androgen in Sertoli cells during spermatogenesis. Methods： We analyzed protein profiles in TM4 Sertoli cells treated with dihydrotestosterone （DHT） using surface enhanced laser desorption ionization time-of-flight mass spectrometry （SELDI-TOF-MS）. Results： We found increases in the expression of a 5.0-kDa protein at 15 min, an 11.3-kDa protein at 24 h and 4.3 kDa, 5.7 kDa, 5.8 kDa, 9.95 kDa and 9.98 kDa proteins at 48 h after the treatment. In contrast, the expression of 6.3 kDa and 8.6 kDa proteins decreased at 30 min, and 4.9 kDa, 5.0 kDa, 12.4 kDa and 19.8 kDa proteins at 48 h after the treatment. The ll.3-kDa protein was identified as macrophage migration inhibitory factor （MIF） known to having various functions. The 9.98-kDa protein was identified as calgizzarin related to calcium channels. The timing of their expression suggests that MIF and calgizzarin are involved in late regulation of spermatogenesis in Sertoli cells by androgen. Conclusion： MIF and calgizzarin are two important androgen-responsive proteins produced by Sertoli cells and they might play a role in regulating spermatogenesis.
文摘Background: The reports of clinical outcomes of patients treated with chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma are rare. We report our results of chemoradiotherapy for primary thyroid non-Hodgkin’s lymphoma. Materials and Methods: The subjects were 67 patients with thyroid non-Hodgkin’s lymphoma among 269 patients with malignant lymphoma who received radiotherapy in our hospital during a period between May 1990 and June 2005. The patients included 16 men and 51 women, with a mean age of 66.2 ± 10.7 years (30 - 84 years). The disease stage was stage I in 42 patients, stage II in 24, and unclear in 1. The histologic type was B-cell lymphoma in 66 patients, MALT in 9, diffuse type in 52, follicular type in 5, and diffuse and follicular type in 1. CHOP chemotherapy regimen for malignant lymphoma patients was as follows. Intravenous drip infusion of cyclophosphamide 750 mg/m<sup>2</sup>, (drip) infusion of doxorubicin 50 mg/m<sup>2</sup>, and intravenous injection of vincristine 1.4 mg/m<sup>2</sup> were administered on day 1, followed by 5 consecutive days of oral prednisolone 100 mg/m<sup>2</sup>. This regimen was repeated every 3 weeks (21 days) in 6 to 8 courses. Modified CHOP chemotherapy regimen was as follows. Intravenous drip infusion of cyclophosphamide 600 mg/m<sup>2</sup>, intravenous (drip) infusion of doxorubicin 40 mg/m<sup>2</sup>, intravenous infusion of vindesine 3 mg/m<sup>2</sup>, and intravenous drip infusion of prednisolone 60 mg/body were administered on day 1, and intravenous prednisolone was changed to oral prednisolone with the dose tapered gradually. After completing one course of this regimen, two courses of radiotherapy (a total of 36 Gy) were performed, followed by 6 courses of the chemotherapy regimen at lower doses (80% of the initial doses) repeated once a month. Results: Results of chemoradiotherapy in all patients were excellent. The 15-year survival rate was over 80%. Although there were no significant differences in the results of chemoradiotherapy among d
