Fermented food Tempeh induces interleukin 12 and enhances macrophage phagocytosis.

It is known that lactic acid bacteria induce the IL-12. The IL-12 activates NK cells and promotes the production of IFN-γ. The IFN-γ activates macrophages resulting in enhanced phagocytosis and bactericidal activity. We have been investigating fermented foods that activate the immune function. In this study, we investigated the IL-12 inducibility of fermented foods using the specific antibody. Fermented soybean foods such as Tempeh and Natto are attracting attention in terms of nutrition, functionality, and food problems. In this study, Tempeh induced 1,080 µg/ml of IL-12, and IFN-γ associated with the induction of IL-12 was also induced at 682 µg/ml. This was more than twice the induced intensity of PBS. On the contrary, Natto hardly induced IL-12 and IFN-γ. Tempeh also accelerated phagocytosis of the macrophage THP-1 cells. In this study, it was found that the fermented soybean-derived food, Tempeh, has a function of activating the immune function. This is the first report that Tempeh activates innate immunity. PRACTICAL APPLICATIONS: Tempeh, a fermented soybean food induced the IL-12 and IFN-γ production and the increase of macrophage phagocytosis in this study suggested a new function to enhance immunity. Tempeh is also expected to be effective in preventing lifestyle diseases. Fermented soybean products of Tempeh was considered to be a very useful health food for the problems of modern society such as maintaining health by eating, improving immunity, and ingesting vegetable protein due to diversifying food.

[A Case of Advanced Esophagogastric Junction Cancer Responding to S-1 Neoadjuvant Chemotherapy].

A 56-year-old man was diagnosed with advanced adenocarcinoma of the esophagogastric junction. He received 1 course of neoadjuvant chemotherapy with S-1. After neoadjuvant chemotherapy, the primary tumor showed a remarkable decrease in size. Subtotalesophagectomy, D2 lymph node dissection, and reconstruction with a gastric tube through the posterior mediastinal route were performed. Pathological examination showed that most of the cancer cells had been destroyed, with a part where adenocarcinoma mucosa was seen. We successfully treated a case of advanced adenocarcinoma of the esophagogastric junction, with neoadjuvant S-1 chemotherapy and surgicalresection.

Therapeutic depletion of myeloid lineage leukocytes by adsorptive apheresis for psoriatic arthritis: Efficacy of a non-drug intervention for patients refractory to pharmacologics.

Psoriatic arthritis (PsA), a chronic inflammatory arthropathy associated with psoriasis, is an intractable immune disorder and refractory to pharmacological intervention. We assessed efficacy of selective depletion of myeloid lineage leukocytes in patients with PsA in a multicenter setting. A total of 20 patients with moderate to severe PsA refractory to conventional and biological disease-modifying antirheumatic drugs were included. Eligible patients had 3 points or more in the classification criteria for PsA. Each patient received five sessions, once a week, of adsorptive granulocyte and monocyte apheresis (GMA) with the Adacolumn® . The primary efficacy outcome was 20% or more decrease in the American College of Rheumatology score 20 (ACR20). Partial responders could receive an additional five GMA sessions. Of 20 patients, two did not complete the study, nine responded to five GMA sessions and nine received 10 sessions. At the first evaluation 2 weeks after the last GMA session, 13 of the 20 (65.0%) patients achieved ACR20. ACR20 was maintained in seven of 10 (70%) and five of 10 (50%) patients at the follow-up evaluation points 8 and 20 weeks after the last GMA session, respectively. GMA was well tolerated without any safety concern. This study demonstrates that GMA with the Adacolumn was effective with good safety profile in patients with PsA refractory to pharmacologicals. The results indicate a major role for myeloid leukocytes in the immunopathogenesis of PsA. A large controlled study is warranted to fully evaluate the efficacy of Adacolumn GMA in patients with PsA.

Direct visualization of pancreatic juice flow using unenhanced MRI with spin labeling can be aid in diagnosing chronic pancreatitis.

OBJECTIVE: The purpose of this study is to prospectively assess whether direct visualization of pancreatic juice flow using an unenhanced MRI technique with spin labeling can aid in the diagnosis of chronic pancreatitis. SUBJECTS AND METHODS: Ten healthy volunteers and 50 patients who were categorized as having no chronic pancreatitis (n = 11), early chronic pancreatitis (n = 7), or established chronic pancreatitis (n = 32) underwent MRI, including direct pancreatic juice visualization using a flow-out technique with a time-spatial labeling inversion pulse, comprising a nonselective inversion recovery pulse immediately followed by a spatially selective inversion labeling pulse. The mean velocities and volumes of pancreatic juice excretion were also obtained. Variance tests were used to evaluate the clinical groups with respect to the appearance rate and mean velocity; the Kruskal-Wallis test was used for volume. RESULTS: There were no significant differences between healthy volunteers and patients with no chronic pancreatitis. The appearance rate, mean velocity, and volume of pancreatic juice excretion tended to decrease with the degree of chronic pancreatitis. Although the difference in these values was statistically significant between the healthy group and the established chronic pancreatitis group, the values of the early group and other groups were not statistically significant. There was a significant correlation between the appearance rate of pancreatic juice and the clinical groups (τ = -0.4376, p = 0.0015). CONCLUSION: The measurement of directly visualized pancreatic juice flow may aid in establishing the diagnosis of chronic pancreatitis.

