Muscle layer histopathology and manometry pattern of primary esophageal motility disorders including achalasia

BACKGROUND

Histopathology of muscularis externa in primary esophageal motility disorders has been characterized previously. We aimed to correlate the results of high-resolution manometry with those of histopathology.

METHODS

During peroral endoscopic myotomy, peroral esophageal muscle biopsy was performed in patients with primary esophageal motility disorders. Immunohistochemical staining for c-kit was performed to assess the interstitial cells of Cajal (ICCs). Hematoxylin Eosin and Azan-Mallory staining were used to detect muscle atrophy, inflammation, and fibrosis, respectively.

KEY RESULTS

Slides from 30 patients with the following motility disorders were analyzed: achalasia (type I: 14, type II: 5, type III: 3), one diffuse esophageal spasm (DES), two outflow obstruction (OO), four jackhammer esophagus (JE), and one nutcracker esophagus (NE). ICCs were preserved in high numbers in type III achalasia (n=9.4±1.2 cells/high power field [HPF]), compared to types I (n=3.7±0.3 cells/HPF) and II (n=3.5±1.0 cells/HPF). Moreover, severe fibrosis was only observed in type I achalasia and not in other types of achalasia, OO, or DES. Four of five patients with JE and NE had severe inflammation with eosinophilic infiltration of the esophageal muscle layer (73.8±50.3 eosinophils/HPF) with no epithelial eosinophils. One patient with JE showed a visceral myopathy pattern.

CONCLUSIONS & INFERENCES

Compared to types I and II, type III achalasia showed preserved ICCs, with variable data regarding DES and OO. In disorders considered as primary esophageal motility disorders, a disease category exists, which shows eosinophilic infiltration in the esophageal muscle layer with no eosinophils in the epithelium.

Observation of the flexoelectricity of a SrTiO3 single crystal by x-ray absorption and emission spectroscopies

Flexoelectricity, defined as the spontaneous electric polarization in a dielectric material induced by a strain gradient, is investigated from the microscopic viewpoint by x-ray spectroscopy. A single crystal SrTiO₃ sample was used as a test system in order to reveal the appearance of the electric dipole moment by simple bending of the crystal. The spectral change characteristic of ferroelectric transition in SrTiO₃ was not observed in the Ti K-edge absorption spectra. Instead, the gradual decrease (increase) of the post-edge feature (pre-edge structure) by bending was qualitatively explained using theoretical calculations that assumed the presence of oxygen vacancies and a slight crystal distortion. This assumption is also supported by the broadening of a tiny charge-transfer peak in the Ti Kβ resonant emission spectra. Therefore, it was revealed that the flexoelectric effect in SrTiO₃ is easily drowned out through local imperfection induced by crystal deformations and cracks.

Effect of Solution Osmotic Pressure on Cell Fusion by Poly(Ethylene Glycol)

Effects of the osmotic pressure of culture medium on the membrane fusion of L929 cells in the monolayer state were investigated using polyethylene glycol) (PEG) with the molecular weight of 3,000 at various concentrations at phosphate buffer saline (PBS). Cell incubation for fusion was performed via three stages; (1) incubation before PEG treatment (preincubation), (2) incubation in the presence of PEG (PEG incubation), and (3) incubation after PEG treatment (postincubation). The PBS concentrations half that of a isotonic solution in the pre- and postincubation stages significantly accelerated the membrane fusion, whereas cell treatment at more hypotonic or hypertonic concentrations of PBS suppressed cell fusion. This result was explained in terms of cell swelling and shrinking induced by the osmotic pressure difference, because such cell morphological changes actually occurred when the PBS concentration was varied from the isotonicity. In contrast, almost no effect of osmotic pressure on cell fusion was observed if PEG was present in the culture medium at 40 w/w% concentration, regardless of the PBS concentration.

Genome-wide DNA markers to support genetic management for domestication and commercial production in a large rodent, the Ghanaian grasscutter (Thryonomys swinderianus)

Domestication and commercial production of the grasscutter, Thryonomys swinderianus, a large rodent, represents an important opportunity to secure sustainable animal protein for local communities in West Africa. To support production, DNA markers are required for population diversity assessment, pedigree analysis and marker-assisted selection. This study reports the application of double-digest RAD sequencing to simultaneously discover and genotype SNP markers in 24 wild and recently domesticated grasscutters. An initial panel of 1209 SNP loci was characterised from a total of more than 21 000 candidate loci containing single SNPs. This genome-wide resource represents the first application of its type to commercial production of a large rodent for food and advances the use of agricultural genomics in Ghana.

Endovascular Treatment Using Detachable Coils for Non-Ruptured Intracranial Aneurysm

Detachable coil embolization was performed on 34 non-ruptured cerebral aneurysms in 33 patients. Patients consisted of 28 females and five males, with an age range of 26 to 77 years.

Angiographic examination after coil embolization revealed complete or near-complete occlusion in 24 aneurysms (70.5%) and partial occlusion in three (8.8%). Detachable coil embolization was attempted unsuccessfully in seven aneurysms (20.5%).

Transient ischemic attack occurred in one case with coil migration. The combined mortality/morbidity rate was 0%.

