AIM： To determine the effect of ellagic acid on apoptosis and proliferation in pancreatic cancer cells and to determine the mechanism of the pro-survival effects of ellagic acid.METHODS： The effect of ellagic acid o...AIM： To determine the effect of ellagic acid on apoptosis and proliferation in pancreatic cancer cells and to determine the mechanism of the pro-survival effects of ellagic acid.METHODS： The effect of ellagic acid on apoptosis was assessed by measuring Phosphatidylserine externalization, caspase activity, mitochondrial membrane potential and DNA fragmentation; and proliferation by measuring DNA thymidine incorporation. Mitochondrial membrane potential was measured in permeabilized cells, and in isolated mitochondria. Nuclear factor κB （NF-κB） activity was measured by electromobility shift assay （EMSA）. RESULTS： We show that ellagic acid, a polyphenolic compound in fruits and berries, at concentrations 10 to 50 mmol/L stimulates apoptosis in human pancreatic adenocarcinoma cells. Further, ellagic acid decreases proliferation by up to 20-fold at 50 mmol/L. Ellagic acid stimulates the mitochondrial pathway of apoptosis associated with mitochondrial depolarization, cytochrome C release, and the downstream caspase activation. Ellagic acid does not directly affect mitochondria. Ellagic acid dose-dependently decreased NF-κB binding activity. Furthermore, inhibition of NF-κB activity using IkB wild type plasmid prevented the effect of ellagic acid on apoptosis. CONCLUSION： Our data indicate that ellagic acid stimulates apoptosis through inhibition of the prosurvival transcription factor NF-κB.展开更多
To summarize the current views and insights on associations between Helicobacter pylori(H. pylori)-related chronic gastritis and colorectal neoplasm, we reviewed recent studies to clarify whether H. pylori infection/H...To summarize the current views and insights on associations between Helicobacter pylori(H. pylori)-related chronic gastritis and colorectal neoplasm, we reviewed recent studies to clarify whether H. pylori infection/H. pylori-related chronic gastritis is associated with an elevated risk of colorectal neoplasm. Recent studies based on large databases with careful control for confounding variables have clearly demonstrated an increased risk of colorectal neoplasm associated with H. pylori infection. The correlation between H. pylori-related chronic atrophic gastritis(CAG) and colorectal neoplasm has only been examined in a limited number of studies. A recent large study using a national histopathological database, and our study based on the stage of H. pylori-related chronic gastritis as determined by serum levels of H. pylori antibody titer and pepsinogen, indicatedthat H. pylori-related CAG confers an increased risk of colorectal neoplasm, and more extensive atrophic gastritis will probably be associated with even higher risk of neoplasm. In addition, our study suggested that the activity of H. pylori-related chronic gastritis is correlated with colorectal neoplasm risk. H. pylori-related chronic gastritis could be involved in an increased risk of colorectal neoplasm that appears to be enhanced by the progression of gastric atrophy and the presence of active inflammation.展开更多
AIM： To investigate the effect of probiotic bacterium, Clostridium butyricum MIYAIRI 588 strain （CBM） on the changes of the fecal flora in Helicobacter pylori （H pylon） treatment. METHODS： Thirty-five patients w...AIM： To investigate the effect of probiotic bacterium, Clostridium butyricum MIYAIRI 588 strain （CBM） on the changes of the fecal flora in Helicobacter pylori （H pylon） treatment. METHODS： Thirty-five patients with gastric or duodenal ulcers positive for H pylori were randomized either to 1 wk amoxicillin, clarithromycin, lansoprazole （Group 1） or to the same regimen supplemented with CBM 7 d ahead of the triple therapy （Group 2）. Stool samples were collected before and 2, 4, 7, 15, and 22 d after the starting eradication therapy, and were examined intestinal flora. Patients were required to keep a diary record of their condition. RESULTS： Obligate anaerobes decreased significantly on d 2, 4, 8 and 15 in Group 1. On the other hand, they did not decrease significantly in Group 2. The Escherichia coli was dominant bacterium in Enterobacteriaceae, but that was replaced by other species such as Klebsiella and Enterobacter after eradication in Group 1. The change was suppressed in Group 2. Abdominal symptoms were less frequent in Group 2 than in Group 1. CONCLUSION： The combined use of CBM reduced the changes in the intestinal flora and decreased the incidence of gastrointestinal side effects.展开更多
AIM:To evaluate whether metabolic factors are related to distant recurrence of hepatocellular carcinoma(HCC) and survival after curative treatment.METHODS:This retrospective study included 344 patients whose HCC was t...AIM:To evaluate whether metabolic factors are related to distant recurrence of hepatocellular carcinoma(HCC) and survival after curative treatment.METHODS:This retrospective study included 344 patients whose HCC was treated curatively by radiofrequency ablation(RFA) therapy.The mean age was 67.6 years and the mean observation period was 4.04 years.The etiological background of liver disease was hepatitis B virus infection in 30,hepatitis C virus infection in 278,excessive alcohol drinking in 9,and other in 27 patients.The Child-Pugh classification grade was A(n = 307) or B(n = 37).The number of HCC nodules was one in 260,two in 61,and three in 23 patients.For surveillance of HCC recurrence after curative therapy with RFA,patients were radiologically evaluated every 3 mo.Factors associated with distant recurrence of HCC or survival were studied.RESULTS:Inadequate maintenance of blood glucose in diabetic patients was associated with higher incidence of distant recurrence.The 1-,2-,and 3-year recurrence rates were significantly higher in diabetic patients with inadequate maintenance of blood glucose compared with the others:50.6% vs 26.8%,83.5% vs 54.4%,and 93.8% vs 73.0%,respectively(P = 0.0001).Inadequate maintenance of blood glucose was an independent predictor of distant recurrence [adjusted relative risk 1.97(95%CI,1.33-2.91),(P = 0.0007)] after adjustment for other risk factors,such as number of HCC nodules [2.03(95%CI,1.51-2.73),P < 0.0001] and initial level of serum alpha fetoprotein(AFP) [1.43(95%CI,1.04-1.97),P = 0.028].Obesity was not an independent predictor of recurrence.The incidence of distant recurrence did not differ between diabetic patients with adequate maintenance of blood glucose and non-diabetic patients.Among 232 patients who had HCC recurrence,138 had a second recurrence.The 1-,2-,and 3-year rates of second recurrence were significantly higher in diabetic patients with inadequate maintenance of blood glucose than in the others:9.0% vs 5.9%,53.1% vs 24.3%,and 69.6% vs 42.3%,respectively(P = 0展开更多
