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Compact, light weight Hi-Vision recorders with low power consumption are very much desired. Our investigation of design concepts shows that a tape transport system with a small scanner, non-segmented format and high recording density would be suitable for reducing size, weight and power consumption.With respect to high recording density where a minimum recorded wavelength is less than 0.4, um, metal evaporated (ME) tapes with a high performance head have the potential to achieve such a short recorded wavelength. We have studied these tapes from the viewpoint of both magnetic recording characteristics and durability.Based on these studies, we have built an experimental Hi-Vision recorder. The diameter of the scanner in the transport system is 76 mm. This machine also has baseband bandwidth luminance of 20 MHz and baseband bandwidth chrominance of 7 MHz, a minimum recorded wavelength of 0.37 gm which is the shortest ever reported, and S/N luminance of 41 dB and S/N chrominance of 45 dB.

In the first report, an attemp was done to develop an expert system with the knowledge base that describes the relations among many components in the system for the sequential control of a marine diesel engine plant.The system was proved to work well in such a complicated operation.In the present report the idea of the knowledge base with hierarchical structure is introduced. Then, the present knowledge base contains two different parts.The first is a kind of common knowledge base that describes the input-output relations of every component included usually in these systems and the hierarchical procedure is employed in the descriptions. The second is used for connecting the knowledge base of the components into a system, being based on the database that describes the component connections in the individual engine plant.Therefore the knowledge base can be easily built up for an individual plant by writing only the database of the component connections.It is finally pointed out that the new knowledge base system can be constructed at ease and work successfully.

Infliximab has played a central role in the treatment of luminal Crohn's disease (CD) due to its great usefulness. Although the seton placement has been widely used for the treatment of anal fistula in patients with CD, we have used infliximab for severe cases in which improvement was not achievable by the seton placement, or for patients in whom improvement of quality of life (QOL) could be expected.The anal region of 383 patients with CD was examined during the period from July 1985 to December 2005 and the presence of a lesion in the anal region was confirmed in 326 patients. Among them, the number of cases with fistula was highest (245), followed by those with skin tags (115), those with fissures (106), those with anal tumefaction and enlarged papillae (61), and those with anal stenosis (56). The seton placement was used for 93 patients with anal fistula; of these, 86 patients received the treatment for one year or more. During the treatment, infliximab was used for 19 patients and their pathology and progress were evaluated.Infliximab was used for 11 severe cases in which improvement had not been achieved using the seton placement, and for 8 patients for improvement of their QOL. For evaluation, the patients who did not undergo additional treatment after infliximab administration were assigned to the good response group, those who underwent additional treatment other than surgical treatment to the intermediate response group and those who required surgical treatment to the poor response group. The good, intermediate and poor response groups included 8 (42.1%), 5 (26.3%) and 6 (31.6%) patients, respectively. A study of the relationship between the diagnostic indications of magnetic resonance imaging (MRI) and the course of disease showed that most of the patients with a localized inflammation of the anal fistula had better courses and most of the patients with diffuse inflammation had poor courses.Approximately 70% of the patients required no surgical treatment. In addition, it was considered important to appropriately select patients for infliximab treatment. MRI was useful as a examination to be performed before infliximab administration because it enabled close examination of the localization of anal fistula and the range of inflammation.

Michiaki Kubo and colleagues report results of a genome-wide association study of ulcerative colitis in the Japanese population. Their study identifies three new susceptibility loci for this common inflammatory bowel disease, including FCGR2A, which has previously been implicated in other autoimmune diseases. Ulcerative colitis is one of the principal forms of inflammatory bowel disease with complex manifestations. Although previous studies have indicated that there is a genetic contribution to the pathogenesis of ulcerative colitis, the genes influencing susceptibility to the disease have not been fully determined. To identify genetic factors conferring risk of ulcerative colitis, here we conducted a two-stage genome-wide association study and subsequent replication study using 1,384 Japanese individuals with ulcerative colitis and 3,057 control subjects. In addition to the expected strong association with the major histocompatibility complex (MHC) region, we identified three new susceptibility loci: the immunoglobulin receptor gene FCGR2A (rs1801274, P = 1.56 × 10−12), a locus on chromosome 13q12 (rs17085007, P = 6.64 × 10−8) and the glycoprotein gene SLC26A3 (rs2108225, P = 9.50 × 10−8). rs1801274 is a nonsynonymous SNP of FCGR2A that is reported to have a critical effect on receptor binding affinity for IgG and to be associated with other autoimmune diseases. Our findings provide insight into the molecular pathogenesis of ulcerative colitis.

