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The diagnosis of type 2 autoimmune pancreatitis (AIP) is dependent on typical radiologic imaging and the presence of the granulocytic epithelial lesion (GEL), which is characterized by ductal neutrophilic infiltration with or without neutrophilic acinar infiltration.We evaluated GEL and related clinicopathologic factors in 165 resected heterotopic pancreata (HPs) [57 gastric (35%), 56 duodenal (34%), 30 omental (18%), and 22 jejunal (13%)] and 29 matched orthotopic pancreata routinely examined during surgery.GEL was noted in 8% (13/165) of HPs, including ductal epithelial (6/13, 46%) and intraluminal (8/13, 62%) neutrophilic infiltrations. However, there was no GEL in orthotopic pancreata. Abdominal pain was observed in 6 (46%) patients with GEL-positive HPs. GEL was more commonly observed in HPs having symptoms (p = 0.029), a larger size (p = 0.028), and an infiltrative growth pattern (p = 0.006). In addition, periductal lymphoplasmacytic infiltration and fibrosis (both p 0.001), interstitial fibrosis (p = 0.017), acinar neutrophilic infiltration (p = 0.032), venulitis (p = 0.050), acinar ductal metaplasia (ADM; p = 0.040), and pancreatic intraepithelial neoplasia/intraductal papillary mucinous neoplasms (PanIN/IPMN; p 0.001) were more commonly seen in HPs with GEL than in those without GEL. Inflammatory bowel disease was present only in one patient with GEL-negative HP.GELs are detected in a subset of HPs without clinical evidence of AIP. Therefore, for the diagnosis of AIP, GEL should be carefully interpreted with the context of other histologic, clinical, and radiologic findings.

The T category of distal extrahepatic bile duct carcinoma (DBDC) is based on invasion depth from the basal lamina to the deepest infiltrating tumor cells. Recently, invasive tumor thickness (ITT) was proposed, defined as maximal vertical distance of invasive tumor components regardless of the basal lamina. We compared the predictive value of T category, and ITT grading in 424 surgically resected DBDCs. DBDCs were categorized as 6 Tis (1.4%), 134 T1 (5 mm; 31.6%), 204 T2 (5 to 12 mm; 48.1%), and 80 T3 (12 mm; 18.9%). With ITT, there were 6 G0 (no invasion; 1.4%), 3 G1 (1 mm; 0.7%), 90 G2 (≥1 and5 mm; 21.2%), 188 G3 (≥5 and10 mm; 44.4%), and 137 G4 (≥10 mm; 32.3%). The 5-year survival rates of T1, T2, and T3 were 58.9%, 44.2%, and 18.2%, and those of ITT G1, G2, G3, and G4 were 33.3%, 54.1%, 51.6%, and 26.7%, respectively. The T category discriminated patient survival by overall (P0.001) and pairwise (T1 vs. T2, P=0.007; T2 vs. T3, P0.001) comparisons. ITT grading distinguished survival by overall and between G3-G4 (both P0.001), with no survival differences observed between G1-G2 and G2-G3 comparisons. The T category more accurately discriminated patient survival than ITT grading. To determine the T category for DBDCs, (1) longitudinal sectioning on gross examination, especially for DBDCs with large papillary or nodular growth patterns; (2) evaluation of serial sections or alternative hematoxylin and eosin slides; (3) use of a straight or curved baseline depending on the shape of the peritumoral normal bile duct wall and/or the basal lamina of the peritumoral normal biliary epithelia/biliary intraepithelial neoplasias are recommended.

