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This study investigated a method for validating and determining the measurement uncertainty for the composition of brominated vegetable oil (BVO) in soft drinks and carbonated waters commonly consumed in South Korea. First, we studied a simple and precise qualitative colorimetric method at the maximum residues level 15 ppm. And an analytical method using ion chromatography (IC) was validated and identified with brominated fatty acids by gas chromatography electron ionization mass spectrometry (GC/EI-MS). The measurement uncertainty was evaluated based on the precisional study and confirmed by the preliminary inter-laboratory study. For IC analysis, the recovery range of BVO was from 97.8% to 107.2% with relative standard deviations between 0.18% and 0.69%. In addition, the expanded uncertainty of the BVO was 1.59. These results indicate that the validated method is appropriate for identifying of BVO and can be used to verify the safety of soft drinks or carbonated waters containing BVO residues.

The biological fermentation of plants is usually used to improve their product properties, including their biological activity. Acanthopanax koreanum is a plant indigenous to Jeju, Korea; however, fermented A. koreanum (FAK) has not been guaranteed to be safe. Therefore, in this study, a safety evaluation of aqueous extracts of FAK was performed using Sprague Dawley rats. The acute toxicity of FAK did not influence animal mortality, body weight changes or the animals' clinical appearance at a concentration of 5000 mg/kg body weight. Using doses of 500, 1000 and 2000 mg/kg/day in a subchronic (13-week) toxicity study, the administration of FAK in male rats increased their body weight, food consumption, absolute liver weight, liver-associated enzymes and total cholesterol content. However, these effects of FAK were not considered toxic because the changes were not accompanied by any evidence of clinical signs or any change in the histopathological examination. On the other hand, the FAK-treated female rats did not exhibit significant changes in their body weight, food consumption, absolute and relative organ weights or liver enzymes. These results suggest that the acute oral administration of FAK is non-toxic to rats, and 13 weeks of repeated dosing demonstrated no FAK-related toxicity at a concentration of 2000 mg/kg. Therefore, the no-observed-adverse-effect level (NOAEL) of FAK was determined to be 2000 mg/kg/day for both male and female rats.

The production of excessive reactive oxygen species by exposure to oxidative stress and solar radiation are primary factors in skin damage. We examined the effects of a citrus-based juice mixture and its bioactive compounds on antioxidant and anti-ageing activities in human dermal fibroblasts and hairless mice via the regulation of antioxidant enzymes and the mitogen-activated protein kinase pathway. The citrus-based juice mixture reduced H2O2-induced cell damage and intracellular reactive oxygen species production in human dermal fibroblasts. Citrus-based juice mixture pretreatment suppressed the activation of the H2O2-mediated mitogen-activated protein kinase pathway by activating the expression of activator protein 1 and matrix metalloproteinases. Moreover, it increased the expression levels of antioxidant enzymes such as glutathione reductase, catalase and manganese superoxide dismutase. In addition, oral administration of the citrus-based juice mixture decreased skin thickness and wrinkle formation and increased collagen content on an ultraviolet light B-exposed hairless mouse. These results indicate that the citrus-based juice mixture is a potentially healthy beverage for the prevention of oxidative stress-induced premature skin ageing.

Previous study showed that nitric oxide (NO) induces apoptosis in mouse embryonic stem (mES) cells, but the precise mechanism governing NO-induced apoptosis in mES remains unclear. This study investigated the mechanism of NO-induced apoptosis of mES cells via MAP kinase signaling pathway. Sodium nitroprusside (SNP), a NO donor, induced apoptosis in mES cells with enhanced production of reactive oxygen species (ROS). In addition, treatment with SNP induced the activation of caspase-3, -8 and -9 as well as mitogen-activated protein (MAP) kinases (JNK, p38 MAP kinase and ERK). However, pretreatment with the p38 MAP kinase inhibitor SB203580 and ERK inhibitor U0126 attenuated NO-induced cell toxicity, ROS production, and caspase-3 activation. Moreover, SB203580 inhibited the translocation of Bax from the cytosol to the mitochondria. Taken together, these results suggest that NO-induced apoptosis in mES cells was mediated through p38 MAP kinase/ERK signaling pathway by triggering caspases activation and Bax translocation from the cytosol to the mitochondria.

