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Germ cells are unique in engendering totipotency, yet the mechanisms underlying this capacity remain elusive. Here, we perform comprehensive and in-depth nucleome analysis of mouse germ-cell development in vitro, encompassing pluripotent precursors, primordial germ cells (PGCs) before and after epigenetic reprogramming, and spermatogonia/spermatogonial stem cells (SSCs). Although epigenetic reprogramming, including genome-wide DNA de-methylation, creates broadly open chromatin with abundant enhancer-like signatures, the augmented chromatin insulation safeguards transcriptional fidelity. These insulatory constraints are then erased en masse for spermatogonial development. Notably, despite distinguishing epigenetic programming, including global DNA re-methylation, the PGCs-to-spermatogonia/SSCs development entails further euchromatization. This accompanies substantial erasure of lamina-associated domains, generating spermatogonia/SSCs with a minimal peripheral attachment of chromatin except for pericentromeres-an architecture conserved in primates. Accordingly, faulty nucleome maturation, including persistent insulation and improper euchromatization, leads to impaired spermatogenic potential. Given that PGCs after epigenetic reprogramming serve as oogenic progenitors as well, our findings elucidate a principle for the nucleome programming that creates gametogenic progenitors in both sexes, defining a basis for nuclear totipotency.
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Epigênese Genética , Células Germinativas , Animais , Cromatina/genética , Cromatina/metabolismo , Metilação de DNA , Epigenômica , Feminino , Células Germinativas/metabolismo , Masculino , Mamíferos/genética , Camundongos , EspermatogôniasRESUMO
PURPOSE: Exercise is considered a strategy to promote mental health among workers. However, the optimal exercise conditions that promote mental health benefits for workers are still unclear. This study examined the cross-sectional associations of weekly exercise time duration, social context of exercise, and exercise motivation levels with the mental health among Japanese workers. METHODS: A web-based cross-sectional questionnaire survey was conducted among 18,902 workers, aged 20-59 years. The mental health variables (psychological distress, psychological stress reaction, physical stress reaction, job satisfaction, and work engagement), exercise participation (non-exercisers, exercisers), and demographic factors of all responders were measured. Weekly exercise time, social context of exercise (alone only, with others only, both alone and with others), and exercise motivation (non-regulation, external/introjected regulation, identified regulation, integrated regulation, and internal regulation) were also measured amongst exercisers. After adjusting for demographic factors, multiple regression analyses were conducted. RESULTS: Exercisers had significantly lower psychological distress, lower psychological and physical stress reactions, higher job satisfaction, and higher work engagement than non-exercisers. Among exercisers, while weekly exercise time duration and social context of exercise were not clearly and robustly associated with mental health variables, respondents with intrinsic regulation had significantly lower psychological distress, lower psychological and physical stress reaction, higher job satisfaction, and higher work engagement than those with lower self-determined motivations. CONCLUSIONS: This study found that more self-determined exercise motivation is closely associated with advantageous mental health variables, than the duration or the social context of exercise among Japanese workers.
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Saúde Mental , Motivação , Humanos , Estudos Transversais , Exercício Físico , Meio Social , Estresse Psicológico/psicologia , Inquéritos e QuestionáriosRESUMO
[Purpose] The effects of multifunctional garments on neuromuscular performance have gained significant research attention in the health sciences. However, the spinal responses to different fabrics have not yet been considered. In the present study, we examined the effects of typical fabrics (cotton and polyester) on the Hoffmann reflex during local heat exposure. [Participants and Methods] Sixteen healthy males aged 20-40â years participated in this study. A heating device comprising a thermal mat, fabric, and a data logger was fabricated. The fabric was affixed to the skin as the contact surface. The temperature of the right posterior lower leg was increased to 39°C followed by 10â min for adaptation at 39-40°C. The H- and M-waves were recorded at each point, including those without heating. An identical trial was conducted seven days later using the alternative fabric. [Results] M-wave amplitude and latency were significantly decreased during heat exposure without fabric. The H-wave latency was prolonged by sustained thermal heat during the session with polyester. Interestingly, the H-wave amplitudes normalized by the maximal M-wave amplitudes decreased with prolonged heat exposure during the session with cotton. However, this index remains unchanged during the sessions using polyester. [Conclusion] During prolonged localized thermal exposure, cotton reduced spinal excitability, whereas polyester preserved spinal excitability.
