Polymorphism of CYP2C19 and gastric emptying in patients with proton pump inhibitor-resistant gastric ulcers

The aim of the present study was to investigate whether CYP2C19 polymorphism status and gastric emptying are related to healing in patients with gastric ulcers. We studied the CYP2C19 status in seven patients with proton pump inhibitor (PPI)-resistant ulcers, 21 with PPI-sensitive ulcers and 46 healthy volunteers using polymerase chain reaction restriction fragment length polymorphism to detect CYP2C19m1 mutation in exon 5 and CYP2C19m2 mutation in exon 4. Gastric emptying was evaluated using the 13C-acetate breath test. The frequency of phenotypes, indicated by genotypes, did not differ significantly between the three patient groups. The peak time of 13C excretion in patients with PPI-resistant ulcers was significantly longer than that of patients with PPI-sensitive ulcers and healthy volunteers. Our results suggest that rate of gastric emptying, but not CYP2C19 polymorphism, is likely to be an important factor in the delayed healing of patients with PPI-resistant gastric ulcer.     

Multicenter randomized comparison of LigaSure versus conventional surgery for gastrointestinal carcinoma

Purpose  

We conducted this randomized trial to compare the LigaSure Vessel Sealing System with conventional methods in gastrointestinal carcinoma surgery at five specialty cancer hospitals.     

Porcine Corneal Ocular Reversibility Assay (PorCORA) predicts ocular damage and recovery for global regulatory agency hazard categories

In this study, we examined the capacity of the Porcine Corneal Ocular Reversibility Assay (PorCORA) to classify the reversibility of ocular effects for 32 test compounds (20 reversible, 12 irreversible) from various chemical classes. PorCORA predicted 28 of 32 compounds correctly when compared to historical rabbit eye test data. The correlation coefficient for PorCORA versus historical rabbit test data was 0.84, based on the last day of damaged cornea reversal. These results demonstrate a high correlation between corneal irritation recovery time in the PorCORA and the rabbit eye. When compared to historical Modified Maximal Average Score (MMAS) in rabbit eyes, PorCORA yielded a correlation coefficient of 0.80, demonstrating ability to predict MMAS. PorCORA was highly predictive of regulatory agency ocular hazard classification categories, resulting in 91% accuracy for EU R41 and GHS Category 1. PorCORA was also predictive of EPA Category I (88% accuracy). Overall, the accuracy (88–91%), sensitivity (79–86%), specificity (94%), positive predictivity (94%), and negative predictivity (85–89%) for all three regulatory classifications indicate that ocular irritation hazardous effects were well predicted by the PorCORA. This study suggests that PorCORA could help discriminate between EU R36 and R41, GHS Categories 1 and 2, and EPA Categories I and II.     

Directional bias in the body while walking through a doorway: its association with attentional and motor factors

Recent studies indicate that cognitively intact individuals experience frequent rightward collisions while walking through narrow doorways. Such a directional bias has been attributed to an attentional bias in spatial perception. However, these studies did not investigate the involvement of any motor factor that could affect the directional bias in the body. In the present study, three experiments were conducted to quantify the impact of the leading foot when crossing a doorway threshold on the directional bias in the body midpoint when passing through the doorway. Participants walked through the perceived center of a relatively wide doorway. Measurements of the deviation of the upper-body midpoint from the center of the doorway demonstrated that the leading foot had a very strong influence on the directional bias. Some participants showed rightward deviation irrespective of which foot was used to step through the doorway (Experiment 1). However, a consistent rightward bias in the body was not observed in other experiments. Both the movement of one hand (Experiment 2) and covert visual attention to one side of the door (Experiment 3) caused contralateral deviation of the body. It is likely that the movement of the hand and a visual stimulus serve as an attentional cue and are effective to avoid neglect of the ipsilateral side; as a result, the body midpoint is deviated to the contralateral side. From these findings, we conclude that the directional bias in locomotor trajectories while passing through a doorway results from the combination of a motor factor, particularly the leading foot, and attentional/brain factors.     

Genome-wide histone methylation profile for heart failure

Epigenetic alterations are implicated in the development of cardiac hypertrophy and heart failure, but little is known of which epigenetic changes in which regions of the genome play such a role. We now show that trimethylation of histone H3 on lysine-4 (K4TM) or lysine-9 (K9TM) is markedly affected in cardiomyocytes in association with the development of heart failure in a rat disease model. High-throughput pyrosequencing performed with ChIP products for K4TM or K9TM prepared from human left ventricular tissue with retained or damaged function also revealed that protein-coding genes located in the vicinity of K4TM marks differ between functional and disabled myocytes, yet both sets of genes encode proteins that function in the same signal transduction pathways for cardiac function, indicative of differential K4TM marking during the development of heart failure. However, K9TM mark-profile was less dependent on the disease status compared to that of K4TM. Our data collectively reveal global epigenetic changes in cardiac myocytes associated with heart failure.     

Static balloon atrial septostomy with buddy wire technique: a case report

The buddy wire technique, i.e. the use of a second 0.014" guidewire placed alongside the one employed to advance balloons, stents or other devices, improves the balloon or stent support and also provides guiding catheter stability. Furthermore, it concentrates forces transferred from the balloon along the line of the wire. We used a second 0.014" Platinum PLUS guidewire as a buddy wire during static balloon atrial septostomy in a 19-day-old baby with hypoplastic left heart syndrome, in whom standard balloon atrial septostomy was inadequate even with a fully dilated balloon. This procedure effectively dilated the atrial septal defect.     

Relationship between right portal and biliary systems based on reclassification of the liver

BACKGROUND: Although the anatomy of the right portal and biliary systems and their interrelationships must be understood to safely and satisfactorily perform left-sided resection of hilar cholangiocarcinoma or right-lobe living donor liver transplantation, the anatomies of the right portal and biliary systems are extremely difficult to understand. METHODS: A total of 60 patients with normal liver underwent computed tomography during both portography and cholangiography to evaluate relationships between the right biliary and portal systems based on reclassification of the liver to divide the right liver into 3 segments. RESULTS: All ventral and posterior ducts constantly join medially to the anterior portal trunk. In contrast, some dorsal ducts join the ventral duct medially and others join the posterior duct lateral to the anterior trunk. CONCLUSIONS: Reclassification of the liver to divide the right liver into 3 segments facilitates an understanding of relationships between the right portal and biliary systems.