A clinical significance of peritoneal carcinomatosis to recurrent colorectal cancer with ileus

We studied a clinical significance of peritoneal carcinomatosis to metastatic recurrent colorectal cancer with ileus. The subjects were 16 patients with ileus confirmed in 1995-2005. Of the 16 patients, 7 had surgical treatment and the other 9 had conservative treatment. The median survival time of the 16 patients was 98 days; the 7 patients of surgical treatment were 235 days; the 9 patients of conservative treatment were only 67 days. Only 4 patients survived more than 200 days. These 4 patients had surgical treatment, and were the cases where no peritoneal fluid was confirmed and the metastatic tumor was excised. However, only 2 patients improved in QOL. The 3 patients in the surgical treatment were aggravated. An optimum resection may prolong a survival time and patient's QOL could be improved. On the other hand, an extended resection may contribute to shorting a survival time.     

Telechelic polystyrene obtained by degradation of polyurethane-polystyrene block copolymers

Polystyrene with one or two terminal hydroxyl groups was obtained in a high yield (88–90%) from polyurethane-polystyrene block copolymers (PU-PS). The block copolymers were prepared by radical polymerization of styrene with a polyurethane-type macroazo initiator, and then the urethane bonds were degraded with 2-aminoethanol. The purity of the hydroxylated polystyrene thus obtained, which consists predominantly of the dihydroxy-telechelic component, was much higher (ca. 90%) than that of polystyrene obtained by conventional radical polymerization using the corresponding low-molecular-weight azo initiator 2,2′-azobis(2-cyanopropanol) (ca. 80% mono- and dihydroxylated polystyrene). Formation of a predominantly telechelic HO—PS—OH was confirmed from the results of the polyaddition reaction of the hydroxylated polystyrene with a diisocyanate.     

Right ventricular relative wall thickness as a predictor of outcomes and of right ventricular reverse remodeling for patients with pulmonary hypertension

Mid-term right ventricular (RV) reverse remodeling after treatment in patients with pulmonary hypertension (PH) is associated with long-term outcome as well as baseline RV remodeling. However, baseline factors influencing mid-term RV reverse remodeling after treatment and its prognostic capability remain unclear. We studied 54 PH patients. Mid-term RV remodeling was assessed in terms of the RV area, which was traced planimetrically at the end-systole (RVESA). RV reverse remodeling was defined as a relative decrease in the RVESA of at least 15% at 10.2?±?9.4 months after treatment. Long-term follow-up was 5 years. Adverse events occurred in ten patients (19%) and mid-term RV reverse remodeling after treatment was observed in 37 (69%). Patients with mid-term RV reverse remodeling had more favorable long-term outcomes than those without (log-rank: p?=?0.01). Multivariate logistic regression analysis showed that RV relative wall thickness (RV-RWT), as calculated as RV free-wall thickness/RV basal linear dimension at end-diastole, was an independent predictor of mid-term RV reverse remodeling (OR 1.334; 95% CI, 1.039–1.713; p?=?0.03). Moreover, patients with RV-RWT ≥0.21 showed better long-term outcomes than did those without (log-rank p?=?0.03), while those with RV-RWT ≥0.21 and mid-term RV reverse remodeling had the best long-term outcomes. Patients with RV-RWT <0.21 and without mid-term RV reverse remodeling, on the other hand, had worse long-term outcomes than other sub-groups. In conclusions, RV-RWT could predict mid-term RV reverse remodeling after treatment in PH patients, and was associated with long-term outcomes. Our finding may have clinical implications for better management of PH patients.     

Surgical treatment for endocardial radiofrequency ablation-resistant sustained monomorphic ventricular tachycardia with mural thrombus including dense calcification in the left ventricle

Catheter ablation provides effective results for sustained monomorphic ventricular tachycardia (VT), but the presence of mural thrombus including dense calcification occasionally causes unfavorable outcomes. The case of a 67-year-old man in whom sustained monomorphic VT, which was resistant to endocardial radiofrequency ablation, in the presence of mural thrombus including dense calcification after coronary artery bypass grafting was successfully treated by left ventricular reconstruction with cryoablation is reported.     

Is bile acid a determinant of the gut microbiota on a high-fat diet?

Recently, we discovered that bile acid, a main component of bile, is a host factor that regulates the composition of the cecal microbiota in rats. Because bile secretion increases on a high-fat diet and bile acids generally have strong antimicrobial activity, we speculated that bile acids would be a determinant of the gut microbiota in response to a high-fat diet. The observed changes in the rat cecal microbiota triggered by cholic acid (the most abundant bile acid in human biliary bile) administration resemble those found in animals fed high-fat diets. Here, we discuss the rationale for this hypothesis by evaluating reported diet-induced gut microbiota alterations based on the postulate that bile acids worked as an underlying determinant. The identification of host factors determining the gut microbiota greatly contributes to understanding the causal relationships between changes in the gut microbiota and disease development, which remain to be elucidated.