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BACKGROUND: Immune checkpoint inhibitors (ICIs) are effective for advanced hepatocellular carcinoma (HCC). However, there are few reports on the correlation between the clinical efficacy of ICIs and the development of immune-related adverse events (irAEs) in patients with HCC. The aim of this study was to investigate the association between irAE development and survival in patients with HCC treated with atezolizumab plus bevacizumab. PATIENTS AND METHODS: We enrolled 150 patients with advanced HCC treated with atezolizumab plus bevacizumab between October 2020 and October 2021 at 5 territorial institutions. We compared the efficacy of atezolizumab plus bevacizumab between patients who experienced irAEs (irAE group) and those who did not (non-irAE group). RESULTS: Thirty-two patients (21.3%) developed irAEs of any grade. Grade 3/4 irAEs were observed in 9 patients (6.0%). The median progression-free survivals (PFS) in the irAE and non-irAE groups were 273 and 189 days, respectively (P = .055). The median overall survivals (OS) in the irAE and non-irAE groups were not reached and 458 days, respectively (P = .036). Grade 1/2 irAEs significantly prolonged PFS (P = .014) and OS (P = .003). Grade 1/2 irAEs were significantly associated with PFS (hazard ratio [HR], 0.339; 95% confidence interval [CI], 0.166-0.691; P = .003) and OS (HR, 0.086; 95% CI, 0.012-0.641; P = .017) on multivariate analysis. CONCLUSION: The development of irAEs was associated with increased survival in a real-world population of patients with advanced HCC treated with atezolizumab plus bevacizumab. Grade 1/2 irAEs were strongly correlated with PFS and OS.
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Carcinoma Hepatocelular , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/tratamento farmacológico , Nivolumabe/uso terapêutico , Bevacizumab/efeitos adversos , Neoplasias Hepáticas/tratamento farmacológico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/tratamento farmacológico , Estudos RetrospectivosRESUMO
Primordial germ cells (PGCs), the founder cells of the germline, are specified in pre-gastrulating embryos in mammals, and subsequently migrate towards gonads to mature into functional gametes. Here, we investigated PGC development in rats, by genetically modifying Prdm14, a unique marker and an essential PGC transcriptional regulator. We trace PGC development in rats, for the first time, from specification until the sex determination stage in fetal gonads using Prdm14 H2BVenus knock-in rats. We uncover that the crucial role of Prdm14 in PGC specification is conserved between rat and mice, by analyzing Prdm14-deficient rat embryos. Notably, loss of Prdm14 completely abrogates the PGC program, as demonstrated by failure of the maintenance and/or activation of germ cell markers and pluripotency genes. Finally, we profile the transcriptome of the post-implantation epiblast and all PGC stages in rat to reveal enrichment of distinct gene sets at each transition point, thereby providing an accurate transcriptional timeline for rat PGC development. Thus, the novel genetically modified rats and data sets obtained in this study will advance our knowledge on conserved versus species-specific features for germline development in mammals.