Indocyanine green (ICG) has been used in clinical practice for more than 40 years and its safety and preferential accumulation of ICG in tumors has been reported for various tumor types, including colon cancer. However, reports on the clinical assessments of ICG-based molecular endoscopy imaging for pre-cancerous lesions are scarce. Therefore, we determined the percent visualization ability of ICG endoscopy in colitis-associated colon cancer using 30 lesions from an animal model and 16 patient tissues. ICG could detect 100% of carcinoma, 90% adenoma, and 57.1% dysplasia, with little background signal at 30 min after injection via real-time fluorescence endoscopy. Correlation analysis of ICG fluorescence intensity and cancer specific molecules revealed a positive correlation of ICG with c-Met and iNOS (r > 0.5). A high level of iNOS expression increased the cellular nitric oxide in cancer cells than that in normal cells, which was related to the inhibition of drug efflux via ABCB1 transporter down regulation resulted to delayed retention of intracellular ICG. These findings highlight the feasibility of ICG as a detector of pre-cancerous lesions in real-time fluorescence endoscopy and suggest that the mechanism of ICG retention in cancer cells is related with intracellular nitric oxide concentration.

Antimicrobial resistance (AMR) represents a relentless, silent pandemic. Contributing to this are wastewater treatment plants (WWTPs), a potential source of antibiotic resistance genes' (ARGs) transmission to the environment, threatening public health. The presence of ARGs in pathogenic bacteria and their release into the environment by WWTPs threatens the public health. The current study investigated changes in ARGs' abundance in biological nutrient removal (BNR) processes and anaerobic digestion (AD) reactors of two WWTPs. Also, microbial community structure, which is known to shape the distribution and abundance of ARGs, was also analyzed. The relative abundance of eight ARGs (tetX, tetA, tetM, TEM, sul1, sul2, ermB and qnrD) was quantified as ARGs' copies/16 S rRNA gene copies using quantitative polymerase chain reaction (qPCR). Microbial community composition was assessed by 16 S rRNA microbiome sequencing analysis. TetX was prevalent among the eight ARGs, followed by TEM and sul1. However, its abundance was decreased in the AD sludges compared to BNR sludges. Proteobacteria was the major bacterial phylum found in all the sludge samples, while Arcobacter, 12up and Acidovorax were the predominant genera. Acinetobacter and Flavobacterium were significantly more abundant in the BNR sludges, while 12up and Aeromonas were predominant in AD sludges. Principal component analysis (PCA) revealed a clear difference in dominant ARGs and bacteria between the sludges in the processes of BNR and AD of the two WWTPs. Clinically relevant bacterial genera, Klebsiella and Enterococcus, found in both the BNR and AD sludges, were significantly correlated with the tetX gene. Throughout this study, the relationship between microbial communities and specific ARGs was revealed, illustrating that the composition of the microbial community could play a vital role in the abundance of ARGs. These results will better inform future studies aimed at controlling the spread of ARGs and their potential hosts from WWTPs.

[Purpose] Diabetic peripheral neuropathy can often lead to balance impairment. The spinal reflex is a mechanism that is reportedly important for balance, but it has not been investigated in diabetic peripheral neuropathy patients. Moreover, inhibitory or facilitatory behavior of the spinal reflex—known as presynaptic inhibition—is essential for controlling postural sway. The purpose of this study was to compare the differences in as presynaptic inhibition and balance in subjects with and without diabetic peripheral neuropathy to determine the influence of presynaptic inhibition on balance in diabetic peripheral neuropathy patients. [Subjects and Methods] Presynaptic inhibition and postural sway were tested in eight patients (mean age, 58±6 years) and eight normal subjects (mean age, 59±7 years). The mean percent difference in conditioned reflex amplitude relative to the unconditioned reflex amplitude was assessed to calculate as presynaptic inhibition. The single-leg balance index was measured using a computerized balance-measuring device. [Results] The diabetic peripheral neuropathy group showed lower presynaptic inhibition (47±30% vs. 75±22%) and decreased balance (0.65±0.24 vs. 0.38±0.06) as compared with the normal group. No significant correlation was found between as presynaptic inhibition and balance score (R=0.37). [Conclusion] Although the decreased as presynaptic inhibition observed in diabetic peripheral neuropathy patients may suggest central nervous system involvement, further research is necessary to explore the role of presynaptic inhibition in decreased balance in diabetic peripheral neuropathy patients.

