Periodic changes in chemical composition and in vitro digestibility of locally available Gramineae feed resources in the Philippines.

Efficient utilization of locally available feed resources is needed for further development of livestock productions in the tropics. However, an inadequate supply of nourish grass is common, and limited information exists regarding the chemical composition and digestibility of locally available feed resources in the different season. There were few reliable information concerning nutritive value of Gramineae resources in dry and rainy seasons in the Philippines. Hence, the present study was conducted to identify the chemical composition and in vitro digestibility of nine kinds of locally available Gramineae feed resources in dry and rainy seasons in the Philippines. The concentration of dry matter (DM), crude protein, and crude fiber of grass samples did not differ among species and seasons. The concentration of organic matter (OM), ether extract (EE), crude ash (CA), nitrogen-free extract (NFE), acid detergent fiber, and neutral detergent fiber (NDF) of grass samples differed significantly among species in both seasons except the NDF in the rainy season. However, the OM, CA, and NDF concentrations of the samples showed no differences between seasons. Imperata cylindrica showed the highest concentration of OM among the samples. Brachiaria brizantha had the lowest EE concentration among the grasses. The lowest NFE concentration was identified in Panicum maximum among the grasses. Although the digestibility of DM (DMD), OM (OMD), and NDF (NDFD) of grass samples showed significant differences among species. The DMD, OMD, and NDFD of I. cylindrica were the lowest among the samples, though Pennisetum purpureum showed the highest DMD, OMD, and NDFD among the species. Relatively high nutritive values of P. purpureum were remarkable among the samples in the present survey area.

Is the eCura system useful for selecting patients who require radical surgery after noncurative endoscopic submucosal dissection for early gastric cancer? A comparative study.

BACKGROUND: We have established a risk-scoring system, termed the "eCura system," for the risk stratification of lymph node metastasis in patients who have received noncurative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). We aimed to clarify whether this system contributes to the selection of patients requiring radical surgery after ESD. METHODS: Between 2000 and 2011, 1,969 patients with noncurative ESD for EGC were included in this multicenter study. Depending on the treatment strategy after ESD, we had patients with no additional treatment (n = 905) and those with radical surgery after ESD (n = 1,064). After the application of the eCura system to these patients, cancer recurrence and cancer-specific mortality in each risk category of the system were compared between the two patient groups. RESULTS: Multivariate Cox analysis revealed that in the high-risk category, cancer recurrence was significantly higher (hazard ratio = 3.13, p = 0.024) and cancer-specific mortality tended to be higher (hazard ratio = 2.66, p = 0.063) in patients with no additional treatment than in those with radical surgery after ESD, whereas no significant differences were observed in the intermediate-risk and low-risk categories. In addition, cancer-specific survival in the low-risk category was high in both patient groups (99.6 and 99.7%). A limitation of this study is that it included a small number of cases with undifferentiated-type EGC (292 cases). CONCLUSIONS: The eCura system is a useful aid for selecting the appropriate treatment strategy after noncurative ESD for EGC. However, caution is needed when applying this system to patients with undifferentiated-type EGC.

Long-term oncological outcomes of submucosal manipulation during non-curative endoscopic submucosal dissection for submucosal invasive gastric cancer: a multicenter retrospective study in Japan.

BACKGROUND: Sufficient information is not available on the extent to which lymph node metastasis (LNM) and prognosis are affected by submucosal manipulation during endoscopic submucosal dissection (ESD) for submucosal invasive gastric cancer (SMGC). We aimed to identify the effects of submucosal manipulation during ESD on LNM and prognosis in patients with SMGC. METHODS: From 19 institutions in Japan, 2526 patients who failed to meet the current curative criteria for ESD between 2000 and 2011 were recruited. After exclusion, 1969 patients were remained. Based on the treatment strategy after ESD, 1064 patients underwent additional radical surgery. A total of 890 of 1064 patients with SMGC, LNM and cancer recurrence, and prognosis were retrospectively reviewed. RESULTS: The median follow-up duration was 67 months. A total of 214 patients had SM1 (depth of tumor invasion from the muscularis mucosae <500 µm) invasive cancer and 676 patients had SM2 (depth of tumor invasion from the muscularis mucosae ≥500 µm) invasive cancer. LNM was found in 84 patients (9.4%), and 14 patients (1.6%) developed cancer recurrence. The 3-year and 5-year overall survival rates were 96.1 and 91.7%, respectively. The 3-year and 5-year disease-specific survival rates were 99.3 and 98.5%, respectively. CONCLUSIONS: The rates of LNM and cancer recurrence, and prognosis of patients who underwent additional radical surgery after non-curative ESD for SMGC were excellent. Submucosal manipulation during ESD for SMGC does not seem to enhance the risk for LNM or worsen the prognosis compared to surgical series.