We review the clinical application of magnification endoscopy with white light imaging and narrow-band imaging in the stomach. Basically, the microvascular architecture is visualized by magnification endoscopy with white light imaging; in addition, the microsurface structure can be visualized by magnification, endoscopy. The basic principles for the analysis of magnification endoscopy are that we should describe the magnification endoscopy findings independently based on the two distinct microanatomies, that is, the microvascular architecture (V) and the microsurface structure (S). Then, we should integrate these two findings into various categories to enable a correct diagnosis of gastrointestinal pathology. Based on these principles, for the new diagnostic system produced by magnification endoscopy and narrowband imaging, we propose a simple classification system for making a correct diagnosis between cancerous and noncancerous pathology. The criterion for cancerous pathology is the presence of either an irregular microvascular pattern or an irregular microsurface pattern. Such a simple classification system is mandatory for the establishment of a scientific diagnostic system, which can be successfully utilized by all endoscopists.

We describe three cases of adult T-cell leukemia/lymphoma (ATL) with malignant cell infiltration into the stomach. Case 1, a 63-year-old man, had a large ulcerative lesion on the lesser curvature of the upper stomach. Case 2, a 44-year-old man, had an irregular depressed lesion simulating a IIc-type early gastric cancer on the posterior wall of the mid portion of the stomach. Case 3, a 58-year-old man, had multiple irregular depressed lesions on the lesser curvature of the lower part of the stomach. In all cases, histologic examinations of the biopsy specimens confirmed ATL-cell infiltration into the stomach. In cases 1 and 2, repeated roentgenographic and endoscopic examinations revealed the characteristic changes of the gastric lesions over the course of time.

Investigation was made on the effect of postharvest application of ethanol and ethylene on softening, respiration, activities of pectinmethylesterase and polygalacturonase, and changes in the total pectic substances and water-soluble pectin in banana during ripening. Peel color development, total soluble solids (as an estimate of total sugar) and acidity were also monitored.Ethanol hastened ripening of bananas but was less effective than ethylene. The respiratory peak of ethylene-, ethanol-treated and control fruits was observed after 4, 8 and 11 days of storage. The fruits were edible ripe at or shortly after CO2 peak and the firmness at this time was comparable to the control. As the fruits softened, polygalacturonase activity increased, total pectic substances decreased and the water-soluble pectin increased. Polygalacturonase activity was low in the pre-climacteric stage, increased during the climacteric and reached a level of 17 to 18 times the initial in post-climacteric phase. The control was slow to ripen and its polygalacturonase activity was always lower than in treated fruits. The activity of pectinmethylesterase was not readily related to the decrease in firmness. The total soluble solids increased to 20-22% during ripening and the increase was most rapid in ethylene-treated fruits and slowest in the control. Acidity in all samples increased slightly during ripening.

上肢の骨形成不全に先天性心疾患を合併するHolt-Oram症候群に脳塞栓症を併発した稀な一症例を経験した.症例は54歳, 右利き, 男性.生下時より左上肢の奇形を除けば正常発育であったが, 20歳時に初めて心房中隔欠損症 (ASD), 動脈管開存症 (PDA) を指摘され, PDAの切離術を受けた.38歳時にASDの閉鎖術, 45歳時には心房細動並びに徐脈発作のためにペースメーカー挿入術を施行された.平成元年4月10日, 正午ごろ, 電話中に突然意識障害, 左片麻痺が出現し入院となった.頭部CTスキャンでは右前頭葉から右側頭葉に低吸収域を認め, 一部に高吸収域の部分も認められた.心電図上は心房細動, ペースメーカー調律を呈していた.心エコーでは左房内に明らかな血栓は認められなかったが, 臨床経過ならびに梗塞巣の部位等より脳梗塞症と診断した.塞栓源として, ASD, PDAの術後であること, 心房細動, ディマンド型のペースメーカーの失調に起因した血栓形成の関与が強く示唆された.

