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Purpose: We assessed the impact of plasma trough concentrations of abiraterone (ABI) and its metabolite Δ4-abiraterone (D4A) and related polymorphisms on adverse events (AEs) in patients with metastatic prostate cancer who received abiraterone acetate (AA). Methods: This prospective study enrolled patients with advanced prostate cancer treated with AA between 2016 and 2021. Plasma trough concentrations of ABI and D4A were measured using high-performance liquid chromatography. The impact of HSD3B1 rs1047303, SRD5A2 rs523349, and cytochrome P450 family 3A member 4 rs2242480 polymorphisms on plasma concentrations of ABI and D4A and the incidence of AEs were also assessed. Results: In 68 patients treated with AA, the median ABI and D4A concentrations were 18.1 and 0.94 ng/mL, respectively. The high plasma trough concentration of ABI (≥ 20.6 ng/mL) was significantly associated with the presence of any AE and its independent risk factor based on multivariable analysis (odds ratio, 7.20; 95% confidence interval (CI): 2.20–23.49). Additionally, a high plasma trough concentration of ABI was an independent risk factor of time to withdraw AA (hazard ratio, 4.89; 95% CI: 1.66–14.38). The risk alleles of three polymorphisms were not statistically associated with the ABI and D4A concentrations and the incidence of AEs. Conclusions: The plasma trough concentration of ABI is associated with the presence of AEs and treatment failure after AA administration. ABI concentration monitoring may be useful in patients with prostate cancer who received AA. [ABSTRACT FROM AUTHOR]

We conducted a risk-adapted upfront docetaxel (DOC) in patients with metastatic hormone-sensitive prostate cancer (mHSPC). Here, we reported an interim analysis of the study. The study enrolled 68 patients with newly diagnosed mHSPC between 2016 and 2018. According to the presence of visceral metastasis, an EOD score ≥ 3, or prostate-specific antigen (PSA) level at 3 months of ≥ 1 ng/mL, patients were divided into low- and high-risk groups. Patients were treated with androgen deprivation therapy (ADT) with or without bicalutamide; those in the high-risk group received upfront treatment involving six cycles of DOC (70 mg/m2). Short-term treatment effect, adverse events, and quality of life (QOL) were evaluated. Fifty (73.5%) were classified in the high-risk group, and 46 (67%) received upfront ADT + DOC. In the ADT + DOC group, 43.5% (20/46) patients achieved a PSA level ≤ 0.2 ng/mL. PSA nadir and time to PSA nadir were 0.291 ng/mL and 288 days, respectively. In the ADT + DOC group, 76.1% (35/42) patients had adverse events (AEs) of grade ≥ 3. During a median follow-up of 18.5 months, 36.4% (8/22) patients in the ADT group and 43.5% (20/46) in the ADT + DOC group had CRPC. Two QOL scores including the physical status and appetite loss at 6 months significantly worsened in the ADT + DOC group but was resolved by 12 months. Upfront DOC achieved high PSA responses without long-term QOL deterioration. However, the short-term outcomes were limited. Longer follow-up is needed to determine the survival advantage. [ABSTRACT FROM AUTHOR]

Purpose: Therapeutic drug monitoring guided by the area under the concentration-time curve (AUC-guided TDM) is recommended for vancomycin. However, validated efficient software remains elusive to popularize AUC-guided TDM in Japan. The aim of this study was to validate a newly developed web application, PAT, for AUC estimation. Methods: PAT was developed on the R ver. 3.6.2 platform for use with mobile phones and personal computers. AUC estimated by PAT (AUCPAT) was evaluated against the reference AUC (AUCREF) calculated with the log-linear trapezoidal rule using eight measured concentrations, or against AUC (AUCBM-P) calculated using an evaluated available software with clinical data. Results: Investigating the best sampling points with limited sampling, PAT produced the least bias using two concentrations at 1 h and 11 h after the end of infusion (slope 1.18, intercept −15.57, median AUCPAT/AUCREF 0.93 [range 0.81–1.24]), where only one estimation (6%) was out of the predetermined acceptable range of 0.8–1.2. Employment of only a trough concentration was more biased (AUCPAT/AUCREF range 0.73–1.30 for 11 h, AUCPAT/AUCREF range 0.62–1.40 for 23 h). In comparison with the evaluated software, AUCPAT was not biased against the AUCBM-P (slope 1.04, intercept −15.80, median AUCPAT/AUCBM-P 1.00 [range 0.86–1.10]). Conclusions: The new application using two concentrations was appropriately validated and might be efficient in popularizing the AUC-guided TDM of vancomycin. [ABSTRACT FROM AUTHOR]

