Postoperative recurrence occurs in approximately half of patients with non-small cell lung cancer(NSCLC), even after complete resection. Disease recurrence after surgical resection reduces the patient's life expec...Postoperative recurrence occurs in approximately half of patients with non-small cell lung cancer(NSCLC), even after complete resection. Disease recurrence after surgical resection reduces the patient's life expectancy sharply. The prognosis after postoperative recurrence is considered to largely depend on both the mode of first recurrence(distant, locoregional or combined) and the treatment modality:(1) The majority of cases of postoperative recurrence involve distant metastasis with or without locoregional recurrence. Platinum-based systemic chemotherapy is practically accepted as the treatment for these diseases on the basis of evidence for original stage Ⅳ disease. The advent of both pemetrexed and molecular-targeted drugs has improved the survival of nonsquamous NSCLC and changed the chemotherapeutic algorithm for NSCLC;(2) Among patients with distant metastatic recurrence without locoregional recurrence at the primary tumor site, the metastasis is often limited in both organ and number. Such metastases are referred to as oligometastases. Local therapy, such as surgical resection and radiotherapy, has been suggested to be the first-line treatment of choice foroligometastatic recurrence; and(3) While locoregional recurrence is likely to cause troublesome symptoms, it is a potentially limited disease. Therefore, providing local control is important, and radiation is usually beneficial for treating local recurrence. In order to obtain better control of the disease and provide treatment with curative intent in patients with limited disease, the administration of concurrent platinum-based chemoradiotherapy is recommended according to the results of originally nonresectable stage ⅢA and ⅢB disease.展开更多
BACKGROUND In recent years,the emergence of multiplex technology that can simultaneously measure multiple anti-islet autoantibodies has become particularly valuable for the staging and early diagnosis of immune-mediat...BACKGROUND In recent years,the emergence of multiplex technology that can simultaneously measure multiple anti-islet autoantibodies has become particularly valuable for the staging and early diagnosis of immune-mediated type 1 diabetes(T1D).While it has been established that 20%-30%of T1D patients suffer from autoimmune thyroid disease(AITD),there is limited available data regarding the presence of anti-islet autoantibodies in AITD patients.Among commercially available anti-islet autoantibodies,glutamic acid decarboxylase 65 autoantibodies(GADAs)are often the first marker measured in general clinical practice.AIM To investigate the frequency of anti-islet autoantibodies in AITD patients.METHODS Our study involved four hundred ninety-five AITD patients,categorized into three distinct groups:AITD with T1D(n=18),AITD with phenotypic type 2 diabetes(T2D)(n=81),and AITD without diabetes(n=396),and the enzyme-linked immunosorbent assay(ELISA)was employed to determine the frequencies of 3 Screen Islet Cell Autoantibody(3 Screen ICA),GADA,insulinoma-associated antigen-2 autoantibodies(IA-2As),and zinc transporter 8 autoantibodies(ZnT8As)within these groups.RESULTS The frequency of 3 Screen ICA in AITD patients with T1D,T2D,and those without diabetes were 88.9%,6.2%,and 5.1%,respectively,with no significant difference seen between the latter two groups.Notably,the frequency of 3 Screen ICA was 11.1%higher in AITD patients with T1D,1.3%higher in AITD patients with T2D,and 1.1%higher in AITD patients without diabetes compared to GADA,respectively.Furthermore,12.5%,20.0%,and 20.0%of the 3 Screen ICA-positive patients were negative for GADA.Additionally,1.3%of the AITD patients who tested negative for 3 Screen ICA in both the AITD with T2D and non-diabetic AITD groups were found to be positive for individual autoantibodies.Among the 3 Screen ICA-positive patients,there was a significantly higher proportion of individuals with multiple autoantibodies in AITD patients with T1D compared to those without diabetes(37.5%vs 5.0%,P<0展开更多
BACKGROUND Despite an expanding number of studies on intraductal papillary neoplasm of the bile duct(IPNB),distant metastasis remains unexplained especially in cases of carcinoma in situ.In the present study,we report...BACKGROUND Despite an expanding number of studies on intraductal papillary neoplasm of the bile duct(IPNB),distant metastasis remains unexplained especially in cases of carcinoma in situ.In the present study,we report a rare and interesting case of IPNB without invasive components that later metastasized to lungs and brain.CASE SUMMARY A 69-year-old male was referred to our hospital due to suspected cholangiocarcinoma.Laboratory tests on admission reported a mild elevation of alkaline phosphatase,γ-glutamyl transpeptidase,and total bilirubin in serum.Endoscopic retrograde cholangiography revealed a filling defect in the common bile duct(CBD)extending to the left hepatic duct.Peroral cholangioscopy delineated a tumor in the CBD that had a papillary pattern.Multidetector computed tomography and magnetic resonance cholangiopancreatography detected partial blockage ot interlude in the CBD leading to cholestasis without evidence of metastasis.Therefore,a diagnosis of IPNB cT1N0M0 was established.Left hepatectomy with bile duct reconstruction was performed.Pathological examination confirmed an intraepithelial neoplasia pattern without an invasive component and an R0 resection achievement.The patient was monitored carefully by regular examinations.However,at 32 mo after the operation,a 26 mm tumor in the lungs and a 12 mm lesion in the brain were detected following a suspicious elevated CA 19-9 level.Video-assisted thoracoscopic surgery of left upper lobectomy and stereotactic radiotherapy are indicated.In addition to histopathological results,a genomic profiling analysis using whole exome sequencing subsequently confirmed lung metastasis originating from bile duct cancer.CONCLUSION This case highlights the important role of genomic profiling analysis using whole exome sequencing in identifying the origin of metastasis in patients with IPNB.展开更多