Bile duct epithelial tumours showing papillary neoplasm in the bile duct lumen are present in the intrahepatic and extrahepatic bile ducts.Clinicopathological images of these tumours are distinctive and diverse,includ...Bile duct epithelial tumours showing papillary neoplasm in the bile duct lumen are present in the intrahepatic and extrahepatic bile ducts.Clinicopathological images of these tumours are distinctive and diverse,including histological images with a low to high grade dysplasia,infiltrating and noninfiltrating characteristics,excessive mucus production,and similarity to intraductal papillary mucinous neoplasm(IPMN)of the pancreas.The World Health Organization Classification of Tumours of the Digestive System in 2010 named these features,intraductal papillary neoplasm of the bile duct(IPNB),as precancerous lesion of biliary carcinoma.IPNB is currently classified into type 1 that is similar to IPMN,and type 2 that is not similar to IPMN.Many of IPNB spreads superficially,and diagnosis with cholangioscopy is considered mandatory to identify accurate localization and progression.Prognosis of IPNB is said to be better than normal bile duct cancer.展开更多
Plants produce jasmonic acid （JA） and its amino acid conjugate, jasmonoyI-L-isoleucine （JA-Ile） as major defense signals in response to wounding and herbivory. In rice （Oryza sativa）, JA and JA-Ile rapidly incre...Plants produce jasmonic acid （JA） and its amino acid conjugate, jasmonoyI-L-isoleucine （JA-Ile） as major defense signals in response to wounding and herbivory. In rice （Oryza sativa）, JA and JA-Ile rapidly increased after mechanical damage, and this increase was further amplified when the wounds were treated with oral secretions from generalist herbivore larvae, lawn armyworms （Spodoptera mauritia）, revealing for the first time active perception mechanisms of herbivore-associated elicitor（s） in rice. In the rice genome, two OsJAR genes can conjugate JA and lie and form JA-Ile in vitro; however, their function in herbivory- induced accumulation of JA-Ile has not been investigated. By functional characterization of TOS17 retrotransposon-tagged Osjarl plants and their response to simulated herbivory, we show that OsJAR1 is essential for JA-Ile production in herbivore-attacked, field-grown plants. In addition, OsJAR1 was required for normal seed development in rice under field conditions. Our results suggest that OsJAR1 possesses at least two major functions in rice defense and development that cannot be complemented by the additional OsJAR2 gene function, although this gene previously showed overlapping enzyme activity in vitro.展开更多
AIM To evaluate the relationship between the location of hepatocellular carcinoma(HCC) and the efficacy of transarterial chemoembolization(TACE).METHODS We evaluated 115 patients(127 nodules), excluding recurrent nodu...AIM To evaluate the relationship between the location of hepatocellular carcinoma(HCC) and the efficacy of transarterial chemoembolization(TACE).METHODS We evaluated 115 patients(127 nodules), excluding recurrent nodules, treated with TACE between January 2011 and June 2014. TACE efficacy was evaluated according to m RECIST. The HCC location coefficient was calculated as the distance from the central portal portion to the HCC center(mm)/liver diameter(mm) on multiplanar reconstruction images rendered(MPR) to visualize bifurcation of the right and left branches of the portal vein and HCC center. The HCC location coefficient was compared between complete response(CR) and non-CR groups in Child-Pugh grade A and B patients.RESULTS The median location coefficient of HCC among all nodules, the right lobe, and the medial segment was significantly higher in the CR group than in the non-CR group in the Child-Pugh grade A patients(0.82 vs 0.62, P < 0.001; 0.71 vs 0.59, P < 0.01; 0.81 vs 0.49, P < 0.05, respectively). However, there was no significant difference in the median location coefficient of the HCC in the lateral segment between in the CR and in the non-CR groups(0.67 vs 0.65, P > 0.05). On the other hand, in the Child-Pugh grade B patients, the HCC median location coefficient in each lobe and segment was not significantly different between in the CR and in the non-CR groups.CONCLUSION Improved TACE efficacy may be obtained for HCC in the peripheral zone of the right lobe and the medial segment in Child-Pugh grade A patients.展开更多
AIM： To search for the optimal surgery for gastrinoma and duodenopancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1. METHODS： Sixteen patients with genetically confirmed multiple e...AIM： To search for the optimal surgery for gastrinoma and duodenopancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1. METHODS： Sixteen patients with genetically confirmed multiple endocrine neoplasia type 1 （MEN 1） and Zollinger-Ellison syndrome （ZES） underwent resection of both gastrinomas and duodenopancreatic neuroendocrine tumors （NETs） between 1991 and 2009. For localization of gastrinoma, selective arterial secretagogue injection test （SASI test） with secretin or calcium solution was performed as well as somatostatin receptor scintigraphy （SRS） and other imaging methods such as computed tomography （CT） or magnetic resonance imaging （MRI）. The modus of surgery for gastrinoma has been changed over time, searching for the optimal surgery： pancreaticoduodenectomy （PD） was first performed guided by localization with the SAST test, then local resection of duodenal gastrinomas with dissection of regional lymph nodes （LR）, and recently pancreas-preserving total duodenectomy （PPTD） has been performed for multiple duodenal gastrinomas. RESULTS： Among various types of preoperative localizing methods for gastrinoma, the SASI test was the most useful method. Imaging methods such as SRS or CT made it essentially impossible to differentiate functioning gastrinoma among various kinds of NETs. However, recent imaging methods including SRS or CT were useful for detecting both distant metastases and ectopic NETs; therefore they are indispensable for staging of NETs. Biochemical cure of gastrinoma was achieved in 14 of 16 patients （87.5%）; that is, 100% in 3 patients who underwent PD, 100% in 6 patients who underwent LR （although in 2 patients （33.3%） second LR was performed for recurrence of duodenal gastri- noma）, and 71.4% in 7 patients who underwent PPTD. Pancreatic NETs more than 1 cm in diameter were resected either by distal pancreatectomy or enucleations, and no hepatic metastases have developed postoperatively. Pathological s展开更多
Availability of novel hormonal therapies as well as docetaxel and cabazitaxel treatment for metastatic castration-resistant prostate cancer （CRPC） has changed the outlook for this group of patients with improvements...Availability of novel hormonal therapies as well as docetaxel and cabazitaxel treatment for metastatic castration-resistant prostate cancer （CRPC） has changed the outlook for this group of patients with improvements in progression-free survival and overall survival. Physicians often diagnose the progression of prostate cancer using serum prostate-specific antigen （PSA）. However, serum PSA is not always correlated with the clinical status in CRPC. To evaluate the PSA dynamics with greater precision, understanding of the control of PSA and of the mechanisms of development of CRPC is needed. Moreover, it is necessary to use new hormonal therapies with an appropriate timing to optimally improve the prognosis and the QOL of the patients. In the present review, we ascertain the PSA dynamics and the mechanisms of the development of CRPC to assist in optimal utilization of the new treatments for mCRPC.展开更多