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Proteínas de Ligação a DNA/genética , Células Germinativas/citologia , Proteínas de Ligação a RNA/genética , Fatores de Transcrição/genética , Animais , Cruzamentos Genéticos , Proteínas de Ligação a DNA/fisiologia , Feminino , Gástrula/fisiologia , Deleção de Genes , Perfilação da Expressão Gênica , Regulação da Expressão Gênica no Desenvolvimento , Heterozigoto , Masculino , Camundongos , Proteínas de Ligação a RNA/fisiologia , Ratos , Processos de Determinação Sexual , Fatores de Transcrição/fisiologia , Transcrição GênicaRESUMO
OBJECTIVES: This study examined the effects of work-related electronic communication (WREC) during non-working hours in the work from home or office setting on health. METHODS: The study recruited 98 information technology workers in a 9-day observational study. They recorded work-life events (eg, work style (working mostly from home or the office) and duration of WREC during non-working hours) and subjective ratings (eg, current fatigue, sleepiness and depression) and wore a sleep actigraph to measure objective sleep variables before bedtime every day. They completed the Brief Psychomotor Vigilance Test (PVT-B) before bedtime for 4 days. RESULTS: The frequency of WREC was significantly higher when working mostly from home than in the office (p<0.01). In addition, the duration of WREC was longer when working mostly from home than in the office (p<0.001). Linear or generalised linear mixed model analysis for fatigue, depression and PVT lapse revealed significant interaction effects between work style and WREC (all p<0.05). Post hoc analysis showed that the longer the WREC, the worse the fatigue and depression and the lower the lapse on working mostly from the office (all p<0.05). CONCLUSIONS: Longer WREC is associated with worse fatigue and depression and lower lapse of PVT (higher alertness) before bedtime for working mostly from the office. Workers, especially those working from the office, should minimise WREC during non-working hours to maintain good health. Therefore, companies, managers and other relevant stakeholders should refrain from contacting workers during non-working hours.
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Tecnologia da Informação , Teletrabalho , Humanos , Tolerância ao Trabalho Programado , Sono , Vigília , Desempenho Psicomotor , Fadiga/etiologia , Comunicação , EletrônicaRESUMO
BACKGROUND: Patients with eosinophilic chronic rhinosinusitis (ECRS) respond poorly to many treatment modalities. Overproduction of periostin in the nasal mucosa is reported to contribute to polyp formation. This study examined periostin levels in patients with ECRS in comparison with levels in patients with non-ECRS. METHODS: Fifty-nine patients with chronic rhinosinusitis were grouped into those with ECRS and those with non-ECRS. We compared the relationships between peripheral blood eosinophil level, serum periostin level, histopathological findings, clinical and laboratory findings, nose findings, diagnostic score of the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis Study, and postoperative recurrence of nasal polyps in each group. RESULTS: In the ECRS group, a positive correlation was found between peripheral blood eosinophil level and serum periostin level (rs = 0.49, P < 0.01: Spearman's rank correlation coefficient). ROC curve analysis was used to evaluate the serum periostin level that could predict postoperative recurrence of nasal polyps in the ECRS group: the area under the curve (AUC) was 0.95, sensitivity was 92%, and specificity was 100%; the serum periostin cutoff value for postoperative recurrence of nasal polyps was 130 ng/ml. In ROC curve analysis to evaluate peripheral blood eosinophil level, the AUC was 0.73, sensitivity was 69.2%, and specificity was 85.0%; the cutoff value was 8.8%. CONCLUSIONS: periostin was implicated in the pathophysiology of ECRS. Periostin shown to be a more useful biomarker than eosinophils in ECRS. Periostin was shown to likely be an important biomarker for pathological severity of ECRS and postoperative recurrence of nasal polyps.
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Pólipos Nasais , Rinite , Sinusite , Humanos , Pólipos Nasais/cirurgia , Eosinófilos/patologia , Mucosa Nasal/patologia , Biomarcadores , Doença CrônicaRESUMO
BACKGROUND: Little is known whether sublingual immunotherapy using Japanese cedar pollen extract (cedar SLIT) is effective for not only Japanese cedar pollinosis but also Japanese cypress pollinosis. We investigated the prevalence rate of Japanese cypress pollinosis, efficacy of cedar SLIT on cypress pollinosis and patients' wish to receive cypress SLIT. METHODS: We investigated a multi-center (31 institutions), cross-sectional survey using a self-administrated questionnaire with four questions for patients received cedar SLIT aged from 5 to 69 years old. RESULTS: 2523 subjects were enrolled for analysis. 83.4% of them had pollinosis symptoms during cypress season before cedar SLIT. In such patients, 37.4% experienced lessened efficacy of cedar SLIT during cypress season. Both the prevalence of cypress pollinosis and the lessened efficacy of cedar SLIT on cypress pollinosis were significantly seen in western Japan as compared to eastern Japan. 76.1% of the subject having cypress pollinosis before SLIT wished to receive cypress SLIT if it is available. CONCLUSION: A lessened efficacy of cedar SLIT during cypress season was broadly seen in Japan, and further showed a regional difference. Together with the finding of high wish by patients, these results suggest a development of cypress SLIT is desirable.
