Risk factors for the progression of endoscopic Barrett's epithelium in Japan: a multivariate analysis based on the Prague C & M Criteria

PURPOSE

To determine the prevalence and progression of Barrett's epithelium and associated risk factors in Japan.

METHODS

The study population comprised 869 cases. Endoscopic Barrett's epithelium was diagnosed based on the Prague C & M Criteria. The correlations of clinical factors with the prevalence and progression of endoscopic Barrett's epithelium were examined.

RESULTS

Endoscopic Barrett's epithelium was diagnosed in 374 cases (43%), in the majority of which the diagnosis was short-segment Barrett's esophagus. The progression of Barrett's epithelium was identified in 47 cases. In univariate and multiple logistic regression analyses, aging, smoking habit, and erosive esophagitis were significantly associated with the prevalence of Barrett's epithelium, whereas aging and erosive esophagitis, especially severe erosive esophagitis, were significant contributing factors to the progression of Barrett's epithelium.

CONCLUSIONS

Forty-three percent of the total study population was diagnosed as having endoscopic Barrett's epithelium. During the follow-up period, 12.6% of the cases with Barrett's epithelium exhibited progression which was associated with aging and severe erosive esophagitis.

Morphological and mtDNA sequence studies on three crucian carps (Carassius: Cyprinidae) including a new stock from the Ob River system, Kazakhstan

Three morphologically and genetically distinct forms of the genus Carassius were collected from the Ob River system, Kazakhstan, Central Asia; Carassius carassius, Carassius gibelio gibelio and an unknown stock tentatively referred to as Carassius gibelio sub-species M. The last mentioned had 33-41 gill rakers, being intermediate between the other two forms (23-27 in C. carassius and 44-49 in C. g. gibelio), and five scales in the upper transverse series, less than in the others. It also had a relatively larger erythrocyte suggesting triploidy and an mtDNA haplotype distinct from all other known crucian carps. Comparative mtDNA phylogenetic analysis suggested that C. gibelio gibelio in the Ob River system was introduced from China and the Amur River, the same possibly being true for European C. gibelio gibelio based on published haplotypes. C. gibelio sub-species M is thought to be more widely distributed in central Asia, probably extending as far west as European Russia.

Interface structures of gold nanoparticles on TiO2 (110)

Scanning transmission electron microscopy and density functional theory are used to characterize atomic structures of nanoscale heterointerfaces between gold nanoparticles and a TiO2 (110) surface. It is found that when the gold nanoparticle size is smaller than a few nanometers, gold atoms preferentially attach to specific sites on the TiO2 surface and thus form an epitaxial and coherent heterointerface. Conversely, as the gold size becomes larger, the gold-TiO2 interface loses lattice coherency in order to accommodate the large lattice mismatch between the two dissimilar crystals.

Aperitif effects on gastric emptying: a crossover study using continuous real-time 13C breath test (BreathID System)

The aim of this study was to determine whether there is a correlation between aperitif and gastric emptying. Ten healthy male volunteers participated in this randomized, two-way crossover study. Under two conditions (after drinking an aperitif versus not), the (13)C breath test was performed for 4 h with a liquid meal (200 kcal/200 ml) containing 100 mg (13)C acetate. We used 50 ml of umeshu as the aperitif. This is a traditional Japanese plum liqueur, and contains 7 ml alcohol (14%). In the aperitif group, T(1/2), T(lag), and T(peak) were significantly delayed [T(1/2) (132: 113-174) versus (112: 92-134) (P = 0.0069); T(lag) (80: 63-94) versus (55: 47-85) (P = 0.0069); and T(peak) (81: 62-96) versus (54: 34-84) (P = 0.0069), (median: range, aperitif versus control, min)]. Gastric emptying was significantly delayed in the aperitif group as compared with the control group. This study revealed that even a small amount of alcohol such as an aperitif may contribute to delayed gastric emptying.

Impact of double-balloon endoscopy on the diagnosis of jejunoileal involvement in primary intestinal follicular lymphomas: a case series

In recent years, primary gastrointestinal follicular lymphoma has been increasingly detected in the duodenum on esophagogastroduodenoscopy (EGD). Primary gastrointestinal follicular lymphomas are frequently distributed to multiple sites in the gastrointestinal tract. Therefore, investigation into the spread of follicular lymphomas in the small bowel is important in order to determine the most appropriate treatment strategy. The performance of double-balloon endoscopy (DBE) in the diagnosis of jejunoileal follicular lymphoma lesions has not been fully evaluated. We aimed to investigate the value of DBE in addition to computed tomography (CT) and (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) in the diagnosis of jejunoileal follicular lymphoma. DBE with biopsy was performed in seven patients with primary duodenal follicular lymphoma diagnosed by EGD, in order to investigate jejunoileal involvement. Jejunoileal follicular lymphoma lesions were detected by DBE in six out of the seven patients (three in the jejunum and three in the jejunum and ileum), whereas CT and (18)F-FDG-PET failed to detect the existence of these lesions. Endoscopic findings of the jejunoileal lesions revealed multiple white nodules and white villi, which were similar to those of duodenal lesions. DBE was more useful for the diagnosis of jejunoileal involvement in primary intestinal follicular lymphoma than CT and (18)F-FDG-PET. The use of DBE will become important for determining the most appropriate treatment for gastrointestinal follicular lymphoma.

