Objective: To estimate the efficacy of 23-valent pneumococcal polysaccharide vaccine (PPSV23) among the elderly, we analyzed the relationship between the mortality of the elderly for pneumonia and the vaccination rate...Objective: To estimate the efficacy of 23-valent pneumococcal polysaccharide vaccine (PPSV23) among the elderly, we analyzed the relationship between the mortality of the elderly for pneumonia and the vaccination rate of PPSV23 from 2008 to 2016 in Iwate Prefecture, Japan. Study Design: The present study was a retrospective, observational, database study adopting an ecological design. The mortality for pneumonia among the elderly over 70 years old from 2006 to 2016 in Iwate Prefecture was calculated based on the data from the Japanese Vital Statistics. We compared the mortality rate (MR) of pneumonia among the elderly over 70 years old between the low-vaccinated period (LVP) (2006-2010) and high-vaccinated period (HVP) (2012-2016) using a Poisson regression model. Results: While the vaccination rate of PPSV23 among the elderly over 65 years old was 3.3% in 2010, it increased rapidly up to 40.7% in 2012 and reached 66.4% in 2016. The MR ratio of the total population during HVP to the average MR during LVP was 0.749. The MR of the total population during HVP was significantly lower than that during LVP (p Conclusion: The increase in vaccination rate of PPSV23 during HVP (2012-2016) may contribute to the decrease in mortality for pneumonia among the elderly over 70 years old in Iwate Prefecture.展开更多
Background： The use of antibiotics in animal diets is facing negative feedback due to the hidden danger of drug residues to human health. Traditional Chinese herbal medicine has been used to replace antibiotics in th...Background： The use of antibiotics in animal diets is facing negative feedback due to the hidden danger of drug residues to human health. Traditional Chinese herbal medicine has been used to replace antibiotics in the past two decades and played an increasingly important role in livestock production. The present study was carried out to assess the feeding effects of a traditional nourishing Chinese herbal medicine mixture on kinetics of plasma glucose, protein and energy metabolism in sheep. Ruminal fermentation characteristics were also determined. Methods： Four sheep were fed on either mixed hay （MH-diet） or MH-diet supplemented with 2% of Chinese herbal medicine （mixture of Astragalus root, Angelica root and Atractylodes rhizome; CHM-diet） over two 3S-day periods using a crossover design. The turnover rate of plasma glucose was measured with an isotope dilution method using [U-^13C]glucose. The rates of plasma leucine turnover and leucine oxidation, whole body protein synthesis （WBPS） and metabolic heat production were measured using the [1-^13C]leucine dilution and open circuit calorimetry. Results： Body weight gain of sheep was higher （P = 0.03） for CHM-diet than for MH-diet. Rumen pH was lower （P = 0.02）, concentration of rumen total volatile fatty acid tended to be higher （P = 0.05） and acetate was higher （P = 0.04） for CHM-diet than for MH-diet. Turnover rates of plasma glucose and leucine did not differ between diets. Oxidation rate of leucine tended to be higher （P = 0.06） for CHM-diet than for MH-diet, but the WBPS did not differ between diets. Metabolic heat production tended to be greater （P = 0.05） for CHM-diet than for MH-diet. Conclusions： The sheep fed on CHM-diet had a higher body weight gain and showed positive impacts on rumen fermentation and energy metabolism without resulting in any adverse response. Therefore, these results suggested that the Chinese herbal medicine mixture should be considered as a potential feed additive for sheep.展开更多
In a tractor automatic navigation system, path planning plays a significant role in improving operation efficiency. This study aims to create a suboptimal reference course for headland turning of a robot tractor and d...In a tractor automatic navigation system, path planning plays a significant role in improving operation efficiency. This study aims to create a suboptimal reference course for headland turning of a robot tractor and design a path-tracking controller to guide the robot tractor along the reference course. A time-minimum suboptimal control method was used to generate the reference turning course based on the mechanical parameters of the test tractor. A path-tracking controller consisting of both feedforward and feedback component elements was also proposed. The feedforward component was directly determined by the desired steering angle of the current navigation point on the reference course, whereas the feedback component was derived from the designed optimal controller. Computer simulation and field tests were performed to validate the path-tracking performance. Field test results indicated that the robot tractor followed the reference courses precisely on flat meadow, with average and standard lateral devia- tions being 0.031 m and 0.086 m, respectively. However, the tracking error increased while operating on sloping meadow due to the employed vehicle kinematic model.展开更多
AIM: To identify the hepatic vascular architecture of patients with hepatitis C virus (HCV) using superb microvascular imaging (SMI) and investigate the use of SMI in the evaluation of liver fibrosis.METHODS: SMI was ...AIM: To identify the hepatic vascular architecture of patients with hepatitis C virus (HCV) using superb microvascular imaging (SMI) and investigate the use of SMI in the evaluation of liver fibrosis.METHODS: SMI was performed in 100 HCV patients. SMI images were classified into five types according to the vascular pattern, and these patterns were compared with the fibrosis stage. Moreover, the images were analyzed to examine vascularity by integrating the number of SMI signals in the region of interest ROI [number of vascular trees (VT)]. The number of VT, fibrosis stage, serum parameters of liver function, and CD34 expression were investigated.RESULTS: There was a significant difference between SMI distribution pattern and fibrosis stage (P < 0.001). The mean VT values in each of the fibrosis stages were as follows: 26.69 ± 7.08 in F0, 27.72 ± 9.32 in F1, 36.74 ± 9.23 in F2, 37.36 ± 5.32 in F3, and 58.14 ± 14.08 in F4. The VT showed excellent diagnostic ability for F4 [area under the receiver operator characteristic (AUROC): 0.911]. The VT was significantly correlated with the CD34 labeling index (r = 0.617, P < 0.0001).CONCLUSION: SMI permitted the detailed delineation of the vascular architecture in chronic liver disease. SMI appears to be a reliable tool for noninvasively detecting significant fibrosis or cirrhosis in HCV patients.展开更多