Use of a Latent Topic Model for Characteristic Extraction from Health Checkup Questionnaire Data

OBJECTIVES

When patients complete questionnaires during health checkups, many of their responses are subjective, making topic extraction difficult. Therefore, the purpose of this study was to develop a model capable of extracting appropriate topics from subjective data in questionnaires conducted during health checkups.

METHODS

We employed a latent topic model to group the lifestyle habits of the study participants and represented their responses to items on health checkup questionnaires as a probability model. For the probability model, we used latent Dirichlet allocation to extract 30 topics from the questionnaires. According to the model parameters, a total of 4381 study participants were then divided into groups based on these topics. Results from laboratory tests, including blood glucose level, triglycerides, and estimated glomerular filtration rate, were compared between each group, and these results were then compared with those obtained by hierarchical clustering.

RESULTS

If a significant (p < 0.05) difference was observed in any of the laboratory measurements between groups, it was considered to indicate a questionnaire response pattern corresponding to the value of the test result. A comparison between the latent topic model and hierarchical clustering grouping revealed that, in the latent topic model method, a small group of participants who reported having subjective signs of urinary disorder were allocated to a single group.

CONCLUSIONS

The latent topic model is useful for extracting characteristics from a small number of groups from questionnaires with a large number of items. These results show that, in addition to chief complaints and history of past illness, questionnaire data obtained during medical checkups can serve as useful judgment criteria for assessing the conditions of patients.

Prediction model for glucose metabolism based on lipid metabolism

OBJECTIVES

We developed a robust, long-term clinical prediction model to predict conditions leading to early diabetes using laboratory values other than blood glucose and insulin levels. Our model protects against missing data and noise that occur during long-term analysis.

METHODS

RESULTS of a 75-g oral glucose tolerance test (OGTT) were divided into three groups: diabetes, impaired glucose tolerance (IGT), and normal (n = 114, 235, and 325, respectively). For glucose metabolic and lipid metabolic parameters, near 30-day mean values and 10-year integrated values were compared. The relation between high-density lipoprotein cholesterol (HDL-C) and variations in HbA1c was analyzed in 158 patients. We also constructed a state space model consisting of an observation model (HDL-C and HbA1c) and an internal model (disorders of lipid metabolism and glucose metabolism) and applied this model to 116 cases.

RESULTS

The root mean square error between the observed HbA1c and predicted HbA1c was 0.25.

CONCLUSIONS

In the observation model, HDL-C levels were useful for prediction of increases in HbA1c. Even with numerous missing values over time, as occurs in clinical practice, clinically valid predictions can be made using this state space model.

Preclinical anticancer effects and toxicologic assessment of hepatic artery infusion of fine-powder cisplatin with lipiodol in vivo

We conducted an in vivo study to evaluate the anticancer effect and toxicity of fine-powder cisplatin suspended in lipiodol (fCDDP/LPD suspension) after a single administration of three different doses to rats via the intrahepatic artery after transplantation of rat ascites hepatoma cells. The toxicity of the fCDDP/LPD suspension was also assessed in the same protocol in noncancer-bearing rats and the observed toxicologic changes were compared among groups administered saline (Sal), an aqueous solution of fCDDP (fCDDP/Sal solution), and LPD alone. In parallel with the toxicity test, plasma CDDP concentrations were compared between the fCDDP/LPD suspension and fCDDP/Sal solution. The mean weight of the tumors in the fCDDP/LPD suspension groups was significantly less than in the LPD-alone group. The pathologic changes in the liver observed in the fCDDP/LPD suspension group increased with dose, were more marked compared with those in the fCDDP/Sal solution and LPD-alone groups, and were reversible. No other toxicologic effects were observed. The concentration of CDDP in the plasma in the fCDDP/LPD suspension group was slightly lower than that in the fCDDP/Sal solution group. In conclusion, the results indicate that the fCDDP/LPD suspension has sufficient anticancer efficacy and tolerability for use in the clinical treatment of hepatocellular carcinoma.

Complement split product C4d deposition in placenta in systemic lupus erythematosus and pregnancy-induced hypertension

Systemic lupus erythematosus (SLE) and pregnancy-induced hypertension (PIH) are related to premature delivery and intrauterine growth restriction (IUGR), and share histological findings of the placenta. Association with complement dysregulation has been reported in pregnancy for both disorders. The purpose of this study was to investigate the utility of C4d immunohistochemistry for placentas with SLE- and PIH-associated pregnancy. C4d staining was performed on paraffin-embedded tissue of placentas from 26 patients with SLE, 26 with PIH, and 25 control cases. We used the H-score with a range of 0-300 for the evaluation of C4d immunoreactivity. Placentas of SLE and PIH cases showed a higher H-score than control cases (average, SLE, 38.3 (P < 0.05); PIH, 17.8; control, 1.68), with linear staining on the membrane of syncytiotrophoblast. C4d-high groups comprised 50% (12/26) of SLE and 35% (9/26) of PIH cases, with H-scores ranging 14-270 and 15-170. C4d-high groups were significantly associated with low-placental weights and low birth weight in both SLE and PIH (P < 0.05), and lower gestational age (P < 0.05) in PIH cases. These results suggest that C4d might be utilized as a biomarker evaluating the subsequent risk for IUGR and disease control during the gestation period in these patients.