Combining cryopreservation of germline stem cells (GSCs) with their subsequent transplantation into recipient fish is a powerful tool for long-term preservation of genetic resources of endangered fishes. However, application of this technique has been limited because endangered species sometimes have small gonads and do not supply enough GSCs to be used for transplantation. This limitation could be overcome by expanding GSCs in vitro, though this has been difficult due to the complexity of reconstructing the gonadal microenvironment that surrounds GSCs. Here, we describe a novel method of in vitro expansion of rainbow trout GSCs using a feeder layer derived from Sertoli cells and a culture medium containing trout plasma. A transplantation assay demonstrated that the in vitro-expanded GSCs exhibited stem cell activity and potency to produce functional eggs, sperm, and eventually healthy offspring. In vitro expansion of GSCs can aid in rescuing fishes that are on the verge of extinction. Yoshiko Iwasaki-Takahashi et al. report the production of fertilization-capable eggs and sperm from rainbow trout spermatagonia, for application to endangered species preservation. Their method avoids the need for limited numbers of germline stem cells for transplantation, instead allowing in vitro expansion of these cells using a Sertoli cell-derived feeder layer. [ABSTRACT FROM AUTHOR]

Purpose: It is unclear whether immunomodulators or biologics, with the exception of corticosteroids, can be risk factors for postoperative infectious complications of ulcerative colitis (UC). Moreover, many immunosuppressive therapies including some biologics are used mainly to treat UC, and many patients are on multi-agent immunosuppressive therapy at the time of surgery. Therefore, we evaluated the influence of pre-operative multiple immunosuppressive agents on the occurrence of surgical site infection (SSI) in UC during the era of biologics. Methods: We reviewed surveillance data from 301 patients who underwent surgery between January 2015 and April 2018. The incidences of SSI and possible risk factors among patients receiving different immunosuppressive therapies were compared and analyzed. Results: The incidence of incisional SSI was 6.6%, and that of organ/space SSI was 7.0%. Doses of corticosteroids were significantly decreased because of the recent shift toward the use of biologics. The types and numbers of immunosuppressive agents did not significantly correlate with each incidence. Age ≥ 65 years (odds ratio (OR) 3.0), total prednisolone dose ≥ 9000 mg (OR 2.7), and perioperative blood transfusion (OR 3.6) were shown to be independent risk factors for incisional SSI, whereas duration of surgery ≥ 252 min (OR 3.8), urgent/emergent surgery (OR 2.9), and perioperative blood transfusion (OR 2.6) were identified as independent risk factors for organ/space SSI. Conclusions: Although no correlation between pre-operative immunosuppressive therapies, except for corticosteroids, was found, selection bias may have occurred due to treatment before surgery. However, biologics, calcineurin inhibitors, and thiopurines did not affect surgical morbidity in UC. [ABSTRACT FROM AUTHOR]

This study examined the influence of the individual and social background in predicting the rearrest of 1124 juveniles who were first brought into the juvenile detention center in a midsized county in California. Independent variables include demographic characteristics, first offense type, gang affiliation, usage of drug, and family characteristics. Using cross-validation to choose an appropriate machine learning model for predicting rearrest, this study identified that the most important predictors of subsequent arrest are age at first arrest, drug usage, gang affiliation, and family with government assistance. Despite the fact that blacks are overrepresented in the juvenile detention population, race was not a significant predictor for rearrest. Future research would continue to explore the utilization of machine learning adding nontraditional variables to enhance the prediction of recidivism. [ABSTRACT FROM AUTHOR]