BACKGROUND Lenvatinib is one of the first-line tyrosine kinase inhibitors used for unresectable hepatocellular carcinoma(HCC). In the present study, we evaluated the potential of early changes in the time-intensity cu...BACKGROUND Lenvatinib is one of the first-line tyrosine kinase inhibitors used for unresectable hepatocellular carcinoma(HCC). In the present study, we evaluated the potential of early changes in the time-intensity curve(TIC) of arterial phase on contrastenhanced ultrasound(CEUS) as early imaging biomarkers of lenvatinib efficacy.AIM To evaluate the potential of the early changes in the TIC of CEUS as early imaging biomarkers of lenvatinib efficacy in patients with unresectable HCC.METHODS We analyzed 20 consecutive patients with unresectable HCC treated with lenvatinib from March to November 2018. Tumor response at 8 wk was assessed by computed tomography using the modified Response Evaluation Criteria in Solid Tumors(m RECIST). CEUS was performed at baseline before treatment(Day 0) and on day 7(Day 7), and the images were analyzed in the arterial phase for 20 seconds after the contrast agent arrived at the target tumor. Three perfusion parameters were extracted from the TICs: the slope of wash-in(Slope),time to peak(TTP) intensity, and the total area under the curve(AUC) during wash-in. The rate of change in the TIC parameters between Day 0 and Day 7 was compared between treatment responders and non-responders based on m RECIST.RESULTS The rate of change for all TIC parameters showed significant differences between the responders(n = 9) and non-responders(n = 11)(Slope, P = 0.025; TTP, P =0.004; and AUC, P = 0.0003). The area under the receiver operating curve values for slope, TTP, and AUC for the prediction of responders were 0.805, 0.869, and0.939, respectively.CONCLUSION CEUS may be useful for the early prediction of tumor response to lenvatinib therapy in patients with unresectable HCC.展开更多
Uterine cervical adenocarcinoma （ADC） has been increasing in its prevalence world widely despite the decrease of squamous cell carcinoma （SCC）. It comprises nearly 20-25% of the all cervical malignancy in develope...Uterine cervical adenocarcinoma （ADC） has been increasing in its prevalence world widely despite the decrease of squamous cell carcinoma （SCC）. It comprises nearly 20-25% of the all cervical malignancy in developed countries. The worse biological behavior had been reported in patients with intermediateand high risk factors after surgery, and in advanced stage over III, radiotherapy （RT） alone and concurrent chemo-radiotherapy （CCRT） with cisplatin was not always effective. As for chemotherapy （CT）, the iaduction CT has not established, as well. Further molecular targeted therapy （MTT） has been studied. The targets of oncogenic driver mutations were vascular endothelial growth factor （VEGF） in SCC, or tyrosine kinase （TK） of endothelial growth factor receptor 2 （EGFR2, Her2/neu）-Ras-MAPK-ERK pathway. Bevacizumab （Bey, anti-VEGF monoclonal antibody） is considered as one of key agent with paclitaxel and carboplatin in SCC, but not for ADC. This article focuses on up-to-date knowledge of biology and possible specific therapeutic directions to explore in the management of cervical ADC.展开更多
AIM:To evaluate the efficacy of transcatheter arterial chemoembolization(TACE) using a suspension of a fine-powder formulation of cisplatin(DDPH) for hepatocellular carcinoma(HCC).METHODS:The study population was comp...AIM:To evaluate the efficacy of transcatheter arterial chemoembolization(TACE) using a suspension of a fine-powder formulation of cisplatin(DDPH) for hepatocellular carcinoma(HCC).METHODS:The study population was comprised of 164 patients who were treated by TACE alone.Of these patients,76 underwent TACE using a suspension of DDPH in lipiodol(LPD)(DDPH group),and the remaining 88 underwent TACE with an emulsion of doxorubicin(ADM) with LPD(ADM group).We compared the DDPH group with the ADM group in terms of the objective early response rate,progression free survival(PFS) and overall survival(OS).RESULTS:The objective early response rate in the DDPH group was significantly higher than that in the ADM group(54% vs 24%,P < 0.001).The PFS rate in the DDPH group was also significantly higher than that in the ADM group(P < 0.001).Moreover,the OS in the DDPH group was significantly longer than that in the ADM group(P = 0.002).Although the incidence rate of nausea or vomiting in the DDPH group was higher than that in the ADM group,the ADM group showed a higher incidence rate of the adverse events of hepatic arterial damage and leucopenia.No other serious complications were observed in either group.CONCLUSION:We conclude that TACE using a suspension of DDPH in LPD could be a useful treatment for HCC.展开更多
Leiomyomas are the most common benign tumors of the esophagus. They usually occur as a single lesion or as two or three nodules. Only two cases of esophageal multiple leiomyomas comprising more than 10 nodules have be...Leiomyomas are the most common benign tumors of the esophagus. They usually occur as a single lesion or as two or three nodules. Only two cases of esophageal multiple leiomyomas comprising more than 10 nodules have been reported previously. Moreover, there have been few reports of esophageal squamous cell carcinoma overlying submucosal tumors. We describe a 71-yearold man who was diagnosed as having a superficial esophageal cancer coexisting with two or three leiomyoma nodules. During surgery, 10 or more nodules that had not been evident preoperatively were palpable in the submucosal and muscular layers throughout the esophagus. As intramural metastasis of the esophageal cancer was suspected, we considered additional lymphadenectomy, but had to rule out this option because of the patient＇s severe anoxemia. Microscopic examination revealed that all the nodules were leiomyomas （20 lesions, up to 3 cm in diameter）, and that invasion of the carcinoma cells was limited to the submucosal layer overlying a relatively large leiomyoma. This is the first report of superficial esophageal cancer coexisting with numerous solitary leiomyomas. Multiple minute leiomyomas are often misdiagnosed as intramural metastasis, and a leiomyoma at the base of a carcinoma lesion can also be rnisdiagnosed as tumor invasion. The present case shows that accurate diagnosis is required for the management of patients with coexisting superficial esophageal cancer and multiple leiomyomas.展开更多
AIM:To evaluate the efficacy of transarterial chemoembolization(TACE) using a suspension of a finepowder formulation of cisplatin(DDPH) in lipiodol(LPD) in the treatment of hepatocellular carcinoma(HCC).METHODS:The su...AIM:To evaluate the efficacy of transarterial chemoembolization(TACE) using a suspension of a finepowder formulation of cisplatin(DDPH) in lipiodol(LPD) in the treatment of hepatocellular carcinoma(HCC).METHODS:The subjects were 262 HCC patients treated with TACE using a DDPH-LPD suspension.The DDPH-LPD suspension was prepared by mixing 50 mg of DDPH into 10 mL of LPD.TACE was repeated when treated lesions relapsed and/or new hepatic lesions were detected.These patients received additional TACE using the same agent.TACE was repeated until complete regression of the tumor was obtained.The primary efficacy endpoint of the current study was the objective early response rate.Secondary efficacy endpoints were progression-free survival(PFS) and overall survival.RESULTS:The objective early response rate was 43.6%.Cumulative PFS rates were 56.7% at 6 mo,23.1% at 12 mo,13.4% at 18 mo,and 10.5% at 24 mo.The median PFS was 6.6 mo.Cumulative survival rates were 90.6% at 6 mo,81.9% at 12 mo,70.5% at 24 mo,and 58.8% at 36 mo.Median survival time was 46.6 mo.All adverse reactions were controllable by temporary suspension of treatment.No serious complications or treatment-related deaths were observed.CONCLUSION:TACE using a suspension of DDPH in LPD may be a useful treatment for HCC.展开更多
