IgG4-related sclerosing cholangitis(IgG4-SC)is often associated with autoimmune pancreatitis.However,the diffuse cholangiographic abnormalities observed in IgG4-SC may resemble those observed in primary sclerosing cho...IgG4-related sclerosing cholangitis(IgG4-SC)is often associated with autoimmune pancreatitis.However,the diffuse cholangiographic abnormalities observed in IgG4-SC may resemble those observed in primary sclerosing cholangitis(PSC),and the presence of segmental stenosis suggests cholangiocarcinoma(CC).IgG4-SC responds well to steroid therapy,whereas PSC is only effectively treated with liver transplantation and CC requires surgical intervention.Since IgG4-SC was first described,it has become a third distinct clinical entity of sclerosing cholangitis.The aim of this review was to introduce the diagnostic methods for IgG4-SC.IgG4-SC should be carefully diagnosed based on a combination of characteristic clinical,serological,morphological,and histopathological features after cholangiographic classification and targeting of a disease for differential diagnosis.When intrapancreatic stenosis is detected,pancreatic cancer or CC should be ruled out.If multiple intrahepatic stenoses are evident,PSC should be distinguished on the basis of cholangiographic findings and liver biopsy with IgG4 immunostaining.Associated inflammatory bowel disease is suggestive of PSC.If stenosis is demonstrated in the hepatic hilar region,CC should be discriminated by ultrasonography,intraductal ultrasonography,bile duct biopsy,and a higher cutoff serum IgG4 level of 182 mg/dL.展开更多
AIM:To investigate human epidermal growth factor receptor 2(HER2)-phosphatidylinositol 3-kinase(PI3K)-vAkt murine thymoma viral oncogene homolog signaling pathway.METHODS:We analyzed 231 formalin-fixed,paraffinembedde...AIM:To investigate human epidermal growth factor receptor 2(HER2)-phosphatidylinositol 3-kinase(PI3K)-vAkt murine thymoma viral oncogene homolog signaling pathway.METHODS:We analyzed 231 formalin-fixed,paraffinembedded gastric cancer tissue specimens from Japanese patients who had undergone surgical treatment.The patients' age,sex,tumor location,depth of invasion,pathological type,lymph node metastasis,and pathological stage were determined by a review of the medical records.Expression of HER2 was analyzed by immunohistochemistry(IHC) using the HercepTest TM kit.Standard criteria for HER2 positivity(0,1+,2+,and 3+) were used.Tumors that scored 3+ were considered HER2-positive.Expression of phospho Akt(pAkt) was also analyzed by IHC.Tumors were considered pAkt-positive when the percentage of positive tumor cells was 10% or more.PI3K,catalytic,alpha polypeptide(PIK3CA) mutations in exons 1,9 and 20 were analyzed by pyrosequencing.Epstein-Barr virus(EBV) infection was analyzed by in situ hybridization targeting EBV-encoded small RNA(EBER) with an EBER-RNA probe.Microsatellite instability(MSI) was analyzed by polymerase chain reaction using the mononucleotide markers BAT25 and BAT26.RESULTS:HER2 expression levels of 0,1+,2+ and 3+ were found in 167(72%),32(14%),12(5%) and 20(8.7%) samples,respectively.HER2 overexpression(IHC 3+) significantly correlated with intestinal histological type(15/20 vs 98 /205,P = 0.05).PIK3CA mutations were present in 20 cases(8.7%) and significantly correlated with MSI(10/20 vs 9/211,P < 0.01).The mutation frequency was high(21%) in T4 cancers and very low(6%) in T2 cancers.Mutations in exons 1,9 and 20 were detected in 5(2%),9(4%) and 7(3%) cases,respectively.Two new types of PIK3CA mutation,R88Q and R108H,were found in exon1.All PIK3CA mutations were heterozygous missense singlebase substitutions,the most common being H1047R(6/20,30%) in exon20.Eighteen cancers(8%) were EBV-positive and this positivity significantly correlated with a diffuse histological type(13/18 vs 93/198,P = 0.04).T展开更多
This is a review of the characteristic findings of inflammatory bowel disease(IBD)associated with primary sclerosing cholangitis(PSC)and their usefulness in the diagnosis of sclerosing cholangitis.PSC is a chronic inf...This is a review of the characteristic findings of inflammatory bowel disease(IBD)associated with primary sclerosing cholangitis(PSC)and their usefulness in the diagnosis of sclerosing cholangitis.PSC is a chronic inflammatory disease characterized by idiopathic fibrous obstruction and is frequently associated with IBD.IBDassociated with PSC(PSC-IBD)shows an increased incidence of pancolitis,mild symptoms,and colorectal malignancy.Although an increased incidence of pancolitis is a characteristic finding,some cases are endoscopically diagnosed as right-sided ulcerative colitis.Pathological studies have revealed that inflammation occurs more frequently in the right colon than the left colon.The frequency of rectal sparing and backwash ileitis should be investigated in a future study based on the same definition.The cholangiographic findings of immunoglobulin G4-related sclerosing cholangitis(IgG4-SC)are similar to those of PSC.The rare association between IBD and IgG4-SC and the unique characteristics of PSC-IBD are useful findings for distinguishing PSC from IgG4-SC.展开更多