BACKGROUMD: Alteration in scapular medial border displacement often observed as scapular winging, can affect the force couples of the rotator cuff muscles and thereby shoulder function. The relationship between scapular medial border displacement and shoulder internal and external rotator muscle function in the baseball player-throwing arm has not been studied. OBJECTIVE: The purpose of the study was to determine if any relationship exists between the amounts of scapular medial border displacement measured at rest and during the sitting hand press up test position and shoulder internal and external rotator muscular strength in Division III baseball players throwing arm. METHODS: A total of 51 Division III baseball players volunteered for the study. Scapular medial border displacement was measured with a standardized posterior scapular displacement measurement tool in two positions, the resting and the sitting hand press-up position. Isokinetic strength of concentric internal rotation (IR) and external rotation (ER) peak torque and time to peak torque for each subject were measured using 3 maximal testing repetitions at 60 ◦ /s. RESULTS: The results of the study showed a linear relationship between the amount of scapular medial border displacement and concentric IR strength and also in time to peak torque. However, no linear relationships were observed between scapular medial border displacement and other isokinetic strength variables. CONCLUSIONS: Scapular medial border displacement produced during a loaded state influences shoulder internal rotatory strength. This may bear on rehabilitation and strengthening exercises in terms of focusing on proper scapular position and subsequent muscular balance to optimize shoulder function.

Background: Musculoskeletal disorders are one of the most common chronic disorders and can develop from repetitive micro-traumas, which occurs often from one’s occupation. Work-related musculoskeletal disorders (WMSD) cost the United States billions of dollars annually. Many traditional therapeutic interventions, like manual therapy. electrical stimulation and hot and cold packs, are being utilized to treat WMSD however there is minimal evidence supporting the use of these interventions to treat WMSD. Therefore, ergonomic interventions (EI) has been proposed as a conservative, non-invasive, and cost-effective intervention to treat WMSD as it functions to correct the cause of repetitive micro-traumas due to one’s occupation by adjusting posture, workstations design, and product selection.Aim: The aim of this paper is to (a) briefly overview the theories of WMSD and EI (b) analyze the efficacy of traditional therapeutic interventions (c) establish the practical applications of EI (d) analyze the efficacy of EI, (e) discuss the contraindications of EI and (f) draw conclusions and discuss the future directions of EI in preventing WMSD.Results and Discussion: It was found that traditional therapeutic interventions provides only short-term pain relief for musculoskeletal disorders, prompting the need for a different approach. EI was found to have promising results in treating WMSD, however there is limited evidence in the form of randomizedcontrolled trials (RCTs) to truly determine the efficacy of EI in addressing WMSD. Further research is needed to determine the efficacy of EI and the long term effects of this intervention in treating WMSD.

Two new 2,5-diarylthiazolo[5,4-d]thiazole derivatives bearing ethylene oxide moieties were synthesized. Their photophysical and electrochemical properties as well as binding properties towards various metal ions were examined. Thiazole derivative 1 showed large fluorescent enhancements with Cr3+ and Al3+. On the other hand, thiazole derivative 2 displayed a selective fluorescent change with Cr3+ among the metal ions examined. As far as we are aware of, these are the first examples of thiazolothiazole derivatives as fluorescent chemosensors for metal ions.

A novel thiazolothiazole-based Cu(2+) colorimetric and fluorescent sensor is reported. A highly selective colorimetric change from yellow to dark green was observed among various metal ions after adding Cu(2+). Unique radical formation can engender these highly selective colorimetric and fluorescent changes.

A new fluorescein derivative 1 bearing a boronic acid group was investigated as a fluorescent chemosensor for F-. An off-on type fluorescence enhancement was observed by the blocking of the photoinduced electron transfer mechanism, which was induced by the interaction between fluoride and boronic acid moiety.