Inflammation has been shown to be a factor in tumorigenesis. The circulating platelet to lymphocyte ratio (PLR) is a representative index of systemic inflammation. In this study, we analyzed the association between pr...Inflammation has been shown to be a factor in tumorigenesis. The circulating platelet to lymphocyte ratio (PLR) is a representative index of systemic inflammation. In this study, we analyzed the association between preoperative PLR levels and clinicopathological variables in two hundred sixty-four Japanese patients with localized breast carcinoma. We also evaluated the prognostic significance of preoperative PLR levels using the Cox proportional hazard model. Seventy-five patients (28.4%) had elevated PLR values, whereas 189 (71.6%) had depressed PLR values. The PLR correlated significantly with venous invasion (P < 0.05). Disease-free survival rates were significantly worse among patients with elevated PLR values than among those with lower PLR value (5-year survival, 81.6% vs. 90.7%, respectively;P < 0.05). In multivariate analysis, elevated PLR, nuclear grade, and lymph node involvement were significant prognostic factors for disease-free survival in patients with breast carcinoma (P < 0.05). Preoperative PLR levels may be an independent prognostic factor in patients with breast carcinoma.展开更多
AIM To assess cancer-testis antigens(CTAs) expression in gastric cancer patients and examined their associations with clinicopathological factors.METHODS Eighty-three gastric cancer patients were evaluated in this stu...AIM To assess cancer-testis antigens(CTAs) expression in gastric cancer patients and examined their associations with clinicopathological factors.METHODS Eighty-three gastric cancer patients were evaluated in this study. Gastric cancer specimens were evaluated for the gene expression of CTAs, Kitakyushu lung cancer antigen-1(KK-LC-1), melanoma antigen(MAGE)-A1, MAGE-A3 and New York esophageal cancer-1(NYESO-1), by reverse transcription PCR. Clinicopathological background information, such as gender, age, tumor size, macroscopic type, tumor histology, depth of invasion, lymph node metastasis, lymphatic invasion, venous invasion, and pathological stage, was obtained. Statistical comparisons between the expression of each CTA and each clinicopathological background were performed using the χ2 test. RESULTS The expression rates of KK-LC-1, MAGE-A1, MAGE-A3, and NY-ESO-1 were 79.5%, 32.5%, 39.8%, and 15.7%, respectively. In early stage gastric cancer specimens, the expression of KK-LC-1 was 79.4%, which is comparable to the 79.6% observed in advanced stage specimens. The expression of KK-LC-1 was not significantly associated with clinicopathological factors, while there were considerable differences in the expression rates of MAGE-A1 and MAGE-A3 with vs without lymphatic invasion(MAGE-A1, 39.3% vs 13.6%, P = 0.034; MAGE-A3, 47.5% vs 18.2%, P = 0.022) and/or vascular invasion(MAGE-A1, 41.5% vs 16.7%, P = 0.028; MAGE-A3, 49.1% vs 23.3%, P = 0.035) and, particularly, MAGE-A3, in patients with early vs advanced stage(36.5% vs 49.0%, P = 0.044), respectively. Patients expressing MAGE-A3 and NYESO-1 were older than those not expressing MAGE-A3 and NY-ESO-1(MAGE-A3, 73.7 ± 7.1 vs 67.4 ± 12.3, P = 0.009; NY-ESO-1, 75.5 ± 7.2 vs 68.8 ± 11.2, P = 0.042). CONCLUSION The KK-LC-1 expression rate was high even in patients with stage I cancer, suggesting that KK-LC-1 is a useful biomarker for early diagnosis of gastric cancer.展开更多
BACKGROUND The ABCD stratification[combination of serum pepsinogen(PG)levels and titers of antibody(immunoglobulin G,IgG)against Helicobacter pylori(H.pylori)]is effective for the classification of individuals at risk...BACKGROUND The ABCD stratification[combination of serum pepsinogen(PG)levels and titers of antibody(immunoglobulin G,IgG)against Helicobacter pylori(H.pylori)]is effective for the classification of individuals at risk of developing gastric cancer(GC).The Kita–Kyushu lung cancer antigen-1(KK-LC-1)is a Cancer/Testis antigen frequently expressed in GC.AIM To evaluate the effectiveness of KK-LC-1 and ABCD stratification in the diagnosis of GC.METHODS We analyzed the gene expression of KK-LC-1 in surgical specimens obtained from GC tumors.The levels of serum PG I/PG II and IgG against H.pylori were measured.According to their serological status,the patients were classified into the four groups of the ABCD stratification.RESULTS Of the 77 examined patients,63(81.8%)expressed KK-LC-1.The IgG titers of H.pylori and PG II were significantly higher in patients expressing KK-LC-1 than those measured in patients not expressing KK-LC-1(P=0.0289 and P=0.0041,respectively).The expression of KK-LC-1 in group C[PG method(+)/H.pylori infection(+)]was as high as 93.9%high.KK-LC-1 was also detected in group A[-/-].CONCLUSION The KK-LC-1 expression in GC was associated with H.pylori infection and atrophic status,so that,KK-LC-1 may be a useful marker for the diagnosis of GC.展开更多
This report presents a case of massive mucosal necrosis of the small intestine in a patient with mitochondrial myopathy,encephalopathy,lactic acidosis,and stroke-like episodes(MELAS),which particularly affects the bra...This report presents a case of massive mucosal necrosis of the small intestine in a patient with mitochondrial myopathy,encephalopathy,lactic acidosis,and stroke-like episodes(MELAS),which particularly affects the brain,nervous system and muscles.A 45-year-old Japanese female,with an established diagnosis of MELAS,presented with vomiting.Computed tomography showed portomesenteric venous gas and pneumatosis intestinalis.She underwent a resection of the small intestine.A microscopic study showed necrosis of the mucosa and vacuolar degeneration of smooth muscle cells in the arterial wall.Immunohistochemistry showed anti-mitochondrial antibody to be highly expressed in the crypts adjacent the necrotic mucosa.The microscopic and immunohistochemical findings suggested the presence of a large number of abnormal mitochondria in MELAS to be closely linked to mucosal necrosis of the small intestine.展开更多