A Scoring System to Stratify Curability after Endoscopic Submucosal Dissection for Early Gastric Cancer: "eCura system".

OBJECTIVES: Although radical surgery is recommended for patients not meeting the curative criteria for endoscopic submucosal dissection (ESD) of early gastric cancer (EGC) because of the potential risk of lymph node metastasis (LNM), this recommendation may be overestimated and excessive. We aimed to establish a simple scoring system for decision making after ESD. METHODS: This multicenter retrospective study consisted of two stages. First, the risk-scoring system for LNM was developed using multivariate logistic regression analysis in 1,101 patients who underwent radical surgery after having failed to meet the curative criteria for ESD of EGC. Next, the system was internally validated by survival analysis in another 905 patients who also did not meet the criteria and did not receive additional treatment after ESD. RESULTS: In the development stage, based on accordant regression coefficients, five risk factors for LNM were weighted with point values: three points for lymphatic invasion and 1 point each for tumor size >30 mm, positive vertical margin, venous invasion, and submucosal invasion ≥500 µm. Then, the patients were categorized into three LNM risk groups: low (0-1 point: 2.5% risk), intermediate (2-4 points: 6.7%), and high (5-7 points: 22.7%). In the validation stage, cancer-specific survival differed significantly among these groups (99.6, 96.0, and 90.1%, respectively, at 5 years; P<0.001). The C statistic of the system for cancer-specific mortality was 0.78. CONCLUSIONS: This scoring system predicted cancer-specific survival in patients who did not meet the curative criteria after ESD for EGC. ESD without additional treatment may be an acceptable option for patients at low risk.

Survival Benefit of Additional Surgery After Non-curative Endoscopic Submucosal Dissection for Early Gastric Cancer: A Propensity Score Matching Analysis.

BACKGROUND AND PURPOSE: Previous studies comparing survival outcomes between patients who did and did not undergo additional surgery after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) were limited in that the baseline characteristics differed significantly between the groups. We aimed to address this limitation and compared survival outcomes between these two groups using propensity score matching analysis. METHODS: The study enrolled 1969 consecutive patients who underwent non-curative ESD for EGC between 2000 and 2011 at any of 19 institutions across Japan. Using propensity score matching analysis, patients who underwent additional surgery (n = 1064) were compared with patients who did not (n = 905). Overall survival (OS) and disease-specific survival (DSS) after ESD were compared between both groups. RESULTS: Propensity score matching analysis yielded 553 matched pairs and well-balanced baseline characteristics between the two groups. The 5-year OS rates were 91.0% in the additional surgery group and 75.5% in the no additional surgery group, and the 5-year DSS rates were 99.0 and 96.8%, respectively. OS and DSS in the additional surgery group were significantly higher than in the no additional surgery group (OS, p < 0.001; DSS, p = 0.013). In Cox proportional hazard analysis, additional surgery significantly reduced gastric cancer-related death after non-curative ESD for EGC (hazard ratio 0.33, 95% confidence interval 0.12-0.79, p = 0.012). CONCLUSIONS: Our findings suggest that additional surgery reduces mortality after non-curative ESD for EGC. We recommend additional surgery for patients after non-curative ESD for EGC.

A case of Trousseau syndrome associated with a mucosa-associated lymphoid tissue lymphoma disseminated to the mesenteric adipose tissue.