Background Metformin use has been associated with decreased cancer risk and mortality. However, the effects of metformin on the development of colorectal adenomas, the precursors of colorectal cancers, are not defined. Aims This study aimed to evaluate the potential effect of metformin on the incidence of colorectal adenomas in diabetic patients with previous colorectal cancer. Methods Among 488 consecutive diabetic patients who underwent colonoscopic surveillance after curative resection of colorectal cancer between 1998 and 2008, 240 patients were enrolled in this study and were compared in two groups: 114 patients taking metformin and 126 patients not taking metformin. Patient demographics, clinical characteristics, and colorectal adenoma incidence rate were analysed. Results After a median follow-up of 58 months, a total of 33 patients (28.9%) exhibited adenomatous colorectal polyps among the 114 patients who used metformin, compared with 58 (46.0%) patients with colorectal adenomas among the 126 patients who did not use metformin (odds ratio = 0.48, 95% confidence interval = 0.280–0.816, P = 0.008). After adjustment for clinically relevant factors, metformin use was found to be associated with a decreased incidence of colorectal adenomas (odds ratio = 0.27, 95% confidence interval = 0.100–0.758, P = 0.012) in diabetic patients with previous colorectal cancer. Metformin use in diabetic patients with previous colorectal cancer is associated with a lower risk of colorectal adenoma.

The roles and effects of Fe on the catalytic performance and physicochemical properties of a PtPd diesel oxidation catalyst prepared by three different methods were investigated by CO oxidation reaction, X-ray diffraction, temperature-programmed reduction (TPR), temperature-programmed oxidation, and BET surface area. It was found that the roles of Fe depended strongly on the sequential order of Fe introduction during the preparation of the PtPd catalyst. The Fe/PtPd/Al2O3 catalyst was prepared by introducing Fe onto the PtPd/Al2O3, and the PtPd/Fe/Al2O3 catalyst was obtained by loading the PtPd onto the Fe/Al2O3. The former had a superior activity. From the TPR results, the catalytic activity of CO oxidation was correlated with the oxygen mobility of the iron oxides. For PtPd/Fe/Al2O3, the iron interacted preferentially with the alumina support forming FeAlO3, which resulted in the stabilization of the support and a reduction in the surface area. The major role of Fe was to promote the enhancement of the catalytic activity of PtPd through an intimate interaction between the PtPd and iron oxides, which had lattice oxygens to generate oxygen with oxidation abilities.

A modified electrolysis method was employed to synthesize copper nanoparticles for mass production. Processing parameters including electrolyte temperature, pH and reduction agents were controlled in order to synthesize the particles continuously and directly from copper plates. As a result, well-dispersed copper nanoparticles with an average diameter of 15 nm were obtained and the oxidation of these particles was prevented by controlling the parameters. Using an amphiphilic surfactant, a water-based copper nano-colloid was prepared and printed onto a polyimide substrate using a conventional ink-jet printer. Copper patterns sintered at 230 °C showed a resistivity of 5.4 μΩ-cm (bulk resistivity; 1.67 μΩ-cm).

Background EMR has emerged as an alternative therapeutic option for selected cases of early colorectal cancer (ECC). However, the factors associated with resectability and curability of EMR for ECC remain unknown. Objective To investigate clinical outcomes and factors related to resectability and curability in ECC cases treated with EMR. Design Retrospective study. Setting Tertiary-care academic medical center. Patients This study involved all patients in whom EMR was performed for ECC at Severance Hospital between March 1997 and August 2007. A total of 236 cases of ECC occurring in 231 patients (66.2% men) were enrolled. Intervention EMR. Curative surgical resection and lymph node dissection were used in cases that were incompletely cured by EMR. Main Outcome Measurements Resectability, curability, and recurrence. Results Complete cure was achieved for 162 lesions (68.6%). Of the remaining 74 cases (31.4%), 69 (29.2%) were incompletely cured, and the other 5 (2.1%) had an undetermined resection status and ultimately required supplementary surgical resection for curative treatment. Location on the right side of the colon, piecemeal resection, and submucosal carcinoma were independently associated with incomplete resection, whereas depressed tumor type was independently related to incomplete cure. Among the ECC cases completely cured by EMR and followed for more than a year (n = 118), local recurrence was observed in one case (0.8%) during the median follow-up period of 39.4 months (range 12.4-123.1 months). Limitations Single-center, retrospective study. Conclusion Our data show that EMR is feasible and could be an effective option for treatment of ECC if the technique is applied with the appropriate indications.