Purpose: Catheter-associated bloodstream infections (CABSIs) are a leading cause of nosocomial infections. The objectives of this study were to establish the incidence of CABSIs after bowel surgery and to identify the risk factors. Methods: We reviewed the prospectively collected data of patients who underwent abdominal surgery with central venous catheter (CVC) insertion between March, 2006 and September, 2009. We analyzed all possible variables, including age, sex, disease, CVC duration, insertion frequency, CVC site, infliximab, corticosteroid, and immunosuppressant administration, preoperative serum albumin level, surgical wound class, and emergency surgery. Results: A total of 1261 patients were prospectively surveyed. The underlying diseases comprised ulcerative colitis (UC; n = 428), Crohn's disease (CD; n = 334), colorectal cancer (CA; n = 344), esophageal cancer (ESO; n = 28), gastric cancer (GAST; n = 44), and others ( n = 83). The incidences of CABSI were 6.9/1000 catheter days for UC, 7.4 for CD, 4.3 for CA, 3.7 for ESO, 3.7 for GAST, and 5.1 for others. CD patients had the highest rate of CABSI. The risk factors for CABSI were CD with an odds ratio (OR) of 1.63, dirty/infected wound class (OR 3.34), and CVC insertion via the internal jugular vein (OR 9.89). Conclusion: A high CABSI incidence was found in association with CD, especially in dirty/infected surgery. Thus, the use of CVCs should be restricted in the presence of these risk factors. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the timing of therapeutic drug monitoring (TDM) in patients with impaired renal function treated with once-daily administration of vancomycin (VCM). Once-daily administration was selected for patients whose creatinine clearance (C) was <80 ml/min. TDM was conducted on day 3 or on day 4. Adult patients whose VCM dosage was not altered according to initial C and for whom subsequent follow-up TDM was performed within 1 week were entered into the study. Patients whose renal function deteriorated at follow-up TDM were excluded. One hundred sixty-five patients were eligible for analysis. Among patients with once-daily dosing, relative increases of C at follow-up TDM compared with initial TDM were 34.5 ± 39.2 % in TDM on day 3 and 16.6 ± 20.6 % in TDM on day 4 ( P = 0.016). In contrast, there was no significant difference in the relative increase of C between TDM on days 3 and 4 (26.1 ± 39.6 vs. 18.4 ± 25.6 %, P = 0.551) in the twice-daily regimen. On multivariate analysis, TDM on day 3 alone (odds ratio, 4.93; 95 % confidence interval, 1.71-14.2) was selected as an independent risk factor associated with a relative increase of C by >30 % in the once-daily regimen. Steady-state VCM serum concentration was not achieved on day 3 in the once-daily regimen in patients with impaired renal function, and TDM on day 3 caused underestimation of C. [ABSTRACT FROM AUTHOR]

The article discusses the practice guidelines which review the factors influencing the voriconazole (VRCZ) pharmacokinetic profile conducted by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring (JSTDM). It examines the data that support exposure-toxicity and exposure-effect relationships that cause difficulty for therapeutic drug monitoring for VRCZ. It also mentions indications for VRCZ therapeutic drug monitoring (TDM).

The article discusses the guidelines for drug monitoring (TDM) of vancomycin (VCM) and the reviews for TDM by Japanese Society of Therapeutic Drug Monitoring (JSTDM) and Japanese Society of Chemotherapy (JSC). It says that the guidelines for TDM of VCM were reviewed by the practice guidelines committee. It states that the TDM and VCM dosing recommendations were not stated in the guidelines for patients undergoing continuous renal replacement therapy (CRRT) and with renal function deterioration.

We report a rare case of peristomal pyoderma gangrenosum with severe gastroduodenal lesions, developing after total colectomy in a patient with ulcerative colitis and concomitant cytomegalovirus (CMV) enteritis. A 19-year-old man underwent total proctocolectomy with an ileal J-pouch anal anastomosis and diverting ileostomy, after 2 years of ineffective medical treatment. On postoperative day 6, severe peristomal pyoderma gangrenosum developed and progressed rapidly. Maintaining immunosuppressive therapy with corticosteroids for 6 days induced melena from the gastroduodenal lesions and enteritis with concomitant CMV reactivation. The patient required a jejunostomy, after the duodenal and intestinal CMV lesions had caused multiple perforations. Treatment with intensive cytapheresis was ineffective against the associated UC lesions, which healed with infliximab induction. The CMV reactivation was treated effectively with ganciclovir. The patient is being maintained on infliximab every 8 weeks and there has been no sign of recurrence of the gastroduodenitis-associated UC and CMV reactivation. [ABSTRACT FROM AUTHOR]