The anti-arrhythmic agent amiodarone （AD） is associated with numerous adverse effects, but serious liver disease is rare. The improved safety of administration of daily low doses of AD has already been established a...The anti-arrhythmic agent amiodarone （AD） is associated with numerous adverse effects, but serious liver disease is rare. The improved safety of administration of daily low doses of AD has already been established and this regimen is used for long-term medication. Nevertheless, asymptomatic continuous liver injury by AD may increase the risk of step-wise progression of non-alcoholic fatty liver disease. We present an autopsy case of AD-induced liver cirrhosis in a patient who had been treated with a low dose of AD （200 rag/d） daily for 84 too. The patient was a 85-year-old male with a history of ischemic heart disease. Seven years after initiation of treatment with AD, he was admitted with cardiac congestion. The total dose of AD was 528 g. Mild elevation of serum aminotransferase and hepatomegaly were present. Liver biopsy specimens revealed cirrhosis, and under electron microscopy numerous lysosomes with electron-dense, whorled, lamellar inclusions characteristic of a secondary phospholipidosis were observed. Initially, withdrawal of AD led to a slight improvement of serum aminotransferase levels, but unfortunately his general condition deteriorated and he died from complications of pneumonia and renal failure. Long-term administration of daily low doses of AD carries the risk of progression to irreversible liver injury. Therefore, periodic examination of liver function and/or liver biopsy is required for the management of patients receiving long-term treatment with AD.展开更多
AIM To determine appropriate fecal calprotectin cut-off values for the prediction of endoscopic and histologic remission in Japanese patients with ulcerative colitis(UC). METHODS We performed a cross-sectional observa...AIM To determine appropriate fecal calprotectin cut-off values for the prediction of endoscopic and histologic remission in Japanese patients with ulcerative colitis(UC). METHODS We performed a cross-sectional observational study of 131 Japanese patients with UC and measured fecal calprotectin levels by fluorescence enzyme immunoassay. The clinical activity of UC was assessed with the partial Mayo score(PMS). Relapse was defined as increase of PMS by 2 points or more in stool frequency or rectal bleeding subscore. The endoscopic and histologic activities of UC were evaluated in 50 patients within a 2-mo period from fecal sampling. Endoscopic activity was determined by Mayo endoscopic subscore, Rachmilewitz endoscopic index, and ulcerative colitis endoscopic index of severity. The histologic grade of inflammation was evaluated with biopsy specimens obtained from the endoscopically most severely inflamed site, according to the scheme by Matts grade and Riley's score.RESULTS Fecal calprotectin levels varied from 1-20783 μg/g. There was a significant correlation between the partial Mayo score and fecal calprotectin levels(r = 0.548, P < 0.001). In 50 patients who underwent colonoscopy with biopsy, levels were significantly correlated with the Mayo endoscopic subscore(r = 0.574, P < 0.001), Rachmilewitz endoscopic index(r = 0.628, P < 0.001), ulcerative colitis endoscopic index of severity(r = 0.613, P < 0.001), Riley's histologic score(r = 0.400, P = 0.006), and Matts grade(r = 0.586, P < 0.001). Receiver-operating characteristic analyses identified the best cut-off value for the prediction of endoscopic remission as 288 μg/g, with an area under the curve of 0.777 or 0.823, while that for histologic remission was 123 or 125 μg/g, with an AUC of 0.881 or 0918, respectively. Of the 131 study patients, 88 patients in clinical remission were followed up 6 mo. During the follow-up period, 19 patients relapsed. The best fecal calprotectin cut-off value for predicting relapse was 175 μg/g.CONCLUSION Fecal calprotectin is a predictive biomarker for endoscopic and histologic remission in Japanese patients with UC.展开更多
Background: Obstructive sleep apnea syndrome (OSAS) is one of the representative sleep disorders believed to be associated with metabolic syndrome. Nasal continuous positive airway pressure (nCPAP) ventilation is the ...Background: Obstructive sleep apnea syndrome (OSAS) is one of the representative sleep disorders believed to be associated with metabolic syndrome. Nasal continuous positive airway pressure (nCPAP) ventilation is the first choice therapy for OSAS, which has been reported to cause an improvement in body fat mass, hepatocellular damage and hypertension. Study Objectives: We evaluated whether the changes in the body weight observed in patients with OSAS may have potential associations with the sleep time during which the patients are under nCPAP. Method: A total of 194 patients (148 obese and 46 non-obese) in whom nCPAP use was present for more than 70% of the nights were enrolled in this study. Using the electronic records of the night use time for CPAP devices, we examined whether the habitual sleep time during nCPAP is associated with changes in body weight. Results: In the non-obese OSAS group, the patients with night time use of nCPAP devices for 6 to 7 hours showed the greatest and the most sustained decrease in body weight. In the obese patients with OSAS, on the other hand, a U-shaped relationship has been demonstrated between a percent weight gain over 9 years and a minimal weight gain in patients with habitual sleep for 5 to 6 hours. Conclusions: These results suggest that changes in body weight in patients with OSAS are associated with habitual sleep time.展开更多
Leonurus sibiricus is a herbaceous plant found in many countries in Asia and America.This plant is widely practiced as a remedy for the treatment of diabetes,menstrual irregularities,and bronchitis.The approval of the...Leonurus sibiricus is a herbaceous plant found in many countries in Asia and America.This plant is widely practiced as a remedy for the treatment of diabetes,menstrual irregularities,and bronchitis.The approval of therapeutic implications of any drugs depends on the well characterized mode of actions of the compounds.The bioactive compounds like diterpenes,triterpenes,flavonoids and phenolic acids in Leonurus sibiricus show analgesic,anti-inflammatory,anti-oxidant,anti-atherogenic and antihemorrhagic,anti-diabetic,anti-bacterial and allelopathic potency.Interestingly,the expression level of some genes is altered by the crude extract treatments,which are effective against cancers,diabetes and cardiovascular diseases where the molecular mechanisms are yet to be explored.Intriguingly,the extracts significantly induce nitric oxide production by endothelial nitric oxide synthase,a signaling molecule of vasodilation in combination with interferon-y indicating positive effect on atherosclerosis.Further investigations are required to unlock the effects of bioactive compounds found in extracts at clinical settings.展开更多
