RESUMEN
Genebanks provide access to diverse materials for crop improvement. To utilize and evaluate them effectively, core collections, such as the World Rice Core Collection (WRC) in the Genebank at the National Agriculture and Food Research Organization, have been developed. Because the WRC consists of 69 accessions with a high degree of genetic diversity, it has been used for >300 projects. To allow deeper investigation of existing WRC data and to further promote research using Genebank rice accessions, we performed whole-genome resequencing of these 69 accessions, examining their sequence variation by mapping against the Oryza sativa ssp. japonica Nipponbare genome. We obtained a total of 2,805,329 single nucleotide polymorphisms (SNPs) and 357,639 insertion-deletions. Based on the principal component analysis and population structure analysis of these data, the WRC can be classified into three major groups. We applied TASUKE, a multiple genome browser to visualize the different WRC genome sequences, and classified haplotype groups of genes affecting seed characteristics and heading date. TASUKE thus provides access to WRC genotypes as a tool for reverse genetics. We examined the suitability of the compact WRC population for genome-wide association studies (GWASs). Heading date, affected by a large number of quantitative trait loci (QTLs), was not associated with known genes, but several seed-related phenotypes were associated with known genes. Thus, for QTLs of strong effect, the compact WRC performed well in GWAS. This information enables us to understand genetic diversity in 37,000 rice accessions maintained in the Genebank and to find genes associated with different phenotypes. The sequence data have been deposited in DNA Data Bank of Japan Sequence Read Archive (DRA) (Supplementary Table S1).
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Variación Genética , Genoma de Planta , Estudio de Asociación del Genoma Completo , Oryza/genética , Secuenciación Completa del Genoma , Ecotipo , Flores/genética , Genes de Plantas , Haplotipos/genética , Mutación/genética , Fenotipo , Filogenia , Análisis de Componente Principal , Carácter Cuantitativo HeredableRESUMEN
BACKGROUND: Postinfarction ventricular septal rupture (VSR) is a lethal complication with high mortality. The aim of this study was to evaluate our surgical strategy and results of VSR. PATIENTS AND METHODS: Between 1996 and 2008, 13 consecutive patients underwent operation for VSR at our hospital. All patients required emergent operation because of severe cardiogenic shock. Surgical procedure consisted of endocardial patch repair with infarct exclusion, so called "Komeda-David operation". In patients with multiple coronary artery disease, myocardial revascularization was done simultaneously. RESULTS: These patients were divided into 2 groups according to the location of VSR. There were 9 patients of anterior VSR. Two of them could not be weaned from cardiopulmonary bypass and died of severe low output syndrome (LOS) at early postoperative period. The site of infarction in both patients was broad anteroseptal region including right ventricle. On the other hand, there were 4 patients of inferior VSP. Two of these patients were lost due to LOS. One patient was complicated with left ventricular free wall rupture. In another patient, infarction was extended proximally toward the mitral annulus and papillary muscles. Both cardiopulmonary bypass time and aortic crossclamp time were significantly longer in inferior VSR than in anterior region. There was no late death in 2 groups. CONCLUSIONS: Despite improvements of surgical procedures, such as infarct exclusion technique, the operative mortality remains high in cases with broad infarction and/or right ventricular infarction. In these particular circumstances, in should be mandatory to consider the optimal timing of operation and the modification of surgical technique itself.