DEAR EDITOR,Miralia alternans(Ruess,1833)is distributed in Borneo,Sumatra,and Java in Southeast Asia.The species is morphologically similar to Raclitia indica,a monotypic genus known from Peninsular Malaysia.Here,we c...DEAR EDITOR,Miralia alternans(Ruess,1833)is distributed in Borneo,Sumatra,and Java in Southeast Asia.The species is morphologically similar to Raclitia indica,a monotypic genus known from Peninsular Malaysia.Here,we collected a juvenile specimen of M.alternans from Borneo,and report on its coloration in life and first prey item recovered from the species.We also explored the phylogenetic position of the genus using molecular phylogenetic analysis of mitochondrial DNA(mtDNA)gene cytochrome b(cyt b)and nuclear gene prolactin receptor(PRLR),confirming M.alternans as sister to R.indica,with the two genera exhibiting relatively high genetic divergence in cyt b(13.0%-13.1%).展开更多
Fully non-inductive plasma start-up was successfully achieved by using a well- controlled microwave source on the spherical tokamak, QUEST. Non-inductive plasmas were maintained for approximately 3-5 min, during which...Fully non-inductive plasma start-up was successfully achieved by using a well- controlled microwave source on the spherical tokamak, QUEST. Non-inductive plasmas were maintained for approximately 3-5 min, during which time power balance estimates could be achieved by monitoring wall and cooling-water temperatures. Approximately 70%-90% of the injected power could be accounted for by calorimetric measurements and approximately half of the injected power was found to be deposited on the vessel wall, which is slightly dependent on the magnetic configuration. The power distribution to water-cooled limiters, which are expected to be exposed to local heat loads, depends significantly on the magnetic configuration, however some of the deposited power is due to energetic electrons, which have large poloidal orbits and are likely to be deposited on the plasma facing components.展开更多
This paper reports stick-slip behaviors of Indian gabbro as studied using a new large-scale biaxial friction apparatus, built in the National Research Institute for Earth Science and Disaster Prevention （NIED）, Tsuk...This paper reports stick-slip behaviors of Indian gabbro as studied using a new large-scale biaxial friction apparatus, built in the National Research Institute for Earth Science and Disaster Prevention （NIED）, Tsukuba, Japan. The apparatus consists of the existing shaking table as the shear-loading device up to 3,600 kN, the main frame for holding two large rectangular prismatic specimens with a sliding area of 0.75 m^2 and for applying normal stresses an up to 1.33 MPa, and a reaction force unit holding the stationary specimen to the ground. The shaking table can produce loading rates v up to 1.0 m/s, accelerations up to 9.4 m/s^2, and displacements d up to 0.44 m, using four servocontrolled actuators. We report results from eight preliminary experiments conducted with room humidity on the same gabbro specimens at v = 0.1-100 mm/s and an = 0.66-1.33 MPa, and with d of about 0.39 m. The peak and steady-state friction coefficients were about 0.8 and 0.6, respectively, consistent with the Byerlee friction. The axial force drop or shear stress drop during an abrupt slip is linearly proportional to the amount of displacement, and the slope of this rela- tionship determines the stiffness of the apparatus as 1.15 × 10^8 N/m or 153 MPa/m for the specimens we used. This low stiffness makes fault motion very unstable and the overshooting of shear stress to a negative value was recognized in some violent stick-slip events. An abrupt slip occurred in a constant rise time of 16-18 ms despite wide variation of the stress drop, and an average velocity during an abrupt slip is linearly proportional to the stress drop. The use of a large-scale shaking table has a great potential in increasing the slip rate and total displacement in biaxial friction experiments with large specimens.展开更多
This paper presents practical distribution system equipment models such as various distributed generators, voltage regulators, and loads for fast three phase unbalanced load flow calculation in distribution systems. T...This paper presents practical distribution system equipment models such as various distributed generators, voltage regulators, and loads for fast three phase unbalanced load flow calculation in distribution systems. The method can calculate voltage and current of distribution systems, in which distributed generators are introduced. The calculation time of the proposed method is about 40 times faster than that of the Newton-Raphson method. Moreover, an introduction effect evaluation tool for distributed generators using the proposed three phase unbalanced load flow calculation is presented. It provides various functions such as a power system network diagram creation function and a voltage profile chart display function. Therefore, the introduction effect evaluation of distributed generators in distribution systems can be evaluated quite easily.展开更多
Napier grass （Pennisetum purpureum Schumach）, a C4 tropical plant, has high dry matter productivity and sustainability without the need for renovating every year due to good overwintering ability and the absence of ...Napier grass （Pennisetum purpureum Schumach）, a C4 tropical plant, has high dry matter productivity and sustainability without the need for renovating every year due to good overwintering ability and the absence of serious pathogens or insects injury. This grass is suitable for multipurpose use, providing forage, bioethanol feedstock and phytoremediation of cadmium （Cd） contaminated soil in Kyushu, Japan. When two cultivars of Napier grass （Wruk wona, WK and Merkeron, ME） were grown in Cd-contaminated soils, dry matter yield and the concentration and uptake of herbage Cd were higher in WK than in ME, and soil Cd concentration was reduced by 14% in a single season of cultivation. A dwarf variety of late-heading type （DL）, Napier grass had superior sustainability for more than 5 years in Miyazaki, Japan, and has gradually increased in cultivation areas for both cut-and-carry and grazing herbage production in cooperation with regional communities. Through the extension in several Kyushu areas, DL Napier grass required temperatures above -6.2 ~C for sustainability in winter, based on its threshold response to the lethal minimum temperature. DL Napier grass pasture can be utilized by grazing beef cattle even in early spring with temperate Italian ryegrass inter-sown into its inter-row spaces. Organic digested animal manure or sun-dried leguminous leaves as green manure can replace chemical fertilizers to reduce energy consumption and allow comparable productivity.展开更多
