BACKGROUND:: Data comparing the incidence and pattern of interstitial lung disease (ILD) in non-small cell lung cancer patients receiving treatment with gefitinib versus erlotinib, both of which are epidermal growth factor receptor tyrosine kinase inhibitors, are scarce. We investigated the incidence of ILD in Japanese patients treated with gefitinib or erlotinib. METHODS:: We reviewed the clinical records of 209 patients treated with erlotinib in 2008 (cohort A) and 330 treated with gefitinib between 2000 and 2003 (cohort B). Toxicity within the first month of treatment was investigated. RESULTS:: The patients in cohort A had fewer known risk factors for ILD (e.g., poor performance status and prior pulmonary fibrosis). ILD was detected in two patients (1.0%) from cohort A and eight patients (2.4%) from cohort B during the first month of treatment. The events were graded as follows: one patient each in grades 1 and 2 (cohort A), and one, one, and six patients in grades 3, 4, and 5, respectively (cohort B). Multivariate analysis revealed that poor performance status and prior pulmonary fibrosis were significantly correlated with the occurrence of ILD, but the type of epidermal growth factor receptor tyrosine kinase inhibitor administered was not. CONCLUSION:: There was a somewhat lower incidence of ILD with erlotinib therapy than with gefitinib therapy, despite no statistically significant difference. Patient selection based on awareness by Japanese physicians of the risk factors for ILD, rather than the type of agent, may explain the difference in ILD incidence between the two treatments.

The effects of microwave irradiation (2.45 GHz, 200 W) on glycosylation promoted by a solid super acid in supercritical carbon dioxide was investigated with particular attention paid to the structure of the acceptor substrate. Because of the symmetrical structure and high diffusive property of supercritical carbon dioxide, microwave irradiation did not alter the temperature of the reaction solution, but enhanced reaction yield when aliphatic acceptors are employed. Interestingly, the use of a phenolic acceptor under the same reaction conditions did not show these promoting effects due to microwave irradiation. In the case of aliphatic diol acceptors, the yield seemed to be dependent on the symmetrical properties of the acceptors. The results suggest that microwave irradiation do not affect the reactivity of the donor nor promoter independently. We conclude that the effect of acceptor structure on glycosylation yield is due to electric delocalization of hydroxyl group and dielectrically symmetric structure of whole molecule.

BACKGROUND: Laparoscopic surgeons require extended experience of cases to overcome the lack of depth perception on a two-dimensional (2D) display. Although a three-dimensional (3D) display was reported to be useful over two decades ago, 3D systems have not been widely used. Recently, we developed a novel 3D dome-shaped display (3DD) system, CyberDome. STUDY DESIGN: In the present study, a total of 23 students volunteered. We evaluated the effects of the 3DD system on depth perception and laparoscopic procedures in comparison with the 2D, a conventional 3D (3DP) or the 2D high definition (HD) systems using seven tasks. RESULTS: The 3DD system significantly improved depth perception and laparoscopic performance compared with the 2D system in six new tasks. We further found that the 3DD system shortened the execution time and reduced the number of errors during suturing and knot tying. The 3DD system also provided more depth perception than the 3DP and 2D HD systems. CONCLUSIONS: The novel 3DD system is a promising tool for providing depth perception with high resolution to laparoscopic surgeons.

BACKGROUND/AIMS: Gastric bubble is present in approximately 70% of normal chest and abdominal radiograph. Most swallowed air is regurgitated and belching is a physiological phenomenon to expel ingested gas from the stomach and is a common symptom in normal adults. In the present study it was investigated whether gastric bubble detected on abdominal radiograph is associated with GERD symptoms. METHODOLOGY: All of the patients who first attend our hospital were asked to respond the F-scale questionnaire regardless of their chief complaints to diagnose GERD. Plain abdominal films in the erect position were used to measure the size of gastric bubble and to classify the form of gastric bubble into four groups: dome-type; irregular-type; stomach-type; and undetected-type. The quantity of gastric bubble (gastric bubble score) was determined as the pixel value on image collected from hospital's digital database. RESULTS: The gastric bubble score of irregular-type was significant lower than that of dome-type and stomach-type. GERD was most frequently detected in stomach-type group, followed by undetected-type, irregular-type, and dome-type. The mean score of F-scale was significantly higher in stomach-type than in dome-type. CONCLUSIONS: It is concluded that gastric bubble detected on plain abdominal films is an informative marker for evaluating the functional disorder of upper digestive tracts. Physicians have to recognize the importance of plain films of the abdomen in the diagnostic process of GERD.