A 66-year-old man with recurrent stroke within a short period of time was referred to our department from the neurology department to rule out any malignancy. An endoscopic examination revealed a white depressed lesion in the body of the stomach, and computed tomography revealed a high-density area in the mesentery around the stomach. A mucosa-associated lymphoid tissue (MALT) lymphoma was detected from both the stomach biopsy and resected mesenteric specimen. Systemic chemotherapy was administered for the MALT lymphoma (Lugano classification stage IV). Cerebral infarction did not occur after the treatment. We concluded that Trousseau syndrome associated with the MALT lymphoma disseminated to the mesenteric adipose tissue. A MALT lymphoma has a small probability of occurring in Trousseau syndrome.

Involvement of intestinal permeability in the oral absorption of clarithromycin and telithromycin.

The involvement of intestinal permeability in the oral absorption of clarithromycin (CAM), a macrolide antibiotic, and telithromycin (TEL), a ketolide antibiotic, in the presence of efflux transporters was examined. In order independently to examine the intestinal and hepatic availability, CAM and TEL (10 mg/kg) were administered orally, intraportally and intravenously to rats. The intestinal and hepatic availability was calculated from the area under the plasma concentration-time curve (AUC) after administration of CAM and TEL via different routes. The intestinal availabilities of CAM and TEL were lower than their hepatic availabilities. The intestinal availability after oral administration of CAM and TEL increased by 1.3- and 1.6-fold, respectively, after concomitant oral administration of verapamil as a P-glycoprotein (P-gp) inhibitor. Further, an in vitro transport experiment was performed using Caco-2 cell monolayers as a model of intestinal epithelial cells. The apical-to-basolateral transport of CAM and TEL through the Caco-2 cell monolayers was lower than their basolateral-to-apical transport. Verapamil and bromosulfophthalein as a multidrug resistance-associated proteins (MRPs) inhibitor significantly increased the apical-to-basolateral transport of CAM and TEL. Thus, the results suggest that oral absorption of CAM and TEL is dependent on intestinal permeability that may be limited by P-gp and MRPs on the intestinal epithelial cells.

[Case of acute necrotizing esophagitis associated with AA amyloidosis secondary to bronchiectasis].

An 82-year-old woman with a history of bronchiectasis for 20 years was admitted to our hospital with anorexia and diarrhea. Sigmoidoscopy showed multiple mucosal erythematous areas and erosions. Histologic examination with Congo red stain revealed massive amyloid deposition around the submucosal vessels as well as in the parenchyma of the mucosa and submucosa. With immunohistochemistry, the diagnosis of secondary/reactive AA amyloidosis was confirmed. Esophagogastroduodenoscopy demonstrated diffuse dark brown mucosa, establishing the diagnosis of acute necrotizing esophagitis. Ischemia associated with amyloid deposition of the vessels in the esophagus was considered to be a possible etiology of acute necrotizing esophagitis. Additionally, gastric outlet obstruction and gastroesophageal reflux associated with gastroduodenal erosions caused by amyloid deposition were supposed to be another factor. Amyloid deposition in the esophageal mucosa may cause a reduction in mucosal defense that is responsible for the pathogenesis. We report the first case of acute necrotizing esophagitis associated with amyloidosis.

Effects of Astaxanthin Preparation Form on the Efficiency of Egg Yolk Pigmentation in Laying Hens.

This study investigated the effects of the preparation form of astaxanthin on egg yolk pigmentation and egg quality in laying hens. The following four astaxanthin sources were prepared in this study: (1) dried cell powder of Paracoccus carotinifaciens (Panaferd-AX), (2) fine cell powder of P. carotinifaciens (Panaferd-P), (3) astaxanthin oil suspension, and (4) water-soluble astaxanthin powder. These astaxanthin preparations were added to the basal diet at a final concentration of 2 mg/kg and fed to White Leghorn laying hens for 14 days. Although the administration of these astaxanthin preparations did not largely affect egg quality (i.e., egg weight, yolk weight, albumen height, and Haugh unit), feeding significantly improved astaxanthin concentration and yolk color fan score. When water-soluble astaxanthin powder was fed, the yolk astaxanthin concentration and color fan score were most improved, followed by Panaferd-P. These results indicated that astaxanthin pulverization and water solubilization significantly improved its bioavailability in laying hens. Furthermore, although diets rich in (all-E)-astaxanthin were fed to the hens, approximately 30% of astaxanthin was present as the Z-isomers in the egg yolk. These findings may contribute to improving not only the egg quality but the nutritional value of hen eggs.

