Optimal band imaging system can facilitate detection of changes in depressed-type early gastric cancer

BACKGROUND: The endoscopic diagnosis of depressed-type early gastric cancers is difficult because these cancers manifest as subtle changes in color and shape. The newly developed optimal band imaging (OBI) system can reconstruct the best spectral images derived from ordinary endoscopic images and enhances the mucosal surface without the use of dyes. This imaging technique is based on narrowing the bandwidth of conventional image arithmetically by using spectral estimation technology. OBJECTIVE: Evaluation of the usefulness of the OBI system for identifying the demarcation line of depressed-type early gastric cancers. DESIGN: Prospective study. SETTING: Jichi Medical University in Japan. PATIENTS: Twenty-seven cases with depressed-type early gastric cancer. MAIN OUTCOME MEASUREMENT: Comparative study for the success rate of identifying the demarcation line of depressed-type early gastric cancer by using optimal band images and conventional endoscopic images. RESULTS: Demarcation of the depressed-type early gastric cancer was easily identified by optimal band images without magnification in 26 of 27 cases (96%), because distinct demarcation was observed endoscopically between the reddish images of the cancerous lesion and the yellowish images of the surrounding noncancerous area. With 40-fold magnification of optimal band images, the demarcation was also clearly recognized in all cases. Medical students could point out the demarcation line with significantly greater accuracy by observing the new nonmagnified optimal band images than by the conventional images (P< .0001). LIMITATION: Small sample size. CONCLUSIONS: The new contrasting images of the OBI system can delineate the depressed-type early gastric cancer more easily than conventional endoscopy.     

A common haplotype at the CD36 locus is associated with high free fatty acid levels and increased cardiovascular risk in Caucasians

CD36 is a class B scavenger receptor recognizing a variety of ligands including long-chain fatty acids and modified LDL. We investigated whether genetic variability at this locus is a determinant of free fatty acid (FFA) plasma levels and risk of coronary artery disease (CAD) in Caucasians. Typing of 21 polymorphic markers, evenly spanning the CD36 gene, revealed two linkage disequilibrium (LD) blocks that could be tagged by five polymorphisms (-33137A>G, -31118G>A, 25444G>A, 27645del>ins and 30294G>C). In 585 non-diabetic individuals of Caucasian origin, the 30294G>C polymorphism was significantly associated with FFA levels (P = 0.02)--an effect that was especially visible among men (P = 0.009). A similar association was observed in this gender at -33137 (P = 0.008) and -31118 (P = 0.028). When the five tag polymorphisms were considered together, men carrying the AGGIG haplotype had 31% higher FFA (P = 0.0002) and 20% higher triglycerides (P = 0.025) than non-carriers. The same haplotype was associated with increased risk of CAD in 197 type 2 diabetic individuals from the US (OR = 2.3, 95% CI 1.2-4.2). A similar tendency was observed in a group of 321 type 2 diabetic individuals from Italy (OR = 1.4, 0.9-2.3), resulting in an overall relative risk of 1.6 (1.1-2.3, P = 0.015) in the two populations considered together. By targeted resequencing, we identified a common variant in the CD36 promoter that is in strong LD with the AGGIG haplotype and could be partly responsible for these findings. In conclusion, this comprehensive study of CD36 variability indicates that the common polymorphisms at this locus modulate lipid metabolism and cardiovascular risk in Caucasians.     

The application of titanium alloy wires for the reattachment of the greater trochanter in total hip arthroplasty

We developed a new fixing method using titanium alloy wires in order to facilitate the attachment of the greater trochanter in total hip arthroplasty. This wire is composed of Ti-3Al-2.5V by weight. According to the fatigue test in vitro, the titanium alloy wire had better fatigue properties than Ortron 90 wire of the same diameter. In experiments in vivo, both titanium alloy wires and SUS-316L wires were used for the reattachment of the greater trochanter of dogs, and the titanium alloy wires showed better biocompatibility than the latter. Thus, titanium alloy wires seem applicable for the reattachment of the greater trochanter in human total hip arthroplasty.     

Neither Incretin or Amino Acid Responses,nor Casein Content,Account for the Equal Insulin Response Following Iso-Lactose Loads of Natural Human and Cow Milk in Healthy Young Adults

Human milk contains <50% less protein (casein) than cow milk, but is equally effective in insulin secretion despite lower postingestion hyperaminoacidemia. Such potency of human milk might be modulated either by incretins (glucagon-like polypeptide-1,GLP-1); glucose-inhibitory-polypeptide, GIP), and/or by milk casein content. Healthy volunteers of both sexes were fed iso-lactose loads of two low-protein milks, i.e., human [Hum] (n = 8) and casein-deprived cow milk (Cow [↓Cas]) (n = 10), as well as loads of two high-protein milks, i.e., cow (n = 7), and casein-added human-milk (Hum [↑Cas]) (n = 7). Plasma glucose, insulin, C-peptide, incretins and amino acid concentrations were measured for 240′. All milks induced the same transient hyperglycemia. The early [20′–30′] insulin and C-peptide responses were comparable among all milk types apart from the low-protein (Cow [↓Cas]) milk, where they were reduced by <50% (p < 0.05 vs. others). When comparing the two high-protein milks, GLP-1 and GIP [5’–20’] responses with the (Hum [↑Cas]) milk were lower (by ≈2–3 fold, p < 0.007 and p < 0.03 respectively) than those with cow milk, whereas incretin secretion was substantially similar. Plasma amino acid increments largely reflected the milk protein content. Thus, neither casein milk content, nor incretin or amino acid concentrations, can account for the specific potency of human milk on insulin secretion, which remains as yet unresolved.     