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Cryptomeria , Cupressus , Rinite Alérgica Sazonal , Imunoterapia Sublingual , Humanos , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Rinite Alérgica Sazonal/terapia , Rinite Alérgica Sazonal/tratamento farmacológico , Pólen , Estudos Transversais , Prevalência , Inquéritos e Questionários , AlérgenosRESUMO
The daily rest period (DRP) is the daily inter-work interval and can include a sleep opportunity, leisure time, and other non-work time. A longer DRP may allow workers to increase time in bed (TIB) and adjust sleep timing, and that may reduce sleep problems such as short sleep duration, sleep debt, social jetlag, and poor sleep quality. The present study examined the longitudinal association between the DRP and these sleep problems among Japanese daytime workers. The DRP, TIB on workdays, sleep quality (Pittsburgh Sleep Quality Index [PSQI]), sleep debt and social jetlag were measured in November 2016 (n = 10,000) and February 2019 (n = 3,098). Of these, 955 permanent daytime workers were divided into five groups based on the change in the DRP duration: shortened ≥2 hr, shortened ≥1 hr, no change (<1 hr), extended ≥1 hr and extended ≥2 hr. Linear mixed-model analysis revealed significant interaction (group × time) effects on the TIB, PSQI score and sleep debt (all p < 0.001), but not on social jetlag (p = 0.476). Post hoc comparisons revealed that the TIB was decreased, and the sleep debt was increased in the shortened ≥2 hr group, whereas the TIB was increased and PSQI score was improved in the extended ≥2 hr group (all p < 0.01). These findings suggest that an extension of the DRP improves sleep quantity and quality but not sleep debt and social jetlag. Aside from extending the DRP, ensuring a sufficient sleep duration and adjusting sleep timing during the DRP may also be needed to prevent sleep problems.
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Qualidade do Sono , Transtornos do Sono-Vigília , Humanos , Japão/epidemiologia , Estudos Prospectivos , Sono , Transtornos do Sono-Vigília/epidemiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To identify patients suitable for endoscopic injection sclerotherapy (EIS) by evaluating their portal hemodynamics and liver function. METHODS: We selected 58 patients with esophagogastric varices (EGV) and liver cirrhosis (LC) related to either hepatitis C virus (C) (n = 19), hepatitis B virus (n = 2), alcohol (AL) (n = 20), C + AL (n = 6), non-alcoholic steatohepatitis (n = 6), others (n = 3), or non-LC (n = 2). All patients underwent EIS. We measured their portal venous tissue blood flow (PVTBF) and hepatic arterial tissue blood flow (HATBF) using xenon computed tomography before and after EIS. We classified them into increased group and decreased group according to the PVTBF to identify the predictors that contribute to PVTBF increase post-EIS. RESULTS: Low value of indocyanine green retention at 15 min (ICG-R15), the absence of paraesophageal veins, and low baseline PVTBF/HATBF (P/A) ratio predicted increased PVTBF in the multivariate logistic analysis (odds ratio (OR) 10.46, p = 0.0391; OR 12.45, p = 0.0088; OR 13.57, p = 0.0073). The protein synthetic ability improved 1 year post-EIS in increased group. Cox proportional hazards regression identified alcohol drinking (hazard ratio; 3.67, p = 0.0261) as an independent predictor of EGV recurrence. CONCLUSIONS: Patients with low ICG-R15, low P/A ratio, and the absence of paraesophageal veins were probable predictors of PVTBF improvement post-EIS. In addition, the improvement of hepatic hemodynamics likely enhanced liver function following EIS.