Apple latent spherical virus(ALSV)vector is a convenient alternative to genetic transformation in horticultural plants,especially in species recalcitrant to genetic transformation.ALSV,an RNA virus,can infect a wide v...Apple latent spherical virus(ALSV)vector is a convenient alternative to genetic transformation in horticultural plants,especially in species recalcitrant to genetic transformation.ALSV,an RNA virus,can infect a wide variety of plant species including major horticultural plants without inducing symptoms.Here,methodologies were developed for infection of ALSV vectors to strawberry seedlings and plantlets cultured in vitro.A seed-propagated F1 hybrid strawberry cultivar'Yotsuboshi'was aseptically grown on half-strength Murashige–Skoog medium for 1 month and true leaves were inoculated with an ALSV RNA preparation by particle bombardment.ALSV vector infection rates varied from 58 to 100%according to the insertion sequences,in‘Yotsuboshi’seedlings.Plantlets(‘Dover’)propagated in vitro could also be infected with ALSV vector at a similar infection rate.For virus-induced gene silencing(VIGS),we prepared an ALSV vector carrying a 201 nucleotide segment of the strawberry phytoene desaturase gene.‘Yotsuboshi’and‘Dover’plants infected by this vector generated completely white leaves at fifth or sixth true leaves and above.For virus-induced flowering(VIF),we used an ALSV vector expressing the Arabidopsis thaliana flowering locus T gene.Strawberry seedlings infected by this vector started to flower from about 2 months post inoculation and bore fruits with viable seeds.The ALSV vector was no longer detected in any of the seedlings from early-flowered strawberries.Thus,the ALSV vector may be beneficial for examination of gene functions by VIGS in strawberry,and VIF using ALSV vector constitutes an effective new plant breeding technique for the promotion of cross-breeding in strawberry.展开更多
The alien woody legume, black locust （Robinia pseudoaca-cia）, has invaded Japanese black pine （Pinus thunbergii） forests located in Japan’s coastal plain and hill regions where gaps are formed in pine forests aft...The alien woody legume, black locust （Robinia pseudoaca-cia）, has invaded Japanese black pine （Pinus thunbergii） forests located in Japan’s coastal plain and hill regions where gaps are formed in pine forests after nematode infestation. Nitrogen fixation by legumes acceler-ates N cycling in forest ecosystems. We studied temporal change in the annual tree-ring resolution N stable isotope composition （δ15N, a per mil deviation of δ15N/14N ratio, relative to atmospheric N2δ15N=0‰） at two natural locations of Japanese black pine forest with black locust that differed in the time since black locust establishment （Shohnai in north-east and Kita-Kyushu in southwest Japan）. Analyzed tree-rings covered the period from 1990/1992 to 2009. N acquisition by Japanese black pine from black locust N input to the soil was evidenced by temporal shifting of N stable isotope composition on the annual pine tree rings. With pro-gressive development of the forest stand,δ15N values of earlier tree-ringsδ15N of -5‰） from black pine associated with black locust shifted to-wards values similar to those of black locustδ15N values nearly to-1‰）, which suggests acquisition of N by N2 fixation （Shohnai site）. In con-trast, in a forest where black locust had settled for two or three genera-tions, in a black pine stand （Kita-Kyushu site）, longer periods of N en-richment in the soil were reflected in the elevated tree-ringδ15N values of newly established black pine trees. Based on tree-ringδ15N data from the Shohnai site, we determined that about 10 years after black locust establishment, soil N had already been enriched by black locust N, this, in turn, contributed to N fertilization of surrounding trees in mixed stands.展开更多
Aim: The aim of this study was to examine the safety and efficacy of endoscopic submucosal dissection (ESD) for early gastric cancer based on approximately 10 years’ experience. Methods: Endoscopic submucosal dissect...Aim: The aim of this study was to examine the safety and efficacy of endoscopic submucosal dissection (ESD) for early gastric cancer based on approximately 10 years’ experience. Methods: Endoscopic submucosal dissection was performed in 1272 patients with early gastric cancer (1657 lesions). We examined en bloc resection rate, curative resection rate, local recurrence rate, procedure time, and complications. Results: The overall en bloc resection rate was 98.6% for all lesions treated by ESD. The median procedure time of the operation was 54.3 minutes (range 5 - 632 min). The incidence of positive horizontal and vertical margins was 3.8% and 4.0%, respectively. The incidence was 2.5% each for perforation and postoperative bleeding. There were no deaths related to ESD. Local recurrence was observed in 10 lesions (0.06%). Conclusion: Since the procedure time and incidence of complications have been reduced, endoscopic submucosal dissection has been considered a standard treatment for early gastric cancer.展开更多
Recent progress in the research regarding the molecular pathogenesis and management of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is reviewed. In approximately 90% of cases, Helicobacter pylori (H. pylo...Recent progress in the research regarding the molecular pathogenesis and management of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is reviewed. In approximately 90% of cases, Helicobacter pylori (H. pylori) infection plays the causative role in the pathogenesis, and H. pylori eradication is nowadays the first-line treatment for this disease, which leads to complete disease remission in 50%-90% of cases. In H. pylori-dependent cases, microbe-generated immune responses, including interaction between B and T cells involving CD40 and CD40L co-stimulatory molecules, are considered to induce the development of MALT lymphoma. In H. pylori-independent cases, activation of the nuclear factor-κB pathway by oncogenic products of specific chromosomal translocations such as t(11;18)/API2-MALT1, or inactivation of tumor necrosis factor alpha-induced protein 3 (A20) are considered to contribute to the lymphomagenesis. Recently, a large-scale Japanese multicenter study confirmed that the long-term clinical outcome of gastric MALT lymphoma after H. pylori eradication is excellent. Treatment modalities for patients not responding to H. pylori eradication include a “watch and wait” strategy, radiotherapy, chemotherapy, rituximab immunotherapy, and a combination of these. Because of the indolent behavior of MALT lymphoma, second-line treatment should be tailored in consideration of the clinical stage and extent of the disease in each patient.展开更多
AIM:To use leptin-deficient(ob/ob) mice with demonstrated differences in steatosis levels to test a new diagnostic method using the acoustical structure quantification(ASQ) mode and the associated analytical parameter...AIM:To use leptin-deficient(ob/ob) mice with demonstrated differences in steatosis levels to test a new diagnostic method using the acoustical structure quantification(ASQ) mode and the associated analytical parameter,"focal disturbance ratio"(FD-ratio).METHODS:Nine ob/ob mice,at 5,8,and 12 wk of age(n = 3 in each age group),were used as models for hepatic steatosis.Echo signals obtained from ultrasonography in the mice were analyzed by ASQ,which uses a statistical analysis of echo amplitude to estimate inhomogeneity in the diagnostic region.FD-ratio,as calculated from this analysis,was the focus of the present study.FD-ratio and fat droplet areas and sizes were compared between age groups.RESULTS:No fibrosis or inflammation was observed in any of the groups.The fat droplet area significantly(P < 0.01) increased with age from 1.25% ± 0.28% at 5 wk to 31.07% ± 0.48% at 8 wk to 51.69% ± 3.19% at 12 wk.The median fat droplet size also significantly(P < 0.01) increased with age,from 1.33(0.55-10.52) m at 5 wk,2.82(0.61-44.13) m at 8 wk and 6.34(0.66-81.83) m at 12 wk.The mean FD-ratio was 0.42 ± 0.11 at 5 wk,0.11 ± 0.05 at 8 wk,and 0.03 ± 0.02 at 12 wk.The FD-ratio was significantly lower at 12 wk than at 5 wk and 8 wk(P < 0.01).A significant negative correlation was observed between the FD-ratio and either the fat droplet area(r =-0.7211,P = 0.0017) or fat droplet size(r =-0.9811,P = 0.0052).CONCLUSION:This tool for statistical analysis of signals from ultrasonography using the FD-ratio can be used to accurately quantify fat in vivo in an animal model of hepatic steatosis,and may serve as a quantitative biomarker of hepatic steatosis.展开更多