Ripening of banana was accelerated by 2-3 days with application of 60% ethanol (10ml/12 fruits). However, 1000ppm ethylene induced more rapid ripening changes: in peel color, sugars and organic acid contents. Sucrose, glucose and fructose were identified by high performance liquid chromatography (HPLC). All the three sugars increased with ripening and sucrose was predominant at all stages of ripeness. The increase in sucrose preceded that of glucose and fructose and the ratio of glucose-frucose was almost constant during the course of ripening, that is, from initial (green) until 9 or 14 days of storage. Malic and citric acids were present in almost equal amounts in green fruits (initial). Malic acid increased 2 to 3.6 times the initial level, becoming the predominant acid in ripe fruits. Citric acid increased only in overripe and senescent fruits.

Summary Background Terminal restriction fragment length polymorphism (T-RFLP) analyses are powerful tools to assess the diversity of complex microbiota. T-RFLPs permit rapid comparisons of microbiota from many samples. Aim To perform T-RFLP analyses of faecal microbiota in Crohn’s disease (CD) patients to investigate potential alterations in faecal microbial communities and furthermore to analyse the effects of elemental diet on faecal microbiota profiles. Methods Thirty-four patients with CD and 30 healthy individuals were enrolled in the study. DNA was extracted from stool samples and 16S rRNA genes were amplified by PCR. PCR products were digested with BslI restriction enzymes and T-RF lengths were determined. Results Faecal microbial communities were classified into seven clusters. Almost all healthy individuals (28/30) were included in cluster I, II and III, but the majority of CD patients (25/34) could be divided into another four clusters (cluster IV–VII). Prediction of bacteria based on the BslI-digested T-RFLP database showed a significant decrease in Clostridium cluster IV, Clostridium cluster XI and subcluster XIVa in CD patients. In contrast, Bacteroides significantly increased in CD patients. Significant increases in Enterobacteriales were also observed in CD patients. Furthermore, elemental diets modulated faecal bacterial communities in CD patients. Conclusions Terminal restriction fragment length polymorphism analyses showed that the diversity of faecal microbiota in patients with CD differed from that of healthy individuals. Furthermore, elemental diets modulated faecal microbiota composition, and this effect may be involved in mechanisms of clinical effects of elemental diet.

Background The early diagnosis of small-bowel tumors (SBT) was a difficult task until the advent of capsule endoscopy (CE) and double-balloon endoscopy (DBE) allowed access to the disease site. However, although CE and DBE have greatly simplified the task, DBE studies have yet to provide sufficient data on the diagnosis and outcome of patients with SBTs. Objective To determine the efficacy of DBE examination in the detection and diagnosis of SBT. Design A retrospective analysis of cross-sectional case series. Setting Seven major medical centers in Japan. Patients The first 1035 consecutive DBE cases at these major Japanese centers since the introduction of DBE. Main Outcome Measurements The percentage of subjects with SBT and a diagnosis of SBT, their indications for DBE, and diagnostic and therapeutic DBE procedures carried out for SBT. Results SBTs were identified in 144 of 1035 subjects (13.9%) who underwent DBE between September 2000 and December 2005. For subjects with SBT, the most common indication for DBE was the suspected presence of a SBT (61/144 [42.4%]). For subjects without SBT, the most common indication was obscure GI bleeding (OGIB) (419/891 [47.0%]). Malignant lymphoma and GI stromal tumor (GIST) were the most frequent (31/144 [21.5%]) and the second-most frequent SBTs (27/144 [18.8%]), respectively, in this database. We also performed 85 biopsies and 45 therapeutic procedures for the evaluation and treatment of SBTs in 144 patients. Although complications were encountered in 5.3% of cases (14/266 sessions), none of these were life threatening in the present study. Conclusion DBE proved a valuable tool for the detection and diagnosis of SBTs, especially when tumors were suspected. Biopsies and therapeutic procedures were also possible in most of these patients, which directed our management of the disease.