Chemotherapeutic treatment of priapism in metastatic rectal cancer

A 65-year-old man was admitted with penile tenderness and dysuria due to priapism. Enhanced computed tomography revealed metastatic tumors in the liver, lung, sacrum and lymph nodes. Advanced rectal cancer, detected by colonoscopy as a primary tumor, was treated with chemotherapy (FOLFOX4). Although the rectal cancer showed no change, five months of chemotherapy improveid the priapism, suggesting that chemotherapy can improve rare symptoms of rectal cancer.

[Indication and timing of surgical intervention for cardiovascular disease in hemodialysis dependent patients]

Surgical intervention on cardiovascular disorders in patients with hemodialysis dependent renal failure improves their life expectancy, but carries high surgical mortality. Decision on the indication of surgery as well as on its timing has crucial impact on surgical outcome. We retrospectively analyzed the data of 21 hemodialysis dependent patients who had undergone cardiovascular surgery in our institution from May 2001 to May 2005 to elucidate the appropriate indication and timing of surgical intervention. The study revealed early mortality (< 30 days) of 4.8% and 5 year survival rate of 83.5%. Risk factors for poor prognosis were older age, and longer hemodialysis history. Despite the opinions advocating early surgery in these patients, we adopted a surgical strategy to wait until patients' condition is optimized. Low surgical mortality and high long-term survival of our surgical series indicated appropriateness of our strategy on the timing of surgery. However, extremely low long-term mortality rate raised the concern that our surgical indication might have been too conservative.

Measurement of plasma potential of liquid-He-free superconducting electron cyclotron resonance ion source

The plasma potential of liquid-He-free superconducting electron cyclotron resonance ion source was measured as a function of minimum strength of mirror magnetic field (B(min)) and gas pressure with the method based on the retarding electric field. We observed that the plasma potential decreased with increasing B(min) up to 0.5 T and then gradually increased again. The plasma potential increased with increasing gas pressure. When we add the O(2) gas to the Ar plasma (gas mixing method), plasma potential gradually decreased with increasing the O(2) gas pressure.

New superconducting electron cyclotron resonance ion source for RIKEN RI beam factory project

For RIKEN radio isotope beam project, we started to construct the new superconducting electron cyclotron resonance ion source (SC-ECRIS), which has an operational frequency of 28 GHz, in 2007. The main feature of this ion source is that we can produce large size of resonance zone with six sets of solenoid coils. Before starting, we intensively studied the effect of several key parameters of ECRIS (magnetic field configuration, microwave power density, negatively biased disk) on the plasma. In this article, we describe the effect of key parameters on the plasma and detailed structure of the new SC-ECRIS.

Production of U beam from RIKEN 18 GHz electron cyclotron resonance ion source

For the RIKEN radio isotope factory (RIBF) project, we produced the multicharged uranium beam with two methods. To produce lower charge state U ion beams (14+-20+) we used the UF(6) gas as an ionized gas. The typical beam intensity of U(14+-20+) was 2-1 particle microA at the extraction voltage of 14 kV. To produce higher charge state U ion beam (U(35+)), we chose the sputtering method. The beam intensity was 70 particle nA at the extraction voltage of 5.4 kV. Using this method, we successfully produced multicharged U beam continuously for one month without break for RIBF commissioning.

A second-generation profiling system for quantitative methylation analysis of multiple gene promoters: application to lung cancer

Cancer-specific gene promoter methylation has been described in many types of cancers, and various semi-quantified results have shown their usefulness. Here, we show a more sensitive and specific second-generation system for profiling the DNA methylation status. This method is based on bisulfite reaction of DNA and real-time PCR using two TaqMan MGB probes labeled with different fluorescence, followed by clustering analysis. Primers were designed with CpG-less sequences, and TaqMan MGB probes were designed to contain three or four CpG sites and to be shorter than conventional TaqMan probes. We have added new criteria for primer and probe design for further specificity. We confirmed the reliability of this system and applied it to analysis of lung cancers. Using 10 promoters, 90 primary lung cancers were clustered into six groups consisting of cases having similar smoking status and pathological findings. EGFR mutation and p16 promoter DNA methylation were exclusive, as previously reported; however, DNA methylation in other genes was unrelated to EGFR mutation. This system was also useful to distinguish double primary lung cancers from a single cancer with intrapulmonary metastasis. As above, our system has widespread availability in clinical use and biological research.

