Aims: To evaluate the efficacy and limitations of endoscopic placement of self-expandable metallic stents (EMS) in cases of malignant gastroduodenal stenosis. Methods : Fourteen patients who ...underwent endoscopic placement of EMS for unresectable malignant gastroduodenal stricture were reviewed. Comparison of pre-and post-stenting conditions and evaluation of clinical efficacy were carried out. Results : All procedures were successful. As for food ingestion, 50.0% of the cases showed improvement and the mean dysphagia score changed from 3.5 to 2.6. In 66.7% of the cases that had a stenosis in the upper stomach, improvement of peroral food intake was achieved. However, such intake did not improve even after stenting in all but one patient with stenosis of the distal stomach or proximal duodenum. Conclusions : Use of EMS for unresectable malignant gastroduodenal stenosis is effective in patients with proximal lesions. However, physical patency of the stenosed alimentary tract by stenting is not likely to alleviate the limitation of peroral food intake in patients with distal gastric or proximal duodenal stenosis.
Germline cells reprogramme extensive epigenetic modifications to ensure the cellular totipotency of subsequent generations and to prevent the accumulation of epimutations. Notably, primordial germ ...cells (PGCs) erase genome-wide DNA methylation and H3K9 dimethylation marks in a stepwise manner during migration and gonadal periods. In this study, we profiled DNA and histone methylation on transposable elements during PGC development, and examined the role of DNA replication in DNA demethylation in gonadal PGCs. CpGs in short interspersed nuclear elements (SINEs) B1 and B2 were substantially demethylated in migrating PGCs, whereas CpGs in long interspersed nuclear elements (LINEs), such as LINE-1, were resistant to early demethylation. By contrast, CpGs in both LINE-1 and SINEs were rapidly demethylated in gonadal PGCs. Four major modifiers of DNA and histone methylation, Dnmt3a, Dnmt3b, Glp and Uhrf1, were actively repressed at distinct stages of PGC development. DNMT1 was localised at replication foci in nascent PGCs, whereas the efficiency of recruitment of DNMT1 into replication foci was severely impaired in gonadal PGCs. Hairpin bisulphite sequencing analysis showed that strand-specific hemi-methylated CpGs on LINE-1 were predominant in gonadal PGCs. Furthermore, DNA demethylation in SINEs and LINE-1 was impaired in Cbx3-deficient PGCs, indicating abnormalities in G1 to S phase progression. We propose that PGCs employ active and passive mechanisms for efficient and widespread erasure of genomic DNA methylation.
Dynamic magnetic resonance imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (EOB-MRI) can be used not only to detect liver tumors but also to estimate liver function. The aim ...of this study was to establish a new EOB-MRI-based formula to determine the resection limit in patients undergoing hepatectomy.
Twenty-eight patients with a normal liver (NL group) and five with an unresectable cirrhotic liver (UL group) who underwent EOB-MRI were included. Standardized liver function (SLF) was calculated based on the signal intensity (SI), the volume of each subsegment (S1-S8), and body surface area. A formula defining the resection limit was devised based on the difference in the SLF values of patients in the NL and UL groups. The formula was validated in 50 patients who underwent EOB-MRI and hepatectomy.
The average SLF value in the NL and UL groups was 2038 and 962 FV/m2, respectively. The difference (1076 FV/m2) was consistent with a 70% in resection volume. Thus, the resection limit for hepatectomy was calculated as a proportion of 70%: 70×(SLF-962)/1076 (%). The one patient who underwent hepatectomy over the resection limit died due to liver failure. In other 49 patients, in whom the resection volume was less than the resection limit, procedures were safely performed.
Our formula for resection limit based on EOB-MRI can improve the safety of hepatectomy.
Signals from extraembryonic tissues in mice determine which proximal epiblast cells become primordial germ cells (PGCs). After their specification, approximately 40 PGCs appear at the base of the ...allantoic bud and migrate to the genital ridges, where they expand to about 25 000 cells by Embryonic Day (E)13.5. The heterochromatin protein 1 (HP1) family members HP1alpha, HP1beta, and HP1gamma (CBX5, CBX1, and CBX3, respectively) are thought to induce heterochromatin structure and to regulate gene expression by binding methylated histone H3 lysine 9. We found a dramatic loss of germ cells before meiosis in HP1gamma mutant (HP1gamma(-/-)) mice that we generated previously. The reduction in PGCs in HP1gamma(-/-) embryos was detectable from the early bud stage (E7.25), and the number of HP1gamma(-/-) PGCs was gradually reduced thereafter. Bromodeoxyuridine incorporation into PGCs was significantly reduced in E7.25 and E12.5 HP1gamma(-/-) embryos. Furthermore, a lower proportion of HP1gamma(-/-) PGCs than wild-type PGCs was in S phase, and a higher proportion, respectively, was in G1 phase at E12.5. Moreover, the proportion of p21 (Cip, official symbol CDKN1A)-positive HP1gamma(-/-) PGCs was increased, suggesting that the G1/S phase transition was inhibited. However, no differences were detected between fate determination, migration, apoptosis, or histone modification of PGCs of control embryos and those of HP1gamma(-/-) embryos. Therefore, the reduction in PGCs in HP1gamma(-/-) embryos could be caused by impaired cell cycle in PGCs. These results suggest that HP1gamma plays an important role in keeping enough germ cells by regulating the PGC cell cycle.