This paper reports a new mass-production method for synthesizing Ag nano-particles using electrolysis. In this method, Ag ions were directly and continuously extracted from 99 wt% Ag metal electrodes and a reduction agent reduced them to Ag nano-particles. By changing the applied voltage and electrolyte temperature, the average size of the synthesized Ag particles was shown to vary in the range of 10–80 nm. These particles were tested for the possibility of micropatterning of the electrode on a polyimide substrate. As a result, patterns as fine as 50–100 μm with a relatively low resistivity of 6.5 μΩ cm were successfully obtained.

The effect of C 3 H 6 on the deNO x activity of CuZSM5, FeZSM5 and V 2 O 5 /TiO 2 catalysts by NH 3 has been examined. The catalytic NO removal activity decreased by the continuous inclusion of C 3 H 6 into the reactor feed gas stream. The higher the feed concentration of C 3 H 6 , the more severe the retardation of the catalyst activity. The primary cause for the inhibition is the competitive adsorption of NH 3 and C 3 H 6 onto the catalyst surface and the useless consumption of NH 3 by the side reaction, including the NH 3 oxidation and ammoxidation reactions during the course of NH 3 /SCR reaction with C 3 H 6 .

Background Secondary endoscopic treatment for remnant lesions of rectal carcinoid tumors after primary EMR or polypectomy is technically difficult because of fibrosis of residual tissues. EMR by using a cap (EMR-C), a method to resect the submucosal layer by suction by using a transparent cap, may be feasible as a salvage treatment. Objective To assess the feasibility of salvage EMR-C. Design Retrospective analysis. Setting Tertiary academic health care system. Patients Thirty-one patients who were referred for salvage treatment of a failed en bloc excision of rectal carcinoid tumors after primary EMR or polypectomy between January 2007 and December 2009. Interventions Salvage EMR-C for remnant carcinoid tumors in the rectum. Main Outcome Measurements Rate of complete resection, complications, length of procedure, and recurrence rate. Results The mean age of the patients was 52.0 ± 11.8 years (range 30–78 years). The mean tumor size was 8.9 ± 3.2 mm (range 5.0–13.0 mm). The mean procedure time was 9.1 ± 3.7 minutes, and clear resection margins were pathologically confirmed in all 31 patients. The most common complication of salvage EMR-C was bleeding (7 patients, 22.6%), which was successfully treated by hemoclipping in all cases. The 1-year follow-up colonoscopy and CT results for all patients were negative for recurrence. Limitations Retrospective design and limited cases at a single center. Conclusions EMR-C is a feasible salvage therapeutic option for failed en bloc excision after primary endoscopic treatment of rectal carcinoid tumors.

