Search

The risk factor for cholelithiasis include low physical activity. With an aging society, the number of bedridden patients who undergo percutaneous endoscopic gastrostomy (PEG) has increased, and cholelithiasis has often been found in these patients. This study aimed to evaluate the risk factors correlated with cholelithiasis in adults who underwent PEG. This retrospective single-center design study reviewed patients who underwent PEG and were confirmed to have cholelithiasis through imaging from March 1996 to December 2021. The investigated variables were age, sex, body mass index (BMI, kg/m2), cause of PEG insertion, initial physical activity status, laboratory findings on PEG insertion day, and incidence of acute cholecystitis. The differences between categorical and continuous variables were analyzed using Student's t test and chi-square test. We enrolled 576 eligible patients who underwent PEG insertion. A total of 161 patients were detected with cholelithiasis (28.0%). The overall independent risk factors for cholelithiasis in patients who underwent PEG insertion were increased C-reactive protein (CRP) levels and decreased physical activity status (bedridden state). The incidence of cholelithiasis was increased by up to 30.7%, especially in patients with bedridden status. However, the incidence of acute cholecystitis among cholelithiasis group was only 5.6%. BMI and total cholesterol were positively correlated with the size of gallbladder (GB) stones. One of the major risk factors for cholelithiasis is decreased physical activity, especially in patients who underwent PEG insertion. Abdominal imaging is recommended to confirm the presence of cholelithiasis and to consider prophylaxis for cholelithiasis, especially in bedridden patients with elevated initial CRP levels at the time of PEG insertion. [ABSTRACT FROM AUTHOR]

The concentration of guest elements (dopants) into host materials play an important role in changing their intrinsic electrical and optical properties. The existence of hetero-element induce defect in crystal structure, affecting conductivity. In the current work, we report Cu2+ ion into hematite in the defectronics point of view and their photoelectrochemical properties. Crystal distortion in the structure of hematite is observed as the amount of dopant increases. Among 1, 3 and 5 mol% of Cu2+ doped hematite, the existence of 1 mol% of Cu2+ ion into hematite crystal structure produce photocurrent value of 0.15 mA/cm2, IPCE value of ~ 4.7% and EIS value of ~ 2000 Ω/cm2 as best performances. However, further increasing dopants increases the number of interstitial defects, which cause the deformation of intrinsic lattice structure. [ABSTRACT FROM AUTHOR]

Treatment of benign biliary strictures (BBS) using fully covered self-expandable metal stents (FCSEMS) has a high success rate, but recurrence can occur. Corticosteroids may be useful based on their anti-fibrotic and anti-inflammatory effects. We investigated the safety and efficacy of corticosteroid-eluting FCSEMS in an animal model. BBSs were created by radiofrequency ablation in 12 mini-pigs. Four weeks later, FCSEMS coated with 0 mg (control), 15 mg (steroid 1 × group), or 30 mg (steroid 2 × group) triamcinolone were inserted endoscopically. The in vitro drug release assay revealed that the optimal stent had 15 mg of triamcinolone and a hydrophilic membrane. No transmural necrosis or perforation occurred in any animal. Fibrous wall thickness tended to decrease macroscopically and microscopically in a triamcinolone dose-dependent manner (control vs. steroid 2 × group: 773.1 vs. 468.5 µm, P = 0.037). Thickness also decreased over time in the steroid 2 × group (3 days vs. 4 weeks: 907.9 vs. 468.5 µm, P = 0.025). Blood parameters tended to improve after stent insertion. In a porcine BBS model, steroid-eluting FCSEMS showed potential as a safe and effective treatment modality to reduce fibrotic tissue. Studies are required to confirm their safety and efficacy in humans with refractory BBS. [ABSTRACT FROM AUTHOR]

For outsiders to higher education institutions (HEIs) in South Korea, predicting the outcomes of the International Education Quality Assurance System (IEQAS)—a Korean institutional accreditation system for HEIs—is challenging. The annual IEQAS accreditation has been conducted behind closed doors; the assessment process is confidential, and there is little access to the data for the public and individuals. However, many stakeholders, such as overseas applicants to Korean HEIs, may want to predict whether particular universities will pass the upcoming IEQAS. Hence, we sought an alternative method for the outsiders to predict a binary result of the IEQAS accreditation by utilizing disclosure data that the Korean government has published. To best predict the outcomes, we mapped out a threefold discrete model combining logistic regression, discriminant analysis, and neural network. We collected the information disclosed by the Ministry of Education in 2019 on 138 Korean private HEIs and then analyzed the secondary public dataset in line with the discrete method that ensures generalizability. Results showed (i) three education investment factors, and one school operations factor appeared as key predictors among the tested indices; (ii) education cost per student within education investment proved to be the most crucial element; and (iii) while leveraging the disclosed data turned out to be reliable, neural network's predictive accuracy was higher than those reported using logistic regression and discriminant analysis. By processing the publicly available disclosure data, our self-study model may effectively assist in predicting IEQAS outcomes, and it can also be used as a diagnostic, prior to accreditation, by local HEIs in other nations to check their preparedness and likelihood of success within similar contexts. [ABSTRACT FROM AUTHOR]

Endoscopic management of benign biliary stricture (BBS) remains challenging. Stenting is currently used for BBS management, but refractory BBS remains problematic. The aim of this study was to assess the safety and feasibility of a dilation balloon-equipped cylindrical light diffuser for BBS in a large animal model. A total of seven mini-pigs were used in the current study. Laser settings were chosen based on the findings of a previous animal study. Five animals were used in a preliminary study to establish process conditions. BBSs were created in the common bile ducts of the other two animals by intraductal radiofrequency ablation (RFA) via endoscopic retrograde cholangiography (ERC). At 4 weeks post-RFA, laser ablation was performed using a customized balloon-equipped cylindrical diffuser at 10 W for 10 s while maintaining balloon inflation for 10 s at 5 atm. A follow-up ERC was performed at 4 weeks post-laser ablation and the animals were sacrificed for histologic evaluation. BBS was observed in all animals by ERC at 4 weeks post-RFA. The mean bile duct stricture diameter in the two animals as determined by ERC was 0.8 mm. Laser ablations were performed without technical difficulty and no adverse event was encountered. At 4 weeks post-laser ablation, mean biliary stricture diameter had dilated to 1.6 mm on cholangiographic finding. On histologic examination, inflammatory cell infiltration in lamina propria and dense collagen deposition were observed, but there was no evidence of bile duct perforation. The devised balloon-equipped cylindrical laser light diffuser appears to be safe and feasible for the treatment of BBS. However, further studies and modifications are required before it can be applied clinically as a monotherapy. [ABSTRACT FROM AUTHOR]