Background and Aim: No reports on the relative risk of development of colorectal cancer (CRC) in Japanese patients with Crohn's disease (CD) have been published. The present study aimed to investigate the relative risk and the clinical features of CRC complicating CD among patients managed at Fukuoka University Chikushi Hospital, Fukuoka, Japan (a tertiary referral center for inflammatory bowel diseases). Methods: The clinical backgrounds were analyzed of 512 patients with CD who have been treated by our department during the last 20-year period (1985–2005) (total 6212.6 person years at risk). The standardized incidence ratio (SIR) refers to the relative risk of CRC in the subjects as compared with that in a sex- and age-matched healthy population. Results: There were six cases with CRC. The SIR was significantly higher (3.2-fold higher; 95% confidence interval, 1.2–6.9 P

This article introduces one of the most advanced endoscopy imaging techniques, magnification endoscopy with narrow-band imaging. This technique can clearly visualize the microvascular (MV) architecture and microsurface (MS) structure. The application of this technique is quite useful for characterizing the mucosal neoplasia in the hypopharynx, oropharynx, esophagus, and stomach. The key characteristic findings for early carcinomatous lesions are an irregular MV pattern or irregular MS pattern as visualized by this technique. Such a diagnostic system could be applied to the early detection of mucosal neoplasia throughout the upper gastrointestinal tract.

Both Crohn's disease and intestinal tuberculosis often have small bowel lesions. Morphological findings are very important for correct diagnosis of these disease. In this manuscript, we described their characteristics of morphological findings including new modality. And as for the treatment of Crohn's disease, we mainly mentioned about new medical treatments such as anti-TNFalpha antibody.

With the development of double balloon endoscopy and video-capsule endoscopy, it has become inevitable for gastroenterologist to diagnose small intestinal ulcers accurately. Chronic nonspecific multiple ulcers of the small intestine (CNSU) and nonsteroidal antiinflammatory drugs-induced enteropathy (NSAIDs-enteropathy) share common clinicopathologic features characterized by histologically nonspecific ulcers and persistent blood loss. In addition, the two disorders had common enteroscopic findings, namely, circular ulcers and concentric stenoses. However, CNSU is distinctive of NSAIDs-enteropathy with respect to intractable ulcers of various configurations. In consideration of widespread use of NSAIDs, a strategy for the prevention of NSAIDs-enteropathy should be examined. Also, much more cases of CNSU should be analyzed to establish the pathophysiology of the disease.

AIM: To classify changes over time in causes of lower gastrointestinal bleeding (LGIB) and to identify factors associated with changes in the incidence and characteristics of diverticular hemorrhage (DH). METHODS: A total of 1803 patients underwent colonoscopy for overt LGIB at our hospital from 1995 to 2013. Patients were divided into an early group (EG, 1995-2006, n = 828) and a late group (LG, 2007-2013, n = 975), and specific diseases were compared between groups. In addition, antithrombotic drug (ATD) use and nonsteroidal anti-inflammatory drug (NSAID) use were compared between patients with and without DH. RESULTS: Older patients (≥ 70 years old) and those with colonic DH were more frequent in LG than in EG (P < 0.01). Patients using ATDs as well as NSAIDs, male sex, obesity (body mass index ≥ 25 kg/m2), smoking, alcohol drinking, and arteriosclerotic diseases were more frequent in patients with DH than in those without. CONCLUSION: Incidence of colonic DH seems to increase with aging of the population, and factors involved include use of ATDs and NSAIDs, male sex, obesity, smoking, alcohol drinking, and arteriosclerotic disease. These factors are of value in handling DH patients.