Biological soil disinfestation compatible with renewable energy production for sustainable agriculture.

Biological soil disinfestation (BSD) is biotechnology to control soil-borne plant pathogens based on the anaerobic-reducing environment in soil and the functions of indigenous microbes. A new sustainable agricultural technology, the GET system, which produces and recovers methane as renewable energy from paddy fields, has a structure and principles similar to those of BSD technology. To confirm the potential of the GET system as BSD technology, the microbial community structures in the GET system were analyzed using next-generation sequencing. Thirty-four phyla were detected: 31 bacterial and 3 archaeal. Firmicutes dominated during the experimental period, which plays an important role in BSD functions such as organic decomposition, nitrate removal, and soil-borne pathogen elimination. The ability of the GET system to control soil-borne pathogens as well as produce renewable energy was demonstrated.

Impact of adrenomedullin on dextran sulfate sodium-induced inflammatory colitis in mice: insights from in vitro and in vivo experimental studies.

BACKGROUND: Although adrenomedullin (AM) is known to ameliorate inflammatory processes, few data exist regarding the effect of AM on inflammatory colitis. Therefore, we examined the effect of AM on inflammatory response in vitro and in vivo colitis model. METHODS: In mice experimental colitis induced by 3% dextran sulfate sodium (DSS) in drinking water for 7 days, AM with 225-900 µg/kg in 0.5 ml of saline or saline alone were given intraperitoneally once a day. In the in vitro experiment, we determined the cytokine response in THP-1 cell activated by lipopolysaccharide with or without AM of 10 nM. Additionally, we performed wound healing assay in Caco-2 cell interfered by DSS with or without AM of 100 nM. RESULTS: In the colitis model, AM significantly reduced the disease activity index, histological score, and local production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, and IL-6 in accordance with reduction of serum amyloid A levels. Secretion of TNF-α in lipopolysaccharide-stimulated THP-1 cells was significantly reduced in the presence of AM. The distance of wound healing interfered by 0.25% DSS was significantly improved in the presence of AM of 100 nM. CONCLUSIONS: These results demonstrate that AM could ameliorate DSS-induced experimental colitis possibly through suppression of systemic and local production of cytokines such as TNF-α, associated with acceleration of ulcer reepithelialization and colon tissue regeneration.

Astaxanthin Z-isomer-rich diets enhance egg yolk pigmentation in laying hens compared to that in all-E-isomer-rich diets.

The effects of feeding diets containing astaxanthin with different Z-isomer ratios to laying hens on egg qualities, such as astaxanthin concentration in egg yolk and yolk color, were investigated. As the astaxanthin source, a natural microorganism Paracoccus carotinifaciens was used. Astaxanthin with different Z-isomer ratios was prepared by thermal treatment with different conditions and then added to the basal diet at a final astaxanthin concentration of 8 mg/kg. We found that, as the Z-isomer ratios of astaxanthin in the diet increased, the astaxanthin concentration in egg yolk and the yolk color fan score also increased significantly. Importantly, feeding a 50.6% Z-isomer ratio diet increased astaxanthin concentration in egg yolk by approximately fivefold and the color fan score by approximately 2 compared to that in hens fed an all-E-isomer-rich diet. Moreover, we showed that feeding Z-isomer-rich astaxanthin to laying hens increased plasma astaxanthin concentration by more than five times in comparison to that in hens fed an all-E-isomer-rich diet. These results indicate that Z-isomers of astaxanthin have higher bioavailability than that of the all-E-isomer and thus they exhibit greater egg yolk-accumulation efficiency.