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Varizes Esofágicas e Gástricas , Varizes , Varizes Esofágicas e Gástricas/etiologia , Varizes Esofágicas e Gástricas/terapia , Hemodinâmica , Humanos , Cirrose Hepática , Veia Porta/diagnóstico por imagem , Escleroterapia/métodosRESUMO
OBJECTIVE: To report a surgical technique and an outcome for the repair of a displaced, transverse scapular body fracture with locking compression plates (LCPs) in a colt. ANIMALS: One 5 month old Thoroughbred colt. STUDY DESIGN: Case report. METHODS: A colt sustained an unstable, comminuted, transverse fracture of the scapular body. Three 4.5/5.0 mm LCPs were used with 6.5 mm cancellous screws, 4.5 mm cortex screws, and 5.0 mm locking head screws. Implants were removed 2 months after surgery. RESULTS: Surgical site infection was identified by purulent discharge at the distal aspect of the suture line 3 days after surgery. The surgical site infection resolved with daily lavage within 15 days after surgery. Three months after internal fixation of the scapular body fracture, the colt was sound and was turned out to pasture. One year later, the colt was sound and in training to be a flat racehorse. CONCLUSION: Repair of a scapular body fracture using LCP provided a good outcome with an early return to soundness. The LCP system can therefore be considered for the repair of scapular body fractures in small equids.
Assuntos
Fraturas Ósseas , Fraturas Cominutivas , Doenças dos Cavalos , Animais , Placas Ósseas/veterinária , Fixação Interna de Fraturas/veterinária , Fraturas Ósseas/cirurgia , Fraturas Ósseas/veterinária , Fraturas Cominutivas/veterinária , Cavalos , Masculino , Escápula/cirurgiaRESUMO
AIM: To examine the long-term efficacy and safety of dapagliflozin, a sodium-glucose co-transporter-2 (SGLT2) inhibitor used to treat type 1 diabetes, in the Japanese subpopulation of the DEPICT-2 study. MATERIALS AND METHODS: Patients with type 1 diabetes were randomized to dapagliflozin 5 mg (n = 55), dapagliflozin 10 mg (n = 41) or placebo (n = 58) plus insulin for a 24-week, double-blind period followed by a 28-week, single-blind extension phase. RESULTS: From baseline to 24 weeks, dapagliflozin reduced HbA1c compared with placebo (mean change of -0.58% and -0.80% for 5 and 10 mg, respectively), and an HbA1c reduction was observed up to 52 weeks. Compared with placebo, dapagliflozin 5 and 10 mg increased the proportion of patients achieving HbA1c reductions of 0.5% or more without severe hypoglycaemia events and reduced glycaemic variability assessed via continuous glucose monitoring. Both dapagliflozin doses decreased body weight and total daily insulin dose at 24 weeks compared with placebo; these reductions were maintained up to 52 weeks. Diabetic ketoacidosis occurred in both dapagliflozin groups (one and two cases, respectively) but not with placebo. CONCLUSIONS: Efficacy and safety results from the Japanese subpopulation of the DEPICT-2 study were generally consistent with those from the overall population, indicating that long-term dapagliflozin adjunct to insulin therapy improves glycaemic control without an increased risk of hypoglycaemia but with a risk of diabetic ketoacidosis in Japanese patients with type 1 diabetes.