Objective: As metastasis of prostate carcinoma occurs in approximately 80 % of terminal prostate carcinoma patients, the prognostic value of the prediction of prostate carcinoma by bone scintigraphy is important. We compared the automated and semi-automated bone scan index (BSI) system with extent of disease (EOD) grade if there is a possibility to substitute for EOD grading. Materials and methods: We evaluated the bone scintigraphic images of 158 prostate carcinoma patients (mean age, 69.2 years old; range 50-97). Bone scans were obtained approximately 3 h after the intravenous injection of 740 MBq technetium-99 m-methylene diphosphonate. EOD grade was evaluated by 2 experienced radiologists using bone scintigraphy, magnetic resonance imaging, and computed tomography. We calculated the BSI using the Bonenavi system (Fujifilm RI Pharma Co., Ltd.), utilizing data from a Japanese database. The semi-automated BSI of the patients was obtained by modifying the automated BSI independently by 3 radiologists (referred to as 'observers' in this study) with 25, 10, and 4 years of experience. We then compared the EOD with the corresponding 4 independent BSIs for each patient. We used the Steel-Dwass test for multiple comparisons of the BSI among different EOD groups of patients. We analyzed the receiver-operating characteristics (ROC) curve to determine the cutoff values of sensitivity and specificity, which were both set at 95 %. Results: There were significant correlations observed among the mean EOD and BSI scores as determined using the Bonenavi system for every patient group for all observers and the automated method. There was also a statistically significant difference in the mean BSI among all EOD groups (grades 0, 1, or 2-4) for all observers and the automated method. Each ROC curve showed an ideal shape and was within the optimal cutoff range. Conclusion: On the basis of the present results, BSI as calculated using the Bonenavi system significantly correlated with EOD. Sensitivity and specificity as measured by the fully automated method were lower than those of semi-automated BSI with modification by radiologists. Therefore, semi-automated BSI is considered to have the possibility to substitute for EOD grading to predict the survival of prostate carcinoma patients with bone metastases, with only slight interobserver variation. [ABSTRACT FROM AUTHOR]

Minimum inhibitory concentration (MIC) creep in vancomycin has prompted guidelines that recommend a target trough concentration ( C) of 15-20 mg/L, and it is also considered necessary to set a C of >15 mg/L for teicoplanin (TEIC), especially in patients with complicated methicillin-resistant Staphylococcus aureus (MRSA) infections. The aim of this study was to investigate the appropriate TEIC regimen for reaching the revised target C (15-30 mg/L) in patients with normal renal function and those with renal dysfunction. We analyzed patients with MRSA infections who were treated with TEIC between July 2006 and December 2009. Two-day loading regimen was studied in patients with non-renal-dysfunction (group 1). The 1-day loading regimen was studied in patients with non-renal-dysfunction (group 2, control) and in patients with renal dysfunction (group 3). The 178 patients in the study consisted of 76, 28, and 74 patients in groups 1, 2, and 3, respectively. C on day 4 was 14.6 ± 5.6, 11.9 ± 4.1, and 13.5 ± 4.2 mg/L, and the proportion of patients achieving the revised target range was 34.2%, 17.9%, and 20.3%, respectively. Only one patient in group 1 revealed C of >30 mg/L. Treatment success rates, nephrotoxicity, and hepatotoxicity were similar among the three groups. It was difficult to achieve the revised target C with the 2-day loading regimen in patients without renal dysfunction and with the standard TEIC regimen, even in patients with renal dysfunction. Further investigation of an even higher TEIC dosing regimen is considered necessary. [ABSTRACT FROM AUTHOR]

Purpose: Patients with Crohn's disease (CD) often need home parenteral nutrition for short bowel syndrome (SBS), as a result of frequent surgery and extended bowel resections. We conducted this study to evaluate the influence of the patient's condition on the occurrence of SBS in CD. Methods: The subjects of this study were 721 patients, who underwent bowel resections for CD at Hyogo College of Medicine between September 1974 and September 2010. The collective total of bowel resection operations was 1286. The possible risk factors for SBS were analyzed by univariate and multivariate logistic regression analyses to determine their predictive significance. Results: SBS was diagnosed in 24 patients. A stepwise logistic regression model revealed that penetrating type (odds ratio 14.9, p = 0.02), remaining small intestine <200 cm (odds ratio 141.4, p < 0.01), ostomy creation (odds ratio 7.5, p = 0.03), and post-total colectomy (odds ratio 17.6, p < 0.01) were independent risk factors for SBS. Conclusion: These results indicate that the length of remaining small bowel is closely related to SBS in patients who have undergone surgery for CD. At least 200 cm of small bowel should be preserved to prevent SBS when total colectomy and ostomy creation are performed for CD. [ABSTRACT FROM AUTHOR]