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Rotura Cardíaca Posinfarto/cirugía , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Resultado del Tratamiento , Rotura Septal Ventricular/cirugíaRESUMEN
Sivelestat sodium hydrate (Ono Pharmaceutical Co., Osaka, Japan) is a selective inhibitor of neutrophil elastase (NE) and is effective in reducing acute lung injury associated with systemic inflammatory response syndrome (SIRS). We conducted a prospective randomized controlled study to investigate the efficacy of perioperative administration of sivelestat sodium hydrate to prevent postoperative acute lung injury in patients undergoing thoracoscopic esophagectomy and radical lymphadenectomy. Twenty-two patients with thoracic esophageal cancer underwent video-assisted thoracoscopic esophagectomy with extended lymph node dissection in our institution between April 2007 and November 2008. Using a double-blinded method, these patients were randomly assigned to one of two groups preoperatively. The active treatment group received sivelestat sodium hydrate intravenously for 72 hours starting at the beginning of surgery (sivelestat-treated group; n= 11), while the other group received saline (control group; n= 11). All patients were given methylprednisolone immediately before surgery. Postoperative clinical course was compared between the two groups. Two patients (one in each group) were discontinued from the study during the postoperative period because of surgery-related complications. Of the remaining 20 patients, 2 patients who developed pneumonia within a week after surgery were excluded from some laboratory analyses, so data from 18 patients (9 patients in each group) were analyzed based on the arterial oxygen pressure/fraction of inspired oxygen ratio, white blood cell count, serum C-reactive protein level, plasma cytokine levels, plasma NE level, and markers of alveolar type II epithelial cells. In the current study, the incidence of postoperative morbidity did not differ between the two groups. The median duration of SIRS in the sivelestat-treated group was significantly shorter than that in the control group: 17 (range 9-36) hours versus 49 (15-60) hours, respectively (P= 0.009). Concerning the parameters used for the diagnosis of SIRS, the median heart rates on postoperative day (POD) 2 were significantly lower in the sivelestat-treated group than in the control group (P= 0.007). The median arterial oxygen pressure/fraction of inspired oxygen ratio of the sivelestat-treated group were significantly higher than those of the control group on POD 1 and POD 7 (POD 1: 372.0 [range 284.0-475.0] vs 322.5 [243.5-380.0], respectively, P= 0.040; POD 7: 377.2 [339.5-430.0] vs 357.6 [240.0-392.8], P= 0.031). Postoperative white blood cell counts, serum C-reactive protein levels, plasma interleukin-1beta, tumor necrosis factor-alpha levels, and plasma NE levels did not differ significantly between the two groups at any point during the postoperative course, nor did serum Krebs von den Lungen 6, surfactant protein-A, or surfactant protein-D levels, which were used as markers of alveolar type II epithelial cells to evaluate the severity of lung injury. Plasma interleukin-8 levels were significantly lower in the sivelestat-treated group than in the control group on POD 3 (P= 0.040). In conclusion, perioperative administration of sivelestat sodium hydrate (starting at the beginning of surgery) mitigated postoperative hypoxia, partially suppressed postoperative hypercytokinemia, shortened the duration of SIRS, and stabilized postoperative circulatory status after thoracoscopic esophagectomy.
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Lesión Pulmonar Aguda/prevención & control , Neoplasias Esofágicas/cirugía , Esofagectomía , Glicina/análogos & derivados , Complicaciones Posoperatorias/prevención & control , Proteínas Inhibidoras de Proteinasas Secretoras/uso terapéutico , Inhibidores de Serina Proteinasa/uso terapéutico , Sulfonamidas/uso terapéutico , Cirugía Torácica Asistida por Video , Anciano , Método Doble Ciego , Esofagectomía/métodos , Femenino , Glicina/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Atención Perioperativa , Estudios ProspectivosRESUMEN
Interleukin-1ß (IL-1ß) is an inflammatory cytokine produced by monocytes/macrophages and is closely associated with periodontal diseases. The NLRP3 inflammasome is involved in IL-1ß activation through pro-IL-1ß processing and pyroptotic cell death in bacterial infection. Recently, glyburide, a hypoglycemic sulfonylurea, has been reported to reduce IL-1ß activation by suppressing activation of the NLRP3 inflammasome. Therefore, we evaluated the possibility of targeting the NLRP3 inflammasome pathway by glyburide to suppress periodontal pathogen-induced inflammation. THP-1 cells (a human monocyte cell line) were differentiated to macrophage-like cells by treatment with phorbol 12-myristate 13-acetate and stimulated by periodontopathic bacteria, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, or Fusobacterium nucleatum, in the presence of glyburide. IL-1ß and caspase-1 expression in the cells and culture supernatants were analyzed by Western blotting and enzyme-linked immunosorbent assay, and cell death was analyzed by lactate dehydrogenase assay. Stimulation of THP-1 macrophage-like cells with every periodontopathic bacteria induced IL-1ß secretion without cell death, which was suppressed by the NLRP3 inhibitor, MCC950, and caspase-1 inhibitor, z-YVAD-FMK. Glyburide treatment suppressed IL-1ß expression in culture supernatants and enhanced intracellular IL-1ß expression, suggesting that glyburide may have inhibited IL-1ß secretion. Subsequently, a periodontitis rat model was generated by injecting periodontal bacteria into the gingiva, which was analyzed histologically. Oral administration of glyburide significantly suppressed the infiltration of inflammatory cells and the number of osteoclasts in the alveolar bone compared with the control. In addition to glyburide, glimepiride was shown to suppress the release of IL-1ß from THP-1 macrophage-like cells, whereas other sulfonylureas (tolbutamide and gliclazide) or other hypoglycemic drugs belonging to the biguanide family, such as metformin, failed to suppress IL-1ß release. Our results suggest that pharmacological targeting of the NLRP3 pathway may be a strategy for suppressing periodontal diseases.