Lipoma is relatively common in the colon but is less often in the small intestine. Most lipomas are incidentally detected at endoscopy and are usually small and asymptomatic. However, some of them can present with obs...Lipoma is relatively common in the colon but is less often in the small intestine. Most lipomas are incidentally detected at endoscopy and are usually small and asymptomatic. However, some of them can present with obstruction and/or intussusceptions. Surgical resection is commonly recommended to remove such significant lipomas with a limited pedicle and larger than 2 cm in size, as endoscopic resection may result in unfavorable complications such as intestinal perforations. We report a case of 62-year-old man presenting with hematochezia. Colonoscopy showed a submucosal tumor, about 50 mm in size, in the terminal ileum. A clinical diagnosis of lipoma was established based on the findings of colonoscopy and abdominal computed tomography (CT). As the patient complained of hematochezia and mild iron deficiency anemia associated with repeated tumor prolapse, we decided to remove his lipoma. Consequently, the lesion was completely removed en bloc . Although abdominal CT immediately after removal of the lesion showed a small amount of free air, conservative treatment was successfully carried out for the perforation. Histologically, the removed lesion was a lipoma.展开更多
Glycosylation of the Fc region of IgG has a profound impact on the safety and clinical efficacy of therapeutic antibodies. While the biantennary complex.type oligosaccharide attached to Asn297 of the Fc is essen- tial...Glycosylation of the Fc region of IgG has a profound impact on the safety and clinical efficacy of therapeutic antibodies. While the biantennary complex.type oligosaccharide attached to Asn297 of the Fc is essen- tial for antibody effector functions, fucose and outer-arm sugars attached to the core heptasaccharide that gen- erate structural heterogeneity （glycoforms） exhibit unique biological activities. Hence, efficient and quan- titative glycan analysis techniques have been increas- ingly important for the development and quality control of therapeutic antibodies, and g｜ycan profiles of the Fc are recognized as critical quality attributes. In the past decade our understanding of the influence of glycosy- lation on the structure/function of IgG-Fc has grown rapidly through X-ray crystallographic and nuclear magnetic resonance studies, which provides possibili- ties for the design of novel antibody therapeutics. Fur- thermore, the chemoenzymatic glycoengineering approach using endoglycosidase-based glycosyn- thases may facilitate the development of homogeneous IgG glycoforms with desirable functionality as next- generation therapeutic antibodies. Thus, the Fc glycans are fertile ground for the improvement of the safety,functionality, and efficacy of therapeutic IgG antibodies in the era of precision medicine.展开更多
This paper discusses the data-driven design of linear quadratic regulators,i.e.,to obtain the regulators directly from experimental data without using the models of plants.In particular,we aim to improve an existing d...This paper discusses the data-driven design of linear quadratic regulators,i.e.,to obtain the regulators directly from experimental data without using the models of plants.In particular,we aim to improve an existing design method by reducing the amount of the required experimental data.Reducing the data amount leads to the cost reduction of experiments and computation for the data-driven design.We present a simplified version of the existing method,where parameters yielding the gain of the regulator are estimated from only part of the data required in the existing method.We then show that the data amount required in the presented method is less than half of that in the existing method under certain conditions.In addition,assuming the presence of measurement noise,we analyze the relations between the expectations and variances of the estimated parameters and the noise.As a result,it is shown that using a larger amount of the experimental data might mitigate the effects of the noise on the estimated parameters.These results are verified by numerical examples.展开更多
Oxygen uptake(V O_(2))was measured during a non-exhaustive high-intensity intermittent cross-exercise(HIICE)protocol consisting of four alternating bouts of 20 s running(R)and three bouts of bicycle exercise(BE)at~160...Oxygen uptake(V O_(2))was measured during a non-exhaustive high-intensity intermittent cross-exercise(HIICE)protocol consisting of four alternating bouts of 20 s running(R)and three bouts of bicycle exercise(BE)at~160%and~170%maximal oxygen uptake(V O_(2)max),respectively,with 10 s between-bout rests(sequence R-BE-R-BER-BE-R).The V O_(2) during the last BE([52.2±5.0]mL⋅kg^(-1)⋅min^(-1))was significantly higher than the V O_(2)max of the BE([48.0±5.4]mL⋅kg^(-1)⋅min^(-1),n=30)and similar to that of running.For clarifying the underlying mechanisms,a corresponding HIICE-protocol with BE and arm cranking ergometer exercise(AC)was used(sequence AC-AC-BE-AC-BE-AC-AC-BE).In some experiments,thigh blood flow was occluded by a cuff around the upper thigh.Without occlusion,the V O_(2) during the AC([39.2±7.1]mL⋅kg^(-1)⋅min^(-1)[6th bout])was significantly higher than the V O_(2)max of AC([30.2±4.4]mL⋅kg^(-1)⋅min^(-1),n=7).With occlusion,the corresponding V O_(2)([29.8±3.9]mL⋅kg^(-1)⋅min^(-1))was reduced to that of the V O_(2)max of AC and significantly less than the V O_(2) without occlusion.These findings suggest that during the last bouts of HIICE may exceed the of the specific exercise,probably because it is a summation of the V O_(2) for the ongoing exercise plus excess post-oxygen consumption(EPOC)produced by the previous exercise with a higher V O_(2)max.展开更多