Immunoglobulin G4-related sclerosing cholangitis(Ig G4-SC) is frequently associated with type 1 autoimmune pancreatitis(AIP). Association with AIP can be utilized in the diagnosis of Ig G4-SC. However, some cases of I...Immunoglobulin G4-related sclerosing cholangitis(Ig G4-SC) is frequently associated with type 1 autoimmune pancreatitis(AIP). Association with AIP can be utilized in the diagnosis of Ig G4-SC. However, some cases of Ig G4-SC are isolated from AIP, which complicates the diagnosis. Most of the reported cases of isolated Ig G4-SC displayed hilar biliary strictures, whereas isolated Ig G4-SC with intrapancreatic biliary stricture is very rare. Recently, we have encountered 5 isolated intrapancreatic Ig G4-SC cases that were not associated with AIP, three of which were pathologically investigated after surgical operation. They all were males with a mean age of 74.2 years. The pancreas was not enlarged in any of these cases. No irregular narrowing of the main pancreatic duct was found. Bile duct wall thickening in lesions without luminal stenosis was detected by abdominal computed tomography in all five cases, by endoscopic ultrasonography in two out of four cases and by intraductal ultrasonography in all three cases. In three cases, serum Ig G4 levels were within the normal limits. The mean serum Ig G4 level measured before surgery was 202.1 mg/d L(4 cases). Isolated intrapancreatic Ig G4-SC is difficult to diagnose, especially if the Ig G4 level remains normal. Thus, this type of Ig G4-SC should be suspected in addition to cholangiocarcinoma and pancreatic cancer if stenosis of intrapancreatic bile duct is present.展开更多
Objective: To investigate the effect of the roselle calyx extract(RCE)(Hibiscus sabdariffa L.) on the in vitro viability and biofilm formation ability of oral pathogenic bacteria. Methods:RCE was prepared by soaking r...Objective: To investigate the effect of the roselle calyx extract(RCE)(Hibiscus sabdariffa L.) on the in vitro viability and biofilm formation ability of oral pathogenic bacteria. Methods:RCE was prepared by soaking roselle calyx powder with ethyl alcohol for 24 h at room temperature. After centrifugation, the extract was lyophilized. Then, the extract was dissolved in phosphate-buffered saline, the p H was adjusted, and the extract was aseptically filtered. We used Streptococcus mutans, Streptococcus sanguinis, Lactobacillus casei, Actinomyces naeslundii, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis and Prevotella intermedia in this study. The antibacterial activity of the RCE was determined by treating the cells of these bacteria with the extract for 10 or 20 min at room temperature. The minimum inhibitory concentration(MIC) and minimum bactericidal concentration was determined using the micro dilution method, and the effect of the RCE on the ability to form biofilm was determined using a polystyrene micro plate assay. In addition, we used the WST-1 assay to determine the cytotoxicity of the RCE on HGF, Ca9-22 and KB cells. Results: The RCE had antibacterial activity against oral bacteria used in this study. In particular, most significant antibacterial activity was observed against Fusobacterium nucleatum, Prevotella intermedia and Porphyromonas gingivalis. The MIC and minimum bactericidal concentration were 7.2 mg/m L–28.8 mg/m L and 14.4 to >57.6 mg/m L. The RCE had an inhibitory effect on biofilm formation at the MIC and sub-MIC levels. In addition, the RCE had low cytotoxic effects on HGF, Ca9-22 and KB cells. Conclusions: Thus, our results indicate that the RCE may be used for preventing oral diseases.展开更多
BACKGROUND The development of biodegradable surgical staples is desirable as non-biodegradable Ti alloy staples reside in the human body long after wound healing, which can cause allergic/foreign-body reactions, adhes...BACKGROUND The development of biodegradable surgical staples is desirable as non-biodegradable Ti alloy staples reside in the human body long after wound healing, which can cause allergic/foreign-body reactions, adhesion, or other adverse effects. In order to develop a biodegradable alloy suitable for the fabrication of surgical staples, we hypothesized that Zn, a known biodegradable metal, could be alloyed with various elements to improve the mechanical properties while retaining biodegradability and biocompatibility. Considering their biocompatibility, Mg, Ca, Mn, and Cu were selected as candidate alloying elements, alongside Ti, the main material of clinically available surgical staples.AIM To investigate the in vitro mechanical properties and degradation behavior and in vivo safety and feasibility of biodegradable Zn alloy staples.METHODS Tensile and bending tests were conducted to evaluate the mechanical properties of binary Zn alloys with 0.1–6 wt.% Mg, Ca, Mn, Cu, or Ti. Based on the results,three promising Zn alloy compositions were devised for staple applications(wt.%): Zn-1.0Cu-0.2Mn-0.1Ti(Zn alloy 1), Zn-1.0Mn-0.1Ti(Zn alloy 2), and Zn-1.0Cu-0.1Ti(Zn alloy 3). Immersion tests were performed at 37℃ for 4 wk using fed-state simulated intestinal fluid(Fe SSIF) and Hank’s balanced salt solution(HBSS). The corrosion rate was estimated from the weight loss of staples during immersion. Nine rabbits were subjected to gastric resection using each Zn alloy staple, and a clinically available Ti staple was used for another group of nine rabbits. Three in each group were sacrificed at 1, 4, and 12 wk post-operation.RESULTS Additions of ≤1 wt.% Mn or Cu and 0.1 wt.% Ti improved the yield strength without excessive deterioration of elongation or bendability. Immersion tests revealed no gas evolution or staple fracture in any of the Zn alloy staples. The corrosion rates of Zn alloy staples 1, 2, and 3 were 0.02 mm/year in HBSS and 0.12, 0.11, and 0.13 mm/year, respectively, in Fe SSIF. These degradation times 展开更多
