Clinical pattern and progression of ulcerative proctitis in the Japanese population: a retrospective study of incidence and risk factors influencing progression

AIM

The rate of extension of proctitis in Western countries has been reported, but no data regarding long-term follow-up have been described for the Japanese population. Additionally, patients with long-standing or extensive ulcerative colitis have an increased risk for developing colorectal cancer. This study evaluated both the rate of extension of the disease and the development of neoplasia among patients with an initial diagnosis of ulcerative proctitis.

METHOD

We retrospectively investigated the medical charts of patients with proctitis from 1979 to 2014. The primary focus of this research was the extension of the inflammatory area. The secondary focus included risk factors for disease extension and the development of neoplasia.

RESULTS

Sixty-six patients satisfied the inclusion criteria. Proximal extension of the disease occurred in 34 patients: 19 patients had left-sided colitis and 15 had pancolitis. According to a multivariate analysis, disease extension was significantly higher in patients with disease onset before 25 years of age (P-value = 0.043). The cumulative rates of disease extension at 10 and 20 years were 33.8% and 52.2%, respectively. Three patients were diagnosed with dysplasia during follow-up, all of whom experienced disease extension before the development of dysplasia.

CONCLUSION

The rate of extension of ulcerative colitis in the Japanese population was comparable to that in Western countries. A younger age of disease onset was associated with disease extension. Extension of proctitis may be associated with an increased risk of colorectal cancer.

[Team Approaches for and Future Challenges to Promoting Perioperative Oral Management]

When the medical fee system was revised in 2012, the category of perioperative oral management was newly organized. However, the calculation of additional fees for such management required referral from medical to dental departments. In addition, requests for such management were limited, possibly owing to an increased burden on doctors engaged in outpatient services. This study examined the usefulness of an approach to promote patients' use of dental services by increasing their awareness of the importance of oral management. In this approach, pharmacists explained doctors' instructions to patients at a chemotherapy center within the study facility. Explanations were provided to 114 patients, 75 (65.8%) of whom subsequently used dental services in the facility. For patients using dental services, oral care was performed most frequently (40; 53.3%), followed by invasive procedures (23; 30.7%). Furthermore, the facility's ethics committee approved a survey to measure the satisfaction of patients undergoing chemotherapy at the center. Of the 110 patients invited to participate in the survey, 77(70.0%) did not respond. Researchers concluded the low response rate was associated with patients' belief that dental services were intended primarily for treating oral cavities and their lack of awareness of the importance of preventive dental care. However, in 2014, the number of calculations of additional fees for perioperative oral management markedly increased each month after the above-mentioned approach, from 62 (January) to 162 (December). Both the hospital-to family and family-to-hospital dentist referral rates significantly increased, from 11.2% and 10.7%, respectively (June 2013), to 21.0% and 41.9%, respectively(June 2014). Future evaluations of the outcomes of perioperative oral management and promoting cooperation between medical and dental communities may be necessary.

Angular sway propagation in One Leg Stance and quiet stance with Inertial Measurement Units for older adults

Postural stability degrades with age, threating the health and life quality of the older adults. One Leg Stance (OLS) is one of the standard and commonly adopted assessments for postural stability, and the postural sway in OLS has been demonstrated to be related with age. The propagation of postural sway between body segments could be a hint to the underlying mechanism of balance control. However, it is not yet fully understood. Therefore, the aim of this paper was to study the angular sways and their propagation of the head, trunk, and lower limb in healthy older adults. A cross-correlation of the normalized angular speeds was performed and the experiment with 68 older adults was conducted. The results showed that the head, hip and ankle joints affected the transfer of angular sway with a relatively lower correlation and longer latency.

Crossover from a heavy fermion to intermediate valence state in noncentrosymmetric Yb2Ni12(P,As)7

We report measurements of the physical properties and electronic structure of the hexagonal compounds Yb₂Ni₁₂Pn₇ (Pn = P, As) by measuring the electrical resistivity, magnetization, specific heat and partial fluorescence yield x-ray absorption spectroscopy (PFY-XAS). These demonstrate a crossover upon reducing the unit cell volume, from an intermediate valence state in Yb₂Ni₁₂As₇ to a heavy-fermion paramagnetic state in Yb₂Ni₁₂P₇, where the Yb is nearly trivalent. Application of pressure to Yb₂Ni₁₂P₇ suppresses T_FL, the temperature below which Fermi liquid behavior is recovered, suggesting the presence of a quantum critical point (QCP) under pressure. However, while there is little change in the Yb valence of Yb₂Ni₁₂P₇ up to 30 GPa, there is a strong increase for Yb₂Ni₁₂As₇ under pressure, before a near constant value is reached. These results indicate that any magnetic QCP in this system is well separated from strong valence fluctuations. The pressure dependence of the valence and lattice parameters of Yb₂Ni₁₂As₇ are compared and at 1 GPa, there is an anomaly in the unit cell volume as well as a change in the slope of the Yb valence, indicating a correlation between structural and electronic changes.