Hypoxemia can occur during endoscopic retrograde cholangiography (ERCP) and it is difficult to achieve adequate ventilation with the prone position. High-flow nasal oxygen (HFNO) has been recommended to be more effectively help ventilation than conventional low flow oxygen. The aim of this study was to evaluate the effect of HFNO during sedated ERCP and to identify predictors of desaturation during ERCP. The investigated variables were age, gender, American Society of Anesthesiologists classes (ASA), duration of exam, and sedative used for midazolam or/and propofol of 262 patients with sedated ERCP. The differences between categorical and continuous variables were analyzed using the Student's t test and the chi-square test. Desaturation (SpO2 ≤ 90%) occurred in 9(3.4%) patients among 262 patients during sedated ERCP. The variables found to predict desaturation were older age (p < 0.01), higher sedation dose for midazolam or propofol (p < 0.01), and use of midazolam (p < 0.01). Desaturation rate was lower during sedated ERCP with HFNO compared to the preliminary study with conventional low flow nasal oxygen. Patients with older age, higher sedation dose, or the use of midazolam might require close monitoring for desaturation and hypoventilation by nursing staff. The study shows the use of high-flow nasal oxygen reduces the incidence of desaturation during ERCP. [ABSTRACT FROM AUTHOR]

Biodegradable porous microspheres, which were initially used as supports for cell growth, are known to have the advantages of maintaining a differentiated cell phenotype and allowing for cell expansion owing to their large surface area. The use of porous microspheres ensures good retention of engrafted cells as platforms for cell delivery. In this study, injectable and porous poly(D, L-lactic-co-glycolic acid) (PLGA) microspheres were fabricated using a microfluidic system. These microspheres had a relatively uniform size and a porous and interconnected internal structure. The prepared PLGA microspheres were used as stem cell carriers for therapy. Here, we demonstrated the feasibility of mesenchymal stem cell (MSC)-loaded microspheres as cell therapy agents for liver damage. The results obtained from a chemically induced liver damage model showed that MSC-loaded microspheres effectively promoted liver recovery. These findings clearly show the feasibility of using injectable microspheres for the therapy and regeneration of tissues. [ABSTRACT FROM AUTHOR]

Endoscopic ultrasonography (EUS)-guided transmural drainage has been accepted as a modality of choice in peripancreatic fluid collection and acute cholecystitis. Each type of stent, including double-pigtail plastic stents, tubular self-expandable metal stents (SEMS), and lumen-apposing metal stents, for these procedure has its own advantages and disadvantages. To overcome their disadvantages, this animal study evaluated the feasibility of a newly designed twisted fully covered SEMS with spiral coiled ends. We performed the EUS-guided cholecystogastrostomy with a newly developed metal stent in eight mini pigs with surgically induced gallbladder distension. This novel stent is a twisted fully covered SEMS with spiral coiled ends, a diameter of 8 mm, and a length of 6 cm. The stent has been maintained for four to seven weeks after EUS-guided cholecystogastrostomy. The primary outcome was the technical success rate, and the secondary outcomes were adverse events, stent dysfunction, stent removability, and fistula formation. The stent was placed successfully between the gallbladder and the stomach in all cases without any adverse event. We observed neither stent migration nor dysfunction during the study period, and all the stents were removed easily as scheduled. We confirmed successful cholecysto-gastric fistula formation at endoscopic and histologic level in all cases. EUS-guided transmural drainage and fistula formation using a new twisted fully covered metal stent with spiral coiled ends was technically feasible without any adverse event in this animal study. Further clinical studies are needed to evaluate its efficacy and safety in real practice. [ABSTRACT FROM AUTHOR]

Background and Aims: To prevent stent migration, transpapillary stent placement has been recommended for the endoscopic treatment of malignant hilar biliary stricture. However, recent studies have suggested that placement above the papilla achieves better results, because it is believed to prevent reflux and prolong stent patency. The aim of this study was to compare the efficacy and safety aspects of transpapillary and suprapapillary stent placement. In addition, the success rates of stent revision were evaluated.Materials and Methods: The medical records of 73 patients with hilar cholangiocarcinoma who underwent endoscopic metal stent insertion between January 2005 and December 2015 were retrospectively reviewed. Patients were assigned by stent location to a suprapapillary (S group; N = 44) or a transpapillary (T group; N = 29) cohort. Clinical outcomes, stent patency, adverse events, and revision success rates were compared between the two study groups.Results: Patency periods were similar in the two groups (S; 140 vs. T; 157 days; P = 0.732). Rates of stent obstruction in the S and T groups were 63.4% and 55.2%, respectively (P = 0.470). An adverse event occurred in 15 (20.5%) of total study subjects, with no significant intergroup difference. The endoscopic revision success rate was significantly higher in the T group (P = 0.01), and the time required for revision tended to be shorter in the T group.Conclusions: The effectiveness and safety of suprapapillary and transpapillary stent insertion were found to be similar, but the success rate of endoscopic revision was significantly higher for the T group. Therefore, we recommend that transpapillary stent placement be considered for patients with hilar cholangiocarcinoma and biliary obstruction. [ABSTRACT FROM AUTHOR]

Background/aim: In research and development of biliary plastic stents (PS), continuous efforts have been made to overcome short patency time and high rate of migration. The aim of this study was to evaluate the patency and migration rate of different PS shapes for a given period of time.Methods: Using an in vitro bile phantom model, we compared the patency among different shapes of PS (three straight PS, four double-pigtail PS, and a new screw-shaped PS). We performed an analysis of the degree of luminal narrowing by light microscopic examination. Using an in vivo swine model, we compared the patency and migration rate among the three different types of PS.Results: Eight weeks after the bile exposure in the bile flow phantom model, 80 PS were retrieved and analyzed. The straight PS showed less biofilm formation and luminal narrowing than other types of PS (p < 0.05). Forty-nine PS were inserted into the dilated bile ducts of 10 swine models, and 39 PS were successfully retrieved 8 weeks later. The stent migration occurred less frequently in the double-pigtail PS and the screw-shaped PS than it did in the straight PS (11.1, 10, and 27.3%, respectively). However, there was no statistical difference in stent patency among the different shapes.Conclusions: Stent patency may not be significantly different depending on the shape of PS for 8 weeks. The screw-shaped PS showed similar patency and migration rate to the double-pigtail PS. These results may help guiding future PS development and clinical decisions. [ABSTRACT FROM AUTHOR]

Background: Endoscopically applicable hemostatic agents have been demonstrated to have high initial hemostasis rates in cases of upper gastrointestinal bleeding (UGIB).Aims: The authors developed a new hemostatic powder (CEGP-003) and evaluated its hemostatic and ulcer healing effects in UGIB.Methods: Patients with peptic ulcer or post-endoscopic resection bleeding were randomly assigned to be treated by epinephrine injection or CEGP-003 spray. All patients were placed under observation for 3 days and underwent second-look endoscopy. The primary outcome was initial hemostasis rate, and the secondary outcomes were rebleeding rate and ulcer healing effect.Results: Seventy-two patients with UGIB were enrolled in this study. Causes of bleeding were peptic ulcer (15, 20.5%), post-endoscopic mucosal resection (11, 15.1%), and post-endoscopic submucosal dissection bleeding (47, 64.4%). Initial hemostasis was achieved in 89.2% (34/37) of patients in the epinephrine group and in 100% (35/35) in the CEGP-003 group (p = 0.115). Rebleeding occurred in 2.7% (1/37) and 8.6% (3/35) in the epinephrine and CEGP-003 groups, respectively (p = 0.35). Three days after endoscopic hemostasis, the ulcer healing effects of epinephrine and CEGP-003 were similar (p = 0.79).Conclusion: This study shows that CEGP-003 spray has a hemostatic effect similar to epinephrine in terms of initial hemostasis and rebleeding rates. The authors consider CEGP-003 a potential therapeutic tool for UGIB as a definitive or bridge therapy and that it is particularly useful for oozing lesions after endoscopic resection. [ABSTRACT FROM AUTHOR]