Hindbrain (vagal) neural crest cells become relatively uniformly distributed along the embryonic intestine during the rostral to caudal colonization wave which forms the enteric nervous system (ENS). When vagal neural crest cells are labeled before migration in avian embryos by in ovo electroporation, the distribution of labeled neural crest cells in the ENS varies vastly. In some cases, the labeled neural crest cells appear evenly distributed and interspersed with unlabeled neural crest cells along the entire intestine. However, in most specimens, labeled cells occur in relatively discrete patches of varying position, area, and cell number. To determine reasons for these differences, we use a discrete cellular automata (CA) model incorporating the underlying cellular processes of neural crest cell movement and proliferation on a growing domain, representing the elongation of the intestine during development. We use multi-species CA agents corresponding to labeled and unlabeled neural crest cells. The spatial distributions of the CA agents are quantified in terms of an index. This investigation suggests that (i) the percentage of the initial neural crest cell population that is labeled and (ii) the ratio of cell proliferation to motility are the two key parameters producing the extreme differences in spatial distributions observed in avian embryos. [ABSTRACT FROM AUTHOR]

The major adverse event associated with linezolid treatment is thrombocytopenia. This study investigated risk factors associated with the development of thrombocytopenia in patients who received linezolid therapy. This was a retrospective study of patients treated with linezolid 600 mg q12h, by the oral or parenteral route, between July 2007 and June 2009. Thrombocytopenia was defined as a ≥10 × 10 cells/mm decrease from the baseline or a ≥30% reduction. Thirty-three variables were analyzed as risk factors associated with thrombocytopenia. Multivariate analysis was performed with SPSS version 16 software. This study included 331 patients (221 male, 58.0 ± 20.2 years). The mean duration of linezolid therapy was 10.5 ± 8.7 days. Thrombocytopenia occurred in 128 patients (38.7%), of whom 21 required platelet transfusion. Thrombocytopenia developed 7.4 ± 4.8 days after linezolid initiation, and the platelet count recovered 12.3 ± 7.8 days after withdrawal. In the final steps of stepwise logistic regression analysis, 5 variables were selected: duration of linezolid therapy ≥14 days [odds ratio (OR) 3.04, 95% confidence interval (CI) 1.73-5.34, P < 0.001], creatinine clearance <50 mL/min (OR 2.32, 95% CI 1.45-3.74, P < 0.001), chronic liver disorders (OR 1.63, 95% CI 0.92-2.86, P = 0.092), and respiratory tract infections (OR 1.75, 95% CI 1.05-2.91, P = 0.031). In contrast to findings with parenteral administration, oral administration of linezolid decreased the risk of thrombocytopenia (OR 0.38, 95% CI 0.15-0.97, P = 0.042). The time to the onset of thrombocytopenia in patients with creatinine clearance <50 mL/min was significantly shorter than that in patients with creatinine clearance ≥50 mL/min (6.7 ± 4.4 and 8.5 ± 5.2 days, P = 0.039), and in patients administered orally the time to the onset of thrombocytopenia was 10.4 ± 6.6 days. Several factors influenced the occurrence of linezolid-induced thrombocytopenia. Dose adjustment may be required in at-risk patients, especially those with renal dysfunction. [ABSTRACT FROM AUTHOR]

Recent studies demonstrated that mortality associated with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia was high when vancomycin was used to treat infections with strains that had a high vancomycin minimum inhibitory concentration (MIC). This study compared several characteristics of vancomycin MIC 2 μg/ml strains isolated from bacteremia with those isolated from infections other than bacteremia. A total of 128 episodes of MRSA bacteremia between 2005 and 2008 were followed-up, and compared with 631 MRSA infections other than bacteremia. The isolation of strains with a 2 μg/ml MIC accounted for 32.0% of isolates from MRSA bacteremia, whereas strains with a 2 μg/ml MIC comprised 9.0% of MRSA isolated from other sites ( p < 0.001). The incidence of pneumonia as the source of infection was significantly higher in patients with bacteremia from strains with a 2 μg/ml MIC than in those with ≤1 μg/ml MIC. Prior vancomycin use did not correlate with the isolation of 2 μg/ml strains. The efficacy of glycopeptides as 1st line therapy in patients infected with 2 μg/ml strains was significantly lower than that for patients infected with ≤1 μg/ml strains (30.0 vs. 78.8%, p < 0.001) in bacteremia. In the analysis of infections other than bacteremia, efficacy did not reveal a significant difference according to MIC (69.0 vs. 79.6%, p = 0.109). In bacteremia, mortality was 65.8% in patients with 2 μg/ml strains and 19.5% in patients with ≤1 μg/ml strains ( p < 0.001), whereas there was no significant difference in mortality from infections other than bacteremia (10.7 vs. 7.8%, p = 0.617). In multivariate analysis, bacteremia with 2 μg/ml strains, intensive care unit (ICU) stay, and liver cirrhosis were independent risk factors for death in patients with bacteremia, and initial appropriate therapy lowered the risk. Several characteristics such as a higher incidence than at other infection sites, a high incidence of pneumonia as a source of infection, a low success rate of vancomycin therapy, and poor prognosis were confirmed in 2 μg/ml MIC MRSA isolated from bacteremia; however, a low success rate of vancomycin and poor prognosis were not apparent in 2 μg/ml MIC MRSA strains isolated from infections other than bacteremia. [ABSTRACT FROM AUTHOR]