BACKGROUND Omarigliptin is one of several once-weekly dipeptidyl peptidase-4 inhibitors(DPP-4is).Despite the high frequency of switching from various daily DPP-4is to omarigliptin in actual clinical practice,data rega...BACKGROUND Omarigliptin is one of several once-weekly dipeptidyl peptidase-4 inhibitors(DPP-4is).Despite the high frequency of switching from various daily DPP-4is to omarigliptin in actual clinical practice,data regarding its efficacy in patients with type 2 diabetes(T2D)after switching are limited.AIM To analyze the efficacy of omarigliptin in Japanese patients with T2D who had previously received treatment with other glucose-lowering agents.METHODS Forty-nine T2D patients treated for the first time with omarigliptin were recruited retrospectively and divided into four groups defined as either add-on or switched from daily DPP-4is:switched from linagliptin,switched from sitagliptin,and switched from vildagliptin.During a 3-mo follow-up,the clinical parameters among these groups were assessed and compared,with the impact of the switch on glycemic variability as measured by continuous glucose monitoring also being evaluated in the switched groups.RESULTS Hemoglobin A1c levels saw a significant decrease of-0.32%±0.41%in the add-on group(P=0.002).However,the other groups’variables depended on the preswitch daily DPP-4i:switched from linagliptin,-0.05%±0.22%;switched from sitagliptin,-0.17%±0.33%;and switched from vildagliptin,0.45%±0.42%,which saw significant worsening(P=0.0007).Multivariate logistic regression analysis revealed that switching from vildagliptin to omarigliptin was independently associated with worsening glycemic control(P=0.0013).The mean and standard deviation of sensor glucose value,the mean amplitude of glycemic excursions,and the mean of daily difference significantly improved when switching the patient from either linagliptin or sitagliptin to omarigliptin.However,in patients switched from vildagliptin,not only did the glucose variability indices see no improvements,the mean of daily difference even underwent significant worsening.CONCLUSION Administering omarigliptin as add-on therapy or switching to it from sitagliptin and linagliptin,but not vildagliptin,improves glycemic control and 展开更多
An Open-Top Chamber with Solar-heated Double Funnels (OTC-SDF2) that uses solar energy as a heating source was developed in this study. Two air entry/exit funnels were connected to the OTC via flat tunnels through whi...An Open-Top Chamber with Solar-heated Double Funnels (OTC-SDF2) that uses solar energy as a heating source was developed in this study. Two air entry/exit funnels were connected to the OTC via flat tunnels through which air was warmed by solar radiation. The new apparatus increased the air temperature by approximately 1°C throughout the chamber when more than half the energy of full sunlight was supplied. Although air flow occurs in only two directions, a nearly constant temperature increase was observed for each wind direction. This increase in temperature was stable for 1 m<sup>ˉs</sup> to 4 m<sup>ˉs</sup> wind speeds in every direction. This degree of warming may be adequate for screening high-temperature tolerant plants from medium to weak cultivars. The OTC-SDF2 has the potential to provide moderately high-temperature treatments for screening various cultivars/strains and may be used to evaluate easy, low-cost cropping methods associated with high-temperature stresses.展开更多
Happiness is a positive feeling characterized by satisfaction, joy, pleasure, or love. Perceived happiness level is likely associated with health and well-being. However, the neurobiological mechanisms underlying the ...Happiness is a positive feeling characterized by satisfaction, joy, pleasure, or love. Perceived happiness level is likely associated with health and well-being. However, the neurobiological mechanisms underlying the positive effects of happiness on psychological and physiological wellness remain obscure. In this study, we found that the medial prefrontal cortex (MPFC) was strongly activated and positive emotions were strongly evoked in individuals with high perceived happiness levels compared to those with low perceived happiness levels when either looked at a favorite person. Moreover, positive mood changes were positively correlated with MPFC activity. These results show that perceived happiness level is associated with positive emotion evocation by means of the MPFC function, which may be involved in psychological and physiological wellness. Therefore, happiness may play an important role in psychological and physiological wellness.展开更多
Purpose: To assess the clinical feasibility of automated segmentation of the myocardial area at risk (MAAR) using coronary computed tomography angiography (CT-MAAR), as compared to stress magnetic resonance myocardial...Purpose: To assess the clinical feasibility of automated segmentation of the myocardial area at risk (MAAR) using coronary computed tomography angiography (CT-MAAR), as compared to stress magnetic resonance myocardial perfusion imaging (MR-MPI). Materials and Methods: Thirty patients who underwent coronary computed tomography angiography (CTA) and stress MR-MPI were retrospectively evaluated. The myocardial territory of the left ventricle (LV) distal to coronary artery stenosis (≥50% or ≥70% stenosis on coronary CTA) was three-dimensionally quantified using a Voronoi diagram. The ratio of all stenosis-related territories to the LV volume was defined as CT-MAAR (%-LV volume). The proportion of segments with perfusion defects in stress MR-MPI to the total of 16 segments (range: 0% - 100%;with a 6.3%-interval scale) was defined as the reference. Correlation was assessed using Spearman’s test. The capability of CT-MAAR to predict the ischemic burden was assessed. Results: Stress MR-MPI depicted a median ischemic burden of 25.2% (range: 18.9% - 44.1%) in 30 patients without myocardial infarction. When CTA stenosis criteria of ≥50% (n = 30) and ≥70% (n = 27) were applied to estimate CT-MAAR, the median CT-MAAR values were 48.2% (31.6% - 64.3%) and 32.5% (23.7% - 51.9%), respectively. The correlations between the CT-MAAR values and the MR-based ischemic burden were significant (0.73 and 0.97 for ≥50% and ≥70% stenosis, respectively). CT-MAAR predicted the MR-based ischemic burden within ±1 segment of %-LV (6.3%) in 40% (12/30) of patients with ≥50% stenosis, and in 81.5% (22/27) of patients with ≥70% stenosis. Conclusions: Comprehensive assessment of resting coronary CTA combined with Voronoi diagram-based myocardial segmentation may help predict the myocardial ischemic burden in patients with severe coronary CTA stenosis.展开更多