BACKGROUND The ABCD stratification[combination of serum pepsinogen(PG)levels and titers of antibody(immunoglobulin G,IgG)against Helicobacter pylori(H.pylori)]is effective for the classification of individuals at risk...BACKGROUND The ABCD stratification[combination of serum pepsinogen(PG)levels and titers of antibody(immunoglobulin G,IgG)against Helicobacter pylori(H.pylori)]is effective for the classification of individuals at risk of developing gastric cancer(GC).The Kita–Kyushu lung cancer antigen-1(KK-LC-1)is a Cancer/Testis antigen frequently expressed in GC.AIM To evaluate the effectiveness of KK-LC-1 and ABCD stratification in the diagnosis of GC.METHODS We analyzed the gene expression of KK-LC-1 in surgical specimens obtained from GC tumors.The levels of serum PG I/PG II and IgG against H.pylori were measured.According to their serological status,the patients were classified into the four groups of the ABCD stratification.RESULTS Of the 77 examined patients,63(81.8%)expressed KK-LC-1.The IgG titers of H.pylori and PG II were significantly higher in patients expressing KK-LC-1 than those measured in patients not expressing KK-LC-1(P=0.0289 and P=0.0041,respectively).The expression of KK-LC-1 in group C[PG method(+)/H.pylori infection(+)]was as high as 93.9%high.KK-LC-1 was also detected in group A[-/-].CONCLUSION The KK-LC-1 expression in GC was associated with H.pylori infection and atrophic status,so that,KK-LC-1 may be a useful marker for the diagnosis of GC.展开更多
文摘Objective: To estimate the efficacy of 23-valent pneumococcal polysaccharide vaccine (PPSV23) among the elderly, we analyzed the relationship between the mortality of the elderly for pneumonia and the vaccination rate of PPSV23 from 2008 to 2016 in Iwate Prefecture, Japan. Study Design: The present study was a retrospective, observational, database study adopting an ecological design. The mortality for pneumonia among the elderly over 70 years old from 2006 to 2016 in Iwate Prefecture was calculated based on the data from the Japanese Vital Statistics. We compared the mortality rate (MR) of pneumonia among the elderly over 70 years old between the low-vaccinated period (LVP) (2006-2010) and high-vaccinated period (HVP) (2012-2016) using a Poisson regression model. Results: While the vaccination rate of PPSV23 among the elderly over 65 years old was 3.3% in 2010, it increased rapidly up to 40.7% in 2012 and reached 66.4% in 2016. The MR ratio of the total population during HVP to the average MR during LVP was 0.749. The MR of the total population during HVP was significantly lower than that during LVP (p Conclusion: The increase in vaccination rate of PPSV23 during HVP (2012-2016) may contribute to the decrease in mortality for pneumonia among the elderly over 70 years old in Iwate Prefecture.
文摘Background： The use of antibiotics in animal diets is facing negative feedback due to the hidden danger of drug residues to human health. Traditional Chinese herbal medicine has been used to replace antibiotics in the past two decades and played an increasingly important role in livestock production. The present study was carried out to assess the feeding effects of a traditional nourishing Chinese herbal medicine mixture on kinetics of plasma glucose, protein and energy metabolism in sheep. Ruminal fermentation characteristics were also determined. Methods： Four sheep were fed on either mixed hay （MH-diet） or MH-diet supplemented with 2% of Chinese herbal medicine （mixture of Astragalus root, Angelica root and Atractylodes rhizome; CHM-diet） over two 3S-day periods using a crossover design. The turnover rate of plasma glucose was measured with an isotope dilution method using [U-^13C]glucose. The rates of plasma leucine turnover and leucine oxidation, whole body protein synthesis （WBPS） and metabolic heat production were measured using the [1-^13C]leucine dilution and open circuit calorimetry. Results： Body weight gain of sheep was higher （P = 0.03） for CHM-diet than for MH-diet. Rumen pH was lower （P = 0.02）, concentration of rumen total volatile fatty acid tended to be higher （P = 0.05） and acetate was higher （P = 0.04） for CHM-diet than for MH-diet. Turnover rates of plasma glucose and leucine did not differ between diets. Oxidation rate of leucine tended to be higher （P = 0.06） for CHM-diet than for MH-diet, but the WBPS did not differ between diets. Metabolic heat production tended to be greater （P = 0.05） for CHM-diet than for MH-diet. Conclusions： The sheep fed on CHM-diet had a higher body weight gain and showed positive impacts on rumen fermentation and energy metabolism without resulting in any adverse response. Therefore, these results suggested that the Chinese herbal medicine mixture should be considered as a potential feed additive for sheep.
基金Project (No. 2006AA10A304) supported by the Hi-Tech Researchand Development Program (863) of China
文摘In a tractor automatic navigation system, path planning plays a significant role in improving operation efficiency. This study aims to create a suboptimal reference course for headland turning of a robot tractor and design a path-tracking controller to guide the robot tractor along the reference course. A time-minimum suboptimal control method was used to generate the reference turning course based on the mechanical parameters of the test tractor. A path-tracking controller consisting of both feedforward and feedback component elements was also proposed. The feedforward component was directly determined by the desired steering angle of the current navigation point on the reference course, whereas the feedback component was derived from the designed optimal controller. Computer simulation and field tests were performed to validate the path-tracking performance. Field test results indicated that the robot tractor followed the reference courses precisely on flat meadow, with average and standard lateral devia- tions being 0.031 m and 0.086 m, respectively. However, the tracking error increased while operating on sloping meadow due to the employed vehicle kinematic model.
文摘AIM: To identify the hepatic vascular architecture of patients with hepatitis C virus (HCV) using superb microvascular imaging (SMI) and investigate the use of SMI in the evaluation of liver fibrosis.METHODS: SMI was performed in 100 HCV patients. SMI images were classified into five types according to the vascular pattern, and these patterns were compared with the fibrosis stage. Moreover, the images were analyzed to examine vascularity by integrating the number of SMI signals in the region of interest ROI [number of vascular trees (VT)]. The number of VT, fibrosis stage, serum parameters of liver function, and CD34 expression were investigated.RESULTS: There was a significant difference between SMI distribution pattern and fibrosis stage (P < 0.001). The mean VT values in each of the fibrosis stages were as follows: 26.69 ± 7.08 in F0, 27.72 ± 9.32 in F1, 36.74 ± 9.23 in F2, 37.36 ± 5.32 in F3, and 58.14 ± 14.08 in F4. The VT showed excellent diagnostic ability for F4 [area under the receiver operator characteristic (AUROC): 0.911]. The VT was significantly correlated with the CD34 labeling index (r = 0.617, P < 0.0001).CONCLUSION: SMI permitted the detailed delineation of the vascular architecture in chronic liver disease. SMI appears to be a reliable tool for noninvasively detecting significant fibrosis or cirrhosis in HCV patients.