AIM： To evaluate the effect of ANP on warm I/R injury in a porcine THVE model.METHODS： Miniature pigs （mini-pigs） weighing 16-24 kg were observed for 120 min after reperfusion following 120 min of THVE. The animal...AIM： To evaluate the effect of ANP on warm I/R injury in a porcine THVE model.METHODS： Miniature pigs （mini-pigs） weighing 16-24 kg were observed for 120 min after reperfusion following 120 min of THVE. The animals were divided into two groups. ANP （0.1 μg/kg per min） was administered to the ANP group （n = 7）, and vehicle was administered to the control group （n = 7）. Either vehicle or ANP was intravenously administered from 30 min before the THVE to the end of the experiment. Arterial blood was collected to measure AST, LDH, and TNF-α. Hepatic tissue blood flow （HTBF） was also measured. Liver specimens were harvested for p38 MAPK analysis and histological study. Those results were compared between the two groups.RESULTS： The AST and LDH levels were lower in the ANP group than in the control group; the AST levels were significantly different between the two groups （60 min： 568.7 ± 113.3 vs 321.6 ± 60.1, P = 0.038 〈 0.05, 120 rain： 673.6± 148.2 vs 281.1±44.8, P = 0.004 〈 0.01）. No significant difference was observed in the TNF-α levels between the two groups. HTBF was higher in the ANP group, but the difference was not significant. A significantly higher level of phosphorylated p38 MAPK was observed in the ANP group compared to the control group （0min： 2.92± 1.1 vs 6.38 ±1.1,,P= 0.011 〈 0.05）.Histological tissue damage was milder in the ANP group than in the control group.CONCLUSION： Our results show that ANP has a protective role in I/R injury with p38 MAPK activation in a porcine THVE model.展开更多
We report the remission of primary gastric lymphoma of the mucosa-associated lymphoid tissue （MALT） type in two immunocompromised pediatric patients. Patient 1, a 14-year-old boy in an immunocompromised state of unk...We report the remission of primary gastric lymphoma of the mucosa-associated lymphoid tissue （MALT） type in two immunocompromised pediatric patients. Patient 1, a 14-year-old boy in an immunocompromised state of unknown cause, complained of repeated abdominal pain. Examinations revealed gastric MALT with local invasion and lymph node involvement. Serum anti-Helicobacter pylori （H pylon） antibody was positive. H pylori eradication was abandoned due to its adverse effects. The MALT lesion spontaneously regressed over the next 24 months without any treatment for lymphoma. Patient 2, a 6-year-old boy, underwent cord blood transplantation for the treatment of adrenoleukodystrophy. He was administered immunosuppressants for graft-versus-host disease after transplantation. Nausea and hematochezia appeared and further examinations revealed gastric MALT with H pylori gastritis. Treatment consisting of medication for the Hpylori infection alone eradicated the Hpylori and completely resolved the patient＇s MALT lesion, as well. Patients i and 2 were followed up over periods of 10 years and 3 years, respectively, without any signs of relapse. In conclusion, gastric lymphoma of the MALT type can be cured by conservative treatment even in immunocompromised pediatric patients.展开更多
In vivo,minimally invasive microscopy in deep cortical and sub-cortical regions of the mouse brain has been challenging.To address this challenge,we present an in vivo high numerical aperture optical coherence microsc...In vivo,minimally invasive microscopy in deep cortical and sub-cortical regions of the mouse brain has been challenging.To address this challenge,we present an in vivo high numerical aperture optical coherence microscopy(OCM)approach that fully utilizes the water absorption window around 1700nm;where ballistic attenuation in the brain is minimized.Key issues,including detector noise,excess light source noise,chromatic dispersion,and the resolution-speckle tradeoff,are analyzed and optimized.Imaging through a thinned-skull preparation that preserves intracranial space,we present volumetric imaging of cytoarchitecture and myeloarchitecture across the entire depth of the mouse neocortex,and some sub-cortical regions.In an Alzheimer's disease model,we report that findings in superficial and deep cortical layers diverge,highlighting the importance of deep optical biopsy.Compared to other microscopic techniques,our 1700nm OCM approach achieves a unique combination of intrinsic contrast,minimal invasiveness,and high resolution for deep brain imaging.展开更多
Background Only a few reports have currently studied the efficacy of dutasteride in patients with small benign prostatic hyperplasia(BPH).We investigated the efficacy of dutasteride on reducing lower urinary tract sym...Background Only a few reports have currently studied the efficacy of dutasteride in patients with small benign prostatic hyperplasia(BPH).We investigated the efficacy of dutasteride on reducing lower urinary tract symptoms among them.Materials and methods A total of 81 patients with BPH who completed 52weeks of 0.5?mg dutasteride treatment were enrolled.Each patient filled out the International Prostatic Symptom Score(IPSS)and overactive bladder symptom score(OABSS)at baseline and at the 6-and 12-month follow-up visits.Total testosterone,prostate-specific antigen,adenoma/prostate volume(PV),uroflowmetry analysis,and postvoid residual volume were evaluated at baseline and at the 12-month follow-up visit.The enrolled patients were divided into 2 groups according to PV at baseline.The groups were as follows:Group A(PV≥30 mL)and Group B(PV<30 mL).Results Groups A and B had mean PVs of 52.1 and 23.6 mL and mean IPSS scores of 16.7 and 14.4,respectively.Group A had significantly higher OABSS and prostate-specific antigen levels at baseline than Group B,while no significant differences in any other baseline characteristics was observed.After dutasteride treatment,adenoma volume and PV decreased significantly,while testosterone level showed a significant increase in both groups.Group A showed significant improvements in the total IPSS,voiding and storage subscore of the IPSS,OABSS,maximum flow rate,and postvoid residual volume.Group B,on the other hand,also showed significant improvements only in the total IPSS,voiding subscore of the IPSS,and maximum flow rate.Conclusions The present study suggests a possible beneficial effect of dutasteride treatment on the reduction of lower urinary tract symptoms in patients with small and large BPH.However,the effectiveness of dutasteride was limited compared to patients with large BPH(PV≥30 mL).展开更多
A 9-year-old girl presented with a chief complaint of abdominal pain. Esophagogastroduodenal endoscopy (EGD) identifi ed a long and large gastric trichobezoar extending into the duodenum. We attempted endoscopic retri...A 9-year-old girl presented with a chief complaint of abdominal pain. Esophagogastroduodenal endoscopy (EGD) identifi ed a long and large gastric trichobezoar extending into the duodenum. We attempted endoscopic retrieval after informed consent was obtained from the patient's mother. Initially, a gasper with 5-prolongs, com monly used for retrieval of endoscopically excised poly ps, failed to remove the whole trichobezoar. When a net was used instead, it proved impossible to remove the trichobezoar completely. Therefore, we withdrew the scope from the mouth, leaving the net grasping the tri co bezoar firmly in the stomach. Subsequently, we were able to retrieve about 70% of the trichobezoar manually by grasping the snare part of the net directly. A second pass found no deep laceration or perforation endoscopically. The remaining trichobezoar was completely retrieved with the net. The procedure was completed within 15 min. The retrieved specimens were34 cm in length and 100 g in weight. The patient was discharged uneventfully 5 d thereafter. She was advised to visit a psychiatrist to avoid suffering from a relapse. Follow-up EGD showed no trichobezoar, and the patient' s frontal hair grew back.展开更多