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Diabetes Mellitus Tipo 1 , Compostos Benzidrílicos/efeitos adversos , Glicemia , Automonitorização da Glicemia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Método Duplo-Cego , Quimioterapia Combinada , Glucosídeos , Hemoglobinas Glicadas/análise , Humanos , Hipoglicemiantes/efeitos adversos , Insulina/uso terapêutico , Japão/epidemiologia , Método Simples-Cego , Resultado do TratamentoRESUMO
PURPOSE: We aimed to cross-sectionally investigate how work and sleep conditions could be associated with excessive fatigue symptoms as an early sign of Karoshi (overwork-related cerebrovascular and cardiovascular diseases; CCVDs). METHODS: We distributed a questionnaire regarding work, sleep, and excessive fatigue symptoms to 5410 truck drivers, as the riskiest occupation for overwork-related CCVDs, and collected 1992 total samples (response rate: 36.8%). The research team collected 1564 investigation reports required for compensation for Karoshi. Of them, 190 reports listed the prodromes of Karoshi, which were used to develop the new excessive fatigue symptoms inventory. RESULTS: One-way analyses of variance showed that the excessive fatigue symptoms differed significantly by monthly overtime hours (p < 0.001), daily working time (p < 0.001), work schedule (p = 0.025), waiting time on-site (p = 0.049), number of night shifts (p = 0.011), and sleep duration on workdays (p < 0.001). Multivariate mixed-model regression analyses revealed shorter sleep duration as the most effective parameter for predicting excessive fatigue symptoms. Multiple logistic regression analysis confirmed that the occurrences of CCVDs were significantly higher in the middle [adjusted ORs = 3.56 (1.28-9.94)] and high-score groups [3.55 (1.24-10.21)] than in the low-score group. CONCLUSION: The findings suggested that shorter sleep duration was associated more closely with a marked increase in fatigue, as compared with the other work and sleep factors. Hence, ensuring sleep opportunities could be targeted for reducing the potential risks of Karoshi among truck drivers.
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Doenças Cardiovasculares/epidemiologia , Fadiga/epidemiologia , Doenças Profissionais/epidemiologia , Sono , Carga de Trabalho , Adulto , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Veículos Automotores , Ocupações , Fatores de Risco , Indenização aos TrabalhadoresRESUMO
Objectives: The work interval duration between the end of one workday and the start of the following workday is referred to as the daily rest period (DRP). The present study examined whether DRP - a proxy for sleep opportunity between work shifts - is associated with indicators of sleep debt and social jetlag among daytime workers. Methods: We used a web-based survey to gather data on demographics, average DRP in the previous month, time in bed (TIB), bedtime, wake-up time, and sleep timing on workdays and non-workdays. The Japanese daytime workers (n = 3,914) were divided into seven DRP groups (hours) as follows: <11, 11, 12, 13, 14, 15, and ≥16. Results: The two-way analyses of covariance (DRP group x day) for TIB, mid-sleep as sleep timing, bedtime, and wake-up time showed significant interactions (all p < .001). Specifically, TIB was significantly shorter, and mid-sleep and wake-up time were significantly earlier on workdays than on non-workdays, across all DRP groups (all p < .001). Additionally, the different values for TIB (sleep debt), sleep timing (social jetlag), bedtime, and wake-up time were calculated by subtracting workdays from non-workdays. The trend analysis showed that workers with longer DRP (sleep opportunity) had smaller differences in TIB, sleep timing, and wake-up time between workdays and non-workdays (all p < .001). Conclusions: Overall, daytime workers reported significant sleep debt and misalignment between work and free sleep-wake periods. However, workers with shorter DRPs (less sleep opportunity between shifts) reported significantly greater amounts of sleep debt and social jetlag than did workers with longer DRPs.
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Síndrome do Jet Lag/complicações , Privação do Sono/complicações , Transtornos do Sono-Vigília/complicações , Adulto , Ritmo Circadiano , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
An 8-month-old thoroughbred colt presented with sudden onset right forelimb lameness. A radiographic series of the right carpus was performed, and it revealed a slab fracture of the fourth carpal bone and fracture of the proximal part of the third metacarpal bone. Arthroscopically guided repair of the slab fracture of the fourth carpal bone with a 3.5 mm cortex screw and lag screw fixation of the fracture of the proximal part of the third metacarpal bone were performed. The horse started to race at 32 months old and started in 65 races over three years without any trouble associated with the right carpus.