文摘Postoperative recurrence occurs in approximately half of patients with non-small cell lung cancer(NSCLC), even after complete resection. Disease recurrence after surgical resection reduces the patient's life expectancy sharply. The prognosis after postoperative recurrence is considered to largely depend on both the mode of first recurrence(distant, locoregional or combined) and the treatment modality:(1) The majority of cases of postoperative recurrence involve distant metastasis with or without locoregional recurrence. Platinum-based systemic chemotherapy is practically accepted as the treatment for these diseases on the basis of evidence for original stage Ⅳ disease. The advent of both pemetrexed and molecular-targeted drugs has improved the survival of nonsquamous NSCLC and changed the chemotherapeutic algorithm for NSCLC;(2) Among patients with distant metastatic recurrence without locoregional recurrence at the primary tumor site, the metastasis is often limited in both organ and number. Such metastases are referred to as oligometastases. Local therapy, such as surgical resection and radiotherapy, has been suggested to be the first-line treatment of choice foroligometastatic recurrence; and(3) While locoregional recurrence is likely to cause troublesome symptoms, it is a potentially limited disease. Therefore, providing local control is important, and radiation is usually beneficial for treating local recurrence. In order to obtain better control of the disease and provide treatment with curative intent in patients with limited disease, the administration of concurrent platinum-based chemoradiotherapy is recommended according to the results of originally nonresectable stage ⅢA and ⅢB disease.
文摘BACKGROUND In recent years,the emergence of multiplex technology that can simultaneously measure multiple anti-islet autoantibodies has become particularly valuable for the staging and early diagnosis of immune-mediated type 1 diabetes(T1D).While it has been established that 20%-30%of T1D patients suffer from autoimmune thyroid disease(AITD),there is limited available data regarding the presence of anti-islet autoantibodies in AITD patients.Among commercially available anti-islet autoantibodies,glutamic acid decarboxylase 65 autoantibodies(GADAs)are often the first marker measured in general clinical practice.AIM To investigate the frequency of anti-islet autoantibodies in AITD patients.METHODS Our study involved four hundred ninety-five AITD patients,categorized into three distinct groups:AITD with T1D(n=18),AITD with phenotypic type 2 diabetes(T2D)(n=81),and AITD without diabetes(n=396),and the enzyme-linked immunosorbent assay(ELISA)was employed to determine the frequencies of 3 Screen Islet Cell Autoantibody(3 Screen ICA),GADA,insulinoma-associated antigen-2 autoantibodies(IA-2As),and zinc transporter 8 autoantibodies(ZnT8As)within these groups.RESULTS The frequency of 3 Screen ICA in AITD patients with T1D,T2D,and those without diabetes were 88.9%,6.2%,and 5.1%,respectively,with no significant difference seen between the latter two groups.Notably,the frequency of 3 Screen ICA was 11.1%higher in AITD patients with T1D,1.3%higher in AITD patients with T2D,and 1.1%higher in AITD patients without diabetes compared to GADA,respectively.Furthermore,12.5%,20.0%,and 20.0%of the 3 Screen ICA-positive patients were negative for GADA.Additionally,1.3%of the AITD patients who tested negative for 3 Screen ICA in both the AITD with T2D and non-diabetic AITD groups were found to be positive for individual autoantibodies.Among the 3 Screen ICA-positive patients,there was a significantly higher proportion of individuals with multiple autoantibodies in AITD patients with T1D compared to those without diabetes(37.5%vs 5.0%,P<0
文摘BACKGROUND Despite an expanding number of studies on intraductal papillary neoplasm of the bile duct(IPNB),distant metastasis remains unexplained especially in cases of carcinoma in situ.In the present study,we report a rare and interesting case of IPNB without invasive components that later metastasized to lungs and brain.CASE SUMMARY A 69-year-old male was referred to our hospital due to suspected cholangiocarcinoma.Laboratory tests on admission reported a mild elevation of alkaline phosphatase,γ-glutamyl transpeptidase,and total bilirubin in serum.Endoscopic retrograde cholangiography revealed a filling defect in the common bile duct(CBD)extending to the left hepatic duct.Peroral cholangioscopy delineated a tumor in the CBD that had a papillary pattern.Multidetector computed tomography and magnetic resonance cholangiopancreatography detected partial blockage ot interlude in the CBD leading to cholestasis without evidence of metastasis.Therefore,a diagnosis of IPNB cT1N0M0 was established.Left hepatectomy with bile duct reconstruction was performed.Pathological examination confirmed an intraepithelial neoplasia pattern without an invasive component and an R0 resection achievement.The patient was monitored carefully by regular examinations.However,at 32 mo after the operation,a 26 mm tumor in the lungs and a 12 mm lesion in the brain were detected following a suspicious elevated CA 19-9 level.Video-assisted thoracoscopic surgery of left upper lobectomy and stereotactic radiotherapy are indicated.In addition to histopathological results,a genomic profiling analysis using whole exome sequencing subsequently confirmed lung metastasis originating from bile duct cancer.CONCLUSION This case highlights the important role of genomic profiling analysis using whole exome sequencing in identifying the origin of metastasis in patients with IPNB.