Roadmapping is a well-established technique in the context of innovation and strategy,with the potential to support organizations address the complex transformative challenges facing humanity in the 21st century.This ...Roadmapping is a well-established technique in the context of innovation and strategy,with the potential to support organizations address the complex transformative challenges facing humanity in the 21st century.This is enabled by its systems-based architecture and visual form of roadmaps,supporting communication and reduction of information asymmetries in complex sociotechnical systems.This paper focuses on an adaptation of the roadmapping method to support strategic planning for roadmapping systems in organizations,addressing implementation challenges.This represents a novel application of roadmapping to business processes and systems,demonstrating the flexibility of the roadmapping approach.A workshop template(‘R2’)and process for supporting the roadmapping of roadmapping systems is presented,developed and refined through a series of six industrial cases,and illustrated with an application example in the additive manufacturing sector.展开更多
AIM:To determine whether hypermagnesemia recently reported in adult patients possibly develops in children with functional constipation taking daily magnesium oxide.METHODS:We enrolled 120 patients (57 male and 63 fem...AIM:To determine whether hypermagnesemia recently reported in adult patients possibly develops in children with functional constipation taking daily magnesium oxide.METHODS:We enrolled 120 patients (57 male and 63 female) aged 1-14 years old (median:4.7 years) with functional constipation from 13 hospitals and two private clinics.All patients fulfilled the Rome Ⅲ criteria for functional constipation and were treated with daily oral magnesium oxide for at least 1 mo.The median treatment dose was 600 (500-800) mg/d.Patients were assessed by an interview and laboratory examination to determine possible hypermagnesemia.Serum magnesium concentration was also measured in sex-and agematched control subjects (n=38).RESULTS:In the constipation group,serum magnesium concentration [2.4 (2.3-2.5) mg/dL,median and interquartile range] was significantly greater than that of the control group [2.2 (2.0-2.2) mg/dL] (P < 0.001).The highest value was 3.2 mg/dL.Renal magnesium clearance was significantly increased in the constipation group.Serum magnesium concentration in the constipation group decreased significantly with age (P < 0.01).There was no significant correlation between the serum level of magnesium and the duration of treatment with magnesium oxide or the daily dose.None of the patients had side effects associated with hypermagnesemia.CONCLUSION:Serum magnesium concentration increased significantly,but not critically,after daily treatment with magnesium oxide in constipated children with normal renal function.展开更多
Introduction: COVID-19 has become a global public health concern. In Nepal, the government has imposed lockdown, school closures, non-pharmacological interventions, isolation, and quarantine. People were asked to acce...Introduction: COVID-19 has become a global public health concern. In Nepal, the government has imposed lockdown, school closures, non-pharmacological interventions, isolation, and quarantine. People were asked to accept self-care interventions. However, the effectiveness of these preventive measures depends on the knowledge and practice of an individual. Therefore, this study aimed to investigate the association between knowledge and practice among Bagmati province residents during the COVID-19 pandemic. Methods: A cross-sectional study was conducted using an online Google Form questionnaire. A total of 296 participants completed the surveys on social media, particularly Facebook. To assess the factors associated with knowledge and practices toward COVID-19, logistic regression analysis was applied. Results: The total scores of knowledge and practice were 7.62 ± 2.06 and 11 ± 1.91, respectively. Results showed that education, people having a medical background, and occupation were significantly associated with knowledge. While urban residence, older age, and living in a rental with a shared room were significantly associated with practice. Conclusions: People with higher education, medical backgrounds, and household workers had high knowledge about COVID-19;however, knowledge was not associated with practice. There was a gap between knowledge and practice.展开更多
AIM:To evaluate the utility of measuring epigenetic alterations in pancreatic and biliary fluids in determining molecular markers for pancreatobiliary cancers.METHODS:DNA was extracted from undiluted pancreatic and bi...AIM:To evaluate the utility of measuring epigenetic alterations in pancreatic and biliary fluids in determining molecular markers for pancreatobiliary cancers.METHODS:DNA was extracted from undiluted pancreatic and biliary fluids.As a surrogate for a genomewide hypomethylation assay,levels of long interspersed nuclear element-1(LINE-1) methylation were analyzed using bisulfite pyrosequencing.CpG island hypermethylation of 10 tumor-associated genes,aryl-hydrocarbon receptor repressor,adenomatous polyposis coli,calcium channel,voltage dependent,T type α1G subunit,insulin-like growth factor 2,O-6-methyl-guanine-DNA methyltransferase,neurogenin 1,CDKN2A,runt-related transcription factor 3(RUNX3),secreted frizzled-related protein 1,and ubiquitin carboxyl-terminal esterase L1(UCHL1),was analyzed using MethyLight.To examine the role of CpG methylation and histone deacetylation in the silencing of UCHL1,human gallbladder carcinoma cell