Background/Aims Anti-tumor necrosis factor drugs (anti-TNF) and thiopurines are important treatment options in patients with inflammatory bowel disease (IBD), including during pregnancy. However, there are limited data on the benefit/risk profile of anti-TNF and thiopurines during pregnancy in Asia. The aim of this study was to analyze pregnancy outcomes of female Japanese IBD patients treated with anti-TNF and/or thiopurines. Methods This cross-sectional study assessed pregnancy outcomes in 72 women with IBD. Pregnancy outcomes were compared among 31 pregnancies without exposure to infliximab (IFX), adalimumab (ADA), or thiopurines; 24 pregnancies with exposure to anti-TNF treatment (23 IFX, 1 ADA); 7 pregnancies with exposure to thiopurines alone; and 10 pregnancies with exposure to both IFX and thiopurines. Results Thirty-five of the 41 pregnancies (85.3%) that were exposed to anti-TNF treatment and/or thiopurines resulted in live births after a median gestational period of 38 weeks. Of the 35 live births, 3 involved premature deliveries; 7, low birth weight; and 1, a congenital abnormality. There were 6 spontaneous abortions in pregnancies that were exposed to anti-TNF treatment (17.7%). Pregnancy outcomes among the 4 groups were similar, except for the rate of spontaneous abortions (P =0.037). Conclusions Exposure to anti-TNF treatment or thiopurines during pregnancy was not related to a higher incidence of adverse pregnancy outcomes in Japanese IBD patients except for spontaneous abortion.

In order to determine barium meal radiographic findings characteristic of amyloidosis, we measured the jejunal diameter, valvular width, and intervalvular distance in 25 patients with small bowel amyloidosis and in 30 control individuals, and compared the two groups with each other. As a result, jejunal diameter demonstrated no difference between amyloidosis cases and controls, while there was a significant difference in valvular width or intervalvular distance between the two groups. Our results indicate that objective estimates of the thickening of the valvulae and the shortening of the intervalvular distance by means of measurements of the given roentgenograms greatly contribute to the clinical diagnosis of this disease.

Radiological findings of 2 patients with immunoproliferative small intestinal disease were studied. One of the cases was associated with alpha-chain disease. Both patients complained of severe diarrhea, and diagnosis was made by endoscopic biopsy of the duodenum and jejunum. Double-contrast studies of the small intestine and hypotonic duodenographies in these patients revealed thickened folds and innumerable fine granular elevations without ulcerations or luminal narrowings. Double-contrast studies are one of the most important examinations in the diagnosis of this disorder.

The endoscopic findings in the colon and terminal ileum in eight cases of Yersinia enterocolitica enterocolitis infection were studied. The diagnosis was based on the isolation of Y. enterocolitica in the feces and/or elevated serum antibody titers to the organism. Total colonoscopy was performed between 7 and 38 days (mean, 24 days) after the onset of symptoms. In all patients, the terminal ileum was affected, followed by frequent involvement of the ileocecal valve and the cecum, and less frequently, the ascending colon. In the terminal ileum, round or oval elevations with or without ulcers were detected. Small ulcers were detected on the ileocecal valve and in the cecum. These findings were observed even 4 to 5 weeks after the onset of symptoms, suggesting a relatively long course for this disease.

Since it is difficult to judge maturity of kiwifruit by appearance, growers measure the soluble solids (S.S.) content using a refractometer. In order to find a suitable harvest index other than S.S. and firmness, starch content, total pectin (TP) and water soluble pectin (WSP) contents, β-amylase and polygalacturonase (PG) activities of kiwifruit were investigated. The S.S. content, measured with a refractometer, and firmness of kiwifruit stored at room temperature (20°C), with or without ethylene treatment were compared. Kiwifruit treated with ethylene after harvest showed more uniform firmness and S.S. content than those without ethylene treatment. β-Amylase and PG activities, TP and WSP contents could not be used as alternative harvest and shipment indices for kiwifruit owing to fluctuation in their values. The use of S.S. content as a maturity index appeared to be applicable in 'Hayward' but not in the early-ripening cv. Koryoku. If 'Koryoku' were to be harvested based on the optimum S.S. content, the fruit would have to be shipped within 2 days after ethylene treatment to maintain suitable firmness. In 'Koryoku', the period of highest starch content is a better maturity index than S.S. content. Harvesting at the suitable period would ensure longer storage and maintenance of firmness and sweetness.