Background Capsule endoscopy (CE) is now widely accepted as a first-line diagnostic modality for obscure GI bleeding (OGIB). However, the clinical implications of negative results of CE studies remain unclear. Objective To investigate long-term (>1 year) outcomes for patients undergoing CE for OGIB and to identify risk factors associated with rebleeding. Design and Setting Retrospective study in a tertiary care hospital. Methods A total of 57 consecutive patients who had undergone CE for OGIB were enrolled and their pre- and post-CE clinical data were collected. Specific treatments were defined as treatments directly aimed at presumed bleeding causes including hemostasis and disease-specific medical therapy, whereas nonspecific treatments were defined as symptomatic treatments for anemia. Results Of the 57 patients, the indication for CE was obscure-overt bleeding in 46 patients and obscure-occult bleeding in 11 patients. Among 51 patients for whom long-term data were available, significant (P2) lesions were found in 23 (45.1%) patients. The overall rebleeding rate was 35.3% during a median follow-up duration of 31.7 months (range 12.8-58.0 months). There was no statistically significant difference in the cumulative rebleeding rate between patients with positive and negative CE results (34.8% vs 35.7%, respectively; P = .989). However, specific treatments after CE (hazard ratio, 0.111; 95% CI, 0.013-0.980; P = .043) significantly decreased rebleeding. Limitations Small number of patients, retrospective study design. Conclusions The rebleeding rate for patients with OGIB and negative CE results was substantial, indicating that these patients should be closely observed. However, specific treatment after CE significantly reduced the incidence of recurrent bleeding.

(-)-Epigallocatechin-3-gallate (EGCG), a major green tea polyphenol, was tested for in vitro cytotoxicity against human laryngeal epidermoid carcinoma of the larynx Hep2 cells. EGCG-induced apoptotic cell death accompanied by a change in the cell cycle. However, EGCG did not result in caspase activation, nor did a caspase inhibitor block cell death. Furthermore, EGCG caused no change in the intracellular levels of reactive oxygen species (ROS). The levels of p53 were increased in the EGCG-treated cells, with a corresponding decrease in Bcl-2 and Bid protein levels as well as an increase in the Bax level. In addition, EGCG induced the cytoplasmic release of cytochrome c from the mitochondria accompanied by a decreased mitochondrial membrane potential, and subsequently upregulated translocation of apoptosis-inducing factor (AIF) and endonuclease G (EndoG) into the nucleus during the apoptotic process. Taken together, these findings indicate that the p53-mediated mitochondrial pathway and the nuclear translocation of AIF and EndoG play a crucial role in EGCG-induced apoptosis of human laryngeal epidermoid carcinoma Hep2 cells, which proceeds through a caspase-independent pathway.

We synthesized a hydroquinone glucoside (HG) as a potential skin-whitening agent using Leuconostoc mesenteroides (B-1299CB BF563) dextransucrase with hydroquinone (HQ) as an acceptor and sucrose as a donor. The product was purified using butanol partitioning and silica gel column chromatography. The structure of the purified HG was determined by nuclear magnetic resonance and the ionic product was observed at m / z 295 (C12, H16, O7 Na) + . HG was identified as 4-hydroxyphenyl-α- d -glucopyranoside. The optimum condition of HG synthesis, determined using a response surface methodology, was 450 mM HQ, 215 mM sucrose, and 0.55 U/mL dextransucrase; the final HG produced was 544 mg/L. The IC 50 of diphenylpicryl-hydrazyl scavenging activity was 3.85 mM indicating a higher antioxidant activity compared to β-arbutin (IC 50 = 6.04 mM). HG-mediated inhibition of lipid peroxidation was 3.51% that of HQ (100%) and much higher than that of β-arbutin (0.81% of HQ). In addition the IC 50 value of nitrite-scavenging activity was 14.76 mM showing a superior scavenging activity to that of β-arbutin (IC 50 = 27.09 mM).

Sodium fluoride (NaF) has been shown to be cytotoxic and produces inflammatory responses in humans. However, the cellular mechanisms underlying the NaF-induced cytotoxicity in periodontal tissues are unclear. This study examined whether or not NaF induces apoptosis in human gingival fibroblasts (HGF), and its underlying mechanisms by monitoring various apoptosis-associated processes. NaF reduced the cell viability of HGF in a dose- and time-dependent manner. NaF increased TUNEL-positive cell and induced apoptosis with concomitant chromatin condensation and DNA fragmentation in HGF. In addition, NaF increased the level of cytochrome c released from the mitochondria into the cytosol, enhanced the caspase-9, -8 and -3 activities, the cleavage of poly (ADP-ribose) polymerase (PARP), and up-regulated the voltage-dependent anion channel (VDAC) 1. However, NaF did not affect the production of reactive oxygen species (ROS) which is a strong apoptotic inducer. Furthermore, NaF up-regulated the Fas-ligand (Fas-L), a ligand of death receptor. Bcl-2, a member of the anti-apoptotic Bcl-2 family, was down-regulated, whereas the expression of Bax, a member of the pro-apoptotic Bcl-2 family, was unaffected in the NaF-treated HGF. These results suggest that NaF induces apoptosis in HGF through both the mitochondria-mediated pathways regulated by the Bcl-2 family and death receptor-mediated pathway.