Background: Endoscopic papillary large balloon dilatation (EPLBD) without endoscopic sphincterotomy (EST) is an accepted, simplified endoscopic technique for large common bile duct (CBD) stone removal. However, little is known about the long-term outcomes of this technique. The purpose of this study was to evaluate the long-term outcomes of EPLBD without EST for the treatment of large CBD stones.Methods: This retrospective study of EPLBD without EST for a large CBD stone was conducted between June 2005 and October 2010. A total of 128 patients with a large CBD stone were included. The primary outcome measurement was complete CBD stone removal after EPLBD. Clinical data obtained from medical records were analyzed.Results: The overall complete stone removal rate was 94.5 %. Mechanical lithotripsy was needed in 18 (14.1 %) patients. Post-procedural pancreatitis and asymptomatic hyperamylasemia occurred in 1 (0.8 %) and 11 (8.6 %) patients, respectively. One (0.8 %) patient experienced minor bleeding. The rate of stone recurrence was 13.1 %, and median time to stone recurrence was 600 days (range 144-2284 days). Over a half (64.3 %) of stone recurrences occurred during the 2 years following stone removal. Recurrence tended to be more frequent in patients with a large CBD diameter and in patients requiring multiple endoscopic sessions for complete CBD stone retrieval.Conclusion: EPLBD without EST may be safe and effective in patients with a large bile duct stone. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effects of hiziki extract on alveolar bone loss, inflammation, and osteo-biomarker expression in hPDL cells (10, 50, 100 μg/ml final concentrations in culture medium) and on a ligature-induced periodontitis rat model (50, 100, 200 mg/kg with oral administration). Hiziki extract increased alkaline phosphatase activity and mineralized nodule formation in hPDL cell. In western blot analysis, hiziki extract resulted in increased expression of osteoblast markers, including transforming growth factor beta (TGF-β), SMAD anchor for receptor activation (SARA) and runt-related transcription factor 2 (RUNX2) in hDPL cells. Additionally, expression of osteoclast markers and inflammatory cytokines was inhibited, which were receptor activator of NF-κB (RANK), RANK receptor (RANKL) and nuclear factor of activated T cells, cytoplasmic 1 (NFATc1). Hiziki extract also prevented alveolar bone loss in a ligature-induced periodontitis rat model through reducing the distance between cementoenamel junction and alveolar bone crest (CBJ-ABC) and furcation involvement. These findings suggested that hiziki extract has prophylactic potential for the prevention of periodontitis through anti-inflammation and, anti-bone resorption effects and the inhibition of alveolar bone destruction. [ABSTRACT FROM AUTHOR]

Chimeric antigen receptor (CAR) T cell therapy is an effective method for treating specific cancers. CARs are normally designed to recognize antigens, which are highly expressed on malignant cells but not on T cells. However, when T cells are engineered with CARs that recognize antigens expressed on the T cell surface, CAR T cells exhibit effector function on other T cells, which results in fratricide, or killing of neighboring T cells. Here, using human leukocyte antigen-DR (HLA-DR)-targeted CAR T cells, we show that weak affinity between CAR and HLA-DR reduces fratricide and induces sustained CAR downregulation, which consequently tunes the avidity of CAR T cells, leading to desensitization. We further demonstrate that desensitized CAR T cells selectively kill Epstein-Barr virus-transformed B cells with enhanced HLA-DR expression, while sparing normal B cells. Our study supports an avidity-tuning strategy that permits sensing of antigen levels by CAR T cells. [ABSTRACT FROM AUTHOR]

Hizikia fusiforme, a brown seaweed, has been utilized as a health food and in traditional medicine. In this study, we investigated whether enzyme-modified H. fusiforme extracts (EH) have immunological effects compared with normal H. fusiforme extracts (NH). The effects of NH and EH on immune responses were investigated by assessing nitric oxide (NO) production, phagocytosis, and cytokine secretion in RAW 264.7 murine macrophages and mice. Also, fucosterol was evaluated to find the active component of NH and EH by addressing cytotoxicity test and NO production. Both of NH and EH significantly increased cell viability and NO synthesis. Tumor necrosis factor-α (TNF-α) expression was more induced by EH with LPS treatment. Phagocytic activity, as the primary function of macrophages, was markedly induced by EH treatment. Additionally, EH encouraged splenocyte proliferation and recovered the levels of cytokines IL-1β, IL-6, and TNF-α in mice. Finally, fucosterol increased NO production with no cytotoxicity, which means that fucosterol is an active component of EH. In conclusion, EH has the potential to modulate immune function and could offer positive therapeutic effect for immune system diseases. [ABSTRACT FROM AUTHOR]

Background: Several studies have reported on the correlation between the experience level of an endoscopist and the outcomes of precut procedures. However, there are limited data on the early use of the precut fistulotomy in relation to the experience of an endoscopist.Aim: To evaluate the efficacy and safety of precut fistulotomy in difficult biliary cannulation after ERCP training.Methods: Two endoscopists, one at each tertiary referral center, performed the precut fistulotomy for difficult biliary cannulation between September 2008 and February 2010. The technical success, complications, and clinical outcomes in three groups were recorded prospectively over time.Results: A total of 159 (23.1%) patients underwent precut fistulotomy. The mean procedure time was decreased as the number of procedures increased (p < 0.01). The success rates of selective biliary cannulation in the three groups were 86.8, 86.8, and 88.7% respectively, for the first attempt (p = 0.77) and 93.7% for the second attempt. Post-ERCP pancreatitis developed in nine (5.7%) patients, which was not statistically significant between the three groups. As the frequency of papillary contacts increased, post-ERCP pancreatitis tended to increase (p = 0.017). In the multivariate analysis, more than 15 attempts at cannulating the major papilla prior to fistulotomy was a risk factor for pancreatitis (odds ratio 4.8, 95% CI 1.178-19.580, p = 0.029).Conclusions: After therapeutic ERCP training involving at least 100 ERCPs, including at least half that were therapeutic cases and more than ten that were precut papillotomies, a precut fistulotomy can be performed safely and effectively in low-risk patients. [ABSTRACT FROM AUTHOR]