文摘Inflammation has been shown to be a factor in tumorigenesis. The circulating platelet to lymphocyte ratio (PLR) is a representative index of systemic inflammation. In this study, we analyzed the association between preoperative PLR levels and clinicopathological variables in two hundred sixty-four Japanese patients with localized breast carcinoma. We also evaluated the prognostic significance of preoperative PLR levels using the Cox proportional hazard model. Seventy-five patients (28.4%) had elevated PLR values, whereas 189 (71.6%) had depressed PLR values. The PLR correlated significantly with venous invasion (P < 0.05). Disease-free survival rates were significantly worse among patients with elevated PLR values than among those with lower PLR value (5-year survival, 81.6% vs. 90.7%, respectively;P < 0.05). In multivariate analysis, elevated PLR, nuclear grade, and lymph node involvement were significant prognostic factors for disease-free survival in patients with breast carcinoma (P < 0.05). Preoperative PLR levels may be an independent prognostic factor in patients with breast carcinoma.
基金Supported by Grant-in-Aid for research by Kitasato University Medical Center,No.H25-0006 and the JSPS,KAKENHI,No.26670609 to Futawatari Nthe JSPS,KAKENHI,No.21700510 and No.17K16578,Takeda Science Foundation and Kitasato University Research Grant for Young Researchers to Fukuyama T
文摘AIM To assess cancer-testis antigens(CTAs) expression in gastric cancer patients and examined their associations with clinicopathological factors.METHODS Eighty-three gastric cancer patients were evaluated in this study. Gastric cancer specimens were evaluated for the gene expression of CTAs, Kitakyushu lung cancer antigen-1(KK-LC-1), melanoma antigen(MAGE)-A1, MAGE-A3 and New York esophageal cancer-1(NYESO-1), by reverse transcription PCR. Clinicopathological background information, such as gender, age, tumor size, macroscopic type, tumor histology, depth of invasion, lymph node metastasis, lymphatic invasion, venous invasion, and pathological stage, was obtained. Statistical comparisons between the expression of each CTA and each clinicopathological background were performed using the χ2 test. RESULTS The expression rates of KK-LC-1, MAGE-A1, MAGE-A3, and NY-ESO-1 were 79.5%, 32.5%, 39.8%, and 15.7%, respectively. In early stage gastric cancer specimens, the expression of KK-LC-1 was 79.4%, which is comparable to the 79.6% observed in advanced stage specimens. The expression of KK-LC-1 was not significantly associated with clinicopathological factors, while there were considerable differences in the expression rates of MAGE-A1 and MAGE-A3 with vs without lymphatic invasion(MAGE-A1, 39.3% vs 13.6%, P = 0.034; MAGE-A3, 47.5% vs 18.2%, P = 0.022) and/or vascular invasion(MAGE-A1, 41.5% vs 16.7%, P = 0.028; MAGE-A3, 49.1% vs 23.3%, P = 0.035) and, particularly, MAGE-A3, in patients with early vs advanced stage(36.5% vs 49.0%, P = 0.044), respectively. Patients expressing MAGE-A3 and NYESO-1 were older than those not expressing MAGE-A3 and NY-ESO-1(MAGE-A3, 73.7 ± 7.1 vs 67.4 ± 12.3, P = 0.009; NY-ESO-1, 75.5 ± 7.2 vs 68.8 ± 11.2, P = 0.042). CONCLUSION The KK-LC-1 expression rate was high even in patients with stage I cancer, suggesting that KK-LC-1 is a useful biomarker for early diagnosis of gastric cancer.
基金Supported by Grant-in-Aid for research by the Kitasato University Medical Center,No.H26-008the JSPS KAKENHI,No.17K16578+3 种基金the JSPS KAKENHI,No.26670609Takeda Science FoundationKitasato University Research Grant for Young ResearchersGrant-in-Aid for research from the Kitasato University Medical Center,No.H25-0006
文摘BACKGROUND The ABCD stratification[combination of serum pepsinogen(PG)levels and titers of antibody(immunoglobulin G,IgG)against Helicobacter pylori(H.pylori)]is effective for the classification of individuals at risk of developing gastric cancer(GC).The Kita–Kyushu lung cancer antigen-1(KK-LC-1)is a Cancer/Testis antigen frequently expressed in GC.AIM To evaluate the effectiveness of KK-LC-1 and ABCD stratification in the diagnosis of GC.METHODS We analyzed the gene expression of KK-LC-1 in surgical specimens obtained from GC tumors.The levels of serum PG I/PG II and IgG against H.pylori were measured.According to their serological status,the patients were classified into the four groups of the ABCD stratification.RESULTS Of the 77 examined patients,63(81.8%)expressed KK-LC-1.The IgG titers of H.pylori and PG II were significantly higher in patients expressing KK-LC-1 than those measured in patients not expressing KK-LC-1(P=0.0289 and P=0.0041,respectively).The expression of KK-LC-1 in group C[PG method(+)/H.pylori infection(+)]was as high as 93.9%high.KK-LC-1 was also detected in group A[-/-].CONCLUSION The KK-LC-1 expression in GC was associated with H.pylori infection and atrophic status,so that,KK-LC-1 may be a useful marker for the diagnosis of GC.
文摘This report presents a case of massive mucosal necrosis of the small intestine in a patient with mitochondrial myopathy,encephalopathy,lactic acidosis,and stroke-like episodes(MELAS),which particularly affects the brain,nervous system and muscles.A 45-year-old Japanese female,with an established diagnosis of MELAS,presented with vomiting.Computed tomography showed portomesenteric venous gas and pneumatosis intestinalis.She underwent a resection of the small intestine.A microscopic study showed necrosis of the mucosa and vacuolar degeneration of smooth muscle cells in the arterial wall.Immunohistochemistry showed anti-mitochondrial antibody to be highly expressed in the crypts adjacent the necrotic mucosa.The microscopic and immunohistochemical findings suggested the presence of a large number of abnormal mitochondria in MELAS to be closely linked to mucosal necrosis of the small intestine.