Use of an ultra-miniaturized IMU-based motion capture system for objective evaluation and assessment of walking skills

The increasing age of the world population is posing new challenges to our society, such as how to keep this aging population healthy and active despite of the age. In recent years, there has been a lot of interest for gait analysis for rehabilitation purposes as well as for performance assessment of this aging population. While current systems work well, they still have several limitations. Cost, need for specialized personnel, need to be used in a research center, and sporadic measurement prevent these systems from being widely used. The authors propose the use of extremely miniaturized, portable measurement systems, which can be worn by the users during their everyday life, and can monitor their gait over a long timespan. This paper presents the preliminary experiments with such a system.

NANOMATRIX STRUCTURE FORMED BY GRAFT COPOLYMERIZATION OF STYRENE ONTO FRESH NATURAL RUBBER

Fresh NR was adopted to prepare rubber with a nanomatrix structure. The nanomatrix structure was formed by graft-copolymerization of styrene onto deproteinized fresh NR (fresh DPNR) in the latex stage using tert-butyl hydroperoxide/tetraethylenepentamine as an initiator. Graft-copolymer consisting of fresh DPNR and polystyrene (fresh DPNR-graft-PS) was characterized by 1H-NMR spectroscopy and transmission electron microscopy. Under a suitable condition of the graft-copolymerization, conversion and grafting efficiency of styrene was 98 and 80 mol%, respectively. Morphology of fresh DPNR-graft-PS was observed by transmission electron microscopy. The rubber particles of about 1 μm in diameter were found to be dispersed in polystyrene matrix of 10–30 nm in thickness. Tensile properties of fresh DPNR were dramatically improved by forming the nanomatrix structure, compared with DPNR.

Mania occurring during systemic lupus erythematosus relapse and its amelioration on clinical and neuroimaging follow-up

Psychiatric manifestations of systemic lupus erythematosus (SLE) that are commonly preceded by organic syndromes include confusional states, anxiety disorder, cognitive dysfunction, mood disorder and psychosis. A 35-year-old woman was admitted to hospital with a relapse of SLE. Laboratory data were exacerbated, with some physical symptoms, and her primary psychiatric symptom was mania. The symptoms were reduced by treatment with prednisolone, methylprednisolone and aripiprazole. Magnetic resonance imaging and single-photon emission computed tomography (SPECT) using 123I-IMP was then performed and analyzed with three-dimensional stereotactic surface projection. This case emphasizes that SLE can commence with organic syndromes and relapse with predominantly psychiatric symptoms, and that the treatment efficacy may be confirmed using a follow-up of SPECT.

Phase II trial of combination therapy of gemcitabine plus anti-angiogenic vaccination of elpamotide in patients with advanced or recurrent biliary tract cancer

Background Elpamotide is an HLA-A*24:02-restricted epitope peptide of vascular endothelial growth factor receptor 2 (VEGFR-2) and induces cytotoxic T lymphocytes (CTLs) against VEGFR-2/KDR. Given the high expression of VEGFR-2 in biliary tract cancer, combination chemoimmunotherapy with elpamotide and gemcitabine holds promise as a new therapy. Patients and Methods Patients with unresectable advanced or recurrent biliary tract cancer were included in this single-arm phase II trial, with the primary endpoint of overall survival. Survival analysis was performed in comparison with historical control data. The patients concurrently received gemcitabine once a week for 3 weeks (the fourth week was skipped) and elpamotide once a week for 4 weeks. Results Fifty-five patients were registered, of which 54 received the regimen and were included in the full analysis set as well as the safety analysis set. Median survival was 10.1 months, which was longer than the historical control, and the 1-year survival rate was 44.4 %. Of these patients, injection site reactions were observed in 64.8 %, in whom median survival was significantly longer (14.8 months) compared to those with no injection site reactions (5.7 months). The response rate was 18.5 %, and all who responded exhibited injection site reactions. Serious adverse reactions were observed in five patients (9 %), and there were no treatment-related deaths. Conclusion Gemcitabine and elpamotide combination therapy was tolerable and had a moderate antitumor effect. For future development of therapies, it will be necessary to optimize the target population for which therapeutic effects could be expected.

Flexible ureteroscopy and lasertripsy (FURSL) for paediatric renal calculi: results from a systematic review

OBJECTIVE

To understand the role, safety and efficacy of flexible ureterorenoscopy and lasertripsy (FURSL) for paediatric renal stones.

MATERIAL AND METHODS

A systematic review was conducted using studies identified by a literature search between January 1990 and March 2014. All English language articles reporting on a minimum of five patients≤18-years old, treated with flexible ureteroscopy and lasertripsy for stone disease were included.