This paper is a report of a study of the effects of a leader-training program, focusing on how public health nurse (PHN) leaders manage staff. In Japan, a system of training after graduation or training after acquisit...This paper is a report of a study of the effects of a leader-training program, focusing on how public health nurse (PHN) leaders manage staff. In Japan, a system of training after graduation or training after acquisition of the PHN license has not been established. At present, PHN leaders are unable to devote as much time as they previously could to in-service education, and this has made it difficult to establish a suitable full-fledged in-service education system. Therefore, it is paramount for PHN leaders to acquire the necessary competence to train staff efficiently and, ultimately, play a more prominent role in the in-service education of novice PHNs. The effecttiveness of this program was evaluated before and after conducting the program over a 1-year period. A total of 145 leaders working for local government agencies in Japan participated in the program, and data from 87 participants were analyzed. Before the training program, Plan-Do-Check-Act cycle activities were less frequent than after the program. Intervention using a leader-training program that combines group and on-the-job training is effective for PHN leaders.展开更多
Alzheimer’s disease (AD) is the common cause of dementia which shows the neuro-pathologies like an accumulation of amyloid-</span><i style="font-family:""><span style="font-family:V...Alzheimer’s disease (AD) is the common cause of dementia which shows the neuro-pathologies like an accumulation of amyloid-</span><i style="font-family:""><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;"> (A</span><i style="font-family:""><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">) and degeneration of cholinergic neuron. Olfactory bulbectomized (OBX) mice show some of AD features, so they have been used to research as AD model. Mesenchymal stem cells (MSCs) can differentiate into many kinds of cells, including neuronal cells. In this study, we intranasally administrated the conditioned medium derived from cultured umbilical cord (UC) MSCs. The intranasal administration of the MSCs medium restored the cognitive impairment observed in OBX mice. In addition, the decreased number of choline acetyltransferase-positive cells in the medial septum was restored by the conditioned medium administration. In conclusion, MSCs-derived conditioned medium may have protective effects of cholinergic neurons in the medial septum, thereby rescuing the cognitive impairment of OBX.展开更多
基金the Department of Veterans Affairs Merit Review (to A.S.G), the Hirshberg foundation and the NIH/NCCAM (1P01AT003960-01)
文摘AIM： To determine the effect of ellagic acid on apoptosis and proliferation in pancreatic cancer cells and to determine the mechanism of the pro-survival effects of ellagic acid.METHODS： The effect of ellagic acid on apoptosis was assessed by measuring Phosphatidylserine externalization, caspase activity, mitochondrial membrane potential and DNA fragmentation; and proliferation by measuring DNA thymidine incorporation. Mitochondrial membrane potential was measured in permeabilized cells, and in isolated mitochondria. Nuclear factor κB （NF-κB） activity was measured by electromobility shift assay （EMSA）. RESULTS： We show that ellagic acid, a polyphenolic compound in fruits and berries, at concentrations 10 to 50 mmol/L stimulates apoptosis in human pancreatic adenocarcinoma cells. Further, ellagic acid decreases proliferation by up to 20-fold at 50 mmol/L. Ellagic acid stimulates the mitochondrial pathway of apoptosis associated with mitochondrial depolarization, cytochrome C release, and the downstream caspase activation. Ellagic acid does not directly affect mitochondria. Ellagic acid dose-dependently decreased NF-κB binding activity. Furthermore, inhibition of NF-κB activity using IkB wild type plasmid prevented the effect of ellagic acid on apoptosis. CONCLUSION： Our data indicate that ellagic acid stimulates apoptosis through inhibition of the prosurvival transcription factor NF-κB.
文摘To summarize the current views and insights on associations between Helicobacter pylori(H. pylori)-related chronic gastritis and colorectal neoplasm, we reviewed recent studies to clarify whether H. pylori infection/H. pylori-related chronic gastritis is associated with an elevated risk of colorectal neoplasm. Recent studies based on large databases with careful control for confounding variables have clearly demonstrated an increased risk of colorectal neoplasm associated with H. pylori infection. The correlation between H. pylori-related chronic atrophic gastritis(CAG) and colorectal neoplasm has only been examined in a limited number of studies. A recent large study using a national histopathological database, and our study based on the stage of H. pylori-related chronic gastritis as determined by serum levels of H. pylori antibody titer and pepsinogen, indicatedthat H. pylori-related CAG confers an increased risk of colorectal neoplasm, and more extensive atrophic gastritis will probably be associated with even higher risk of neoplasm. In addition, our study suggested that the activity of H. pylori-related chronic gastritis is correlated with colorectal neoplasm risk. H. pylori-related chronic gastritis could be involved in an increased risk of colorectal neoplasm that appears to be enhanced by the progression of gastric atrophy and the presence of active inflammation.
文摘AIM： To investigate the effect of probiotic bacterium, Clostridium butyricum MIYAIRI 588 strain （CBM） on the changes of the fecal flora in Helicobacter pylori （H pylon） treatment. METHODS： Thirty-five patients with gastric or duodenal ulcers positive for H pylori were randomized either to 1 wk amoxicillin, clarithromycin, lansoprazole （Group 1） or to the same regimen supplemented with CBM 7 d ahead of the triple therapy （Group 2）. Stool samples were collected before and 2, 4, 7, 15, and 22 d after the starting eradication therapy, and were examined intestinal flora. Patients were required to keep a diary record of their condition. RESULTS： Obligate anaerobes decreased significantly on d 2, 4, 8 and 15 in Group 1. On the other hand, they did not decrease significantly in Group 2. The Escherichia coli was dominant bacterium in Enterobacteriaceae, but that was replaced by other species such as Klebsiella and Enterobacter after eradication in Group 1. The change was suppressed in Group 2. Abdominal symptoms were less frequent in Group 2 than in Group 1. CONCLUSION： The combined use of CBM reduced the changes in the intestinal flora and decreased the incidence of gastrointestinal side effects.