Megestrol acetate (MGA) belongs to the BCS class II drugs with low solubility and high permeability, and its oral absorption in conventional dosage form MGA microcrystal suspension (MGA MS) is very limited and greatly affected by food. In this study, MGA nanoemulsion (MGA NE) was formulated based on solubility, phase-diagram and release studies. Then oral bioavailability of MGA NE and MGA MS was evaluated. A randomized two-way crossover trial was conducted on six male dogs under fed and fasting conditions. Blood concentrations of MGA were analyzed using LC-MS/MS. MGA NE yielded 5.00-fold higher oral bioavailability in fasting conditions and displayed more stable absorption profiles after food intake compared with MGA MS. [ABSTRACT FROM AUTHOR]

Galla chinensis (GAC) is a natural traditional Chinese medicine that has been widely used in folk medicine. Although GAC compounds (mainly gallic acid and methyl gallate) possess strong antiviral, antibacterial, anticancer, and antioxidant activities, there is no report regarding topical or oral administration of GAC compounds on UVB irradiation-induced photoaging in hairless mice (SKH: HR-1). In the present study, we examined cell viability, intracellular reactive oxygen species (ROS), matrix metalloproteinase-1 (MMP-1), and interleukin-6 (IL-6) in skin fibroblasts and keratinocytes induced by UVB in vitro. We also studied skin damage by measuring skin thickness, elasticity, wrinkling and levels of protein MMP-1, elastin, procollagen type I, and transforming growth factor-β1 (TGF-β1) in hairless mouse skin chronically irradiated by UVB in vivo. GAC treatment significantly prevented skin photoaging by reducing the levels of ROS, MMP-1, and IL-6 and promoting production of elastin, procollagen type I, and TGF-β1. According to the results of H&E staining and Masson's trichrome staining, GAC reduced skin thickness and wrinkle formation while it increased skin elasticity. The effects of GAC on UVB-induced skin photoaging may be due to suppressed MMP-1 expression. These findings could be referenced for the development of new agents that target UVB-induced photoaging. [ABSTRACT FROM AUTHOR]

Self-expanding non-vascular metal stents (SEMS) is now a choice of treatment for tumor-induced obstructive symptoms of gastrointestinal tract. But in-growing tumor causes re-stenosis. Here, we studied a paclitaxel-eluting nanofiber-covered stent for palliative chemotherapy of gastrointestinal cancer and its related stenosis. In vivo and in vitro feasibility of nanofiber-covered nonvascular stent was evaluated in this study. Nanofiber-covered stent released paclitaxel (PTX) in controlled manner for 30 days. PTX-NFM significantly inhibited the growth of CT-26 colon cancer in comparison with PTX injection. PTX maintained higher tumor concentrations over 1.0 μg/ml for more than 14 days without systemic exposure. TUNEL and H&E staining proved locally concentrated PTX induced the higher apoptosis than PTX injection. In this way, PTX-eluting nanofiber-covered stent possibly inhibits in-growth of cancer and extends patency of stent. Clinical feasibility of PTX-eluting nanofiber nonvascular stent for cholangiocarcinoma and gastrointestinal cancers will be investigated in further studies. [ABSTRACT FROM AUTHOR]

Background/Aim: Endoscopic treatment for removal of large or impacted bile duct stones is challenging, and may not be successful. The aim of this study was to evaluate the safety and efficacy of endoscopic balloon dilation lithotripsy (EBDL) as a means of treating difficult extrahepatic bile duct stones refractory to failed conventional endoscopic treatments. Patients and Methods: The patients were included in the indication of EBDL only if stones were confirmed as brown-pigmented stones or recurrent. Balloon dilation was performed using a balloon dilation catheter in order to crush large and/or impacted stones at the common hepatic duct or common bile duct level in seven cases, and then fragmented stones were removed using a basket and/or an extraction balloon catheter. Results: The median diameter of the balloons used for EBDL was 32.4 ± 10.5 mm (range, 12.4-52.1). Balloon dilation was performed for 60 s per session. The mean number of EBDL sessions required to crush stones was two (range, 1-5), the mean number of ERCP sessions required for complete stone removal was 2.4 ± 0.8 (range, 1-3), the overall procedure-related complication rate was 0 % (0/7), and the success rate was 100 % (7/7). Conclusion: EBDL might be a safe and effective option for the treatment of large and impacted extrahepatic bile duct stones refractory to conventional endoscopic treatments. [ABSTRACT FROM AUTHOR]

Exposure to ultraviolet (UV) light causes matrix metalloproteinase (MMP) overexpression and extracellular matrix depletion, leading to skin photoaging. The activation of MMP is related to increased interlukin-6 (IL-6) and type I procollagen production, which is regulated by transforming growth factor-β1 (TGF-β1). Activator protein-1 (AP-1) activation induces MMP-1 production and reduces type I procollagen secretion. Fucosterol, which is extracted and purified from the brown algae Hizikia fusiformis, is a phytosterol. We assessed the effects of fucosterol on photodamage and investigated its molecular mechanism of action in UVB-irradiated normal human dermal fibroblasts by using enzyme-linked immunosorbent assay, Western blot analysis, and reverse transcription-polymerase chain reaction. Our results showed that fucosterol significantly decreased the UVB-induced expression of MMP-1, IL-6, p-c-Jun, and p-c-Fos. Additionally, fucosterol markedly increased the UVB-induced production of type I procollagen and TGF-β1. Our results indicate that fucosterol regulates MMP-1 and type I procollagen expression by modulating AP-1 and TGF-β1 signaling and that MMP-1 activation is correlated with IL-6. These data suggest that fucosterol is a promising botanical agent to protect against skin photodamage. [ABSTRACT FROM AUTHOR]

Fucosterol was extracted and purified from the brown algae Hizikia fusiformis. We assessed the anti-inflammatory effects of fucosterol on 2,4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis (AD)-like lesions in NC/Nga mice. Fucosterol decreased the lipopolysaccharide-induced production of nitric oxide in mouse macrophage cells. Oral administration of fucosterol (200 mg/kg weight/day) decreased the frequency of scratching, epidermal thickness of the dorsal skin, and number of degranulated mast cells. In addition, fucosterol treatment decreased levels of DNCB-stimulated serum immunoglobulin E (IgE). Compared to the control concanavalin A, fucosterol inhibited levels of IL-4 and TNF-α and increased secretion of IFN-γ, in the media of cultured splenocytes. Taken together, our results suggest that fucosterol may attenuate AD-like lesions by exerting anti-inflammatory effects, including inhibition of IgE and inflammatory cytokines, which modulate the Th1/Th2 balance. [ABSTRACT FROM AUTHOR]