Visualization of pancreatic juice movement using unenhanced MR imaging with spin labeling: preliminary results in normal and pathophysiologic conditions.

PURPOSE: To visualize the movement of pancreatic juice noninvasively by using an unenhanced magnetic resonance (MR) imaging technique. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained for this study. A flow-out technique of time-spatial labeling inversion pulse (SLIP) technique was applied using both nonselective and selective inversion pulses to label, or tag, pancreatic juice to move out of the region. Ten normal (eight men, two women; age range, 22-61 years; mean age, 35 years) and two pathologic conditions were examined on a commercially available 1.5 Tesla MR imager with quadrature-detected phased-array coils. All images were evaluated by two radiologists to assess depiction of the pancreatic juice movement or pancreatic juice reflux as compared to the pancreatic duct or the common bile duct on MRCP obtained before time-SLIP examination. RESULTS: The tagged pancreatic juice was satisfactory visualized after applying the pulse labeling. Noninvasive visualization of pancreatic juice movement, including normal pancreatic juice movement and reflux from the main pancreatic duct into the common bile duct, was possible by using the unenhanced time-SLIP technique. CONCLUSION: Noninvasive visualization of pancreatic juice movement is possible by using the unenhanced MR imaging time-SLIP technique.

Diagnostic efficacy of the cell block method in comparison with smear cytology of tissue samples obtained by endoscopic ultrasound-guided fine-needle aspiration.

BACKGROUND: The diagnostic efficacy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology may vary greatly depending on the treatment of the samples obtained and the level of proficiency of the cytopathologist or cytoscreener. METHODS: We prospectively evaluated the diagnostic efficacy of the cell block (CB) method and that of smear cytology using tissue samples obtained in the same needle pass at EUS-FNA in 33 patients with pancreatic tumors, abdominal tumors or swollen lymph nodes. An average of 3.1 passes were applied during the procedure without affirmation by rapid cytology. About half of the material obtained by each single pass was subjected to smear cytology, while the other half was evaluated by the CB method. Four to 12 glass slides were prepared for both Papanicolaou stain and Giemsa stain. The CB sections were prepared using the sodium alginate method and subjected to HE, PAS-AB and immunohistochemical stains. Two pathologists independently made cytological and histological diagnoses. The final diagnosis was based on integration of cytohistological findings, diagnostic imaging, and clinical course. RESULTS: The diagnostic accuracy of the CB method and that of smear cytology were 93.9 and 60.6%, respectively (p = 0.003), and their respective sensitivities were 92.0 and 60.0% (p = 0.02). It was easier to make a definite diagnosis of not only malignancies but also benign conditions by the CB method than by the smear method. CONCLUSION: The CB method with immunostaining showed a higher diagnostic yield than smear cytology in patients who had undergone EUS-FNA without rapid on-site cytology.

High b-value diffusion-weighted MRI for detecting gallbladder carcinoma: preliminary study and results.

The aim of this preliminary study was to retrospectively evaluate the usefulness of high b-value diffusion-weighted MR imaging (DWI) in the detection of gallbladder carcinoma. Fifteen patients with gallbladder carcinoma and 14 other patients were included in this study. All patients and subjects underwent DWI, and images were evaluated by two radiologists. The area under the receiver operating characteristic curve (AUC), apparent diffusion coefficient (ADC) measurement, sensitivity and specificity were calculated. An AUC yielded 0.980 (95% CI, 0.850-0.999) and 0.941 (95% CI, 0.791-0.990) for the two radiologists. The mean sensitivity and specificity were 83.3% and 100%, respectively. The mean ADC value of gallbladder carcinoma was (1.28 +/- 0.41)x10(-3) mm(2)/s and that of control gallbladder lesions was (1.92 +/- 0.21)x10(-3) mm(2)/s (P < 0.01). According to the results of our preliminary study, high b-value DWI might be a useful tool for detecting gallbladder carcinoma by measuring the ADC value and direct visual assessment.

[Pathological complete response in an elderly patient with locally advanced gastric cancer treated with S-1/CDDP].

We report a patient with locally advanced gastric carcinoma successfully treated with S-1/CDDP. The patient was a 77-year-old woman who had gastric cancer surgically diagnosed as T4N2, invading the pancreas and mesocolon. After the firsts exploratory laparotomy, chemotherapy was begun as follows. S-1(80 mg/day)was orally administered for 3 weeks followed by 2 weeks' rest as a course, and CDDP(75 mg/body)was administered by intravenous drip on day 8. Because of severe anorexia and nausea, however, the CDDP administration had to be discontinued. Therefore, we changed the procedure to S-1 single treatments, 2 weeks' administration followed by 2 weeks' rest. The total 9 courses of this procedure proved successful. Subsequently, she underwent curative surgery consisting of total gastrectomy with D2 lymph node dissection, combined with distal pancreatectomy and splenectomy, and obtained pathological CR. S-1/CDDP appears to be an effective treatment modality for advanced gastric cancer.