In this study, two quercetin-α- d -glucopyranosides were synthesized via the acceptor reaction of a glucansucrase obtained from Leuconostoc mesenteroides B-1299CB, with quercetin and sucrose. The two transfer products were purified via HPLC, and the structures of the products were identified as quercetin-4′-O-α- d -glucopyranoside (Q-G1) and quercetin-3′-O-α- d -glucopyranoside (Q-G1′), in accordance with the results of 1H, 13C, HSQC, H-H COSY, HMBC analyses. The primary product (Q-G1) evidenced slower effects on DPPH radical-scavenging activity (SC50 = 25.2 μM) than was seen with quercetin (SC50 = 6.5 μM). The water solubility of Q-G1 was 12.7 mM, whereas the quercetin was barely soluble in water. The Ki value of Q-G1 (674.5 μM) was almost identical to that of quercetin (673.3 μM) with regard to tyrosinase inhibition effects.

Epigallocatechin-3-gallate (EGCG) is a major constituent of green tea polyphenols. This study was aimed to investigate the possible mechanisms of EGCG-mediated inhibition against apoptosis in rat pheochromocytoma PC12 cells by exposure to CoCl(2). Exposure to CoCl(2) caused the generation of ROS and induced cell death with appearance of apoptotic morphology and DNA fragmentation. However, EGCG rescued the loss of viability in the cells exposed to CoCl(2) and led the reduction of DNA fragmentation and sub-G(1) fraction of cell cycle. Also, EGCG attenuated the CoCl(2)-induced disruption of mitochondrial membrane potential (DeltaPsim), release of cytochrome c from the mitochondria to cytosol and abolished the CoCl(2)-stimulated activities of the caspase cascades, caspase-9 and caspase-3. In addition, EGCG ameliorated the increase in the Bax to Bcl-2 ratio, a marker of apoptosis proceeding, induced by CoCl(2) treatment. Taken together, the present results suggest that EGCG inhibit the CoCl(2)-induced apoptosis of PC12 cells through the mitochondria-mediated apoptosis pathway involved in modulating the Bcl-2 family.

Thermophoresis of ultrafine particles in a turbulent pipe flow was studied using high-temperature and high-concentration polydisperse ultrafine particles. Experimental conditions were designed to simulate particle behaviour in an automobile exhaust pipe, with a particular focus on establishing similar particle residence time. From the experimental results, thermophoresis was found to be a dominant mechanism for ultrafine particle deposition in the turbulent pipe flow. A previous thermophoretic deposition model was found to be inadequate with respect to estimating the results of the experimental conditions. In this study, the experimental data and the computational analysis results reflect the necessity of establishing a new formula for thermophoretic deposition for high-concentration polydisperse ultrafine particles in a pipe flow.

Leuconostoc mesenteroides NRRL B-1149 sucrose phosphorylase (SPase) gene, 1149sp, was isolated and characterized. It is composed of 1479 bp nucleotides and encodes a 1149SPase of 492 amino acid residues with a calculated molecular mass of 56.1 kDa. It has unique C-terminal amino acid sequence (439DVETPSDTTIKITRKDKSGENVAVLVANAADKTFTITANGEEILANTEADKQQL492). 1149sp was expressed in Escherichia coli and the purified 1149SPase specific activity was 1.49 U/mg for sucrose. The optimum temperature and pH for SPase activities were ranged broad between 20 and 50 °C, between pH 6.0 and 7.5, respectively. The optimum temperature and pH were 37 °C at pH 6.7 and it showed Km of 6.3 mM and kcat of 1.59 s−1 for sucrose. It had a broad range of acceptor specificity and transferred the glucosyl moiety of sucrose or glucose-1-phosphate to various acceptors.