Background: Patients with functional dyspepsia frequently show delayed gastric emptying, and dietary advice is frequently given for its improvement. If meal temperature influences gastric emptying, advice regarding the meal temperature may become a possible component of dietary therapy. However, little information exists concerning the thermal effect of meals on gastric emptying. The aim of this study was to determine the thermal effect of liquid and solid meals on gastric emptying.Methods: The gastric emptying of liquid and solid test meals was examined in healthy volunteers (liquid, n = 25, mean age = 35.7 +/- 9.6 years, male-to-female ratio = 22:3; solid, n = 25, mean age = 35.2 +/- 8.8 years, male-to-female ratio = 20:5). Gastric emptying after the ingestion of liquid or solid meals at three different temperatures (4, 37, and 60 degrees C) was investigated with the [(13)C]-labeled acetate breath test. The lag phase time (T (max-calc)) and the half-emptying time (T (1/2)) were calculated from the (13)CO(2) breath excretion curve as indices of gastric emptying.Results: The values of T (max-calc) at 60 degrees C with both the liquid and solid meals were significantly smaller than those at 37 degrees C (P < 0.05). However, there was no difference in the T (1/2) values. In the analysis of the percent excretion of (13)CO(2) in 1 h (% dose/h) data with the liquid meal test in the earlier phase within 30 min, significantly larger values were found at 60 degrees C than at the other temperatures. These findings suggest that a hot meal significantly accelerates gastric emptying.Conclusions: Meal temperature may be considered as a component of dietary therapy for patients with functional dyspepsia. [ABSTRACT FROM AUTHOR]

Background: Barrett's esophagus is a well-known acquired condition resulting from gastroesophageal reflux disease (GERD). However, it is still unknown whether Barrett's esophagus develops gradually over time in patients with GERD. To address this issue, we investigated the change in the prevalence and length of short-segment Barrett's esophagus (SSBE) over time.Methods: From January 2005 to March 2007, we enrolled 5338 patients who received upper gastrointestinal endoscopy. Prevalence and length of endoscopically identified SSBE were evaluated within groups divided on the basis of 10-year age intervals. The factors possibly influencing SSBE length such as symptoms, antacid use, and endoscopic findings were also evaluated. Additionally, the length change in 236 patients with histologically confirmed Barrett's esophagus was evaluated over a 2-year follow-up.Results: Of the 5338 enrolled patients, 1997 had SSBE. The prevalence of endoscopically identified SSBE was significantly higher and its length was significantly longer in elderly patients. Multiple regression analysis showed that age, presence of reflux esophagitis, reflux symptoms, and hiatal hernia were positively correlated with SSBE length. Analysis of the 2-year follow-up study of histologically confirmed SSBE revealed significant extension of Barrett's length in 28.0% of 236 patients. Presence of reflux symptoms and hiatal hernia were identified as positive predictors and proton pump inhibitor administration as a negative predictor of SSBE elongation.Conclusions: Positive predictors for the extension of SSBE were presence of hiatal hernia and reflux symptoms, but not age. [ABSTRACT FROM AUTHOR]

A 52-year-old woman presented to our hospital with dysphagia. The initial endoscopic examination revealed plaques on the esophageal mucosa that were consistent with candidiasis, as well as narrowing of the distal one-third of the esophagus. After 7 days of administration of antimycotic drugs, endoscopy and esophagography showed multiple small saccular diverticula in the lower esophagus. Dysphagia continued despite resolution of candidiasis. Based on a diagnosis of esophageal intramural pseudodiverticulosis, we performed endoscopic balloon dilatation of the stenosis, which resulted in the disappearance of clinical symptoms. [ABSTRACT FROM AUTHOR]