High prevalence of fulminant hepatic failure among patients with mutant alleles for truncation of ATP7B in Wilson's disease.

OBJECTIVE: Although many mutations of the Wilson's disease (WD) gene (ATP7B) have been reported, few data exist regarding the occurrence of fulminant hepatic failure (FHF). We sought to determine if genotypic assignment according to type of protein-product could be related to the prevalence of FHF among patients with WD. MATERIAL AND METHODS: We performed gene analysis in Japanese patients with WD as well as genotype-phenotype analysis in 51 patients. We divided genotypes into two groups according to type of ATP7B product: truncated group [T] consisted of two truncated alleles including nonsense, insertion, deletion, or splice site mutation, and missense group [M] consisted of one or two missense alleles. We also divided phenotypes into two groups: [FHF] group and [non-FHF] group. RESULTS: We were able to determine genotype in 42 patients. Genotypically, 11 patients were assigned to [T] group and 31 to [M] group. Phenotypically, 4 patients were [FHF] and 38 were [non-FHF]. All patients in [FHF] group belonged to [T] group. The prevalence of [FHF] in [T] group was 36.4% and was significantly higher than in [M] group (p < 0.003). CONCLUSIONS: These results demonstrated that genotypes for truncation of ATP7B are associated with high prevalence of FHF.

Seasonal variations in the concentration of antimicrobial components in milk of dairy cows.

The incidence of bovine mastitis and the bulk milk somatic cell count (BMSCC) are influenced by season, which may be associated with innate immune functions, including antimicrobial components in mammary glands. Therefore, the present study was conducted to examine the effect of season on antimicrobial components in milk. Rectal temperature and plasma cortisol, thyroxine, and derivatives of reactive oxygen metabolites (d-ROMs) were measured as stress parameters. Concentrations of lactoferrin (LF), lingual antimicrobial peptide (LAP), psoriasin (S100A7), and Immunoglobulin A (IgA) in milk were measured as indicators of innate immune function. LF and LAP concentrations were significantly lower in summer than in winter and spring, respectively, whereas the concentration of S100A7 was significantly lower in winter than in spring and autumn. The rectal temperature was significantly higher in summer than in other seasons, whereas plasma cortisol, thyroxine, and d-ROMs did not exhibit any seasonal variation. In conclusion, even though stress parameters were not changed, the concentration of antimicrobial components, such as LF and LAP, decreased in summer, which may explain the frequent occurrence of mastitis during this season.

Alterations in lycopene concentration and Z-isomer content in egg yolk of hens fed all-E-isomer-rich and Z-isomer-rich lycopene.

Effects of feeding lycopene isomers to laying hens on egg qualities such as lycopene concentration and color of the yolk were investigated. Firstly, to evaluate the dietary transfer of lycopene to egg yolk, (all-E)-lycopene-rich diets (lycopene content, 100, 200, or 300 mg/kg diet) were fed to hens for 21 days. Lycopene in egg yolk could be detected after 4 days or more from the start of feeding, and the lycopene concentration increased according to the feed amount and period. Even though most of the dietary lycopene was the all-E-isomer, more than 65% of lycopene in egg yolk was present as Z-isomers. Thus, the effect of lycopene Z-isomer content in the diet (lycopene content, 200 mg/kg diet; lycopene Z-isomer content, 35.1% or 61.3%) on egg qualities was investigated. As the Z-isomer content increased, the lycopene concentration in the egg yolk increased, for example, when fed a diet rich in Z-isomers (61.3%), the lycopene concentration in the egg yolk was approximately three times higher than when fed the (all-E)-lycopene-rich diet for 21 days. The results indicated that Z-isomers of lycopene had higher bioavailability and/or higher transfer efficiency to the egg yolk than the all-E-isomer.

Is radical surgery necessary in all patients who do not meet the curative criteria for endoscopic submucosal dissection in early gastric cancer? A multi-center retrospective study in Japan.