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Inflamación , Animales , Caspasa 1 , Inflamasomas , Inflamación/tratamiento farmacológico , Interleucina-1beta , Monocitos , Proteína con Dominio Pirina 3 de la Familia NLR , Periodontitis , RatasRESUMEN
We achieved efficient spectral broadening for mid-IR pulses of few-microjoule energy. The spectral bandwidth of the femtosecond pulses at the center wavelength of 5000 nm increased from 540 nm to 2060 nm (from 220 to 910 cm(-1) in frequency) by nonlinear propagation in a gallium arsenide single crystal. The spectral broadening was accompanied by nonlinear absorption loss of 25%. The demonstrated scheme should be available at any operation wavelength within the material transparency range and provides a useful tool in nonlinear vibrational spectroscopy.
RESUMEN
The relationship between Helicobacter pylori eradication and reflux esophagitis is controversial. We analyzed the development of reflux esophagitis and the change in the grade of pre-existing reflux esophagitis after eradication. Enrolled were 559 Japanese patients who received eradication therapy for H. pylori. The grade of reflux esophagitis by endoscopy before and after therapy was evaluated retrospectively. No esophagitis was present before eradication in 526 patients. H. pylori was and was not eradicated in 429 and 97, respectively. Reflux esophagitis developed in 40 of the eradication group and in three of the treatment failure group, with prevalence higher with successful eradication (P = 0.04). Successful eradication and hiatus hernia were significant risk factors for reflux esophagitis development. Twenty-seven of 33 patients with pre-existing reflux esophagitis had successful eradication and six treatment failure. The reflux esophagitis grade worsened in two (Los Angeles classification from A to B) and improved in 14 patients after eradication. With treatment failure, reflux esophagitis worsened in none and improved in three patients. There showed no significant change in the grade of pre-existing reflux esophagitis after H. pylori eradication but the sample size was too small to evaluate the difference. In conclusion, the eradication of H. pylori increases the prevalence of reflux esophagitis, and hiatus hernia was a significant risk factor for the development of reflux esophagitis.
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Esofagitis Péptica/epidemiología , Esofagitis Péptica/patología , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/efectos de los fármacos , Adulto , Distribución por Edad , Análisis de Varianza , Antibacterianos/uso terapéutico , Antiulcerosos/uso terapéutico , Esofagitis Péptica/tratamiento farmacológico , Esofagitis Péptica/etiología , Esofagoscopía , Femenino , Estudios de Seguimiento , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori/aislamiento & purificación , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Probabilidad , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Factores de Tiempo , Resultado del TratamientoRESUMEN
Two successful cases of Konno procedure for congenital aortic stenosis and left ventricular outflow tract obstruction (LVOTO) were reported herein. A 3-year-old child previously underwent definitive repair of complete atrioventricular septal defect. Follow-up echocardiography revealed progression of valvular aortic stenosis and subaortic tunnel stenosis. Second patient was a 30-year-old male with congenital aortic stenosis, severe LVOTO and funnel chest. Both patients underwent Konno procedure, and their postoperative courses were uneventful. The Konno procedure is effective and stenotic lesion could be enlarged sufficiently even in complex LVOTO. Especially in the patient of advanced age, care should be taken to fragility of the left ventricular muscle and coronary malperfusion caused by the procedure itself.