基金supported by the Shikata Memorial Trust for Nature Conservation to I.F.Asahi Glass Foundation to K.N.+2 种基金JSPS Core-to-Core Program Type B.Asia-Africa Science Platforms(Coordinator:M.Motokawa)JST/JICA,SATREPS to T.ItiokaThe field trip by M.M.and K.N.was made possible by a grant from the Monbusho through the Japanese Society for the Promotion of Science(JSPS,Field Research,No.20405013) to M.M.
文摘DEAR EDITOR,Miralia alternans(Ruess,1833)is distributed in Borneo,Sumatra,and Java in Southeast Asia.The species is morphologically similar to Raclitia indica,a monotypic genus known from Peninsular Malaysia.Here,we collected a juvenile specimen of M.alternans from Borneo,and report on its coloration in life and first prey item recovered from the species.We also explored the phylogenetic position of the genus using molecular phylogenetic analysis of mitochondrial DNA(mtDNA)gene cytochrome b(cyt b)and nuclear gene prolactin receptor(PRLR),confirming M.alternans as sister to R.indica,with the two genera exhibiting relatively high genetic divergence in cyt b(13.0%-13.1%).
基金supported by Grant-in-Aid for JSPS Fellows(KAKENHI Grant Number 16H02441,24656559)performed with the support and under the auspices of the NIFS Collaboration Research Program(NIFS05KUTRO14,NIFS11KUTR061,NIFS13KUTR085,NIFS14KUTR103)+1 种基金supported in part by the Collaborative Research Program of the Research Institute for Applied Mechanics,Kyushu Universitypartly supported by the JSPS-NRF-NSFC A3 Foresight Program in the Field of Plasma Physics(No.11261140328)
文摘Fully non-inductive plasma start-up was successfully achieved by using a well- controlled microwave source on the spherical tokamak, QUEST. Non-inductive plasmas were maintained for approximately 3-5 min, during which time power balance estimates could be achieved by monitoring wall and cooling-water temperatures. Approximately 70%-90% of the injected power could be accounted for by calorimetric measurements and approximately half of the injected power was found to be deposited on the vessel wall, which is slightly dependent on the magnetic configuration. The power distribution to water-cooled limiters, which are expected to be exposed to local heat loads, depends significantly on the magnetic configuration, however some of the deposited power is due to energetic electrons, which have large poloidal orbits and are likely to be deposited on the plasma facing components.
基金supported by the NIED research project titled‘‘Development of the Earthquake Activity Monitoring and Forecasting,’’the JSPS KAKENHI Grant No.23340131the State Key Laboratory of Earthquake Dynamics,Institute of Geology,CEA(LED2014A06)
文摘This paper reports stick-slip behaviors of Indian gabbro as studied using a new large-scale biaxial friction apparatus, built in the National Research Institute for Earth Science and Disaster Prevention （NIED）, Tsukuba, Japan. The apparatus consists of the existing shaking table as the shear-loading device up to 3,600 kN, the main frame for holding two large rectangular prismatic specimens with a sliding area of 0.75 m^2 and for applying normal stresses an up to 1.33 MPa, and a reaction force unit holding the stationary specimen to the ground. The shaking table can produce loading rates v up to 1.0 m/s, accelerations up to 9.4 m/s^2, and displacements d up to 0.44 m, using four servocontrolled actuators. We report results from eight preliminary experiments conducted with room humidity on the same gabbro specimens at v = 0.1-100 mm/s and an = 0.66-1.33 MPa, and with d of about 0.39 m. The peak and steady-state friction coefficients were about 0.8 and 0.6, respectively, consistent with the Byerlee friction. The axial force drop or shear stress drop during an abrupt slip is linearly proportional to the amount of displacement, and the slope of this rela- tionship determines the stiffness of the apparatus as 1.15 × 10^8 N/m or 153 MPa/m for the specimens we used. This low stiffness makes fault motion very unstable and the overshooting of shear stress to a negative value was recognized in some violent stick-slip events. An abrupt slip occurred in a constant rise time of 16-18 ms despite wide variation of the stress drop, and an average velocity during an abrupt slip is linearly proportional to the stress drop. The use of a large-scale shaking table has a great potential in increasing the slip rate and total displacement in biaxial friction experiments with large specimens.
文摘This paper presents practical distribution system equipment models such as various distributed generators, voltage regulators, and loads for fast three phase unbalanced load flow calculation in distribution systems. The method can calculate voltage and current of distribution systems, in which distributed generators are introduced. The calculation time of the proposed method is about 40 times faster than that of the Newton-Raphson method. Moreover, an introduction effect evaluation tool for distributed generators using the proposed three phase unbalanced load flow calculation is presented. It provides various functions such as a power system network diagram creation function and a voltage profile chart display function. Therefore, the introduction effect evaluation of distributed generators in distribution systems can be evaluated quite easily.
文摘Napier grass （Pennisetum purpureum Schumach）, a C4 tropical plant, has high dry matter productivity and sustainability without the need for renovating every year due to good overwintering ability and the absence of serious pathogens or insects injury. This grass is suitable for multipurpose use, providing forage, bioethanol feedstock and phytoremediation of cadmium （Cd） contaminated soil in Kyushu, Japan. When two cultivars of Napier grass （Wruk wona, WK and Merkeron, ME） were grown in Cd-contaminated soils, dry matter yield and the concentration and uptake of herbage Cd were higher in WK than in ME, and soil Cd concentration was reduced by 14% in a single season of cultivation. A dwarf variety of late-heading type （DL）, Napier grass had superior sustainability for more than 5 years in Miyazaki, Japan, and has gradually increased in cultivation areas for both cut-and-carry and grazing herbage production in cooperation with regional communities. Through the extension in several Kyushu areas, DL Napier grass required temperatures above -6.2 ~C for sustainability in winter, based on its threshold response to the lethal minimum temperature. DL Napier grass pasture can be utilized by grazing beef cattle even in early spring with temperate Italian ryegrass inter-sown into its inter-row spaces. Organic digested animal manure or sun-dried leguminous leaves as green manure can replace chemical fertilizers to reduce energy consumption and allow comparable productivity.