基金Supported by A Grant-in-Aid from the Ministry of Health,Labor and Welfare,Japan
文摘AIM:To evaluate whether metabolic factors are related to distant recurrence of hepatocellular carcinoma(HCC) and survival after curative treatment.METHODS:This retrospective study included 344 patients whose HCC was treated curatively by radiofrequency ablation(RFA) therapy.The mean age was 67.6 years and the mean observation period was 4.04 years.The etiological background of liver disease was hepatitis B virus infection in 30,hepatitis C virus infection in 278,excessive alcohol drinking in 9,and other in 27 patients.The Child-Pugh classification grade was A(n = 307) or B(n = 37).The number of HCC nodules was one in 260,two in 61,and three in 23 patients.For surveillance of HCC recurrence after curative therapy with RFA,patients were radiologically evaluated every 3 mo.Factors associated with distant recurrence of HCC or survival were studied.RESULTS:Inadequate maintenance of blood glucose in diabetic patients was associated with higher incidence of distant recurrence.The 1-,2-,and 3-year recurrence rates were significantly higher in diabetic patients with inadequate maintenance of blood glucose compared with the others:50.6% vs 26.8%,83.5% vs 54.4%,and 93.8% vs 73.0%,respectively(P = 0.0001).Inadequate maintenance of blood glucose was an independent predictor of distant recurrence [adjusted relative risk 1.97(95%CI,1.33-2.91),(P = 0.0007)] after adjustment for other risk factors,such as number of HCC nodules [2.03(95%CI,1.51-2.73),P < 0.0001] and initial level of serum alpha fetoprotein(AFP) [1.43(95%CI,1.04-1.97),P = 0.028].Obesity was not an independent predictor of recurrence.The incidence of distant recurrence did not differ between diabetic patients with adequate maintenance of blood glucose and non-diabetic patients.Among 232 patients who had HCC recurrence,138 had a second recurrence.The 1-,2-,and 3-year rates of second recurrence were significantly higher in diabetic patients with inadequate maintenance of blood glucose than in the others:9.0% vs 5.9%,53.1% vs 24.3%,and 69.6% vs 42.3%,respectively(P = 0
文摘Bile duct epithelial tumours showing papillary neoplasm in the bile duct lumen are present in the intrahepatic and extrahepatic bile ducts.Clinicopathological images of these tumours are distinctive and diverse,including histological images with a low to high grade dysplasia,infiltrating and noninfiltrating characteristics,excessive mucus production,and similarity to intraductal papillary mucinous neoplasm(IPMN)of the pancreas.The World Health Organization Classification of Tumours of the Digestive System in 2010 named these features,intraductal papillary neoplasm of the bile duct(IPNB),as precancerous lesion of biliary carcinoma.IPNB is currently classified into type 1 that is similar to IPMN,and type 2 that is not similar to IPMN.Many of IPNB spreads superficially,and diagnosis with cholangioscopy is considered mandatory to identify accurate localization and progression.Prognosis of IPNB is said to be better than normal bile duct cancer.
基金supported by the Japan Advanced Plant Science Networkthe Grant-in-Aid for Scientific Research No.24570026 provided to IG by the Japan Society for the Promotion of Science
文摘Plants produce jasmonic acid （JA） and its amino acid conjugate, jasmonoyI-L-isoleucine （JA-Ile） as major defense signals in response to wounding and herbivory. In rice （Oryza sativa）, JA and JA-Ile rapidly increased after mechanical damage, and this increase was further amplified when the wounds were treated with oral secretions from generalist herbivore larvae, lawn armyworms （Spodoptera mauritia）, revealing for the first time active perception mechanisms of herbivore-associated elicitor（s） in rice. In the rice genome, two OsJAR genes can conjugate JA and lie and form JA-Ile in vitro; however, their function in herbivory- induced accumulation of JA-Ile has not been investigated. By functional characterization of TOS17 retrotransposon-tagged Osjarl plants and their response to simulated herbivory, we show that OsJAR1 is essential for JA-Ile production in herbivore-attacked, field-grown plants. In addition, OsJAR1 was required for normal seed development in rice under field conditions. Our results suggest that OsJAR1 possesses at least two major functions in rice defense and development that cannot be complemented by the additional OsJAR2 gene function, although this gene previously showed overlapping enzyme activity in vitro.
文摘AIM To evaluate the relationship between the location of hepatocellular carcinoma(HCC) and the efficacy of transarterial chemoembolization(TACE).METHODS We evaluated 115 patients(127 nodules), excluding recurrent nodules, treated with TACE between January 2011 and June 2014. TACE efficacy was evaluated according to m RECIST. The HCC location coefficient was calculated as the distance from the central portal portion to the HCC center(mm)/liver diameter(mm) on multiplanar reconstruction images rendered(MPR) to visualize bifurcation of the right and left branches of the portal vein and HCC center. The HCC location coefficient was compared between complete response(CR) and non-CR groups in Child-Pugh grade A and B patients.RESULTS The median location coefficient of HCC among all nodules, the right lobe, and the medial segment was significantly higher in the CR group than in the non-CR group in the Child-Pugh grade A patients(0.82 vs 0.62, P < 0.001; 0.71 vs 0.59, P < 0.01; 0.81 vs 0.49, P < 0.05, respectively). However, there was no significant difference in the median location coefficient of the HCC in the lateral segment between in the CR and in the non-CR groups(0.67 vs 0.65, P > 0.05). On the other hand, in the Child-Pugh grade B patients, the HCC median location coefficient in each lobe and segment was not significantly different between in the CR and in the non-CR groups.CONCLUSION Improved TACE efficacy may be obtained for HCC in the peripheral zone of the right lobe and the medial segment in Child-Pugh grade A patients.
基金Supported by a Health and Labor Sciences Research Grant from the Ministry of Health, Labor and Welfare, Government of Japan (Grant No. H21-Nanchi-Ippan-037)
文摘AIM： To search for the optimal surgery for gastrinoma and duodenopancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1. METHODS： Sixteen patients with genetically confirmed multiple endocrine neoplasia type 1 （MEN 1） and Zollinger-Ellison syndrome （ZES） underwent resection of both gastrinomas and duodenopancreatic neuroendocrine tumors （NETs） between 1991 and 2009. For localization of gastrinoma, selective arterial secretagogue injection test （SASI test） with secretin or calcium solution was performed as well as somatostatin receptor scintigraphy （SRS） and other imaging methods such as computed tomography （CT） or magnetic resonance imaging （MRI）. The modus of surgery for gastrinoma has been changed over time, searching for the optimal surgery： pancreaticoduodenectomy （PD） was first performed guided by localization with the SAST test, then local resection of duodenal gastrinomas with dissection of regional lymph nodes （LR）, and recently pancreas-preserving total duodenectomy （PPTD） has been performed for multiple duodenal gastrinomas. RESULTS： Among various types of preoperative localizing methods for gastrinoma, the SASI test was the most useful method. Imaging methods such as SRS or CT made it essentially impossible to differentiate functioning gastrinoma among various kinds of NETs. However, recent imaging methods including SRS or CT were useful for detecting both distant metastases and ectopic NETs; therefore they are indispensable for staging of NETs. Biochemical cure of gastrinoma was achieved in 14 of 16 patients （87.5%）; that is, 100% in 3 patients who underwent PD, 100% in 6 patients who underwent LR （although in 2 patients （33.3%） second LR was performed for recurrence of duodenal gastri- noma）, and 71.4% in 7 patients who underwent PPTD. Pancreatic NETs more than 1 cm in diameter were resected either by distal pancreatectomy or enucleations, and no hepatic metastases have developed postoperatively. Pathological s
文摘Availability of novel hormonal therapies as well as docetaxel and cabazitaxel treatment for metastatic castration-resistant prostate cancer （CRPC） has changed the outlook for this group of patients with improvements in progression-free survival and overall survival. Physicians often diagnose the progression of prostate cancer using serum prostate-specific antigen （PSA）. However, serum PSA is not always correlated with the clinical status in CRPC. To evaluate the PSA dynamics with greater precision, understanding of the control of PSA and of the mechanisms of development of CRPC is needed. Moreover, it is necessary to use new hormonal therapies with an appropriate timing to optimally improve the prognosis and the QOL of the patients. In the present review, we ascertain the PSA dynamics and the mechanisms of the development of CRPC to assist in optimal utilization of the new treatments for mCRPC.