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Estenosis de la Válvula Aórtica/congénito , Estenosis de la Válvula Aórtica/cirugía , Obstrucción del Flujo Ventricular Externo/cirugía , Adulto , Preescolar , Femenino , Humanos , Masculino , Obstrucción del Flujo Ventricular Externo/complicacionesRESUMEN
BACKGROUND: Although the aortic root dissection is a common finding in patients with type A acute aortic dissection, it is potentially fatal. Several procedures are available for reconstruction of the aortic root, and the choice depends on the mode of dissection; rupture, coronary ostial disruption or pre-existing cardiovascular diseases (annulo-aortic ectasia, aortic regurgitation: AR). The purpose of this study was to evaluate our surgical strategy of type A acute aortic dissection with proximal involvement. METHODS: Between 1996 and 2008, 100 patients with type A acute aortic dissection underwent emergency operation at our hospital. Fifteen of them received aortic root intervention simultaneously. RESULTS: In the initial 3 patients, the dissected aortic root was reinforced by fibrin glue and concomitant coronary bypass grafting was performed. During the follow-up term, residual aortic insufficiency was noted in 2 patients. Aortic root reconstruction was performed in 12 patients. Of these, the most recent 2 young patients underwent a new type of aortic valve sparing procedure, so called "partial remodeling". The postoperative echocardiography demonstrated no AR. There was no operative death in this series, and the long-term results were good. CONCLUSION: The excellent outcome was demonstrated with the change of surgical strategy. Special care should be taken for precise recognition of the proximal extension of the aortic dissection at operation. Although we recommend consideration of the partial remodeling procedure as an alternative, close observation is mandatory in this particular circumstance.
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Aorta/cirugía , Aneurisma de la Aorta/cirugía , Disección Aórtica/cirugía , Enfermedad Aguda , Adulto , Anciano , Procedimientos Quirúrgicos Cardiovasculares/métodos , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) is one of the most complex and lengthy endoscopic procedures, so deep sedation during ESD is indispensable. Our study aims were to determine whether bispectral index (BIS) monitoring is useful in titrating and reducing the dose of the sedative propofol during ESD, and to measure the satisfaction of patients and endoscopists involved in this complex and lengthy endoscopic therapy. PATIENTS AND METHODS: We performed a prospective, randomized clinical trial from July 2006 to February 2008. A total of 156 patients, with gastric neoplasm to be treated using ESD, were randomized to two groups. The BIS group (n = 78) was monitored for propofol sedation using BIS, and the no-BIS group (n = 78) was monitored by standard methods only. The two groups were compared by evaluating the doses of propofol administered to patients and the satisfaction scores (scale of 0 - 10) of patients and endoscopists. RESULTS: Although there were no significant differences between the two groups in the mean dose of propofol used (BIS group vs. no-BIS group, 5.32 mg/kg/hour vs. 4.85 mg/kg/hour; P = 0.10), the satisfaction scores of the patients (9.15 vs. 7.94; P < 0.01) and endoscopists (8.53 vs. 6.42; P < 0.001) were significantly higher with BIS monitoring. CONCLUSIONS: Monitoring with BIS during the ESD procedure did not lead to a reduction in the dose of propofol required, but did lead to higher satisfaction scores from the patients and endoscopists. A complicated and prolonged endoscopic treatment such as ESD can be carried out with optimal safety, control, and comfort by using BIS to monitor propofol sedation.
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Sedación Profunda , Hipnóticos y Sedantes/administración & dosificación , Monitoreo Intraoperatorio/instrumentación , Propofol/administración & dosificación , Neoplasias Gástricas/cirugía , Anciano , Anciano de 80 o más Años , Disección , Endoscopía , Femenino , Humanos , Masculino , Satisfacción del Paciente , Estudios ProspectivosRESUMEN
Paroxysmal atrial fibrillation and other types of tachyarrhythmia are common, but might be potentially fatal complications in patients undergoing aortic valve replacement due to aortic stenosis. We report the effects of ultra-short-acting beta-blocker (landiolol) in treating 2 patients with postoperative tachycardia. The heart rate was controlled adequately without subsequent hypotension and postoperative course was uneventful. This strategy seems to be safe and beneficial in this particular circumstance.