lines and pancreatic carcinoma cell lines were treated with 2 or 5 μmol/L 5-AZA-dC for 72 h or 100 nmol/L Trichostatin A for 24 h.After the treatment,UCHL1 expression was analyzed by real-time reverse transcription-polymerase chain reaction.RESULTS:Pancreatobiliary cancers exhibited significantly lower LINE-1 methylation levels in pancreatic and biliary fluids than did noncancerous pancreatobiliary disease(58.7% ± 4.3% vs 61.7% ± 2.2%,P = 0.027;53.8% ± 6.6% vs 57.5% ± 1.7%,P = 0.007);however,LINE-1 hypomethylation was more evident in pancreatic cancer tissues than in pancreatic fluids(45.4% ± 5.5% vs 58.7% ± 4.3%,P < 0.001).CpG island hypermethylation of tumor-associated genes was detected at various frequencies,but it was not correlated with LINE-1 hypomethylation.Hypermethylation of the UCHL1 gene was cancer-specific and most frequently detected in pancreatic(67%) or biliary(70%) fluids from patients with pancreatobiliary cancer.As a single marker,hypermethylation of the UCHL1 gene in pancreatic and biliary fluids was most useful for the detection of pancreatic and pancreatobilia展开更多
The modulation of twin tropical cyclogenesis in the Indian-western Pacific Oceans by the Madden-Julian Oscillation (MJO) during the onset period of 1997/98 ENSO is explored for the period of September 1996 to June 199...The modulation of twin tropical cyclogenesis in the Indian-western Pacific Oceans by the Madden-Julian Oscillation (MJO) during the onset period of 1997/98 ENSO is explored for the period of September 1996 to June 1997 based on daily OLR, NCEP/NCAR wind vector, and JTWC best track datasets. The MJO westerly wind burst associated with its eastward propagation can result in a series of tropical cyclogeneses in a multi-day interval. Only in the transition seasons are pairs of tropical cyclones observed in both the tropical sectors of the Indian-western Pacific Oceans. Two remarkable twin tropical cyclogeneses probably modulated by the MJO westerly wind burst are found: one is observed in the Indian Ocean in the middle of October 1996, and the other is observed in the Western Pacific Ocean in late May 1997. The twin tropical cyclogenesis in mid-October 1996 is observed when the super cloud cluster separates into two isolated clusters by the enhanced westerly wind, which is accompanied by two independent vortices in the equatorial tropical sectors. The other one, in late-May 1997, however, is characterized by one cyclonic flow that later results in another cyclonic cell in its opposite equatorial sector. Thus, there are two very important conditions for twin cyclogenesis: one is the MJO westerly wind straddling the equator, and the other is the integral super cloud cluster, which later splits into two cloud convective clusters with independent vortices.展开更多
Objective： This study was originally designed to observe the effects of propranolol （a β-blocker） and Zhigancao Decoction （炙甘草汤 ZGCD） on bone mass in ovariectomized rats. Methods： Thirty-eight female Spragu...Objective： This study was originally designed to observe the effects of propranolol （a β-blocker） and Zhigancao Decoction （炙甘草汤 ZGCD） on bone mass in ovariectomized rats. Methods： Thirty-eight female Sprague-Dawley rats were divided into four groups initially, a sham-operated group （Sham, n=7）, a model ovariectomized （OVX） group （Model, n=7）, a propranolol group （Pro, n=12） and a ZGCD group （ZGCD, n=12）. After 15 weeks of treatment, the expected effects were not found. In order to verify the situations of the experiment, we modified the study by administering calcitonin to a subgroup of the tested Pro and ZGCD rats. Results： The Pro and ZGCD treatments showed decreased heart rate and plasma norepinephrine level, but neither an increased bone mass nor any bone metabolism differences from the model rats were found. However, the OVX-induced bone loss was prevented by the sequent treatment of calcitonin. Conclusions： The results provide no evidence that the β-blocker propranolol may stimulate bone formation, and do not iustify its use for clinical treatment of osteoporosis.展开更多
Spontaneous transition of the plasma confinement mode was observed in thehelical-axis heliotron device 'Heliotron J' for three different plasma heating schemes, i.e.ECH-only, NBI-only and the combination of EC...Spontaneous transition of the plasma confinement mode was observed in thehelical-axis heliotron device 'Heliotron J' for three different plasma heating schemes, i.e.ECH-only, NBI-only and the combination of ECH and NBI. The transition seems to occur above a certaincritical density. In addition to the confinement transition, a spontaneous shift of the hittingposition of the divertor plasma flux on the wall was observed. This shift could be related with thechange of the edge field topology caused by non-inductive toroidal currents.展开更多