文摘BACKGROUND Lenvatinib is one of the first-line tyrosine kinase inhibitors used for unresectable hepatocellular carcinoma(HCC). In the present study, we evaluated the potential of early changes in the time-intensity curve(TIC) of arterial phase on contrastenhanced ultrasound(CEUS) as early imaging biomarkers of lenvatinib efficacy.AIM To evaluate the potential of the early changes in the TIC of CEUS as early imaging biomarkers of lenvatinib efficacy in patients with unresectable HCC.METHODS We analyzed 20 consecutive patients with unresectable HCC treated with lenvatinib from March to November 2018. Tumor response at 8 wk was assessed by computed tomography using the modified Response Evaluation Criteria in Solid Tumors(m RECIST). CEUS was performed at baseline before treatment(Day 0) and on day 7(Day 7), and the images were analyzed in the arterial phase for 20 seconds after the contrast agent arrived at the target tumor. Three perfusion parameters were extracted from the TICs: the slope of wash-in(Slope),time to peak(TTP) intensity, and the total area under the curve(AUC) during wash-in. The rate of change in the TIC parameters between Day 0 and Day 7 was compared between treatment responders and non-responders based on m RECIST.RESULTS The rate of change for all TIC parameters showed significant differences between the responders(n = 9) and non-responders(n = 11)(Slope, P = 0.025; TTP, P =0.004; and AUC, P = 0.0003). The area under the receiver operating curve values for slope, TTP, and AUC for the prediction of responders were 0.805, 0.869, and0.939, respectively.CONCLUSION CEUS may be useful for the early prediction of tumor response to lenvatinib therapy in patients with unresectable HCC.
文摘Uterine cervical adenocarcinoma （ADC） has been increasing in its prevalence world widely despite the decrease of squamous cell carcinoma （SCC）. It comprises nearly 20-25% of the all cervical malignancy in developed countries. The worse biological behavior had been reported in patients with intermediateand high risk factors after surgery, and in advanced stage over III, radiotherapy （RT） alone and concurrent chemo-radiotherapy （CCRT） with cisplatin was not always effective. As for chemotherapy （CT）, the iaduction CT has not established, as well. Further molecular targeted therapy （MTT） has been studied. The targets of oncogenic driver mutations were vascular endothelial growth factor （VEGF） in SCC, or tyrosine kinase （TK） of endothelial growth factor receptor 2 （EGFR2, Her2/neu）-Ras-MAPK-ERK pathway. Bevacizumab （Bey, anti-VEGF monoclonal antibody） is considered as one of key agent with paclitaxel and carboplatin in SCC, but not for ADC. This article focuses on up-to-date knowledge of biology and possible specific therapeutic directions to explore in the management of cervical ADC.
文摘AIM:To evaluate the efficacy of transcatheter arterial chemoembolization(TACE) using a suspension of a fine-powder formulation of cisplatin(DDPH) for hepatocellular carcinoma(HCC).METHODS:The study population was comprised of 164 patients who were treated by TACE alone.Of these patients,76 underwent TACE using a suspension of DDPH in lipiodol(LPD)(DDPH group),and the remaining 88 underwent TACE with an emulsion of doxorubicin(ADM) with LPD(ADM group).We compared the DDPH group with the ADM group in terms of the objective early response rate,progression free survival(PFS) and overall survival(OS).RESULTS:The objective early response rate in the DDPH group was significantly higher than that in the ADM group(54% vs 24%,P < 0.001).The PFS rate in the DDPH group was also significantly higher than that in the ADM group(P < 0.001).Moreover,the OS in the DDPH group was significantly longer than that in the ADM group(P = 0.002).Although the incidence rate of nausea or vomiting in the DDPH group was higher than that in the ADM group,the ADM group showed a higher incidence rate of the adverse events of hepatic arterial damage and leucopenia.No other serious complications were observed in either group.CONCLUSION:We conclude that TACE using a suspension of DDPH in LPD could be a useful treatment for HCC.
文摘Leiomyomas are the most common benign tumors of the esophagus. They usually occur as a single lesion or as two or three nodules. Only two cases of esophageal multiple leiomyomas comprising more than 10 nodules have been reported previously. Moreover, there have been few reports of esophageal squamous cell carcinoma overlying submucosal tumors. We describe a 71-yearold man who was diagnosed as having a superficial esophageal cancer coexisting with two or three leiomyoma nodules. During surgery, 10 or more nodules that had not been evident preoperatively were palpable in the submucosal and muscular layers throughout the esophagus. As intramural metastasis of the esophageal cancer was suspected, we considered additional lymphadenectomy, but had to rule out this option because of the patient＇s severe anoxemia. Microscopic examination revealed that all the nodules were leiomyomas （20 lesions, up to 3 cm in diameter）, and that invasion of the carcinoma cells was limited to the submucosal layer overlying a relatively large leiomyoma. This is the first report of superficial esophageal cancer coexisting with numerous solitary leiomyomas. Multiple minute leiomyomas are often misdiagnosed as intramural metastasis, and a leiomyoma at the base of a carcinoma lesion can also be rnisdiagnosed as tumor invasion. The present case shows that accurate diagnosis is required for the management of patients with coexisting superficial esophageal cancer and multiple leiomyomas.
文摘AIM:To evaluate the efficacy of transarterial chemoembolization(TACE) using a suspension of a finepowder formulation of cisplatin(DDPH) in lipiodol(LPD) in the treatment of hepatocellular carcinoma(HCC).METHODS:The subjects were 262 HCC patients treated with TACE using a DDPH-LPD suspension.The DDPH-LPD suspension was prepared by mixing 50 mg of DDPH into 10 mL of LPD.TACE was repeated when treated lesions relapsed and/or new hepatic lesions were detected.These patients received additional TACE using the same agent.TACE was repeated until complete regression of the tumor was obtained.The primary efficacy endpoint of the current study was the objective early response rate.Secondary efficacy endpoints were progression-free survival(PFS) and overall survival.RESULTS:The objective early response rate was 43.6%.Cumulative PFS rates were 56.7% at 6 mo,23.1% at 12 mo,13.4% at 18 mo,and 10.5% at 24 mo.The median PFS was 6.6 mo.Cumulative survival rates were 90.6% at 6 mo,81.9% at 12 mo,70.5% at 24 mo,and 58.8% at 36 mo.Median survival time was 46.6 mo.All adverse reactions were controllable by temporary suspension of treatment.No serious complications or treatment-related deaths were observed.CONCLUSION:TACE using a suspension of DDPH in LPD may be a useful treatment for HCC.