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Antagonistas Adrenérgicos beta/uso terapéutico , Estenosis de la Válvula Aórtica/cirugía , Prótesis Valvulares Cardíacas , Morfolinas/uso terapéutico , Urea/análogos & derivados , Anciano , Válvula Aórtica , Femenino , Humanos , Cuidados Posoperatorios , Urea/uso terapéuticoRESUMEN
Recent technological advances have enabled the miniaturization of catheters for coronary angiography and intervention. As a result of this advancement, the transradial approach is becoming more popular. The advantages of this approach include a lower incidence of access site complications, earlier patient ambulation, improved patient satisfaction, and lower cost. The cardiologists of our institute have introduced this technique without delay and have taken the initiative in Japan. However, there are concerns regarding the effect of transradial cardiac catheterization on the condition of radial artery grafts for coronary artery bypass grafting (CABG). In this study, we evaluated the influence of transradial catheterization on CABG. We retrospectively evaluated 157 patients who had undergone CABG using the radial artery. The condition of the grafts was assessed intraoperatively. Postoperative coronary angiography was carried out 3 months after the surgical intervention. The patency of the grafts was assessed by 2 cardiologists. One-quarter of the radial artery grafts were affected by transradial catheterization. Since most of them were located only at the puncture site, the graft itself was capable of being used for grafting after the resection of its affected distal end. The patency rate was not affected by transradial catheterization.
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Cateterismo Cardíaco/efectos adversos , Cateterismo Cardíaco/métodos , Puente de Arteria Coronaria/métodos , Arteria Radial , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Arteria Radial/patología , Arteria Radial/trasplante , Esclerosis , Grado de Desobstrucción VascularRESUMEN
BACKGROUND: Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder characterized by abdominal pain and abnormal bowel habits, both of which are exacerbated by psychological stress. The translocator protein 18kDa (TSPO) is a marker of reactive gliosis in a number of central nervous system (CNS) diseases and responsible for many cellular functions, including neurosteroidogenesis. Although it has been reported that psychological stress disturbs neurosteroids levels, the pathophysiological relevance of TSPO in IBS is poorly understood. METHODS: We examined the effects of a TSPO antagonist, ONO-2952, on stress-induced stool abnormality and abdominal pain in rats, and on anxiety-related behavior induced by cholecystokinin. KEY RESULTS: Oral administration of ONO-2952 attenuated stress-induced defecation and rectal hyperalgesia in rats with an efficacy equivalent to that of a 5-HT3 receptor antagonist. In addition, ONO-2952 suppressed cholecystokinin-induced anxiety-like behavior with an efficacy equivalent to that of psychotropic drugs. On the other hand, ONO-2952 did not affect spontaneous defecation, gastrointestinal transit, visceral nociceptive threshold, and neurosteroid production in non-stressed rats even at a dose 10 times higher than its effective dose in the stress models. CONCLUSIONS AND INFERENCES: These results suggest that TSPO antagonism results in antistress action, and that ONO-2952 is a promising candidate for IBS without side effects associated with current treatment.
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Dolor Abdominal/psicología , Proteínas Portadoras/antagonistas & inhibidores , Ciclopropanos/farmacología , Defecación/efectos de los fármacos , Compuestos Heterocíclicos de 4 o más Anillos/farmacología , Estrés Psicológico/complicaciones , Dolor Abdominal/metabolismo , Animales , Ansiedad/metabolismo , Tránsito Gastrointestinal/efectos de los fármacos , Hiperalgesia/metabolismo , Hiperalgesia/psicología , Síndrome del Colon Irritable/metabolismo , Síndrome del Colon Irritable/psicología , Masculino , Ratas , Ratas Endogámicas Lew , Ratas Wistar , Receptores de GABA-ARESUMEN
A recent study showed that p11 expressed in cholinergic interneurons (CINs) of the nucleus accumbens (NAc) is a key regulator of depression-like behaviors. Dopaminergic neurons projecting to the NAc are responsible for reward-related behaviors, and their function is impaired in depression. The present study investigated the role of p11 in NAc CINs in dopamine responses to rewarding stimuli. The extracellular dopamine and acetylcholine (ACh) levels in the NAc were determined in freely moving male mice using in vivo microdialysis. Rewarding stimuli (cocaine, palatable food, and female mouse encounter) induced an increase in dopamine efflux in the NAc of wild-type (WT) mice. The dopamine responses were attenuated (cocaine) or abolished (food and female mouse encounter) in constitutive p11 knock-out (KO) mice. The dopamine response to cocaine was accompanied by an increase in ACh NAc efflux, whereas the attenuated dopamine response to cocaine in p11 KO mice was restored by activation of nicotinic or muscarinic ACh receptors in the NAc. Dopamine responses to rewarding stimuli and ACh release in the NAc were attenuated in mice with deletion of p11 from cholinergic neurons (ChAT-p11 cKO mice), whereas gene delivery of p11 to CINs restored the dopamine responses. Furthermore, chemogenetic studies revealed that p11 is required for activation of CINs in response to rewarding stimuli. Thus, p11 in NAc CINs plays a critical role in activating these neurons to mediate dopamine responses to rewarding stimuli. The dysregulation of mesolimbic dopamine system by dysfunction of p11 in NAc CINs may be involved in pathogenesis of depressive states.