Background: Informed consent forms and clinical study participation explanations contain many specialized words including medical terms that are difficult to understand. The difficulty is particularly obvious for chil...Background: Informed consent forms and clinical study participation explanations contain many specialized words including medical terms that are difficult to understand. The difficulty is particularly obvious for children with developmental disorders who show attention or similar problems. This study quantitatively evaluated the decision-making ability of these children using the Wechsler Intelligence Scale for Children-III (WISC-III) as a preliminary study for a multi-faceted investigation that would also use physiological indices. Methods: Participants were 11 children with Attention Deficit/Hyperactivity Disorder (AD/HD). The WISC-III was used for quantitative evaluation of their decision-making ability. Results of intelligence quotients (IQs), group indices, and subtest scores were analyzed. Results: The mean Performance IQ was four points lower than the mean Verbal IQ. The mean score for the Processing Speed index was lower by more than one standard deviation (SD). The mean scores for the Coding and Object Assembly subtests were lower by more than two SDs. Conclusion: The WISC-III results for IQ and group indices suggested the efficacy of auditory explanations. In addition, the subtest results suggested the necessity to pay sufficient attention to risk-benefit weighting in explanations. These findings suggested that the decision-making ability of children with AD/HD could be assessed using the WISC-III.展开更多
文摘IgG4-related sclerosing cholangitis(IgG4-SC)is often associated with autoimmune pancreatitis.However,the diffuse cholangiographic abnormalities observed in IgG4-SC may resemble those observed in primary sclerosing cholangitis(PSC),and the presence of segmental stenosis suggests cholangiocarcinoma(CC).IgG4-SC responds well to steroid therapy,whereas PSC is only effectively treated with liver transplantation and CC requires surgical intervention.Since IgG4-SC was first described,it has become a third distinct clinical entity of sclerosing cholangitis.The aim of this review was to introduce the diagnostic methods for IgG4-SC.IgG4-SC should be carefully diagnosed based on a combination of characteristic clinical,serological,morphological,and histopathological features after cholangiographic classification and targeting of a disease for differential diagnosis.When intrapancreatic stenosis is detected,pancreatic cancer or CC should be ruled out.If multiple intrahepatic stenoses are evident,PSC should be distinguished on the basis of cholangiographic findings and liver biopsy with IgG4 immunostaining.Associated inflammatory bowel disease is suggestive of PSC.If stenosis is demonstrated in the hepatic hilar region,CC should be discriminated by ultrasonography,intraductal ultrasonography,bile duct biopsy,and a higher cutoff serum IgG4 level of 182 mg/dL.
基金Supported by Grants-in-Aid for Scientific Research from the Ministry of Education,Culture,Sports,Science and Technology of Japan,to Yamamoto H and Shinomura Y
文摘AIM:To investigate human epidermal growth factor receptor 2(HER2)-phosphatidylinositol 3-kinase(PI3K)-vAkt murine thymoma viral oncogene homolog signaling pathway.METHODS:We analyzed 231 formalin-fixed,paraffinembedded gastric cancer tissue specimens from Japanese patients who had undergone surgical treatment.The patients' age,sex,tumor location,depth of invasion,pathological type,lymph node metastasis,and pathological stage were determined by a review of the medical records.Expression of HER2 was analyzed by immunohistochemistry(IHC) using the HercepTest TM kit.Standard criteria for HER2 positivity(0,1+,2+,and 3+) were used.Tumors that scored 3+ were considered HER2-positive.Expression of phospho Akt(pAkt) was also analyzed by IHC.Tumors were considered pAkt-positive when the percentage of positive tumor cells was 10% or more.PI3K,catalytic,alpha polypeptide(PIK3CA) mutations in exons 1,9 and 20 were analyzed by pyrosequencing.Epstein-Barr virus(EBV) infection was analyzed by in situ hybridization targeting EBV-encoded small RNA(EBER) with an EBER-RNA probe.Microsatellite instability(MSI) was analyzed by polymerase chain reaction using the mononucleotide markers BAT25 and BAT26.RESULTS:HER2 expression levels of 0,1+,2+ and 3+ were found in 167(72%),32(14%),12(5%) and 20(8.7%) samples,respectively.HER2 overexpression(IHC 3+) significantly correlated with intestinal histological type(15/20 vs 98 /205,P = 0.05).PIK3CA mutations were present in 20 cases(8.7%) and significantly correlated with MSI(10/20 vs 9/211,P < 0.01).The mutation frequency was high(21%) in T4 cancers and very low(6%) in T2 cancers.Mutations in exons 1,9 and 20 were detected in 5(2%),9(4%) and 7(3%) cases,respectively.Two new types of PIK3CA mutation,R88Q and R108H,were found in exon1.All PIK3CA mutations were heterozygous missense singlebase substitutions,the most common being H1047R(6/20,30%) in exon20.Eighteen cancers(8%) were EBV-positive and this positivity significantly correlated with a diffuse histological type(13/18 vs 93/198,P = 0.04).T
文摘This is a review of the characteristic findings of inflammatory bowel disease(IBD)associated with primary sclerosing cholangitis(PSC)and their usefulness in the diagnosis of sclerosing cholangitis.PSC is a chronic inflammatory disease characterized by idiopathic fibrous obstruction and is frequently associated with IBD.IBDassociated with PSC(PSC-IBD)shows an increased incidence of pancolitis,mild symptoms,and colorectal malignancy.Although an increased incidence of pancolitis is a characteristic finding,some cases are endoscopically diagnosed as right-sided ulcerative colitis.Pathological studies have revealed that inflammation occurs more frequently in the right colon than the left colon.The frequency of rectal sparing and backwash ileitis should be investigated in a future study based on the same definition.The cholangiographic findings of immunoglobulin G4-related sclerosing cholangitis(IgG4-SC)are similar to those of PSC.The rare association between IBD and IgG4-SC and the unique characteristics of PSC-IBD are useful findings for distinguishing PSC from IgG4-SC.