SPIROCH?TA HEBDOMADIS,THE CAUSATIVE AGENT OF SEVEN DAY FEVER (NANUKAYAMI) : FIRST PAPER.

A new species of spirochete which we have called Spirochæta hebdomadis has been described as the specific etiological agent of seven day fever, a disease prevailing in the autumn in Fukuoka and other parts of Japan. This spirochete is distinguishable from Spirochæta icterohæmorrhagiæ to which it presents certain similarities. Young guinea pigs are susceptible to inoculation with the blood of patients and to pure cultures of the spirochete, and those developing infection exhibit definite symptoms suggestive of those of seven day fever in man. The blood serum of convalescents from seven day fever contains specific immune bodies acting spirochetolytically and spirocheticidally against the specific spirochetes, but not against Spirochæta icterohæmorrhagiæ. The field mouse (Microtus montebelli) is the normal host of the spirochetes, which have been detected in the kidneys and urine of 3.3 per cent of the animals examined. The endemic area of prevalence of seven day fever corresponds with the region in which field mice abound.     

THE SERUM TREATMENT OF WEIL'S DISEASE (SPIROCH?TOSIS ICTEROH?MORRHAGICA)

Horses immunized with cultures of Spirochæta icterohæmorrhagiæ yield an immune serum having therapeutic properties. With rare exceptions the serum destroys completely the spirochetes contained in the circulating blood. The development of antibodies is promoted by the serum injections. The number of spirochetes in the organs is reduced by the treatment. Secondary manifestations due to the serum are slight and disappear promptly. The ultimate effects of the serum treatment on the symptoms and final outcome of the disease have still to be determined.     

Analysis of potential anti-aging beverage Pru,a traditional Cuban refreshment,by desorption electrospray ionization-mass spectrometry and FTICR tandem mass spectrometry

Aging has been established as a major risk factor for prevalent diseases and hence, the development of anti-aging medicines is of great importance. Recently, herbal fermented beverages have emerged as a promising source of potential anti-aging drug. Pru, a traditional Cuban refreshment produced by decoction and fermentation of multispecies plants with sugar, has been consumed for many years and is claimed to have multiple medicinal properties. Besides the traditional method, Pru is also manufactured industrially. The present study analyzed the major components of both traditional Pru (TP) and industrial Pru (IP) to reveal their potential application in promoting the health span. We performed desorption electrospray ionization-mass spectrometry (DESI-MS) and acquired mass spectra by scanning over the 50–1200 m/z range in both positive and negative ion modes. Fourier transform ion cyclotron resonance (FTICR) tandem mass spectrometry (MS/MS) was performed for validating the compound assignments. Three important compounds were identified by comparing the MS and MS/MS spectra with reported literature and the online database. One of the identified compounds, gluconic acid, was found to be the most abundant shared metabolite between TP and IP whereas the other two compounds, magnoflorine and levan were exclusively detected in TP. The present study is the first report of component profiling in Cuban traditional and industrial Pru using DESI-MS and FTICR MS/MS, and reveals the potential application of Pru as a health-promoting agent.     

Navigator-echo-based MR provides high-resolution images and precise volumetry of swine livers without breath holding or injection of contrast media.

The accurate calculation of hepatic volume by computed tomography (CT) or magnetic resonance (MR) is complicated by the need for breath holding and the injection of contrast media. These are often contraindicated in patients with liver failure, and we examined the ability of unenhanced 3-dimensional (3-D) navigator-echo-based MR (NE-MR) to accurately image livers and measure volumes without breath holding compared to unenhanced (plain) or gadolinium-diethylene triamine pentaacetic acid enhanced MR (Gd-MR) in miniature swine (n = 8). Without breath holding, diaphragm movement monitoring with NE-MR reduced motion artifacts in hepatic images compared with the other modalities. Without the injection of contrast media, the signal-to-noise ratios of the images obtained using NE-MR were significantly higher than those from plain MR; Gd-MR was superior to NE-MR, however (79.5 +/- 7.5 vs. 63.2 +/- 6.0 or 97.8 +/- 8.1, respectively; P < 0.01 for each). Overall, NE-MR produced improved high-resolution liver images. Consequently, liver volumes calculated based on NE-MR images were more highly correlated with actual liver weights compared to plain or Gd-MR in the whole livers (n = 8; r = 0.937 vs. 0.835 or 0.904, respectively). Also, NE-MR demonstrated significantly strong correlation between actual weights and volumetry-calculated volumes in regenerative livers 7 days after massive hepatectomy (n = 10, r = 0.989, P < 0.01). In conclusion, our results indicate that without breath holding or the injection of contrast media, 3-D NE-MR can provide both high-resolution liver images and precise hepatic volumes in patients with liver failure due to liver surgery (massive hepatectomy and living donor liver transplantation) or fulminant hepatic failure.     

Radiographic evaluation of bioactive glass-ceramic grafts in postero-lateral lumbar fusion

STUDY DESIGN: Follow-up study of bioactive glass-ceramic graft for postero-lateral fusion (PLF) in the lumbar spine was performed using plain radiography. OBJECTIVES: To investigate the fusion state of the porous stick type of bioactive glass-ceramic which has been used in PLF in the lumbar spine, by plain radiography, and to evaluate the usefulness of this technique. METHODS: Fourteen patients who underwent PLF using apatite and wollastonite-containing glass-ceramic (A-W. GC) were followed-up for more than 1 year and 6 months by plain radiography. RESULTS: Six patients who were followed up for more than 2 years were considered to have obtained subtotal or total fusion. CONCLUSION: PLF using A-W. GC mixed with autologous grafted bone can preserve bone stock without the need to harvest a bone graft from the iliac crest and will be useful for PLF in the lumbar spine.