Which Has Superior Acid-Suppressive Effect, 10 Mg Omeprazole Once Daily or 20 Mg Famotidine Twice Daily? Effects of Single or Repeated Administration in Japanese <Emphasis Type="Italic">Helicobacter Pylori</Emphasis>-Negative CYP2C19 Extensive Metabolizers

Low-dose omeprazole is superior to full-dose famotidine in maintenance therapy for gastroesophageal reflux disease, whereas “on-demand” famotidine is more effective for relief of episodes of heartburn. To explain this apparent discrepancy, intragastric pH was measured for 24-hr seven times in eight Japanese Helicobacter pylori-negative cytochrome P450 2C19 extensive metabolizers; on Days 1, 8, and 15 of repeated administration of 10 mg of omeprazole once daily and of 20 mg of famotidine twice daily and before medication. During repeated administration of omeprazole, mean intragastric pH and % time that intragastric pH > 4.0 were significantly higher and became greater. With famotidine, although these parameters were significantly higher, the degrees became smaller. Consequently, acid-suppressive effect was in the order; omeprazole < famotidine on Day 1, omeprazole≈famotidine on Day 8, and omeprazole >famotidine on Day 15. This discrepancy possibly results from the “potentiation” of acid-suppressive effect of omeprazole and the “tolerance” phenomenon in respect to famotidine.     

Selective hepatic vascular exclusion for the hepatic resection of HCC

BACKGROUND/AIMS: Selective hepatic vascular exclusion (SHVE) is an effective technique for the control of bleeding in major hepatic resections. Outcomes of the procedures of the SHVE group were compared with the non-SHVE group. METHODOLOGY: A retrospective study was carried out of 312 hepatic resections performed over a period of 10 years. The cases in this study were limited to Child's classification A, because of the rate of Child A in the SHVE group (n=82) was significantly higher than that within the non-SHVE group (n=158) (93% vs. 71%; p < 0.001). Preoperative factors, like age, gender, tumor size, intraoperative blood loss, operation time, and the postoperative course of the two groups were compared for both groups. RESULTS: The SHVE group showed significantly less blood loss, necessary blood transfusion, and a significant rate of severe postoperative complications. The rate of segmentectomy and subsegmentectomy in the SHVE group was higher than in the non-SHVE group, and the rate of partial hepatectomy and lobectomy in the non-SHVE group was higher than that in the SHVE group. Although the more difficult operations were performed in the SHVE group than in the non-SHVE group, there was no significant difference in the postoperative hospital stays in both groups. CONCLUSIONS: The SHVE technique is effective for bleeding control in major liver resections.     

Vaginal epithelial dendritic cells renew from bone marrow precursors

Dendritic cells (DCs) represent key professional antigen-presenting cells capable of initiating primary immune responses. A specialized subset of DCs, the Langerhans cells (LCs), are located in the stratified squamous epithelial layer of the skin and within the mucosal epithelial lining of the vaginal and oral cavities. The vaginal mucosa undergoes cyclic changes under the control of sex hormones, and the renewal characteristics of the vaginal epithelial DCs (VEDCs) remain unknown. Here, we examined the origin of VEDCs. In contrast to the skin epidermal LCs, the DCs in the epithelium of the vagina were found to be repopulated mainly by nonmonocyte bone-marrow-derived precursors, with a half-life of 13 days under steady-state conditions. Upon infection with HSV-2, the Gr-1(hi) monocytes were found to give rise to VEDCs. Furthermore, flow cytometric analysis of the VEDCs revealed the presence of at least three distinct populations, namely, CD11b(+)F4/80(hi), CD11b(+)F4/80(int), and CD11b(-)F4/80(-). Importantly, these VEDC populations expressed CD207 at low levels and had a constitutively more activated phenotype compared with the skin LCs. Collectively, our results revealed mucosa-specific features of the VEDCs with respect to their phenotype, activation status, and homeostatic renewal potential.     

Protein-bound polysaccharide-K reduces colitic tumors and improves survival of inflammatory bowel disease in vivo

Protein-bound polysaccharide-K (PSK) is a biological response modifier that possesses antitumor effects against various tumors. Although an inflammatory response has been considered to play an important role in the development of colorectal cancer, the anti-inflammatory effect of PSK has yet to be elucidated. An inflammatory bowel disease (IBD)-induced colorectal tumor model with 1.2-dimethyl hydrazine (DMH) and dextran sodium sulfate (DSS) was used to examine the effects of PSK on tumor suppression and survival. Although 90% of the mice that were not treated with PSK developed colitic tumors, oral administration of PSK suppressed tumor formation by less than 30%. Although deaths associated with DSS-induced melena were observed, PSK significantly reduced mortality. In conclusion, the present study showed that PSK not only suppressed colorectal tumor formation in the DMH+DSS-induced IBD model, but also improved the survival rate, indicating that anti-inflammatory activity is one of the mechanisms for the antitumor effects of PSK.     

Nutritional recovery after open and laparoscopic gastrectomies

Background  

The aim of this study was to evaluate longitudinal changes in body composition after laparoscopic and open gastrectomies for gastric cancer.     

Determination of total cefozopran concentrations in human peritoneal fluid by HPLC with cefepime as an internal standard: Comparative pharmacokinetics in the fluid and plasma

A simple, rapid and precise HPLC method using ultrafiltration to remove protein was developed to determine total cefozopran concentrations in human peritoneal fluid in the same manner as in human plasma, irrespective of the amount of protein. The recovery of cefozopran after ultrafiltration in peritoneal fluid was higher than that in plasma, because the protein content in peritoneal fluid was lower than that in plasma. Furthermore, it was found that an internal standard with a similar protein-binding ratio to cefozopran could revise the cefozopran loss by ultrafiltration in plasma and peritoneal fluid samples irrespective of the amount of protein. Therefore, it was concluded that cefepime may be used as an internal standard. Cefozopran and cefepime were detected by measuring their ultraviolet absorbances at 235 nm. The calibration curve obtained for cefozopran in peritoneal fluid was linear from 0.2 to 200 μg/ml. The intraday and interday precisions were less than 5.77% (CV), and the accuracy was between 96.3% and 108% above 0.2 μg/ml. The lower limit of detection was 0.05 μg/ml in peritoneal fluid, which was the same as that in plasma. The assay has been applied to therapeutic drug monitoring of cefozopran in both plasma and peritoneal fluid and has contributed to peritoneal pharmacokinetic studies in patients.