基金Supported by Grants-in-Aid No. 16590289,16790211 and 16790212, and "Open Research Center" Project for Private Universities: Matching fund Subsidy (2004-2008), from Ministry of Education, Culture, Sports, Science and Technology, Japan
文摘The anti-arrhythmic agent amiodarone （AD） is associated with numerous adverse effects, but serious liver disease is rare. The improved safety of administration of daily low doses of AD has already been established and this regimen is used for long-term medication. Nevertheless, asymptomatic continuous liver injury by AD may increase the risk of step-wise progression of non-alcoholic fatty liver disease. We present an autopsy case of AD-induced liver cirrhosis in a patient who had been treated with a low dose of AD （200 rag/d） daily for 84 too. The patient was a 85-year-old male with a history of ischemic heart disease. Seven years after initiation of treatment with AD, he was admitted with cardiac congestion. The total dose of AD was 528 g. Mild elevation of serum aminotransferase and hepatomegaly were present. Liver biopsy specimens revealed cirrhosis, and under electron microscopy numerous lysosomes with electron-dense, whorled, lamellar inclusions characteristic of a secondary phospholipidosis were observed. Initially, withdrawal of AD led to a slight improvement of serum aminotransferase levels, but unfortunately his general condition deteriorated and he died from complications of pneumonia and renal failure. Long-term administration of daily low doses of AD carries the risk of progression to irreversible liver injury. Therefore, periodic examination of liver function and/or liver biopsy is required for the management of patients receiving long-term treatment with AD.
文摘AIM To determine appropriate fecal calprotectin cut-off values for the prediction of endoscopic and histologic remission in Japanese patients with ulcerative colitis(UC). METHODS We performed a cross-sectional observational study of 131 Japanese patients with UC and measured fecal calprotectin levels by fluorescence enzyme immunoassay. The clinical activity of UC was assessed with the partial Mayo score(PMS). Relapse was defined as increase of PMS by 2 points or more in stool frequency or rectal bleeding subscore. The endoscopic and histologic activities of UC were evaluated in 50 patients within a 2-mo period from fecal sampling. Endoscopic activity was determined by Mayo endoscopic subscore, Rachmilewitz endoscopic index, and ulcerative colitis endoscopic index of severity. The histologic grade of inflammation was evaluated with biopsy specimens obtained from the endoscopically most severely inflamed site, according to the scheme by Matts grade and Riley's score.RESULTS Fecal calprotectin levels varied from 1-20783 μg/g. There was a significant correlation between the partial Mayo score and fecal calprotectin levels(r = 0.548, P < 0.001). In 50 patients who underwent colonoscopy with biopsy, levels were significantly correlated with the Mayo endoscopic subscore(r = 0.574, P < 0.001), Rachmilewitz endoscopic index(r = 0.628, P < 0.001), ulcerative colitis endoscopic index of severity(r = 0.613, P < 0.001), Riley's histologic score(r = 0.400, P = 0.006), and Matts grade(r = 0.586, P < 0.001). Receiver-operating characteristic analyses identified the best cut-off value for the prediction of endoscopic remission as 288 μg/g, with an area under the curve of 0.777 or 0.823, while that for histologic remission was 123 or 125 μg/g, with an AUC of 0.881 or 0918, respectively. Of the 131 study patients, 88 patients in clinical remission were followed up 6 mo. During the follow-up period, 19 patients relapsed. The best fecal calprotectin cut-off value for predicting relapse was 175 μg/g.CONCLUSION Fecal calprotectin is a predictive biomarker for endoscopic and histologic remission in Japanese patients with UC.
文摘Background: Obstructive sleep apnea syndrome (OSAS) is one of the representative sleep disorders believed to be associated with metabolic syndrome. Nasal continuous positive airway pressure (nCPAP) ventilation is the first choice therapy for OSAS, which has been reported to cause an improvement in body fat mass, hepatocellular damage and hypertension. Study Objectives: We evaluated whether the changes in the body weight observed in patients with OSAS may have potential associations with the sleep time during which the patients are under nCPAP. Method: A total of 194 patients (148 obese and 46 non-obese) in whom nCPAP use was present for more than 70% of the nights were enrolled in this study. Using the electronic records of the night use time for CPAP devices, we examined whether the habitual sleep time during nCPAP is associated with changes in body weight. Results: In the non-obese OSAS group, the patients with night time use of nCPAP devices for 6 to 7 hours showed the greatest and the most sustained decrease in body weight. In the obese patients with OSAS, on the other hand, a U-shaped relationship has been demonstrated between a percent weight gain over 9 years and a minimal weight gain in patients with habitual sleep for 5 to 6 hours. Conclusions: These results suggest that changes in body weight in patients with OSAS are associated with habitual sleep time.
文摘Leonurus sibiricus is a herbaceous plant found in many countries in Asia and America.This plant is widely practiced as a remedy for the treatment of diabetes,menstrual irregularities,and bronchitis.The approval of therapeutic implications of any drugs depends on the well characterized mode of actions of the compounds.The bioactive compounds like diterpenes,triterpenes,flavonoids and phenolic acids in Leonurus sibiricus show analgesic,anti-inflammatory,anti-oxidant,anti-atherogenic and antihemorrhagic,anti-diabetic,anti-bacterial and allelopathic potency.Interestingly,the expression level of some genes is altered by the crude extract treatments,which are effective against cancers,diabetes and cardiovascular diseases where the molecular mechanisms are yet to be explored.Intriguingly,the extracts significantly induce nitric oxide production by endothelial nitric oxide synthase,a signaling molecule of vasodilation in combination with interferon-y indicating positive effect on atherosclerosis.Further investigations are required to unlock the effects of bioactive compounds found in extracts at clinical settings.
文摘Apple latent spherical virus(ALSV)vector is a convenient alternative to genetic transformation in horticultural plants,especially in species recalcitrant to genetic transformation.ALSV,an RNA virus,can infect a wide variety of plant species including major horticultural plants without inducing symptoms.Here,methodologies were developed for infection of ALSV vectors to strawberry seedlings and plantlets cultured in vitro.A seed-propagated F1 hybrid strawberry cultivar'Yotsuboshi'was aseptically grown on half-strength Murashige–Skoog medium for 1 month and true leaves were inoculated with an ALSV RNA preparation by particle bombardment.ALSV vector infection rates varied from 58 to 100%according to the insertion sequences,in‘Yotsuboshi’seedlings.Plantlets(‘Dover’)propagated in vitro could also be infected with ALSV vector at a similar infection rate.For virus-induced gene silencing(VIGS),we prepared an ALSV vector carrying a 201 nucleotide segment of the strawberry phytoene desaturase gene.‘Yotsuboshi’and‘Dover’plants infected by this vector generated completely white leaves at fifth or sixth true leaves and above.For virus-induced flowering(VIF),we used an ALSV vector expressing the Arabidopsis thaliana flowering locus T gene.Strawberry seedlings infected by this vector started to flower from about 2 months post inoculation and bore fruits with viable seeds.The ALSV vector was no longer detected in any of the seedlings from early-flowered strawberries.Thus,the ALSV vector may be beneficial for examination of gene functions by VIGS in strawberry,and VIF using ALSV vector constitutes an effective new plant breeding technique for the promotion of cross-breeding in strawberry.