文摘Lipoma is relatively common in the colon but is less often in the small intestine. Most lipomas are incidentally detected at endoscopy and are usually small and asymptomatic. However, some of them can present with obstruction and/or intussusceptions. Surgical resection is commonly recommended to remove such significant lipomas with a limited pedicle and larger than 2 cm in size, as endoscopic resection may result in unfavorable complications such as intestinal perforations. We report a case of 62-year-old man presenting with hematochezia. Colonoscopy showed a submucosal tumor, about 50 mm in size, in the terminal ileum. A clinical diagnosis of lipoma was established based on the findings of colonoscopy and abdominal computed tomography (CT). As the patient complained of hematochezia and mild iron deficiency anemia associated with repeated tumor prolapse, we decided to remove his lipoma. Consequently, the lesion was completely removed en bloc . Although abdominal CT immediately after removal of the lesion showed a small amount of free air, conservative treatment was successfully carried out for the perforation. Histologically, the removed lesion was a lipoma.
文摘Glycosylation of the Fc region of IgG has a profound impact on the safety and clinical efficacy of therapeutic antibodies. While the biantennary complex.type oligosaccharide attached to Asn297 of the Fc is essen- tial for antibody effector functions, fucose and outer-arm sugars attached to the core heptasaccharide that gen- erate structural heterogeneity （glycoforms） exhibit unique biological activities. Hence, efficient and quan- titative glycan analysis techniques have been increas- ingly important for the development and quality control of therapeutic antibodies, and g｜ycan profiles of the Fc are recognized as critical quality attributes. In the past decade our understanding of the influence of glycosy- lation on the structure/function of IgG-Fc has grown rapidly through X-ray crystallographic and nuclear magnetic resonance studies, which provides possibili- ties for the design of novel antibody therapeutics. Fur- thermore, the chemoenzymatic glycoengineering approach using endoglycosidase-based glycosyn- thases may facilitate the development of homogeneous IgG glycoforms with desirable functionality as next- generation therapeutic antibodies. Thus, the Fc glycans are fertile ground for the improvement of the safety,functionality, and efficacy of therapeutic IgG antibodies in the era of precision medicine.
文摘This paper discusses the data-driven design of linear quadratic regulators,i.e.,to obtain the regulators directly from experimental data without using the models of plants.In particular,we aim to improve an existing design method by reducing the amount of the required experimental data.Reducing the data amount leads to the cost reduction of experiments and computation for the data-driven design.We present a simplified version of the existing method,where parameters yielding the gain of the regulator are estimated from only part of the data required in the existing method.We then show that the data amount required in the presented method is less than half of that in the existing method under certain conditions.In addition,assuming the presence of measurement noise,we analyze the relations between the expectations and variances of the estimated parameters and the noise.As a result,it is shown that using a larger amount of the experimental data might mitigate the effects of the noise on the estimated parameters.These results are verified by numerical examples.
基金supported in part by a KAKENHI Grant-in-Aid for Challenging Exploratory Research 26560406 from the Japan Society for the Promotion of Sciences.
文摘Oxygen uptake(V O_(2))was measured during a non-exhaustive high-intensity intermittent cross-exercise(HIICE)protocol consisting of four alternating bouts of 20 s running(R)and three bouts of bicycle exercise(BE)at~160%and~170%maximal oxygen uptake(V O_(2)max),respectively,with 10 s between-bout rests(sequence R-BE-R-BER-BE-R).The V O_(2) during the last BE([52.2±5.0]mL⋅kg^(-1)⋅min^(-1))was significantly higher than the V O_(2)max of the BE([48.0±5.4]mL⋅kg^(-1)⋅min^(-1),n=30)and similar to that of running.For clarifying the underlying mechanisms,a corresponding HIICE-protocol with BE and arm cranking ergometer exercise(AC)was used(sequence AC-AC-BE-AC-BE-AC-AC-BE).In some experiments,thigh blood flow was occluded by a cuff around the upper thigh.Without occlusion,the V O_(2) during the AC([39.2±7.1]mL⋅kg^(-1)⋅min^(-1)[6th bout])was significantly higher than the V O_(2)max of AC([30.2±4.4]mL⋅kg^(-1)⋅min^(-1),n=7).With occlusion,the corresponding V O_(2)([29.8±3.9]mL⋅kg^(-1)⋅min^(-1))was reduced to that of the V O_(2)max of AC and significantly less than the V O_(2) without occlusion.These findings suggest that during the last bouts of HIICE may exceed the of the specific exercise,probably because it is a summation of the V O_(2) for the ongoing exercise plus excess post-oxygen consumption(EPOC)produced by the previous exercise with a higher V O_(2)max.
文摘AIM： To evaluate the effect of ANP on warm I/R injury in a porcine THVE model.METHODS： Miniature pigs （mini-pigs） weighing 16-24 kg were observed for 120 min after reperfusion following 120 min of THVE. The animals were divided into two groups. ANP （0.1 μg/kg per min） was administered to the ANP group （n = 7）, and vehicle was administered to the control group （n = 7）. Either vehicle or ANP was intravenously administered from 30 min before the THVE to the end of the experiment. Arterial blood was collected to measure AST, LDH, and TNF-α. Hepatic tissue blood flow （HTBF） was also measured. Liver specimens were harvested for p38 MAPK analysis and histological study. Those results were compared between the two groups.RESULTS： The AST and LDH levels were lower in the ANP group than in the control group; the AST levels were significantly different between the two groups （60 min： 568.7 ± 113.3 vs 321.6 ± 60.1, P = 0.038 〈 0.05, 120 rain： 673.6± 148.2 vs 281.1±44.8, P = 0.004 〈 0.01）. No significant difference was observed in the TNF-α levels between the two groups. HTBF was higher in the ANP group, but the difference was not significant. A significantly higher level of phosphorylated p38 MAPK was observed in the ANP group compared to the control group （0min： 2.92± 1.1 vs 6.38 ±1.1,,P= 0.011 〈 0.05）.Histological tissue damage was milder in the ANP group than in the control group.CONCLUSION： Our results show that ANP has a protective role in I/R injury with p38 MAPK activation in a porcine THVE model.