Signals from extraembryonic tissues in mice determine which proximal epiblast cells become primordial germ cells (PGCs). After their specification, approximately 40 PGCs appear at the base of the ...allantoic bud and migrate to the genital ridges, where they expand to about 25 000 cells by Embryonic Day (E)13.5. The heterochromatin protein 1 (HP1) family members HP1alpha, HP1beta, and HP1gamma (CBX5, CBX1, and CBX3, respectively) are thought to induce heterochromatin structure and to regulate gene expression by binding methylated histone H3 lysine 9. We found a dramatic loss of germ cells before meiosis in HP1gamma mutant (HP1gamma−/−) mice that we generated previously. The reduction in PGCs in HP1gamma−/− embryos was detectable from the early bud stage (E7.25), and the number of HP1gamma−/− PGCs was gradually reduced thereafter. Bromodeoxyuridine incorporation into PGCs was significantly reduced in E7.25 and E12.5 HP1gamma−/− embryos. Furthermore, a lower proportion of HP1gamma−/− PGCs than wild-type PGCs was in S phase, and a higher proportion, respectively, was in G1 phase at E12.5. Moreover, the proportion of p21 (Cip, official symbol CDKN1A)-positive HP1gamma−/− PGCs was increased, suggesting that the G1/S phase transition was inhibited. However, no differences were detected between fate determination, migration, apoptosis, or histone modification of PGCs of control embryos and those of HP1gamma−/− embryos. Therefore, the reduction in PGCs in HP1gamma−/− embryos could be caused by impaired cell cycle in PGCs. These results suggest that HP1gamma plays an important role in keeping enough germ cells by regulating the PGC cell cycle.
We conducted a questionnaire survey among Wound, Ostomy and Continence Certified Nurses (WOCN) to examine the use of ostomy supplies donated after the Great East Japan Earthquake. During the 4 days ...prior to the arrival of donated ostomy supplies, they used products stored at hospitals. However, these supplies were limited and ostomy patient requests could not be addressed sufficiently. For example, several patients did not know the exact names of the products they required, and some had to use different products due to an insufficient stock. Nurses provided guidance on theproper product use, and WOCN felt that they were able to do this adequately. Other issues that arose involved patients such as those who could not use scissors or those who insisted on using their own appliances. For these cases, the nurses commented on the necessity to be flexible while providing guidance. Effective stock control could be improved through the negotiation and disclosure of donated supplies among patient groups, medical societies and appliance associations.
To elucidate the physico-chemical properties of the juice and the fruit as a whole for pomegranates harvested in the Yamanashi prefecture in Japan compared to that of the imported ones, following ...analysis were conducted. ① On average, the domestic fruit weight was approximately 150g per fruit, while the aril and juice ratios to the fruit weight were about 60% and 42%, respectively. The juice ratio to the aril weight was approximately 70%. These ratios were lower than those calculated for the imported fruit (approximately 400g per fruit), and not dependent on the fruit size. ② The brix measurement of pomegranate juice from domestic fruit was 17 and the sugar was glucose and fructose, while both ratios were nearly equivalent, it was slightly high in fructose. The same results were obtained for imported fruits. Titratable acidity in the imported fruit was much higher than that in the domestic fruit, which mainly composed of 0.7% oxalic acid. However the organic acid content in the imported fruit was 1.5% citric acid with a small amount of malic acid. ③ The dominant free-amino acids in the juices listed in order of high to low concentration were glutamine, glutamic acid, aspartic acid and serine. There were no significant differences between the juices from domestic And the imported fruit. Small quantities of sarcosine were detected in both juices. ④ Total polyphenol content in the juices was approximately 100mg% and 200mg% in the domestic and imported fruit, respectively. The HPLC analysis of the polyphenol revealed that punicalin and punicalagin were detected in the juices from the domestic fruit and not the imported fruit.
The prevalence of human T-lymphotropic retrovirus (HTLV) was examined in Taiwan's indigenous populations. In all, 797 healthy subjects in Taiwan including Han Chinese and nine indigenous populations ...(Ami, Atayal, Bunun, Saisiat, Paiwan, Puyuma, Rukai, Tsuo, and Yami) were examined for the presence of antibodies to HTLV by particle agglutination, indirect immunofluorescence and Western blot test. Two seropositive cases were found in this screening. One Saisiat male and a Han Chinese female were seropositive for HTLV. The Western blot profile indicated the virus was type-1 HTLV.
PDF