文摘The alien woody legume, black locust （Robinia pseudoaca-cia）, has invaded Japanese black pine （Pinus thunbergii） forests located in Japan’s coastal plain and hill regions where gaps are formed in pine forests after nematode infestation. Nitrogen fixation by legumes acceler-ates N cycling in forest ecosystems. We studied temporal change in the annual tree-ring resolution N stable isotope composition （δ15N, a per mil deviation of δ15N/14N ratio, relative to atmospheric N2δ15N=0‰） at two natural locations of Japanese black pine forest with black locust that differed in the time since black locust establishment （Shohnai in north-east and Kita-Kyushu in southwest Japan）. Analyzed tree-rings covered the period from 1990/1992 to 2009. N acquisition by Japanese black pine from black locust N input to the soil was evidenced by temporal shifting of N stable isotope composition on the annual pine tree rings. With pro-gressive development of the forest stand,δ15N values of earlier tree-ringsδ15N of -5‰） from black pine associated with black locust shifted to-wards values similar to those of black locustδ15N values nearly to-1‰）, which suggests acquisition of N by N2 fixation （Shohnai site）. In con-trast, in a forest where black locust had settled for two or three genera-tions, in a black pine stand （Kita-Kyushu site）, longer periods of N en-richment in the soil were reflected in the elevated tree-ringδ15N values of newly established black pine trees. Based on tree-ringδ15N data from the Shohnai site, we determined that about 10 years after black locust establishment, soil N had already been enriched by black locust N, this, in turn, contributed to N fertilization of surrounding trees in mixed stands.
文摘Aim: The aim of this study was to examine the safety and efficacy of endoscopic submucosal dissection (ESD) for early gastric cancer based on approximately 10 years’ experience. Methods: Endoscopic submucosal dissection was performed in 1272 patients with early gastric cancer (1657 lesions). We examined en bloc resection rate, curative resection rate, local recurrence rate, procedure time, and complications. Results: The overall en bloc resection rate was 98.6% for all lesions treated by ESD. The median procedure time of the operation was 54.3 minutes (range 5 - 632 min). The incidence of positive horizontal and vertical margins was 3.8% and 4.0%, respectively. The incidence was 2.5% each for perforation and postoperative bleeding. There were no deaths related to ESD. Local recurrence was observed in 10 lesions (0.06%). Conclusion: Since the procedure time and incidence of complications have been reduced, endoscopic submucosal dissection has been considered a standard treatment for early gastric cancer.
文摘Recent progress in the research regarding the molecular pathogenesis and management of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is reviewed. In approximately 90% of cases, Helicobacter pylori (H. pylori) infection plays the causative role in the pathogenesis, and H. pylori eradication is nowadays the first-line treatment for this disease, which leads to complete disease remission in 50%-90% of cases. In H. pylori-dependent cases, microbe-generated immune responses, including interaction between B and T cells involving CD40 and CD40L co-stimulatory molecules, are considered to induce the development of MALT lymphoma. In H. pylori-independent cases, activation of the nuclear factor-κB pathway by oncogenic products of specific chromosomal translocations such as t(11;18)/API2-MALT1, or inactivation of tumor necrosis factor alpha-induced protein 3 (A20) are considered to contribute to the lymphomagenesis. Recently, a large-scale Japanese multicenter study confirmed that the long-term clinical outcome of gastric MALT lymphoma after H. pylori eradication is excellent. Treatment modalities for patients not responding to H. pylori eradication include a “watch and wait” strategy, radiotherapy, chemotherapy, rituximab immunotherapy, and a combination of these. Because of the indolent behavior of MALT lymphoma, second-line treatment should be tailored in consideration of the clinical stage and extent of the disease in each patient.
文摘AIM:To use leptin-deficient(ob/ob) mice with demonstrated differences in steatosis levels to test a new diagnostic method using the acoustical structure quantification(ASQ) mode and the associated analytical parameter,"focal disturbance ratio"(FD-ratio).METHODS:Nine ob/ob mice,at 5,8,and 12 wk of age(n = 3 in each age group),were used as models for hepatic steatosis.Echo signals obtained from ultrasonography in the mice were analyzed by ASQ,which uses a statistical analysis of echo amplitude to estimate inhomogeneity in the diagnostic region.FD-ratio,as calculated from this analysis,was the focus of the present study.FD-ratio and fat droplet areas and sizes were compared between age groups.RESULTS:No fibrosis or inflammation was observed in any of the groups.The fat droplet area significantly(P < 0.01) increased with age from 1.25% ± 0.28% at 5 wk to 31.07% ± 0.48% at 8 wk to 51.69% ± 3.19% at 12 wk.The median fat droplet size also significantly(P < 0.01) increased with age,from 1.33(0.55-10.52) m at 5 wk,2.82(0.61-44.13) m at 8 wk and 6.34(0.66-81.83) m at 12 wk.The mean FD-ratio was 0.42 ± 0.11 at 5 wk,0.11 ± 0.05 at 8 wk,and 0.03 ± 0.02 at 12 wk.The FD-ratio was significantly lower at 12 wk than at 5 wk and 8 wk(P < 0.01).A significant negative correlation was observed between the FD-ratio and either the fat droplet area(r =-0.7211,P = 0.0017) or fat droplet size(r =-0.9811,P = 0.0052).CONCLUSION:This tool for statistical analysis of signals from ultrasonography using the FD-ratio can be used to accurately quantify fat in vivo in an animal model of hepatic steatosis,and may serve as a quantitative biomarker of hepatic steatosis.
基金Supported by Grant-in-Aid for research by the Kitasato University Medical Center,No.H26-008the JSPS KAKENHI,No.17K16578+3 种基金the JSPS KAKENHI,No.26670609Takeda Science FoundationKitasato University Research Grant for Young ResearchersGrant-in-Aid for research from the Kitasato University Medical Center,No.H25-0006
文摘BACKGROUND The ABCD stratification[combination of serum pepsinogen(PG)levels and titers of antibody(immunoglobulin G,IgG)against Helicobacter pylori(H.pylori)]is effective for the classification of individuals at risk of developing gastric cancer(GC).The Kita–Kyushu lung cancer antigen-1(KK-LC-1)is a Cancer/Testis antigen frequently expressed in GC.AIM To evaluate the effectiveness of KK-LC-1 and ABCD stratification in the diagnosis of GC.METHODS We analyzed the gene expression of KK-LC-1 in surgical specimens obtained from GC tumors.The levels of serum PG I/PG II and IgG against H.pylori were measured.According to their serological status,the patients were classified into the four groups of the ABCD stratification.RESULTS Of the 77 examined patients,63(81.8%)expressed KK-LC-1.The IgG titers of H.pylori and PG II were significantly higher in patients expressing KK-LC-1 than those measured in patients not expressing KK-LC-1(P=0.0289 and P=0.0041,respectively).The expression of KK-LC-1 in group C[PG method(+)/H.pylori infection(+)]was as high as 93.9%high.KK-LC-1 was also detected in group A[-/-].CONCLUSION The KK-LC-1 expression in GC was associated with H.pylori infection and atrophic status,so that,KK-LC-1 may be a useful marker for the diagnosis of GC.