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BACKGROUND: Recent improvements in stone extraction implements and apparatus have lessened the complexity of the endoscopic bile duct stone treatment. However, despite confirmation of complete removal, cases of residual stones have been reported, which can result in recurrent biliary symptoms, cholangitis, and pancreatitis and considerably increase cost given the need for repeat imaging and/or procedures. To date, risk factors for residual bile duct stones following endoscopic retrograde cholangiopancreatography (ERCP) extraction have not been thoroughly evaluated. This study retrospectively investigated the incidence and risk factors of residual bile duct stones following extraction via ERCP. METHODS: We retrospectively reviewed all ERCP cases that underwent endoscopic bile duct stone extraction between April 2014 and March 2019. A total of 505 patients were enrolled and evaluated for the incidence and risk factors of residual bile duct stones after ERCP. RESULTS: The rate of residual stones was 4.8% (24/505). Residual stones were detected by computed tomography (12/24) or magnetic resonance cholangiopancreatography (12/24). In univariate analyses, a large number of stones (P = 0.01), long procedure time (P = 0.005), and performance of the pancreatic duct guidewire placement method (P-GW) for selective bile duct cannulation (P = 0.01) were the factors involved in residual stones. In multiple logistic regression analysis, performing P-GW was retained as the only independent factor of residual stones (adjusted odds ratio, 3.44; 95% CI, 1.19-9.88; P = 0.02). CONCLUSIONS: When removing bile duct stones with a pancreatic guidewire in place, paying attention to residual stones is necessary.
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Colangiopancreatografia Retrógrada Endoscópica , Ductos Pancreáticos , Cateterismo , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Humanos , Ductos Pancreáticos/diagnóstico por imagem , Ductos Pancreáticos/cirurgia , Estudos Retrospectivos , Fatores de Risco , Esfinterotomia Endoscópica , Resultado do TratamentoRESUMO
BACKGROUND: In clinical trials, a pangenotype direct-acting antiviral (DAA) regimen consisting of glecaprevir (GLE) and pibrentasvir (PIB) exhibited high virologic efficacy and tolerability in patients with hepatitis C virus (HCV) infection. This study sought to confirm these findings in real-world settings, focusing on patients with cirrhosis, history of DAA failure, or HCV genotype 3 who were treated with a 12-week regimen in a large multicenter study from Japan. METHODS: In a nationwide multicenter prospective cohort study, we analyzed background characteristics, tolerability, and treatment outcome of patients who underwent a 12-week GLE/PIB regimen. RESULTS: Of 1190 patients, 509 (42.8%) underwent the 12-week regimen, and the remaining patients underwent an 8-week regimen. The rate of sustained virologic response (SVR) of patients treated with the 12-week regimen was 99.0%, comparable with that of patients treated with the 8-week regimen. The adverse events were observed in 29.1% of patients. The main adverse event was pruritus, which was observed in 14.7%. Ten patients (2.0%) discontinued therapy during treatment period. CONCLUSION: The 12-week GLE/PIB regimen was well-tolerated with high virologic efficacy in patients with cirrhosis, experience of DAA, or HCV genotype 3; tolerability and SVR rate were comparable with those of DAA-naïve, non-cirrhotic, non-genotype 3 patients who underwent 8-week regimen.
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Antivirais/administração & dosagem , Benzimidazóis/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Pirrolidinas/administração & dosagem , Quinoxalinas/administração & dosagem , Sulfonamidas/administração & dosagem , Adulto , Idoso , Estudos de Coortes , Combinação de Medicamentos , Feminino , Seguimentos , Hepatite C Crônica/virologia , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resposta Viral Sustentada , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND AND AIM: The presence of cirrhosis is an important factor for the management of patients with hepatitis C virus (HCV) infection and it determines the duration of treatment for HCV with the direct-acting antiviral (DAA) regimen of glecaprevir (GLE) and pibrentasvir (PIB), that is, 8 or 12 weeks, if patients do not have a history of DAA failure. However, in real-world settings, determination of cirrhosis depends on the discretion of the attending hepatologists, and it is unclear whether compensated cirrhosis was homogenously diagnosed or not. In this study, we investigated the real-world diagnosis of cirrhosis by characterizing DAA-naïve patients who underwent a 12-week GLE/PIB regimen in whom cirrhosis was diagnosed, comparing their characteristics with those of patients who underwent an 8-week regimen in whom cirrhosis was absent. METHODS: In a large, multicenter cohort study, we compared background characteristics and treatment outcomes among DAA-naïve patients who underwent an 8-week versus a 12-week GLE/PIB regimen. RESULTS: Among 977 patients enrolled, 296 (30.3%) were determined to have cirrhosis and underwent a 12-week regimen. Some patient characteristics largely overlapped between the two groups, including liver fibrosis indices. Sustained viral response rates were similar between groups after adjusting liver fibrosis index with propensity score matching. CONCLUSION: Although adequately diagnosed, the determination of cirrhosis varied widely among institutions or by hepatologists in real-world settings, and the severity of liver fibrosis overlapped significantly between patients in whom compensated cirrhosis was determined to be present and patients in whom cirrhosis was absent. Virologic efficacy was similar after adjusting for the degree of liver fibrosis.