C1q and tumor necrosis factor-related protein 3 (CTRP3)/cartducin, a novel serum protein, is a member of the CTRP superfamily. Although CTRP3/cartducin gene is markedly upregulated in rat carotid arteries after balloon injury, little is known about its biological roles in arterial remodeling and neointima formation in injured blood vessels. We have investigated the mechanisms underlying CTRP3/cartducin upregulation and the in vitro effects of CTRP3/cartducin on vascular smooth muscle cells. CTRP3/cartducin expression in cultured p53LMAC01 vascular smooth muscle cells was induced by transforming growth factor-beta 1 (TGF-beta1), but not by fibroblast growth factor-basic (bFGF) or platelet-derived growth factor-BB (PDGF-BB). Exogenous CTRP3/cartducin promoted the proliferation of p53LMAC01 cells in a dose-dependent manner via extracellular signal-regulated kinase 1/2 (ERK1/2)- and p38 mitogen-activated protein kinase (MAPK)-signaling pathways. In contrast, CTRP3/cartducin exhibited no effect on the migration of p53LMAC01 cells. Taken together, the results of the present study demonstrate a novel biological role of CTRP3/cartducin in promoting vascular smooth muscle cells proliferation in blood vessel walls after injury.

We present the video of a transanal radical resection of the rectum on a swine model (see Video, Supplemental Digital Content 1, http://links.lww.com/DCR/A4). The equipment used included simple instruments used in perianal surgery and a flexible endoscope with diathermy. The equipment and skill set required for this technique is easily accessible and reproduced. The potential exists to further develop this procedure with the ultimate aim of performing an incisionless and painless radical resection of the rectum in humans.

Effects of a Kampo (Japanese herbal) medicine 'shoseiryuto (SST, xiao-qing-long-tang in Chinese)', which has been used for the treatment of allergic bronchial asthma clinically, were examined on ovalbumin (OVA)-sensitized allergic airway inflammation model (i.e. bronchial asthma) in a mouse. When SST was orally administered at 0.5 g kg(-1) day(-1) from day 1 to 6 after OVA inhalation, SST reduced the inflammation in lung tissue, the number of eosinophils and the OVA-specific immunoglobulin E (IgE) antibody titer in bronchoalveolar lavage (BAL) fluids at 7 days after the OVA inhalation. SST also reduced the airway hyperreactivity at 6 days after the OVA inhalation. Proteomic analysis with the agarose two-dimensional electrophoresis showed that the expression of spectrin alpha2 was reduced in the lung tissue of OVA-sensitized mice and SST recovered the expression. Western blot and immunohistochemical analyses of lung tissue also confirmed this result. When prednisolone was orally administered at 3 mg kg(-1) day(-1) from day 1 to 6 after OVA inhalation, the inflammation in lung tissue, the number of eosinophils in BAL fluids and airway hyperreactivity were reduced in the OVA-sensitized mice. However, prednisolone did not reduce the OVA-specific IgE antibody titer in BAL fluids and did not recover the expression of spectrin alpha2 in lung tissue. These results suggest that at least a part of action mechanism of SST against OVA-sensitized allergic airway inflammation in a mouse model is different from that of prednisolone.

GATA-1-dependent transcription is essential for erythroid differentiation and maturation. Suppression of programmed cell death is also thought to be critical for this process; however, the link between these two features of erythropoiesis has remained elusive. Here, we show that the POZ-Krüppel family transcription factor, LRF (also known as Zbtb7a/Pokemon), is a direct target of GATA1 and plays an essential antiapoptotic role during terminal erythroid differentiation. We find that loss of Lrf leads to lethal anemia in embryos, due to increased apoptosis of late-stage erythroblasts. This programmed cell death is Arf and p53 independent and is instead mediated by upregulation of the proapoptotic factor Bim. We identify Lrf as a direct repressor of Bim transcription. In strong support of this mechanism, genetic Bim loss delays the lethality of Lrf-deficient embryos and rescues their anemia phenotype. Thus, our data define a key transcriptional cascade for effective erythropoiesis, whereby GATA-1 suppresses BIM-mediated apoptosis via LRF.

BACKGROUND: In modern postoperative management, early and enforced feeding has been implemented. The aim of this study is to determine the feasibility of individualized feeding according to the patient's appetite. METHODS: Patients who underwent elective surgery for colon cancer from January 2007 to December 2008 were studied. Liquid intake was allowed on the day of operation and solid normal meal (1800 Kcal) was served according to the recovery of appetite. RESULTS: Two hundred and nine patients were included. Open and laparoscopic surgeries were performed in 104 and 105 patients, respectively. Solid meal was started by the second postoperative day in 81.3% of patients. Intravenous drip infusion was completed within 1 day of the start of the solid meal in 86.6% of the patients and 182 out of 209 patients (87.1%) did not require drip infusion by the third postoperative day. There were no mortalities and readmission rate was 1.0%(2/209). CONCLUSION: The introduction of feeding according to the recovery of appetite was safe and feasible with no delay in establishing oral intake.