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Acetilcolina/farmacología , Cocaína/farmacología , Dopamina/metabolismo , Interneuronas/efectos de los fármacos , Recompensa , Acetilcolina/metabolismo , Animales , Colinérgicos/farmacología , Neuronas Colinérgicas/efectos de los fármacos , Interneuronas/metabolismo , Ratones Noqueados , Núcleo Accumbens/efectos de los fármacos , Núcleo Accumbens/metabolismo , Receptores Muscarínicos/efectos de los fármacos , Receptores Muscarínicos/metabolismoAsunto(s)
Antineoplásicos/uso terapéutico , Indoles/uso terapéutico , Neoplasias Meníngeas/tratamiento farmacológico , Meningioma/tratamiento farmacológico , Terapia Molecular Dirigida/métodos , Pirroles/uso terapéutico , Cromatografía Líquida de Alta Presión , Femenino , Humanos , Inmunohistoquímica , Neoplasias Meníngeas/metabolismo , Neoplasias Meníngeas/patología , Meningioma/metabolismo , Meningioma/patología , Persona de Mediana Edad , Proteómica/métodos , Receptor beta de Factor de Crecimiento Derivado de Plaquetas/análisis , Receptor beta de Factor de Crecimiento Derivado de Plaquetas/biosíntesis , Espectrometría de Masa por Ionización de Electrospray , SunitinibRESUMEN
BACKGROUND: Although Helicobacter pylori infection is closely associated with gastric cancer development, follow-up studies after H. pylori eradication are still scarce. AIM: To clarify the cancer preventive effect of H. pylori eradication, with special attention to differences in effect according to histology. METHODS: Patients who underwent H. pylori eradication therapy and were followed-up endoscopically for at least 1 year were analysed. The incidence of gastric cancer and factors associated with cancer development were investigated. RESULTS: A total of 1807 patients were enrolled. Six of 1519 H. pylori eradicated and five of 288 persistent subjects developed gastric cancer. Four of the eradicated subjects developed the intestinal type and two the diffuse type, while four of the persistent subjects developed the intestinal type and one the diffuse type. Kaplan-Meier analysis indicated a significantly lower incidence in eradicated patients than in persistent patients. The incidence of intestinal type was significantly lower than in eradicated patients, while the diffuse type could not be evaluated because of the low incidence. CONCLUSIONS: Helicobacter pylori-eradicated patients had a reduced incidence of gastric cancer compared with H. pylori-persistent patients, particularly the intestinal type, suggesting that H. pylori is strongly associated with intestinal-type gastric cancer.
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Infecciones por Helicobacter/prevención & control , Helicobacter pylori , Neoplasias Gástricas/microbiología , Anciano , Supervivencia sin Enfermedad , Quimioterapia Combinada , Femenino , Infecciones por Helicobacter/mortalidad , Humanos , Incidencia , Japón/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Neoplasias Gástricas/mortalidadRESUMEN
To prevent patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR), we set up our original standard criteria for the selection of the size of the prosthetic valve. We also routinely perform supra-annular enlargement in patients with small aortic annuli. The objective of this study was to assess the impact of our procedure on the postoperative cardiac function of patients suffering from aortic stenosis (AS). We retrospectively reviewed 102 consecutive surgical patients with AS from 1999 to 2004. The patients were classified into the following 3 groups based on the sizes of their prosthesis (group S : 19 mm prosthesis, n = 34; group M : 21 mm prosthesis, n = 51; and group L : > 23 mm prosthesis, n = 17). Cardiac function was evaluated using echocardiography preoperatively, immediately postoperatively, and 6 months after the operation. There were no hospital deaths during the study period. A favorable hemodynamic outcome of all 3 groups was achieved. Our surgical strategy for AS was thought to be useful to prevent PPM after AVR.