文摘We report the remission of primary gastric lymphoma of the mucosa-associated lymphoid tissue （MALT） type in two immunocompromised pediatric patients. Patient 1, a 14-year-old boy in an immunocompromised state of unknown cause, complained of repeated abdominal pain. Examinations revealed gastric MALT with local invasion and lymph node involvement. Serum anti-Helicobacter pylori （H pylon） antibody was positive. H pylori eradication was abandoned due to its adverse effects. The MALT lesion spontaneously regressed over the next 24 months without any treatment for lymphoma. Patient 2, a 6-year-old boy, underwent cord blood transplantation for the treatment of adrenoleukodystrophy. He was administered immunosuppressants for graft-versus-host disease after transplantation. Nausea and hematochezia appeared and further examinations revealed gastric MALT with H pylori gastritis. Treatment consisting of medication for the Hpylori infection alone eradicated the Hpylori and completely resolved the patient＇s MALT lesion, as well. Patients i and 2 were followed up over periods of 10 years and 3 years, respectively, without any signs of relapse. In conclusion, gastric lymphoma of the MALT type can be cured by conservative treatment even in immunocompromised pediatric patients.
基金National Institutes of Health grants NS094681,NS 105043,EB029747,EB023591,and EY031469.
文摘In vivo,minimally invasive microscopy in deep cortical and sub-cortical regions of the mouse brain has been challenging.To address this challenge,we present an in vivo high numerical aperture optical coherence microscopy(OCM)approach that fully utilizes the water absorption window around 1700nm;where ballistic attenuation in the brain is minimized.Key issues,including detector noise,excess light source noise,chromatic dispersion,and the resolution-speckle tradeoff,are analyzed and optimized.Imaging through a thinned-skull preparation that preserves intracranial space,we present volumetric imaging of cytoarchitecture and myeloarchitecture across the entire depth of the mouse neocortex,and some sub-cortical regions.In an Alzheimer's disease model,we report that findings in superficial and deep cortical layers diverge,highlighting the importance of deep optical biopsy.Compared to other microscopic techniques,our 1700nm OCM approach achieves a unique combination of intrinsic contrast,minimal invasiveness,and high resolution for deep brain imaging.
文摘Background Only a few reports have currently studied the efficacy of dutasteride in patients with small benign prostatic hyperplasia(BPH).We investigated the efficacy of dutasteride on reducing lower urinary tract symptoms among them.Materials and methods A total of 81 patients with BPH who completed 52weeks of 0.5?mg dutasteride treatment were enrolled.Each patient filled out the International Prostatic Symptom Score(IPSS)and overactive bladder symptom score(OABSS)at baseline and at the 6-and 12-month follow-up visits.Total testosterone,prostate-specific antigen,adenoma/prostate volume(PV),uroflowmetry analysis,and postvoid residual volume were evaluated at baseline and at the 12-month follow-up visit.The enrolled patients were divided into 2 groups according to PV at baseline.The groups were as follows:Group A(PV≥30 mL)and Group B(PV<30 mL).Results Groups A and B had mean PVs of 52.1 and 23.6 mL and mean IPSS scores of 16.7 and 14.4,respectively.Group A had significantly higher OABSS and prostate-specific antigen levels at baseline than Group B,while no significant differences in any other baseline characteristics was observed.After dutasteride treatment,adenoma volume and PV decreased significantly,while testosterone level showed a significant increase in both groups.Group A showed significant improvements in the total IPSS,voiding and storage subscore of the IPSS,OABSS,maximum flow rate,and postvoid residual volume.Group B,on the other hand,also showed significant improvements only in the total IPSS,voiding subscore of the IPSS,and maximum flow rate.Conclusions The present study suggests a possible beneficial effect of dutasteride treatment on the reduction of lower urinary tract symptoms in patients with small and large BPH.However,the effectiveness of dutasteride was limited compared to patients with large BPH(PV≥30 mL).
文摘A 9-year-old girl presented with a chief complaint of abdominal pain. Esophagogastroduodenal endoscopy (EGD) identifi ed a long and large gastric trichobezoar extending into the duodenum. We attempted endoscopic retrieval after informed consent was obtained from the patient's mother. Initially, a gasper with 5-prolongs, com monly used for retrieval of endoscopically excised poly ps, failed to remove the whole trichobezoar. When a net was used instead, it proved impossible to remove the trichobezoar completely. Therefore, we withdrew the scope from the mouth, leaving the net grasping the tri co bezoar firmly in the stomach. Subsequently, we were able to retrieve about 70% of the trichobezoar manually by grasping the snare part of the net directly. A second pass found no deep laceration or perforation endoscopically. The remaining trichobezoar was completely retrieved with the net. The procedure was completed within 15 min. The retrieved specimens were34 cm in length and 100 g in weight. The patient was discharged uneventfully 5 d thereafter. She was advised to visit a psychiatrist to avoid suffering from a relapse. Follow-up EGD showed no trichobezoar, and the patient' s frontal hair grew back.
文摘This paper is a report of a study of the effects of a leader-training program, focusing on how public health nurse (PHN) leaders manage staff. In Japan, a system of training after graduation or training after acquisition of the PHN license has not been established. At present, PHN leaders are unable to devote as much time as they previously could to in-service education, and this has made it difficult to establish a suitable full-fledged in-service education system. Therefore, it is paramount for PHN leaders to acquire the necessary competence to train staff efficiently and, ultimately, play a more prominent role in the in-service education of novice PHNs. The effecttiveness of this program was evaluated before and after conducting the program over a 1-year period. A total of 145 leaders working for local government agencies in Japan participated in the program, and data from 87 participants were analyzed. Before the training program, Plan-Do-Check-Act cycle activities were less frequent than after the program. Intervention using a leader-training program that combines group and on-the-job training is effective for PHN leaders.
文摘Alzheimer’s disease (AD) is the common cause of dementia which shows the neuro-pathologies like an accumulation of amyloid-</span><i style="font-family:""><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;"> (A</span><i style="font-family:""><span style="font-family:Verdana;">β</span></i><span style="font-family:Verdana;">) and degeneration of cholinergic neuron. Olfactory bulbectomized (OBX) mice show some of AD features, so they have been used to research as AD model. Mesenchymal stem cells (MSCs) can differentiate into many kinds of cells, including neuronal cells. In this study, we intranasally administrated the conditioned medium derived from cultured umbilical cord (UC) MSCs. The intranasal administration of the MSCs medium restored the cognitive impairment observed in OBX mice. In addition, the decreased number of choline acetyltransferase-positive cells in the medial septum was restored by the conditioned medium administration. In conclusion, MSCs-derived conditioned medium may have protective effects of cholinergic neurons in the medial septum, thereby rescuing the cognitive impairment of OBX.