基金Supported by Health Labor Science Research Grants from Research on Measures for Intractable Diseases,the IntractableHepato-Biliary Diseases Study Group in Japan
文摘Immunoglobulin G4-related sclerosing cholangitis(Ig G4-SC) is frequently associated with type 1 autoimmune pancreatitis(AIP). Association with AIP can be utilized in the diagnosis of Ig G4-SC. However, some cases of Ig G4-SC are isolated from AIP, which complicates the diagnosis. Most of the reported cases of isolated Ig G4-SC displayed hilar biliary strictures, whereas isolated Ig G4-SC with intrapancreatic biliary stricture is very rare. Recently, we have encountered 5 isolated intrapancreatic Ig G4-SC cases that were not associated with AIP, three of which were pathologically investigated after surgical operation. They all were males with a mean age of 74.2 years. The pancreas was not enlarged in any of these cases. No irregular narrowing of the main pancreatic duct was found. Bile duct wall thickening in lesions without luminal stenosis was detected by abdominal computed tomography in all five cases, by endoscopic ultrasonography in two out of four cases and by intraductal ultrasonography in all three cases. In three cases, serum Ig G4 levels were within the normal limits. The mean serum Ig G4 level measured before surgery was 202.1 mg/d L(4 cases). Isolated intrapancreatic Ig G4-SC is difficult to diagnose, especially if the Ig G4 level remains normal. Thus, this type of Ig G4-SC should be suspected in addition to cholangiocarcinoma and pancreatic cancer if stenosis of intrapancreatic bile duct is present.
基金supported by scholarship from Futoku Foundation and Hokkaido Gas Co.Ltd
文摘Objective: To investigate the effect of the roselle calyx extract(RCE)(Hibiscus sabdariffa L.) on the in vitro viability and biofilm formation ability of oral pathogenic bacteria. Methods:RCE was prepared by soaking roselle calyx powder with ethyl alcohol for 24 h at room temperature. After centrifugation, the extract was lyophilized. Then, the extract was dissolved in phosphate-buffered saline, the p H was adjusted, and the extract was aseptically filtered. We used Streptococcus mutans, Streptococcus sanguinis, Lactobacillus casei, Actinomyces naeslundii, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis and Prevotella intermedia in this study. The antibacterial activity of the RCE was determined by treating the cells of these bacteria with the extract for 10 or 20 min at room temperature. The minimum inhibitory concentration(MIC) and minimum bactericidal concentration was determined using the micro dilution method, and the effect of the RCE on the ability to form biofilm was determined using a polystyrene micro plate assay. In addition, we used the WST-1 assay to determine the cytotoxicity of the RCE on HGF, Ca9-22 and KB cells. Results: The RCE had antibacterial activity against oral bacteria used in this study. In particular, most significant antibacterial activity was observed against Fusobacterium nucleatum, Prevotella intermedia and Porphyromonas gingivalis. The MIC and minimum bactericidal concentration were 7.2 mg/m L–28.8 mg/m L and 14.4 to >57.6 mg/m L. The RCE had an inhibitory effect on biofilm formation at the MIC and sub-MIC levels. In addition, the RCE had low cytotoxic effects on HGF, Ca9-22 and KB cells. Conclusions: Thus, our results indicate that the RCE may be used for preventing oral diseases.
文摘BACKGROUND The development of biodegradable surgical staples is desirable as non-biodegradable Ti alloy staples reside in the human body long after wound healing, which can cause allergic/foreign-body reactions, adhesion, or other adverse effects. In order to develop a biodegradable alloy suitable for the fabrication of surgical staples, we hypothesized that Zn, a known biodegradable metal, could be alloyed with various elements to improve the mechanical properties while retaining biodegradability and biocompatibility. Considering their biocompatibility, Mg, Ca, Mn, and Cu were selected as candidate alloying elements, alongside Ti, the main material of clinically available surgical staples.AIM To investigate the in vitro mechanical properties and degradation behavior and in vivo safety and feasibility of biodegradable Zn alloy staples.METHODS Tensile and bending tests were conducted to evaluate the mechanical properties of binary Zn alloys with 0.1–6 wt.% Mg, Ca, Mn, Cu, or Ti. Based on the results,three promising Zn alloy compositions were devised for staple applications(wt.%): Zn-1.0Cu-0.2Mn-0.1Ti(Zn alloy 1), Zn-1.0Mn-0.1Ti(Zn alloy 2), and Zn-1.0Cu-0.1Ti(Zn alloy 3). Immersion tests were performed at 37℃ for 4 wk using fed-state simulated intestinal fluid(Fe SSIF) and Hank’s balanced salt solution(HBSS). The corrosion rate was estimated from the weight loss of staples during immersion. Nine rabbits were subjected to gastric resection using each Zn alloy staple, and a clinically available Ti staple was used for another group of nine rabbits. Three in each group were sacrificed at 1, 4, and 12 wk post-operation.RESULTS Additions of ≤1 wt.% Mn or Cu and 0.1 wt.% Ti improved the yield strength without excessive deterioration of elongation or bendability. Immersion tests revealed no gas evolution or staple fracture in any of the Zn alloy staples. The corrosion rates of Zn alloy staples 1, 2, and 3 were 0.02 mm/year in HBSS and 0.12, 0.11, and 0.13 mm/year, respectively, in Fe SSIF. These degradation times
文摘Roadmapping is a well-established technique in the context of innovation and strategy,with the potential to support organizations address the complex transformative challenges facing humanity in the 21st century.This is enabled by its systems-based architecture and visual form of roadmaps,supporting communication and reduction of information asymmetries in complex sociotechnical systems.This paper focuses on an adaptation of the roadmapping method to support strategic planning for roadmapping systems in organizations,addressing implementation challenges.This represents a novel application of roadmapping to business processes and systems,demonstrating the flexibility of the roadmapping approach.A workshop template(‘R2’)and process for supporting the roadmapping of roadmapping systems is presented,developed and refined through a series of six industrial cases,and illustrated with an application example in the additive manufacturing sector.