Acrylamide is a neurological and reproductive toxicant in humans and laboratory animals; however, the neuron developmental toxicity of acrylamide remains unclear. The aims of this study are to investigate the cytotoxicity and neurite outgrowth inhibition of acrylamide in nerve growth factor (NGF)- or fibroblast growth factor 1 (FGF1)-mediated neural development of PC12 cells. MTS assay showed that acrylamide treatment suppresses NGF- or FGF1-induced PC12 cell proliferation in a time- and dose-dependent manner. Quantification of neurite outgrowth demonstrated that 0.5 mM acrylamide treatment resulted in significant decrease in differentiation of NGF- or FGF1-stimulated PC12 cells. This decrease is accompanied with the reduced expression of growth-associated protein-43, a neuronal marker. Moreover, relative levels of pERK, pAKT, pSTAT3 and pCREB were increased within 5-10 min when PC12 cells were treated with NGF or FGF1. Acrylamide (0.5 mM) decreases the NGF-induced activation of AKT-CREB but not ERK-STAT3 within 20 min. Similarly, acrylamide (0.5 mM) decreases the FGF1-induced activation of AKT-CREB within 20 min. In contrast to the NGF treatment, the ERK-STAT3 activation that was induced by FGF1 was slightly reduced by 0.5 mM acrylamide. We further showed that PI3K inhibitor (LY294002), but not MEK inhibitor (U0126), could synergize with acrylamide (0.5 mM) to reduce the cell viability and neurite outgrowth in NGF- or FGF1-stimulated PC12 cells. Moreover, acrylamide (0.5 mM) increased reactive oxygen species (ROS) activities in NGF- or FGF1-stimulated PC12 cells. This increase was reversed by Trolox (an ROS scavenging agent) co-treatment. Together, our findings reveal that NGF- or FGF1-stimulation of the neuronal differentiation of PC12 cells is attenuated by acrylamide through the inhibition of PI3K-AKT-CREB signaling, along with the production of ROS. [ABSTRACT FROM AUTHOR]

The gastrointestinal (GI) endoscopy has become a standard diagnostic tool for GI ulcers and cancer. In this study we studied endoscopic application of epidermal growth factor-containing chitosan hydrogel (EGF-CS gel) for treatment of GI ulcer. We hypothesized that directional ulcer-coating using EGF-CS gel via endoscope would precipitate ulcer-healing. EGF-CS gel was directly introduced to the ulcer-region after ulceration in acetic acid-induced gastric ulcer (AAU) and mucosal resection-induced gastric ulcer (MRU) rabbit and pig models. The ulcer dimensions and mucosal thicknesses were estimated and compared with those in the control group. Healing efficacy was more closely evaluated by microscopic observation of the ulcer after histological assays. In the AAU model, the normalized ulcer size of the gel-treated group was 2.3 times smaller than that in the non-treated control group on day 3 after ulceration ( P < 0.01). In the MRU model, the normalized ulcer size of the gel-treated group was 5.4 times smaller compared to that in the non-treated control group on day 1 after ulceration ( P < 0.05). Histological analysis supported the ability of EGF-CS gel to heal ulcers. The present study suggests that EGF-CS gel is a promising candidate for treating gastric bleeding and ulcers. [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of our study was to determine the predictors of recurrences in hepatocellular carcinoma (HCC) patients who had achieved complete remission (CR) by transarterial chemoembolization (TACE). Methods: A total of 220 consecutive HCC patients who had achieved CR by TACE were followed for a median 72 months. CR was defined as complete lipiodol uptake based on the results of lipiodol-computed tomography 4 weeks after TACE and no additional tumor staining on the follow-up angiography. Recurrence patterns were classified as local recurrence and secondary tumor, respectively, in relation to the location of recurrence; early and late recurrence were classified in relation to recurrence time. Results: Recurrence of HCC was observed in 169 patients (77 %), of whom 91 (54 %) had local recurrences, 61 (36 %) had secondary tumor, and 17 (10 %) had both. There were 45 (27 %) early and 124 (73 %) late recurrences. Local recurrence developed more frequently in patients with early recurrence than in those with late recurrence (62 vs. 51 %, respectively), while secondary tumor was detected more commonly in patients with late recurrence than in those with early recurrence (39 vs. 29 %, respectively; P < 0.001). In multivariate analyses, multinodularity [hazard ratio (HR) 2.351, P = 0.023] and a persistently high serum alpha-fetoprotein level following CR (HR 3.173, P < 0.001) were significant predictors of early recurrence. Older age (≥60 years; HR 1.531, P = 0.043), advanced Child-Pugh class (HR 1.983, P = 0.002), and the association with cirrhosis (HR 1.756, P = 0.028) were predictors of late recurrence following CR. Conclusions: Early recurrences following CR by TACE may be due mainly to undetectable remaining tumors, whereas late recurrences may be caused by newly appearing tumors in patients with a background of advanced cirrhotic liver. [ABSTRACT FROM AUTHOR]

Background: Lack of established guidelines for endoscopic papillary large balloon dilation (EPLBD) may be a reason for aversion of its use in removal of large common bile duct (CBD) stones. Aims: We sought to identify factors predictive of adverse events (AEs) following EPLBD. Methods: This multicenter retrospective study investigated 946 consecutive patients who underwent attempted removal of CBD stones ≥10 mm in size using EPLBD (balloon size 12-20 mm) with or without endoscopic sphincterotomy (EST) at 12 academic medical centers in Korea and Japan. Results: Ninety-five (10.0 %) patients exhibited AEs including bleeding in 56, pancreatitis in 24, perforation in nine, and cholangitis in six; 90 (94.7 %) of these were classified as mild or moderate in severity. There were four deaths, three as a result of perforation and one due to delayed massive bleeding. Causative factors identified in fatal cases were full-EST and continued balloon inflation despite a persistent waist seen fluoroscopically. Multivariate analyses showed that cirrhosis (OR 8.03, p = 0.003), length of EST (full-EST: OR 6.22, p < 0.001) and stone size (≥16 mm: OR 4.00, p < 0.001) were associated with increased bleeding, and distal CBD stricture (OR 17.08, p < 0.001) was an independent predictor for perforation. On the other hand, balloon size was associated with deceased pancreatitis (≥14 mm: OR 0.27, p = 0.015). Conclusions: EPLBD appears to be a safe and effective therapeutic approach for retrieval of large stones in patients without distal CBD strictures and when performed without full-EST. [ABSTRACT FROM AUTHOR]

Agroforestry systems are widely practiced in tropical forests to recover degraded and deforested areas and also to balance the global carbon budget. However, our understanding of difference in soil respiration rates between agroforestry and natural forest systems is very limited. This study compared the seasonal variations in soil respiration rates in relation to fine root biomass, microbial biomass, and soil organic carbon between a secondary forest and two agroforestry systems dominated by Gmelina arborea and Dipterocarps in the Philippines during the dry and the wet seasons. The secondary forest had significantly higher ( p < 0.05) soil respiration rate, fine root biomass and soil organic matter than the agroforestry systems in the dry season. However, in the wet season, soil respiration and soil organic matter in the G. arborea dominated agroforestry system were as high as in the secondary forest. Whereas soil respiration was generally higher in the wet than in the dry season, there were no differences in fine root biomass, microbial biomass and soil organic matter between the two seasons. Soil respiration rate correlated positively and significantly with fine root biomass, microbial biomass, and soil organic C in all three sites. The results of this study indicate, to some degree, that different land use management practices have different effects on fine root biomass, microbial biomass and soil organic C which may affect soil respiration as well. Therefore, when introducing agroforestry system, a proper choice of species and management techniques which are similar to natural forest is recommended. [ABSTRACT FROM AUTHOR]