X-ray telescope onboard Astro-E. III. Guidelines to performance improvements and optimization of the ray-tracing simulator.

We present a detailed study of the performance of the Astro-E x-ray telescope (XRT) onboard the Astro-E satellite. As described in preceding papers the ground-based calibrations of the Astro-E XRT revealed that its image quality and effective area are somewhat worse than that expected from the original design. Conceivable causes for such performance degradation are examined by x-ray and optical microscopic measurements at various levels, such as individual reflectors, sectors, and quadrants of the XRT and their alignments. We can attribute, based on detailed measurements, the degradation of the image quality to a slope error in the individual reflectors and the positioning error of reflectors. As for the deficit of the effective area, the shadowing of x rays within the XRT body is the dominant factor. Error budgets for the performance degradation of the Astro-E XRT are summarized. The ray-tracing simulator, which is needed to construct the response function for arbitrary off-axis angles and spatial distributions of any celestial x-ray sources, has been developed and tuned based on the results of detailed measurements. The ray-tracing simulation provides results that are consistent within 3% with the real measurement except for large off-axis angles and higher energies. We propose, based on knowledge obtained from all the measurements and simulations, several plans for future developments to improve the performance of the nested thin-foil mirrors.

Autoimmune pancreatitis and multiple bile duct strictures treated effectively with steroid.

We herein report a patient with strictures of the hepatic hilar and intrapancreatic bile duct associated with autoimmune pancreatitis, who responded well to corticosteroid therapy. Although this bile duct lesion resembled primary sclerosing cholangitis (PSC) morphologically,its dramatic response to corticosteroid therapy seems to indicate that it is a different entity. A review of the literature revealed 13 patients with multiple biliary strictures and chronic pancreatitis successfully treated with corticosteroid therapy. From the clinical point of view, knowledge of the existence of a patient group with autoimmune pancreatitis with morphology similar to that of PSC and which responds well to corticosteroid therapy is important.

Characterization of the supermirror hard-x-ray telescope for the InFOCmuS balloon experiment.

A hard-x-ray telescope is successfully produced for balloon observations by making use of depth-graded multilayers, or so-called supermirrors, with platinum-carbon (Pt/C) layer pairs. It consists of four quadrant units assembled in an optical configuration with a diameter of 40 cm and a focal length of 8 m. Each quadrant is made of 510 pieces of coaxially and confocally aligned supermirrors that significantly enhance the sensitivity in an energy range of 20-40 keV. The configuration of the telescope is similar to the x-ray telescope onboard Astro-E, but with a longer focal length. The reflectivity of supermirrors is of the order of 40% in the energy range concerned at a grazing angle of 0.2 deg. The effective area of a fully assembled telescope is 50 cm2 at 30 keV. The angular resolution is 2.37 arc min at half-power diameter 8.0 keV. The field of view is 12.6 arc min in the hard-x-ray region, depending somewhat on x-ray energies. We discuss these characteristics, taking into account the figure errors of reflectors and their optical alignment in the telescope assembly. This hard-x-ray telescope is unanimously afforded in the International Focusing Optics Collaboration for muCrab Sensitivity balloon experiment.

Spindle cell angiosarcoma following irradiation therapy for cervical carcinoma.

BACKGROUND: Angiosarcomas arise in the scalp and face in the elderly, in association with chronic lymphedema (Stewart-Treves syndrome), and in irradiated areas. Rarely in these settings, angiosarcomas exhibit pure spindle cell phenotype. METHODS: Herein, the clinicopathologic features of a 72-year-old-woman with spindle cell angiosarcoma are described. RESULTS: A 72-year-old woman presented with numerous nodules and diffuse induration from the lower abdomen to the right buttock, corresponding to the area exposed to 60Co-irradiation during treatment for cervical carcinoma 10 years earlier. Histopathological examination revealed inflitrative, atypical, spindle cells that labeled with antibodies to CD31, CD34, and factor VIII-related antigen. Ultrastructurally, these malignant spindle cells contained Weibel-Palade bodies. No features suggesting radiation dermatitis (sclerosis or bizarre, large fibroblasts) were identified, but lymphangiectases and widely spaced collagen bundles(lymphedema) were prominent in the skin surrounding the angiosarcoma. Computed tomographic scan of the abdomen highlighted this histologic finding by demonstrating tumor masses limited to areas of lymphedema. Treatment with intravenous and local injections of recombinant interleukin 2 (rIL 2) followed by electron beam irradiation were initially effective with tumor remission for 2 months. However, the recurrent tumor did not respond to a second course of one-shot injection of rIL 2 through the abdominal aorta and the patient succumbed to her angiosarcoma 19 months after diagnosis. CONCLUSIONS: Radiation-induced lymphedema may be a factor in angiosarcoma associated with radiotherapy.