This paper describes the seasonal changes in starch content of kiwifruit in relation to starch synthetase activity and also examines the properties of this enzyme in the two cultivars, "Hayward" and "Koryoku". The highest activity of starch synthetase was observed in the middle of October for "Koryoku" and in late October for "Hayward". The highest starch contents in "Koryoku" and "Hayward" were observed in the middle and late October or early November, respectively. These increases in starch coincided with the highest activities of starch synthetase. Starch content in early-ripening 'Koryoku' peaked around half a month earlier than in late-ripening "Hayward". Since the soluble solids content in "Koryoku" could not be used as a harvest index because suitable firmness was not kept, the highest starch content was selected as the index in a previous paper. Starch synthetase activity followed the pattern of increasing starch content during the maturation and could explain maturity. Starch synthetase activity is a better index of maturity than β-amylase activity, because it supports decreasing starch content during the harvest period of "Koryoku".

Endoscopic and biopsy findings of the esophagus, stomach, duodenum, and colorectum were studied in 37 patients with amyloidosis involving the gastrointestinal tract. Endoscopic examinations revealed fine granular appearance, polypoid protrusions, erosions, ulcerations, and mucosal friability in many cases. These findings were most marked and noticed most often in the second portion of the duodenum. The frequency of amyloid deposition in the biopsy specimens was as follows; 100% in the duodenum, 95% in the stomach, 91% in the colorectum, and 72% in the esophagus. The degree of amyloid deposition in the duodenum, which was the highest of the entire gastrointestinal tract, significantly correlated with the frequency of endoscopic findings such as fine granular appearance and polypoid protrusions. Therefore, the two endoscopic findings described above are characteristic of this disease and may reflect amyloid deposition in the mucosa or submucosa of the alimentary tract. Our results indicate that for a diagnosis of amyloidosis, it is important to examine the upper gastrointestinal tract, especially the duodenum, using endoscopy and biopsy techniques.

This paper describes the changes in phosphorylase and invertase activities during ripening of bananas subjected to ethanol and ethylene treatments.Starch content in the banana pulp decreased from about 20% at the green stage to less than 1% at the fully ripe stage while total sugar increased to 20%. At the same stage of ripeness, the starch and sugar contents, and enzyme ativities of ethanol- and ethylenetreated fruits were comparable to that of the control.Phosphorylase activity increased during the period of rapid starch breakdown(peel color index 2) and declined at the later stages of ripening, concurrent to the decrease in starch content. On the other hand, invertase activity was very low at the green stage but increased sharply at peel color index 3 (more green than yellow)concomitant to the increase in sucrose.

A 57-year-old man was admitted to our hospital because of low-grade fever and pain in the right hypochondrium. Abdominal ultrasonographic (US) examination revealed a hyperechoic mass in the body of the gallbladder. The wall of the gallbladder towards the fundus was markedly thickened, while the wall near the gallbladder neck showed no abnormality. Power Doppler and contrast-enhanced CT of the abdomen revealed absence of blood flow in the fundic wall of the gallbladder, however, a contrast-enhanced image of the entire wall was obtained by contrast US, although the blood flow to the fundus was decreased. Torsion of the gallbladder was diagnosed and laparoscopic cholecystectomy was performed. The gallbladder was found to be a wandering gallbladder, Gross I type, and slight counterclockwise torsion was found at the neck of the gallbladder. We report a case of partial torsion of the gallbladder neck, in which the details of the ischemic hemodynamic changes could be observed by contrast-enhanced US.