文摘AIM:To determine whether hypermagnesemia recently reported in adult patients possibly develops in children with functional constipation taking daily magnesium oxide.METHODS:We enrolled 120 patients (57 male and 63 female) aged 1-14 years old (median:4.7 years) with functional constipation from 13 hospitals and two private clinics.All patients fulfilled the Rome Ⅲ criteria for functional constipation and were treated with daily oral magnesium oxide for at least 1 mo.The median treatment dose was 600 (500-800) mg/d.Patients were assessed by an interview and laboratory examination to determine possible hypermagnesemia.Serum magnesium concentration was also measured in sex-and agematched control subjects (n=38).RESULTS:In the constipation group,serum magnesium concentration [2.4 (2.3-2.5) mg/dL,median and interquartile range] was significantly greater than that of the control group [2.2 (2.0-2.2) mg/dL] (P < 0.001).The highest value was 3.2 mg/dL.Renal magnesium clearance was significantly increased in the constipation group.Serum magnesium concentration in the constipation group decreased significantly with age (P < 0.01).There was no significant correlation between the serum level of magnesium and the duration of treatment with magnesium oxide or the daily dose.None of the patients had side effects associated with hypermagnesemia.CONCLUSION:Serum magnesium concentration increased significantly,but not critically,after daily treatment with magnesium oxide in constipated children with normal renal function.
文摘Introduction: COVID-19 has become a global public health concern. In Nepal, the government has imposed lockdown, school closures, non-pharmacological interventions, isolation, and quarantine. People were asked to accept self-care interventions. However, the effectiveness of these preventive measures depends on the knowledge and practice of an individual. Therefore, this study aimed to investigate the association between knowledge and practice among Bagmati province residents during the COVID-19 pandemic. Methods: A cross-sectional study was conducted using an online Google Form questionnaire. A total of 296 participants completed the surveys on social media, particularly Facebook. To assess the factors associated with knowledge and practices toward COVID-19, logistic regression analysis was applied. Results: The total scores of knowledge and practice were 7.62 ± 2.06 and 11 ± 1.91, respectively. Results showed that education, people having a medical background, and occupation were significantly associated with knowledge. While urban residence, older age, and living in a rental with a shared room were significantly associated with practice. Conclusions: People with higher education, medical backgrounds, and household workers had high knowledge about COVID-19;however, knowledge was not associated with practice. There was a gap between knowledge and practice.
基金Supported by Grants-in-Aid for Scientific Research from the Ministry of Education,Culture,Sports,Science and Technology of Japan (to Yamamoto H and Shinomura Y)
文摘AIM:To evaluate the utility of measuring epigenetic alterations in pancreatic and biliary fluids in determining molecular markers for pancreatobiliary cancers.METHODS:DNA was extracted from undiluted pancreatic and biliary fluids.As a surrogate for a genomewide hypomethylation assay,levels of long interspersed nuclear element-1(LINE-1) methylation were analyzed using bisulfite pyrosequencing.CpG island hypermethylation of 10 tumor-associated genes,aryl-hydrocarbon receptor repressor,adenomatous polyposis coli,calcium channel,voltage dependent,T type α1G subunit,insulin-like growth factor 2,O-6-methyl-guanine-DNA methyltransferase,neurogenin 1,CDKN2A,runt-related transcription factor 3(RUNX3),secreted frizzled-related protein 1,and ubiquitin carboxyl-terminal esterase L1(UCHL1),was analyzed using MethyLight.To examine the role of CpG methylation and histone deacetylation in the silencing of UCHL1,human gallbladder carcinoma cell lines and pancreatic carcinoma cell lines were treated with 2 or 5 μmol/L 5-AZA-dC for 72 h or 100 nmol/L Trichostatin A for 24 h.After the treatment,UCHL1 expression was analyzed by real-time reverse transcription-polymerase chain reaction.RESULTS:Pancreatobiliary cancers exhibited significantly lower LINE-1 methylation levels in pancreatic and biliary fluids than did noncancerous pancreatobiliary disease(58.7% ± 4.3% vs 61.7% ± 2.2%,P = 0.027;53.8% ± 6.6% vs 57.5% ± 1.7%,P = 0.007);however,LINE-1 hypomethylation was more evident in pancreatic cancer tissues than in pancreatic fluids(45.4% ± 5.5% vs 58.7% ± 4.3%,P < 0.001).CpG island hypermethylation of tumor-associated genes was detected at various frequencies,but it was not correlated with LINE-1 hypomethylation.Hypermethylation of the UCHL1 gene was cancer-specific and most frequently detected in pancreatic(67%) or biliary(70%) fluids from patients with pancreatobiliary cancer.As a single marker,hypermethylation of the UCHL1 gene in pancreatic and biliary fluids was most useful for the detection of pancreatic and pancreatobilia
基金supported by the CATT,Japanthe Scientific Research Foundation for the R.eturned Overseas Chinese Scholars,State Ed-ucation MinistryLASG,Institute of Atmospheric Physics,Chinese Academy of Sciences.