Background: Choledocholithiasis commonly occurs in patients with symptomatic cholelithiasis. Although the recently developed multidetector computed tomography (MDCT) scan enhances the ability to diagnose choledocholithiasis, this technique is considered to have some limitations for evaluating the common bile duct (CBD). Aim: The purpose of this study was to evaluate the necessity for performing endoscopic ultrasound (EUS) as an add-on test to detect choledocholithiasis in patients who were diagnosed with gallstone disease without choledocholithiasis based on MDCT. Methods: Three hundred twenty patients with gallstone disease and no evidence of CBD stones according to MDCT underwent EUS between March 2006 and April 2011. If CBD stones were suspected based on the EUS results or clinical symptoms, a final diagnosis was obtained by endoscopic retrograde cholangiopancreatography (ERCP). The patients' medical records were retrospectively analyzed based on clinical symptoms, biochemical findings, and results of the imaging studies. Results: CBD stones were not detected with MDCT in 41 (12.8 %) out of 320 patients with gallstone disease. The causes for these discrepancies could be attributed to small stone size ( n = 19, 46.3 %), isodensity ( n = 18, 43.9 %), impacted stones ( n = 1, 2.4 %), and misdiagnosis ( n = 3, 7.3 %). If EUS were used as a triage tool, unnecessary diagnostic ERCP and its complications could be avoided for 245 (76.6 %) patients. Conclusions: MDCT may not be a primary technique for detecting CBD stones. EUS should be performed instead as an add-on test to evaluate the CBD for patients with gallstone-related disease. In particular, EUS should be routinely recommended for patients with abnormal liver enzyme levels, pancreatitis, and dilated CBD. [ABSTRACT FROM AUTHOR]

A highly sensitive tyrosinase (TYR)-based amperometric biosensor is prepared using biologically designed gold nanowires (AuNWs) for pesticide detection. The AuNWs were synthesized by dodecapeptide Midas-11 and were modified with the formation of self-assembled monolayer (SAM), followed by covalent binding with TYR. The prepared TYR-AuNWs-SPCE (screen printed carbon electrode) was compared with bare, AuNWs-, modified-AuNWs-SPCE by the measurement of cyclic voltammetry. The quantitative relationship between the inhibition percentage and the pesticide concentration at the TYR-AuNWs-SPCE was obtained by measuring the current response in various concentrations of pesticides. The reasonable detection range of parathion was determined to be 0.1 ppt through 10 ppb (R=0.990) with 0.087 ppt of detection limits. The higher sensitivity and wider detection range of the TYR-based biosensor was achieved by the use of biologically synthesized AuNWs. [ABSTRACT FROM AUTHOR]

Laquer tree ( Rhus verniciflua Stokes; Anacardiaceae, RVS) has been used in oriental medicines. This study examined whether the extract of RVS free of urushiol (detoxified RVS extract, DRE) exerting antiinflammation could alleviate the symptoms of atopic dermatitis (AD) induced with 2,4-dinitrochlorobenzene (DNCB) in NC/Nga mice. DRE contained flavonoids like fustin (153 mg/g), fisetin (14.6 mg/g), sulfuretin (13.3 mg/g), and quercetin (0.95 mg/g). DRE (10 μg/mL) decreased the production of nitric oxide activated by lipopolysaccharide. Oral administration of DRE (200 mg/kg weight/day) decreased scratching frequencies, the epidermal thickness on dorsal skin, and the number of degranulated mast cell. DRE significantly lowered the levels of IgE in sera ( p<0.01), which were elevated by DNCB. DNCB reciprocally raised IL-4 and lowered IFN-γ in media of spleenocyte. DRE reversely raised IFN-γ and lowered IL-4. Contrastively, dexamethasone suppressed the overall immune reactions. In conclusion, DRE inhibited Th2-mediated IgE overproduction through modulation of Th1/2 balance, which was in part attributed to anti-inflammatory activity. [ABSTRACT FROM AUTHOR]

Background: Covered biliary metal stents have been introduced for the purpose of overcoming tumor ingrowth and treatment of benign biliary stricture. The aim of this study was to evaluate the biodurability of three commercially available biliary metal stent covering materials [e-PTFE (expanded polytetrafluoroethylene), silicone, and polyurethane] in a bile flow phantom. Materials and Methods: By operation of a peristaltic pump, human bile was circulated continuously in an experimental perfusion system containing covered metal stents. Each stent was removed, respectively, 1, 2, 4, and 6 months after bile exposure. We performed a gross inspection of the covered stents. The covering membrane was detached from the stent and observed by scanning electron microscopy (SEM). Finally, we measured tensile and tear strength of the membranes. Results: Bile -staining of the membrane showed gradual progression after bile exposure; however, progress was the fastest in e-PTFE. SEM examination showed that the polyurethane surface was smooth, and the silicone surface was relatively smooth. However, e-PTFE had a rough and uneven surface. After bile exposure, there were no significant changes in polyurethane and silicone; however, biofilms and microcracks were observed in e-PTFE. In contrast to a gradual decrease of tensile/tear strength of polyurethane and silicone, those of e-PTFE showed a rapid reduction despite of the strongest baseline tensile and tear strength. Conclusion: e-PTFE tended to form biofilms more frequently than polyurethane and silicone during bile exposure. e-PTFE seemed to be less durable than silicone and polyurethane, however, as clinically applicable material because of strong absolute tensile/tear strengths. [ABSTRACT FROM AUTHOR]

Background and Aims: Every country has standardized reprocessing guidelines for reducing the risk of microorganism transmission via reusable biopsy forceps. Sterilization is performed either by autoclaving or with the use of ethylene oxide (EO) gas. However, there are no clear standard global recommendations. The aim of this study was to determine whether EO gas or autoclaving is a safer and more effective method for the sterilization of reusable forceps. Methods: This was a prospective study conducted at multiple tertiary referral centers. Seventy reusable biopsy forceps that had been reused at least 20 times each were collected from six endoscopy centers. In all, 61 forceps from five centers were sterilized using EO gas, and the nine forceps from the remaining center were placed in an autoclave. We performed real-time polymerase chain reaction (RT-PCR) for Mycobacterium tuberculosis and hepatitis B virus and performed bacterial cultures on the reusable forceps, which were cut into 2- to 3-cm sections. The forceps were also scanned with an electron microscope (EM) to detect surface damage and contamination. Results: Escherichia coli bacteria were cultured from 2 of the 61 (3.3%) reusable biopsy forceps sterilized with EO gas. On EM scanning, abundant debris and tissue materials remained on the cup surfaces of the reused biopsy forceps and on their inner wires. No microorganisms were found on the autoclaved forceps. Conclusions: Sterilization with EO gas may be inadequate because the complicated structure of the forceps may interfere with sterilization. Therefore, for optimum safety, reusable biopsy forceps should be sterilized by autoclaving. [ABSTRACT FROM AUTHOR]