BACKGROUND: Although radical surgery is routinely performed for patients who do not meet the curative criteria for endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) due to the risk of lymph node metastasis (LNM), this standard therapeutic option may be excessive given the lower number of patients with LNM. Therefore, we aimed to investigate long-term outcomes and validate risk factors predicting recurrence after ESD. METHODS: Of 15,785 patients who underwent ESD for EGC at 19 institutions between 2000 and 2011, 1969 patients not meeting the curative criteria were included in this multi-center study. Based on the treatment strategy after ESD, patients were divided into radical surgery (n = 1064) and follow-up (no additional treatment, n = 905) groups. RESULTS: Overall survival (OS) and disease-specific survival (DSS) were significantly higher in the radical surgery group than in the follow-up group (p < 0.001 and p = 0.012, respectively). However, the difference in 3-year DSS between the groups (99.4 vs. 98.7 %) was rather small compared with the difference in 3-year OS (96.7 vs. 84.0 %). LNM was found in 89 patients (8.4 %) in the radical surgery group. Lymphatic invasion was found to be an independent risk factor for recurrence in the follow-up group (hazard ratio 5.23; 95 % confidence interval 2.01-13.6; p = 0.001). CONCLUSIONS: This multi-center study, representing the largest cohort to date, revealed a large discrepancy between OS and DSS in the two groups. Since follow-up with no additional treatment after ESD may be an acceptable option for patients at low risk, further risk stratification is needed for appropriate individualized treatment strategies.

Impact of gastrectomy on high-density lipoprotein cholesterol elevation in nonobese patients during a 10-year follow-up.

AIM: The role of gastrectomy in glycemic control has been established in the current era of bariatric surgery for obesity. Gastrectomy in obese patients is associated with increased levels of high-density lipoprotein cholesterol (HDL-C). However, limited data on the effects of gastrectomy in nonobese patients are available. We herein investigated the long-term plasma lipid changes in nonobese patients who had undergone gastrectomy. METHODS: Patients were enrolled as part of routine healthcare examinations from 1984 to 2003. Preoperative and postoperative data from patients who had undergone curative gastrectomy were analyzed for up to 10 years postoperatively. Three age- and sex-matched controls were assigned to each case. RESULTS: Sixty-four nonobese patients without diabetes mellitus or a history of having taken lipid-lowering drugs who underwent curative gastrectomy during the study period were enrolled (60 subtotal gastrectomies, four total gastrectomies). The median follow-up period was 7.6 years. The mean body mass index was 9.6% lower one year after gastrectomy (p < 0.01), then plateaued with a slight recovery. Intriguingly, the preoperative HDL-C level was 21% higher one year after gastrectomy (p < 0.01), increased by another 30% six years after gastrectomy and remained at this level for the rest of the follow-up period. No significant changes in the HDL-C level were observed in the controls. The degree of HDL-C elevation was consistently significant, irrespective of the baseline triglyceride level, HDL-C level or body weight. CONCLUSIONS: Gastrectomy in nonobese patients was associated with consistent and distinct long-term HDL-C elevations and body mass index reductions.

Upper-limb tremor suppression with a 7DOF exoskeleton power-assist robot.

A tremor which is one of the involuntary motions is somewhat rhythmic motion that may occur in various body parts. Although there are several kinds of the tremor, an essential tremor is the most common tremor disorder of the arm. The essential tremor is a disorder of unknown cause, and it is common in the elderly. The essential tremor interferes with a patient's daily living activity, because it may occur during a voluntary motion. If a patient of an essential tremor uses an EMG-based controlled power-assist robot, the robot might misunderstand the user's motion intention because of the effect of the essential tremor. In that case, upper-limb power-assist robots must carry out tremor suppression as well as power-assist, since a person performs various precise tasks with certain tools by the upper-limb in daily living. Therefore, it is important to suppress the tremor at the hand and grasped tool. However, in the case of the tremor suppression control method which suppressed the vibrations of the hand and the tip of the tool, vibration of other part such as elbow might occur. In this paper, the tremor suppression control method for upper-limb power-assist robot is proposed. In the proposed method, the vibration of the elbow is suppressed in addition to the hand and the tip of the tool. The validity of the proposed method was verified by the experiments.