文摘The modulation of twin tropical cyclogenesis in the Indian-western Pacific Oceans by the Madden-Julian Oscillation (MJO) during the onset period of 1997/98 ENSO is explored for the period of September 1996 to June 1997 based on daily OLR, NCEP/NCAR wind vector, and JTWC best track datasets. The MJO westerly wind burst associated with its eastward propagation can result in a series of tropical cyclogeneses in a multi-day interval. Only in the transition seasons are pairs of tropical cyclones observed in both the tropical sectors of the Indian-western Pacific Oceans. Two remarkable twin tropical cyclogeneses probably modulated by the MJO westerly wind burst are found: one is observed in the Indian Ocean in the middle of October 1996, and the other is observed in the Western Pacific Ocean in late May 1997. The twin tropical cyclogenesis in mid-October 1996 is observed when the super cloud cluster separates into two isolated clusters by the enhanced westerly wind, which is accompanied by two independent vortices in the equatorial tropical sectors. The other one, in late-May 1997, however, is characterized by one cyclonic flow that later results in another cyclonic cell in its opposite equatorial sector. Thus, there are two very important conditions for twin cyclogenesis: one is the MJO westerly wind straddling the equator, and the other is the integral super cloud cluster, which later splits into two cloud convective clusters with independent vortices.
文摘Objective： This study was originally designed to observe the effects of propranolol （a β-blocker） and Zhigancao Decoction （炙甘草汤 ZGCD） on bone mass in ovariectomized rats. Methods： Thirty-eight female Sprague-Dawley rats were divided into four groups initially, a sham-operated group （Sham, n=7）, a model ovariectomized （OVX） group （Model, n=7）, a propranolol group （Pro, n=12） and a ZGCD group （ZGCD, n=12）. After 15 weeks of treatment, the expected effects were not found. In order to verify the situations of the experiment, we modified the study by administering calcitonin to a subgroup of the tested Pro and ZGCD rats. Results： The Pro and ZGCD treatments showed decreased heart rate and plasma norepinephrine level, but neither an increased bone mass nor any bone metabolism differences from the model rats were found. However, the OVX-induced bone loss was prevented by the sequent treatment of calcitonin. Conclusions： The results provide no evidence that the β-blocker propranolol may stimulate bone formation, and do not iustify its use for clinical treatment of osteoporosis.
基金The project partially supported by the Grant-in-Aid for Science Research of MEXT in Japan and by the Collaboration Program of the Laboratory for Complex Energy ProcessesIAEKyoto University
文摘Spontaneous transition of the plasma confinement mode was observed in thehelical-axis heliotron device 'Heliotron J' for three different plasma heating schemes, i.e.ECH-only, NBI-only and the combination of ECH and NBI. The transition seems to occur above a certaincritical density. In addition to the confinement transition, a spontaneous shift of the hittingposition of the divertor plasma flux on the wall was observed. This shift could be related with thechange of the edge field topology caused by non-inductive toroidal currents.
文摘Background: Informed consent forms and clinical study participation explanations contain many specialized words including medical terms that are difficult to understand. The difficulty is particularly obvious for children with developmental disorders who show attention or similar problems. This study quantitatively evaluated the decision-making ability of these children using the Wechsler Intelligence Scale for Children-III (WISC-III) as a preliminary study for a multi-faceted investigation that would also use physiological indices. Methods: Participants were 11 children with Attention Deficit/Hyperactivity Disorder (AD/HD). The WISC-III was used for quantitative evaluation of their decision-making ability. Results of intelligence quotients (IQs), group indices, and subtest scores were analyzed. Results: The mean Performance IQ was four points lower than the mean Verbal IQ. The mean score for the Processing Speed index was lower by more than one standard deviation (SD). The mean scores for the Coding and Object Assembly subtests were lower by more than two SDs. Conclusion: The WISC-III results for IQ and group indices suggested the efficacy of auditory explanations. In addition, the subtest results suggested the necessity to pay sufficient attention to risk-benefit weighting in explanations. These findings suggested that the decision-making ability of children with AD/HD could be assessed using the WISC-III.