Insulin resistance is often associated with obesity and can precipitate type 2 diabetes. To date, most known approaches that improve insulin resistance must be preceded by the amelioration of obesity and hepatosteatosis. Here, we show that this provision is not mandatory; insulin resistance and hyperglycemia are improved by the modification of hepatic fatty acid composition, even in the presence of persistent obesity and hepatosteatosis. Mice deficient for Elovl6, the gene encoding the elongase that catalyzes the conversion of palmitate to stearate, were generated and shown to become obese and develop hepatosteatosis when fed a high-fat diet or mated to leptin-deficient ob/ob mice. However, they showed marked protection from hyperinsulinemia, hyperglycemia and hyperleptinemia. Amelioration of insulin resistance was associated with restoration of hepatic insulin receptor substrate-2 and suppression of hepatic protein kinase C epsilon activity resulting in restoration of Akt phosphorylation. Collectively, these data show that hepatic fatty acid composition is a new determinant for insulin sensitivity that acts independently of cellular energy balance and stress. Inhibition of this elongase could be a new therapeutic approach for ameliorating insulin resistance, diabetes and cardiovascular risks, even in the presence of a continuing state of obesity.

We report on the effect of oxygen deficiency on the structural and magnetic properties of Ba(Co1−xMnx)O3 (x = 0.10–0.20) ceramics, as characterized by synchrotron X-ray spectroscopy. Different amounts of oxygen deficiency were introduced by an annealing process under vacuum. The stoichiometry of the oxygen ions in the ceramic samples gradually decreased from an ABO3-perovskite type to an ABO2 type with increasing annealing temperature. Saturation magnetization decreased with increasing annealing temperature irrespective of the amount of Mn substitution, and the magnetic properties for the x = 0.10–0.20 samples changed from ferromagnetic to paramagnetic. According to the X-ray photoelectron spectroscopy (XPS) using synchrotron X-ray radiation and X-ray absorption near-edge structure (XANES) spectroscopy measurements for the x = 0.10 samples, the valence states of the Co and Mn ions gradually changed from tetravalent to trivalent to divalent with increasing annealing temperatures. The transient states of the structural and magnetic properties owing to the induced oxygen deficiency could be observed by synchrotron X-ray spectroscopy.

Ferromagnetic layered structure has been made at sub-surface of the antiferromagnetic FeRh bulk samples by high energy He ion beam irradiation. In accordance with the Transport of Ions in Matter simulation, such ion beam can effectively deposit the elastic collision energy in several μm regions in the depth from the surface. Measurement with a superconducting quantum interference device reveals the irradiated samples to be ferromagnetic. Assuming that only the part the energy deposited can be modified to be ferromagnetic, the corresponding irradiation induced magnetization is consistent with the data that we previously reported. On the other hand, the X-ray magnetic circular dichroism (XMCD) spectra for the irradiated samples are totally unchanged as those for the unirradiated samples. Since XMCD signal in total emission yield method is considered to be surface sensitive with a typical probing depth of several nm, the surface magnetic state is maintained to be antiferromagnetic. By utilizing these phenomena, three-dimensional magnetic patterning of FeRh can be realized, which may potentially be used for future magnetic exchange device application such as nano-scale sensors and memories.

Background The source of small-bowel stricture is often difficult to diagnose due to the difficulty of placing an endoscope into the small bowel. It has recently become possible to examine the entire small bowel and perform balloon dilatation for stricture by means of double balloon endoscopy (DBE). Objective To identify clinical features of small-bowel stricture and determine the validity of balloon dilatation as a treatment option. Design Retrospective multicenter study. Setting Researchers at 7 institutions affiliated with the DBE Working Group. Patients One hundred seventy-nine patients with stricture among a total of 1035 patients who underwent DBE at the 7 institutions. Interventions Surgical treatment or balloon dilatation was performed as clinically indicated. Main Outcome Measurements Ability to detect stricture lesions by DBE, types of lesions, locations of small-bowel strictures, details of strictures, treatments for strictures, and outcomes of balloon dilatation for strictures associated with inflammatory disease. Results The total number of patients with strictures was 179. Lesions were detected within the small bowel in 156 patients. Inflammatory disease was the most common (n = 87) in patients with small-bowel stricture, and the ileum was the most common site of the inflammatory disease. Crohn's disease was the most common of the inflammatory diseases (n = 57). Balloon dilatations were performed in 31 patients with inflammatory disease, and long-term success was achieved in 22 patients. Limitations The number of patients treated by balloon dilatation was small. Conclusion DBE appears to be useful for the detection as well as treatment of small-bowel lesions.