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Estenosis de la Válvula Aórtica/fisiopatología , Válvula Aórtica/cirugía , Implantación de Prótesis de Válvulas Cardíacas , Corazón/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Estenosis de la Válvula Aórtica/cirugía , Bioprótesis , Ecocardiografía , Femenino , Prótesis Valvulares Cardíacas , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Ajuste de Prótesis , Estudios RetrospectivosRESUMEN
BACKGROUND: Whether proton pump inhibitors (PPIs) relieve heartburn or precordial pain after endoscopic resection (ER) for esophageal squamous cell carcinoma (ESCC) remains unclear. The aim of this study was to investigate the efficacy of PPI therapy for these symptoms after ER for ESCC. METHODS: We conducted a multicenter prospective randomized controlled trial among 15 hospitals in Japan. In total, 229 patients with cT1a ESCC were randomly assigned to receive PPI therapy for 5 weeks after ER (the PPI group, n = 115) or follow-up without PPI therapy (the non-PPI group, n = 114). The primary end point was the incidence of gastroesophageal reflux disease (GERD)-like symptoms after ER from a self-reported questionnaire (Frequency Scale for Symptoms of GERD). Secondary end points were ulcer healing rate at 5 weeks, incidence of pain, improvement rate of symptoms in those who started PPI therapy because of GERD-like symptoms in the non-PPI group, and adverse events. RESULTS: No significant difference was observed in the incidence of GERD-like symptoms after ER between the non-PPI and PPI groups (30 % vs 34 %, respectively). No significant differences were observed in the ulcer healing rate at 5 weeks (84 % vs 85 %) and incidence of pain within 1 week (36 % vs 45 %). In nine of ten patients (90 %) who started PPI therapy because of GERD-like symptoms in the non-PPI group, PPI administration relieved GERD-like symptoms. No adverse events related to PPI administration were observed. CONCLUSION: PPI therapy is not efficacious in reducing symptoms and did not promote healing of ulcers in patients undergoing ER for ESCC.
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Carcinoma de Células Escamosas/cirugía , Neoplasias Esofágicas/cirugía , Esofagoscopía/efectos adversos , Reflujo Gastroesofágico/tratamiento farmacológico , Inhibidores de la Bomba de Protones/uso terapéutico , Adulto , Anciano , Carcinoma de Células Escamosas/patología , Enfermedades del Esófago/tratamiento farmacológico , Enfermedades del Esófago/etiología , Neoplasias Esofágicas/patología , Carcinoma de Células Escamosas de Esófago , Esofagoscopía/métodos , Femenino , Reflujo Gastroesofágico/etiología , Pirosis/tratamiento farmacológico , Pirosis/etiología , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor/métodos , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/etiología , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Úlcera/tratamiento farmacológico , Úlcera/etiologíaRESUMEN
smg p21 is a member of the ras p21/ras p21-like small GTP-binding protein (G protein) superfamily, having the same putative effector domain as ras p21s. In the preceding report, we showed that smg p21 was a major G protein in bovine aortic smooth muscle membranes. Recently, two different smg p21 cDNA clones, designated smg-21A and -B, were isolated from a bovine brain cDNA library. In the present studies, we resolved the bovine aortic smg p21 fraction into two distinct G protein fractions on hydroxyapatite column chromatography and purified them separately to near homogeneity (22K G1 and -2). Both 22K G1 and -2 were specifically recognized by an anti-smg p21 polyclonal antibody. 22K G1 and -2 were identified as smg p21B and -A, respectively, by peptide map and amino acid sequence analyses. Purified smg p21A and -B showed GDP/GTP-binding and GTPase activities similar to each other. The GTPase activities of smg p21A and -B were equally stimulated by smg p21 GTPase activating protein 1 and -2. Moreover, both smg p21A and -B were phosphorylated by cyclic AMP-dependent protein kinase with a stoichiometry of one phosphate/molecule of protein. These results indicate that smg p21A and -B coexist in bovine aortic smooth muscle membranes and suggest that smg p21A and -B may serve as intermediates for cyclic AMP actions.