RESULTS

A total of six studies (282 patients) were reported, with a mean age of 7.3 years (range 0.25-17 years). The stone sizes ranged from 1 to 30 mm. The mean stone-free rate across the three studies was 85.5% (range 58.0-93.0%) after initial ureteroscopy, with a postoperative stent inserted in 81.8% (range 66.7-98.0%). There were a total of 35 complications (12.4%), with the most severe complication being a Clavien class III (five ureteral injuries, one urinoma). There were no deaths in any of the studies.

CONCLUSION

The present review shows that FURSL for management of renal calculi in the paediatric population is an effective and safe procedure. To ensure that outcomes keep on improving, these procedures should be undertaken by experienced surgeons who are familiar with the difficulties encountered in the paediatric population.

Role of valence fluctuations in the superconductivity of Ce122 compounds

Pressure dependence of the Ce valence in CeCu(2)Ge(2) has been measured up to 24 GPa at 300 K and to 17 GPa at 18-20 K using x-ray absorption spectroscopy in the partial fluorescence yield. A smooth increase of the Ce valence with pressure is observed across the two superconducting (SC) regions without any noticeable irregularity. The chemical pressure dependence of the Ce valence was also measured in Ce(Cu(1-x)Ni(x))(2)Si(2) at 20 K. A very weak, monotonic increase of the valence with x was observed, without any significant change in the two SC regions. Within experimental uncertainties, our results show no evidence for the valence transition with an abrupt change in the valence state near the SC II region, challenging the valence-fluctuation mediated superconductivity model in these compounds at high pressure and low temperature.

Effect of soccer shoe upper on ball behaviour in curve kicks

New soccer shoes have been developed by considering various concepts related to kicking, such as curving a soccer ball. However, the effects of shoes on ball behaviour remain unclear. In this study, by using a finite element simulation, we investigated the factors that affect ball behaviour immediately after impact in a curve kick. Five experienced male university soccer players performed one curve kick. We developed a finite element model of the foot and ball and evaluated the validity of the model by comparing the finite element results for the ball behaviour immediately after impact with the experimental results. The launch angle, ball velocity, and ball rotation in the finite element analysis were all in general agreement with the experimental results. Using the validated finite element model, we simulated the ball behaviour. The simulation results indicated that the larger the foot velocity immediately before impact, the larger the ball velocity and ball rotation. Furthermore, the Young's modulus of the shoe upper and the coefficient of friction between the shoe upper and the ball had little effect on the launch angle, ball velocity, and ball rotation. The results of this study suggest that the shoe upper does not significantly influence ball behaviour.

MicroRNA-1246 expression associated with CCNG2-mediated chemoresistance and stemness in pancreatic cancer

Background:

Pancreatic cancer has a poor prognosis because of its high refractoriness to chemotherapy and tumour recurrence, and these properties have been attributed to cancer stem cells (CSCs). MicroRNA (miRNA) regulates various molecular mechanisms of cancer progression associated with CSCs. This study aimed to identify the candidate miRNA and to characterise the clinical significance.

Methods:

We established gemcitabine-resistant Panc1 cells, and induced CSC-like properties through sphere formation. Candidate miRNAs were selected through microarray analysis. The overexpression and knockdown experiments were performed by evaluating the in vitro cell growth and in vivo tumourigenicity. The expression was studied in 24 pancreatic cancer samples after laser captured microdissection and by immunohistochemical staining.

Results:

The in vitro drug sensitivity of pancreatic cancer cells was altered according to the miR-1246 expression via CCNG2. In vivo, we found that miR-1246 could increase tumour-initiating potential and induced drug resistance. A high expression level of miR-1246 was correlated with a worse prognosis and CCNG2 expression was significantly lower in those patients.

Conclusions:

miR-1246 expression was associated with chemoresistance and CSC-like properties via CCNG2, and could predict worse prognosis in pancreatic cancer patients.

Very-low-voltage operation of Mach-Zehnder interferometer-type electroabsorption modulator using asymmetric couplers

We have proposed and developed a new type of electroabsorption modulator (EAM) that employs both optical absorption and interferometric extinction. The EAM operates at a record low voltage of 0.2 V at 25.8-Gbit/s modulation, which can reduce optical transmitter power consumption and allows the adoption of cost-effective CMOS drivers.

Development of new muscle contraction sensor to replace sEMG for using in muscles analysis fields

Nowadays, the technologies for detecting, processing and interpreting bioelectrical signals have improved tremendously. In particular, surface electromyography (sEMG) has gained momentum in a wide range of applications in various fields. However, sEMG sensing has several shortcomings, the most important being: measurements are heavily sensible to individual differences, sensors are difficult to position and very expensive. In this paper, the authors will present an innovative muscle contraction sensing device (MC sensor), aiming to replace sEMG sensing in the field of muscle movement analysis. Compared with sEMG, this sensor is easier to position, setup and use, less dependent from individual differences, and less expensive. Preliminary experiments, described in this paper, confirm that MC sensing is suitable for muscle contraction analysis, and compare the results of sEMG and MC sensor for the measurement of forearm muscle contraction.