Evaluation of atherosclerosis-associated factors and pulse wave velocity for predicting cerebral infarction: a hospital-based, case?control study in Japan

BACKGROUND

The mortality rate for cerebrovascular diseases is much higher in Japan than in North American and West European countries. The primary aim of this study was to elucidate from an epidemiological perspective, the associations between cerebral infarction and demographic factors, medical history and other clinical measurements including pulse wave velocity, a newly introduced non-invasive measurement procedure used to assess aortic stiffness.

METHODS

This was a hospital-based, matched case-control study in northern Japan where there is a high incidence of cerebrovascular disease. The study group consisted of 92 matched pairs of cerebral infarction patients (cases) and healthy individuals admitted for a thorough health check-up (controls) at the Southern Tohoku General Hospital in Fukushima Prefecture, Japan. A conditional logistic regression model was used in the statistical analysis.

RESULTS

In univariate analyses, 14 variables were significantly associated with cerebral infarction, of which four remained significant in the final multivariate model. These were family history of hypertension (odds ratio (OR) = 8.61), cerebrovascular diseases (OR = 13.70), high-density lipoprotein cholesterol of 40 mg/dL or higher (OR = 0.08), and pulse wave velocity over 1600 cm/s (OR = 2.92).

CONCLUSION

Findings from the study indicate that a high pulse wave velocity, in addition to other traditional risk factors, may be associated with a higher risk of cerebral infarction. Further prospective studies are necessary to evaluate the use of this measure as a predictor of the disease.

Long-range correlated glucose fluctuations in diabetes

OBJECTIVES

Our objective is to investigate diabetes-related alteration of glucose control in diurnal fluctuations in normal daily life by detrended fluctuation analysis (DFA).

METHODS

The fluctuations of glucose of 12 non-diabetic subjects and 15 diabetic patients were measured using a continuous glucose monitoring system (CGMS) over a period of one day. The glucose data was calculated by the DFA method, which is capable of revealing the presence of long-range correlations in time series with inherent non-stationarity.

RESULTS

Compared with the non-diabetic subjects, the mean glucose level and the standard deviation are significantly higher in the diabetic group. The DFA exponent alpha is calculated, and glucose time series are searched for the presence of negatively (0.5 < alpha < 1.5) or positively (1.5 < alpha) correlated fluctuations. A crossover phenomenon, i.e. a change in the level of correlations, is observed in the non-diabetic subjects at about two hours; the net effects of glucose flux/reflux causing temporal changes in glucose concentration are negatively correlated in a "long-range" (> two hours) regime. However, for diabetic patients, the DFA exponent alpha = 1.65 +/- 0.30, and in the same regime positively correlated fluctuations are observed, suggesting that the net effects of the flux and reflux persist for many hours.

CONCLUSIONS

Such long-range positive correlation in glucose homeostasis may reflect pathogenic mechanisms of diabetes, i.e., the lack of the tight control in blood glucose regulation. Using modern time series analysis methods such as DFA, continuous evaluation of glucose dynamics could promote better diagnoses and prognoses of diabetes and a better understanding of the fundamental mechanism of glucose dysregulation in diabetes.

Cytoplasmic localization of p63 is associated with poor patient survival in lung adenocarcinoma

AIMS

To determine the significance of p63 protein expression in the development and progression of lung adenocarcinoma.

METHODS AND RESULTS

The expression of p63 was immunohistochemically investigated in 92 cases of lung adenocarcinoma with a maximum diameter of 30 mm or less. p63 expression was observed not only in the nuclei (46/92 cases, 50%), but also in the cytoplasm of neoplastic cells (47/92, 51%). Nuclear localization of p63 was correlated with nuclear accumulation of p53 (P=0.0120), whereas the presence of nuclear p63 had no apparent effect on patient survival. Cytoplasmic localization of p63 was found to be correlated with shorter survival periods by univariate and multivariate analyses (P=0.0486 and P=0.0488, respectively) and the relation was independent of clinicopathological factors. Cytoplasmic localization of p63 was further confirmed by immunoblots of the cytoplasmic fraction of HLC-1, a lung adenocarcinoma cell line which predominately expressed DeltaNp63alpha transcript relative to TAp63 transcript by quantitative reverse transcriptase-polymerase chain reaction.

CONCLUSIONS

Cytoplasmic expression of p63 is an adverse prognostic factor in patients with adenocarcinoma of the lung.