Fertilization is essential to seedling production in nursery culture, but excessive fertilization can contaminate surface and ground water around the nursery. The optimal fertilization practice is that which maximizes seedling growth and minimizes nutrient loss. We tested three fertilization strategies: (1) constant fertilization (2) a three-stage rate, and (3) exponential fertilization on Liriodendron tulipifera and Larix leptolepis containerized seedlings. Growth performance, nutrient uptake, and nutrient loss in leaching were measured. Height, root collar diameter, and dry weight of both species were not significantly different among treatments even though the nutrient supply of the exponential treatment was half that of the constant and three-stage treatments. Generally, nutrient losses in leached solutions were higher in constant and three-stage than the exponential treatment. Nutrient use efficiency was calculated as the ratio of the nutrient content of the seedlings to the amount of nutrient applied to the containers. The nitrogen use efficiency in the constant, three-stage, and exponential treatments was 63, 61, and 85% for yellow poplar, respectively, and 35, 30, and 53% for larch. Similar results were obtained for phosphorus and potassium. Thus, the exponential treatment had the highest nutrient use efficiency as well as the least nutrient loss. Adjusting fertilization rates can reduce soil and water contamination around the nursery without compromising growth performance, which reduces both producer's investments and environmental impacts. [ABSTRACT FROM AUTHOR]

The photoinduced electron transfer from chlorophyll a through the interface of positively charged dioctadecyltrimethylammonium chloride (DODAC), neutral dipalmitoylphosphatidylcholine (DPPC) and negatively charged dihexadecylphosphate (DHP) headgroup of the lipid bilayers was studied. The photoinduced radicals were identified by electron spin resonance (ESR) and radical yields of chlorophyll a were determined by double integration of the ESR spectra. The formation of vesicles was identified indirectly by measuring change of the λ value of optical absorption spectrophotometer from diethyl ether solution to vesicle solutions, and observed directly with scanning and transmission electron microscopic images. The interaction distance between chlorophyll a and interface water (DO) determined by deuterium modulation depth with electron spin echo modulation (ESEM) showed a decreasing order DODAC > DPPC > DHP. The interface charge of each vesicle was determined with zeta potential measurement. The interface charge of the lipid bilayers affected the radical yields of chlorophyll a more critically than the interaction distance between chlorophyll a and interface water. Graphical Abstract: [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

Purpose: To study the development of porous poly(lactic-co-glycolic acid) microparticles (PLGA MPs) coated initially with albumin and then with palmityl-acylated exendin-4 (Pal-Ex4) as an inhalation system for treating diabetes. Methods: Porous PLGA MPs were prepared by w/o/w double emulsification using hydroxypropyl-β-cyclodextrin and poly(ethylene- alt-maleic anhydride). Albumin was covalently attached to the MPs using EDC (1-(3-dimethylaminopropyl)-3-ethylcarbodiimide); Pal-Ex4 was then bound on the albumin surface. Albumin-binding degree and aerosolization efficiency were investigated. Deposition of the MPs after insufflations into the lungs of ICR mice was observed by image monitoring, and pulmonary hypoglycemic efficacies were examined in db/db mice. Cytotoxicity and histopathology induced by MPs were examined in Calu-3 and A549 cells and in the lungs of db/db mice, respectively. Results: Albumin-coating and Pal-Ex4-binding to porous MP were performed with acceptable efficiencies. Pal-Ex4-bound albumin-coated MPs (Pal-Ex4/HSA-PLGA MP) were of high porosity and had appropriate aerodynamic sizes. Furthermore, this MP was efficiently deposited throughout mouse lungs, and exhibited a prolonged hypoglycemia and no significant lung tissue damage in db/db mice. Conclusion: Pal-Ex4/HSA-PLGA MP demonstrated many meaningful pharmaceutical advantages for the treatment of diabetes, in terms of aerosolization efficiency, drug loading, sustained drug-release, and hypoglycemic duration in vivo. [ABSTRACT FROM AUTHOR]

Bacterial cellulose (BC)/Chitosan (Ch) composite has been successfully prepared by immersing wet BC pellicle in Ch solution followed by freeze-drying process. The morphology of BC/Ch composite was examined by scanning electron microscope (SEM) and compared with pristine BC. SEM images show that Ch molecules can penetrate into BC forming three-dimensional multilayered scaffold. The scaffold has very well interconnected porous network structure and large aspect surface. The composite was also characterized by Fourier transform infrared spectrum, X-ray diffraction, thermogravimetric analysis and tensile test. By incorporation of Ch into BC, crystallinity tends to decrease from 82% to 61%, and the thermal stability increases from 263 °C to 296 °C. At the same time, the mechanical properties of BC/Ch composite are maintained at certain levels between BC and Ch. The biocompatibility of composite was preliminarily evaluated by cell adhesion studies. The cells incubated with BC/Ch scaffolds for 48 h were capable of forming cell adhesion and proliferation. It showed much better biocompatibility than pure BC. Since the prepared BC/Ch scaffolds are bioactive and suitable for cell adhesion, these scaffolds can be used for wound dressing or tissue-engineering scaffolds. [ABSTRACT FROM AUTHOR]

In this study, a poly(L-lactic acid)- b-poly(ethylene glycol) (PLLA- b-PEG) diblock copolymer modified with a sialic acid derivative (methyl- b-neuraminic acid: mNA) was prepared for the development and application of a therapeutic nanosystem with multifunctionality. The terminal carboxyl group of PEG was coupled with mNA via N,N′-dicyclohexyl carbodiimide (DCC)-and N-hydroxysuccinimide (NHS)-mediated amide formation. Polymeric micelles were formed using the diafilteration method at pH 7.4, which resulted in a micelle self-assembly with the PLLA block at the core and PEG-mNA block on the shell. An anionic charge was formed on the surface of the micelle at physiological pH (∼pH 7.4) due to mNA. Amantadine (AMT), a model drug for antiviral treatment, was loaded into the micellar core. These micelles were expected to exhibit multiple therapeutic activity that originated from the antiviral activity of mNA on the shell and the sustained release of AMT from the micellar core. [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

Polyurethane (PU) films incorporated with an anti-cancer drug paclitaxel (PTX) were prepared using a solvent casting method for potential applications to stent-based drug delivery and the local treatment of malignant tumors around gastrointestinal stents. The films were examined by scanning electron microscopy (SEM), and PTX micro-aggregates were observed when the drug loading was > 2.7 wt%. The in vitro release study revealed that the amount of drug released from the film was virtually independent and cumulative percentage release was inversely proportional to the drug loading. When plotted against the square root of time, the cumulative percentage release was initially linear, but the fraction of the linear region decreased with increasing drug loading, indicating that diffusion-controlled release is not applicable to the PTX molecules in micro-aggregates. When 1.25% PTX-PU films were placed under pre-existing CT-26 tumors in mice, tumor growth was slowed by an average of 65.5% compared to that in the control group. [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