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Hepatite C Crônica/tratamento farmacológico , Cirrose Hepática/diagnóstico , Idoso , Ácidos Aminoisobutíricos , Antivirais/administração & dosagem , Benzimidazóis/administração & dosagem , Estudos de Coortes , Ciclopropanos , Humanos , Japão , Lactamas Macrocíclicas , Leucina/análogos & derivados , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Prolina/análogos & derivados , Pontuação de Propensão , Pirrolidinas , Quinoxalinas/administração & dosagem , Índice de Gravidade de Doença , Sulfonamidas/administração & dosagem , Fatores de TempoRESUMO
The scallop Mizuhopecten yessoensis accumulates carotenoids in the ovary during the maturation stage. Its conspicuous pink color implies the presence of carotenoprotein. However, the carotenoprotein from the scallop ovary has never been isolated and characterized, probably due to its instability and complexity. Here, we developed an extraction and isolation procedure for the carotenoprotein by employing a basic buffer containing potassium bromide to facilitate its efficient extraction from the ovary, and we succeeded in obtaining the carotenoprotein, termed pectenovarin. The carotenoid composition of the pectenovarin was similar to that of the ovary. The N-terminal and internal amino acid sequences of pectenovarin showed a high similarity to those of vitellogenin, the precursor of egg yolk protein under analysis.
Assuntos
Carotenoides/química , Proteínas do Ovo/metabolismo , Ovário/metabolismo , Pectinidae/metabolismo , Sequência de Aminoácidos , Animais , Feminino , Homologia de SequênciaRESUMO
BACKGROUND: Eosinophilic chronic rhinosinusitis (ECRS) is a subtype of chronic rhinosinusitis associated with asthma. CD69 is an important marker of activation for eosinophils. But, whether a correlation exist between the CD69 expression on eosinophils and clinical findings is unclear. METHODS: We performed quantitative PCR and/or flow cytometry using tissue and purified eosinophils from the blood and nasal polyps of 12 patients with ECRS and from 8 patients without ECRS (controls). We assessed clinical findings including nasal polyp (NP) scores, sinus CT findings, and pulmonary function test results, and examined their possible association with the CD69 expression. We also performed CD69 cross-linking experiments in mouse eosinophils to investigate the functional role of CD69. RESULTS: Levels of cytokine mRNAs (IL-4, -5, -10, and -13) were significantly higher in purified NP eosinophils and tissues from patients with ECRS than the levels of those in controls. The expressions of major basic protein (MBP), eosinophilic cationic protein (ECP), eosinophilic-derived neurotoxin (EDN), eosinophil peroxidase (EPX) in cytotoxic granules, and CD69 mRNA were significantly higher in purified eosinophils from NPs than in those from blood. We also found a correlation between expression of CD69 and clinical findings. Moreover, we found EPX release from mouse eosinophils following CD69 cross-linking. CONCLUSIONS: These data suggest that increased CD69 expression by eosinophils is not only a biomarker for nasal obstruction and pulmonary dysfunction, but also a potential therapeutic target for patients with ECRS and asthma.