We present a 72-year-old female patient with mucosal Barrett's cancer. Although preoperative diagnosis suggested tumor invasion throughout the mucosal layer, she was treated by endoscopic mucosal resection at her preference. The tumor invasion depth was “m-3.” However, tumor cells were observed along the endothelium of a small vein. Following endoscopic treatment, ultimately the patient underwent radical surgery. Neither residual tumor nor lymph node metastasis was found in the resected specimens. We also reviewed published reports regarding the relationship between tumor depth and vessel involvement in early-stage Barrett's cancer. In Barrett's cancer with a tumor invasion of m-3 where tumor had invaded throughout the mucosal layer, blood or lymphatic vessel invasion was observed in 12.5% of cases (6/48). However, no lymph node metastasis was found. Therefore, we considered that endoscopic mucosal ablation therapy may be applicable to treat intramucosal Barrett's cancer with a tumor invasion depth of m-3. [ABSTRACT FROM AUTHOR]

Restriction Landmark Genomic Scanning (RLGS) profiles, which are based on the concept of using restriction enzyme sites as landmarks and are generated by two-dimensional gel electrophoresis, were applied to the analysis of plant genomes. This study identified landmark enzymes in RLGS profiles of rice, tobacco, and arabidopsis, because the success of RLGS analysis depends on finding useful landmarks and these are the most frequently studied higher plants. As the results demonstrate, in each plant RLGS analysis various landmark enzymes were identified as useful landmark enzymes. However, the number of spots in a single profile was smaller than in mouse RLGS profiles and differed remarkably in the various plants. In addition, we demonstrate the optimal electrophoresis conditions and a convenient spot-cloning method. [ABSTRACT FROM AUTHOR]

During skin pigmentation in amniotes, melanin synthesized in the melanocyte is transferred to keratinocytes by a particle called the melanosome. Previous studies, mostly using dissociated cultured cells, have proposed several different models that explain how the melanosome transfer is achieved. Here, using a technique that labels the plasma membrane of melanocytes within a three-dimensional system that mimics natural tissues, we have visualized the plasma membrane of melanocytes with EGFP in chicken embryonic skin. Confocal time-lapse microscopy reveals that the melanosome transfer is mediated, at least in part, by vesicles produced by plasma membrane. Unexpectedly, the vesicle release is accompanied by the membrane blebbing of melanocytes. Blebs that have encapsulated a melanosome are pinched off to become vesicles, and these melanosome-containing vesicles are finally engulfed by neighboring keratinocytes. For both the membrane blebbing and vesicle release, Rho small GTPase is essential. We further show that the membrane vesicle-mediated melanosome transfer plays a significant role in the skin pigmentation. Given that the skin pigmentation in inter-feather spaces in chickens is similar to that in inter-hair spaces of humans, our findings should have important consequences in cosmetic medicine. [ABSTRACT FROM AUTHOR]

A correction to the article "Preferable timing of therapeutic drug monitoring in patients with impaired renal function treated with once-daily administration of vancomycin," by Yoshiko Takahashi and colleagues that was published online in April 10, 2013 issue is presented.

Inflammation is an essential physiological response to infection and injury that must be kept within strict bounds. The IL-10/STAT3 anti-inflammatory response (AIR) is indispensable for controlling the extent of inflammation, although the complete mechanisms downstream of STAT3 have not yet been elucidated. The AIR is widely known to extend to other myeloid cells, but it has best been characterized in macrophages. Here we set out to characterize the LPS-mediated pro-inflammatory response and the AIR across a range of myeloid cells. We found that whereas the LPS-induced pro-inflammatory response is broadly similar among macrophages, dendritic cells, neutrophils, mast cells and eosinophils, the AIR is drastically different across all myeloid cell types that respond to IL-10 (all bar eosinophils). We propose a model whereby the IL-10/STAT3 AIR works by selectively inhibiting specific pathways in distinct cell types: in macrophages the AIR most likely works through the inhibition of NF-κB target genes; in DCs and mast cells through indirect IRF disruption; and in neutrophils through IRF disruption and possibly also indirect NF-κB inhibition. In summary, no conserved IL-10/STAT3 AIR effectors were identified; instead a cell type-specific model of the AIR is proposed. [ABSTRACT FROM AUTHOR]