Oxidative stress in liver injury is a major pathogenetic factor in progress of liver fibrosis. Resveratrol, a representative antioxidant derived from grapes, has been reported to show widespread pharmacological properties. In this study, we investigated the protective effects of resveratrol on dimethylnitrosamine (DMN)-induced liver fibrosis in rats. Rats were treated with resveratrol daily by oral gavage for seven days after a single intraperitoneal injection of DMN (40 mg/kg). Resveratrol remarkably recovered body and liver weight loss due to DMNinduced liver fibrosis. Liver histology showed that resveratrol alleviated the infiltration of inflammatory cells and fibrosis of liver tissue. Resveratrol decreased the level of malondialdehyde and increased the levels of glutathione peroxidase and superoxide dismutase. Also, resveratrol significantly inhibited the mRNA expression of inflammatory mediators including inducible nitric oxide, tumor necrosis factor-alpha and interleukin-1beta. In addition, resveratrol showed not only reduced mRNA expression of fibrosis-related genes such as transforming growth factor beta 1, collagen type I, and alpha-smooth muscle actin, but also a significant decrease of hydroxyproline in rats with DMN-induced liver fibrosis. Our results suggest that resveratrol could be used to treat liver injury and fibrosis and be useful in preventing the development of liver fibrosis and cirrhosis. [ABSTRACT FROM AUTHOR]

OBJECTIVES:For frail, elderly patients with large impacted common bile duct (CBD) stones, long-term treatment with biliary stenting provides palliation. Biliary stenting with choleretic agents such as ursodeoxycholic acid (UDCA) and terpene preparations may promote CBD stone size reduction. We studied the effectiveness of biliary stenting combined with UDCA and a terpene preparation as a medical treatment for difficult-to-remove CBD stones in patients older than 65 years in this multicenter, prospective study.METHODS:A total of 28 elderly patients with CBD stones refractory to conventional endoscopic removal, including mechanical lithotripsy, underwent endoscopic placement of a straight 10-F plastic biliary stent. Each patient was administered 600 mg of UDCA and 300 mg of a terpene preparation daily for a mean of 6 months. After 6 months of medication following the initial endoscopic retrograde cholangiopancreatography (ERCP), a second ERCP was performed and endoscopic stone removal was again attempted. Differences in stone size and CBD diameter before and after biliary stenting and medication were compared. The complete stone removal rate after treatment was obtained.RESULTS:The mean size (transverse × longitudinal diameter) of the CBD stones was initially 21.6 × 29.5 mm, and it decreased significantly to 12.2 × 20.1 mm at the second ERCP (P<0.01). The mean CBD diameter measured initially at the cystic duct insertion level was 23.2 mm, and it decreased significantly to 19.5 mm at the second ERCP (P<0.01). After biliary stenting with medication, endoscopic stone removal was successful in 26 of 28 patients (92.8%), with a mean of 1.7 subsequent ERCP sessions.CONCLUSIONS:Endoscopic biliary stenting with a period of combined UDCA and terpene preparation administration seems to be a safe and effective method for retained CBD stones in elderly patients. A prospective study with randomization and a control group is required to confirm these results. [ABSTRACT FROM AUTHOR]

Six leaf traits, i.e., fresh mass (FM), dry mass (DM), leaf dry matter content (DMC), area (AR), specific leaf area (SLA) and thickness (TH) from 23 plant species in the southeastern Keerqin Sandy Lands, China were measured. The results show that leaf traits of herbs were more diversified than those of shrubs and trees and average SLA tended towards a decreasing trend from herbs to shrubs to trees. On the contrary, DMC and DM show an upward trend from herbs to shrubs to trees. No apparent difference was found in TH. Except forDMand TH, there were significant variations in SLA and DMC among three different growth forms. Moreover, a significant correlation was found between SLA and DMC. It is concluded that SLA and DMC could be used to predict species position along a resource use gradient. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate possible beneficial effects of morin on CCl4-induced acute hepatotoxicity in rats. Rats received a single dose of CCl4 (150 μL/100 g 1:1 in corn oil). Morin treatment (20 mg/kg) was given at 48, 24, and 2 h before CCl4 administration. CCl4 challenge elevated serum alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP) levels, but these effects were prevented by the pretreatment of rats with morin. To identify the mechanism of protective activity of morin in CCl4-induced hepatotoxicity in rats, we investigated expressions of tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and inducible nitric oxide (iNOS). The expressions of TNF-α, IL-1β, IL-6, and iNOS were increased by CCl4 treatment and increased expressions of those were decreased by morin. These findings suggest that morin prevents acute liver damage by inhibiting the production of TNF-α, IL-1β, IL-6, and iNOS. [ABSTRACT FROM AUTHOR]

A lignan derivative, (-)-(7R, SSJ-dihydrodehydrodiconiferyl alcohol (DHDA), was isolated from Kalopanax septemlobus L. and was observed to have neuritogenic activity. DHDA at 50 μ? caused a marked induction of neurite outgrowth and an enhancement of nerve growth factor (NGF)-mediated neurite outgrowth from PC12 cells. However, it did not exhibit any neu-rotrophic action. At 50 μ?, DHDA enhanced NGF-induced neurite-bearing activity. This activity was partially blocked by the mitogen-activated protein kinase inhibitor PD98059 and by GF109203X, a protein kinase inhibitor. These results suggest that DHDA can induce neurite outgrowth and enhance NGF-induced neurite outgrowth from PC12 cells by amplifying up-stream steps such as and PKC. [ABSTRACT FROM AUTHOR]

In this research, a vision system for detecting breakages of small-diameter taps, which are rarely detected by the indirect in-process monitoring methods such as acoustic emission, cutting torque and motor current, was developed. Two HMI (Human Machine Interface) programs to embed the developed vision system into a Siemens open architecture controller, 840D, were developed. They are placed in sub-windows of the main window of the 840D and can be activated or deactivated either by a softkey on the operating panel or the M code in the NC part program. In the event that any type of tool breakage is detected, the HMI program issues a command for an automatic tool change or sends an alarm signal to the NC kernel. An evaluation test in a high-speed tapping machine showed that the developed vision system was successful in detecting breakages of small-diameter taps up to M1. [ABSTRACT FROM AUTHOR]

Improved composition control of Hg1-xCdxTe layers grown by molecular beam epitaxy using in-situ spectroscopic ellipsometry is described. This has increased our composition yields from <40% to approximately 70% for a specification of x to within 0.0015 of target composition. Knowledge of composition during growth also enables corrections to effusion cell temperatures so that the in-depth composition profile can be controlled. Further improvements were obtained after active composition control was implemented whereby the ellipsometer controls the Te cell temperature to maintain the desired composition. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Anaesthetists' Society Journal is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)