Background and Aim: Clinicians encounter difficulties distinguishing enterocutaneous fistulae from postoperative suture abscesses solely by diagnostic imaging in patients with Crohn’s disease. The aim of this study was to examine whether use of intraintestinal administration of indocyanine green (ICG) could differentiate the conditions. Methods: Twenty-four patients with Crohn’s disease and a possible enterocutaneous fistula at the abdominal wall based on manifestations of pus drainage and exudate were enrolled. A positive test was defined by macroscopic confirmation of staining by ICG dye, which had been administered orally, on the gauze dressing applied to the lesion site. Results: Positive responses occurred in 16 of the 24 patients. In 13 of the 16 positive patients, a fistulous communication between the lesion and the gastrointestinal tract was documented by either surgery or X-ray examination. In the remaining three, fistulae were completely closed after administration of infliximab. The positive predictive value of the oral ICG test was 16/16 (100%). Six of the eight negative oral ICG test patients (75%) had subcutaneous (silk-suture) abscesses that were easily closed following fistulotomy. The other two patients had fistulas confirmed either by surgery or fistulography, indicating a false negative response from the oral ICG test. The negative predictive value of the oral ICG test was 6/8 (75%); thus, the ability of the oral ICG test to correctly diagnose was 22/24 (92%). Conclusions: This oral ICG test offers a suitable methodology for those patients possessing an occult fistulous lesion at an early stage, and where a differential diagnosis is difficult using diagnostic imaging.

It has been reported that the administration of ulinastatin, gabexate mesylate, or somatostatin may be effective in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. However, few randomized trials of ulinastatin and gabexate mesylate for the prevention of post-ERCP pancreatitis have been reported. The aim of this study was to compare the efficacy of ulinastatin and gabexate mesylate for the prevention of post-ERCP pancreatitis. Sixty-eight patients who underwent diagnostic ERCP at our hospital were divided at random by computer-generated randomization into an ulinastatin group (n = 34) and a gabexate group (n = 34). Each patient received a continuous intravenous infusion of ulinastatin (150 000 units) or gabexate mesylate (600 mg), beginning 60–90 min before the ERCP and continuing until 22 h after the ERCP. The primary endpoint was the incidence of post-ERCP pancreatitis, and the secondary endpoints were the incidences of hyperenzymemia and pain. The overall incidence of post-ERCP pancreatitis was 2.9% (two patients), comprising one patient in the ulinastatin group and one patient in the gabexate group (2.9% vs 2.9%, respectively). Neither of these two patients developed severe pancreatitis. There were no significant differences in the serum levels of pancreatic enzymes or in the levels of pain between the two groups. There was no clinical difference between the effect of preventive administration of ulinastatin and that of gabexate mesylate on the incidence of post-ERCP pancreatitis. Ulinastatin may be equivalent in efficacy to gabexate for reducing the incidence of post-ERCP pancreatitis.

We encountered 4 cases of hepatic peribiliary cysts (HPBC) in our hospital. Two were asymptomatic, one was complicated by a choledocholithiasis, and one by cholangitis and sepsis. Based on a review of the 38 cases of HPBC clinically diagnosed in Japan, the main problem associated with this disease seemed incorrect preoperative diagnosis leading to an unnecessary hepatectomy. Another problem was concomitant cholangitis, which tended to recur and in some cases needed aggressive treatment using drainage.

We report a case of severe ulcerative colitis complicated with primary diabetes mellitus that was effectively treated with oral tacrolimus. A 36-year-old man suffered his first attack of ulcerative colitis. Because it was difficult to control the patient's diabetes, we instituted tacrolimus and azathioprine without a corticosteroid regimen as the initial treatment. Within two weeks, the ulcerative colitis activity went into remission and the patient's diabetes did not worsen.