文摘BACKGROUND Omarigliptin is one of several once-weekly dipeptidyl peptidase-4 inhibitors(DPP-4is).Despite the high frequency of switching from various daily DPP-4is to omarigliptin in actual clinical practice,data regarding its efficacy in patients with type 2 diabetes(T2D)after switching are limited.AIM To analyze the efficacy of omarigliptin in Japanese patients with T2D who had previously received treatment with other glucose-lowering agents.METHODS Forty-nine T2D patients treated for the first time with omarigliptin were recruited retrospectively and divided into four groups defined as either add-on or switched from daily DPP-4is:switched from linagliptin,switched from sitagliptin,and switched from vildagliptin.During a 3-mo follow-up,the clinical parameters among these groups were assessed and compared,with the impact of the switch on glycemic variability as measured by continuous glucose monitoring also being evaluated in the switched groups.RESULTS Hemoglobin A1c levels saw a significant decrease of-0.32%±0.41%in the add-on group(P=0.002).However,the other groups’variables depended on the preswitch daily DPP-4i:switched from linagliptin,-0.05%±0.22%;switched from sitagliptin,-0.17%±0.33%;and switched from vildagliptin,0.45%±0.42%,which saw significant worsening(P=0.0007).Multivariate logistic regression analysis revealed that switching from vildagliptin to omarigliptin was independently associated with worsening glycemic control(P=0.0013).The mean and standard deviation of sensor glucose value,the mean amplitude of glycemic excursions,and the mean of daily difference significantly improved when switching the patient from either linagliptin or sitagliptin to omarigliptin.However,in patients switched from vildagliptin,not only did the glucose variability indices see no improvements,the mean of daily difference even underwent significant worsening.CONCLUSION Administering omarigliptin as add-on therapy or switching to it from sitagliptin and linagliptin,but not vildagliptin,improves glycemic control and
文摘An Open-Top Chamber with Solar-heated Double Funnels (OTC-SDF2) that uses solar energy as a heating source was developed in this study. Two air entry/exit funnels were connected to the OTC via flat tunnels through which air was warmed by solar radiation. The new apparatus increased the air temperature by approximately 1°C throughout the chamber when more than half the energy of full sunlight was supplied. Although air flow occurs in only two directions, a nearly constant temperature increase was observed for each wind direction. This increase in temperature was stable for 1 m<sup>ˉs</sup> to 4 m<sup>ˉs</sup> wind speeds in every direction. This degree of warming may be adequate for screening high-temperature tolerant plants from medium to weak cultivars. The OTC-SDF2 has the potential to provide moderately high-temperature treatments for screening various cultivars/strains and may be used to evaluate easy, low-cost cropping methods associated with high-temperature stresses.
文摘Happiness is a positive feeling characterized by satisfaction, joy, pleasure, or love. Perceived happiness level is likely associated with health and well-being. However, the neurobiological mechanisms underlying the positive effects of happiness on psychological and physiological wellness remain obscure. In this study, we found that the medial prefrontal cortex (MPFC) was strongly activated and positive emotions were strongly evoked in individuals with high perceived happiness levels compared to those with low perceived happiness levels when either looked at a favorite person. Moreover, positive mood changes were positively correlated with MPFC activity. These results show that perceived happiness level is associated with positive emotion evocation by means of the MPFC function, which may be involved in psychological and physiological wellness. Therefore, happiness may play an important role in psychological and physiological wellness.
文摘Purpose: To assess the clinical feasibility of automated segmentation of the myocardial area at risk (MAAR) using coronary computed tomography angiography (CT-MAAR), as compared to stress magnetic resonance myocardial perfusion imaging (MR-MPI). Materials and Methods: Thirty patients who underwent coronary computed tomography angiography (CTA) and stress MR-MPI were retrospectively evaluated. The myocardial territory of the left ventricle (LV) distal to coronary artery stenosis (≥50% or ≥70% stenosis on coronary CTA) was three-dimensionally quantified using a Voronoi diagram. The ratio of all stenosis-related territories to the LV volume was defined as CT-MAAR (%-LV volume). The proportion of segments with perfusion defects in stress MR-MPI to the total of 16 segments (range: 0% - 100%;with a 6.3%-interval scale) was defined as the reference. Correlation was assessed using Spearman’s test. The capability of CT-MAAR to predict the ischemic burden was assessed. Results: Stress MR-MPI depicted a median ischemic burden of 25.2% (range: 18.9% - 44.1%) in 30 patients without myocardial infarction. When CTA stenosis criteria of ≥50% (n = 30) and ≥70% (n = 27) were applied to estimate CT-MAAR, the median CT-MAAR values were 48.2% (31.6% - 64.3%) and 32.5% (23.7% - 51.9%), respectively. The correlations between the CT-MAAR values and the MR-based ischemic burden were significant (0.73 and 0.97 for ≥50% and ≥70% stenosis, respectively). CT-MAAR predicted the MR-based ischemic burden within ±1 segment of %-LV (6.3%) in 40% (12/30) of patients with ≥50% stenosis, and in 81.5% (22/27) of patients with ≥70% stenosis. Conclusions: Comprehensive assessment of resting coronary CTA combined with Voronoi diagram-based myocardial segmentation may help predict the myocardial ischemic burden in patients with severe coronary CTA stenosis.