Three epigallocatechin gallate (EGCG) glucosides were synthesized by the acceptor reaction of a glucansucrase from Leuconostoc mesenteroides B-1299CB with EGCG and sucrose. After 1H, 13C, heteronuclear single quantum coherence, 1H–1H correlation spectroscopy, and heteronuclear multiple bond correlation nuclear magnetic resonance analyses, the glucosides were identified as (−)-epigallocatechin gallate 4′′-O-α- d -glucopyranoside (EGCG-G1), (−)-epigallocatechin gallate 7,4′′-di-O-α- d -glucopyranoside (EGCG-G2A), and (−)-epigallocatechin gallate 4′,4′′-di-O-α- d -glucopyranoside (EGCG-G2B). Two of the compounds (EGCG-G1 and EGCG-G2A) are reported for the first time. The EGCG glucosides exhibited antioxidant effects, depending on their structures (EGCG > EGCG-G1 > EGCG-G2A > EGCG-G2B). They also uniformly exhibited greater browning resistance than was observed in EGCG. Also, the water solubility of EGCG-G1, EGCG-G2A, and EGCG-G2B were 69, 126, and 122 times higher, respectively, than that of EGCG.

Glucansucrases from Leuconostoc mesenteroides catalyze the transfer of glucosyl units from sucrose to other carbohydrates by acceptor reaction. We modified salicyl alcohol, phenol and salicin by using various glucansucrases and with sucrose as a donor of glucosyl residues. Salicin, phenyl glucose, isosalicin, isomaltosyl salicyl alcohol, and a homologous series of oligosaccharides, connected to the acceptors and differing from one another by one or more glucose residues, were produced as major reaction products. By using salicin and salicyl alcohol as acceptors, B-1355C2 and B-1299CB-BF563 dextransucrases synthesized most widely diverse products, producing more than 12 and 9 different kinds of saccharides, respectively. With phenol, two acceptor products and oligosaccharides were synthesized by using the B-1299CB-BF563 dextransucrase. Salicyl derivatives, as acceptor products, showed higher anti-coagulation activity compared with that of salicin or salicyl alcohol that were used as acceptors.

The inhibition kinetics for isoacarbose (a pseudotetrasaccharide, IsoAca) and acarviosine-glucose (pseudotrisaccharide, AcvGlc), both of which are derivatives of acarbose, were investigated with various types of alpha-glucosidases obtained from microorganisms, plants, and insects. IsoAca and AcvGlc, competitive inhibitors, allowed classification of alpha-glucosidases into two groups. Enzymes of the first group were strongly inhibited by AcvGlc and weakly by IsoAca, in which the K(i) values of AcvGlc (0.35-3.0 microM) were 21- to 440-fold smaller than those of IsoAca. However, the second group of enzymes showed similar K(i) values, ranging from 1.6 to 8.0 microM for both compounds. This classification for alpha-glucosidases is in total agreement with that based on the similarity of their amino acid sequences (family I and family II). This indicated that the alpha-glucosidase families I and II could be clearly distinguished based on their inhibition kinetic data for IsoAca and AcvGlc. The two groups of alpha-glucosidases seemed to recognize distinctively the extra reducing-terminal glucose unit in IsoAca.

Non-reducible dielectric composition satisfying X8R specifications (−55 to 150°C, ±15%) for automotive applications was investigated in a BaTiO 3 –MgCO 3 –MnO 2 –rare earth elements (La, Pr, Gd, Tb, Dy, Ho, Er, Yb, Lu) system. In the cases of Er, Yb, Lu-substituted samples, a transition of the Curie point shifted to a higher temperature was observed. The peak shift toward higher temperatures indicated that the tetragonal phase became more stable at the high temperature. The ionic radius of rare earth elements was found to be an important factor in controlling the temperature dependency of the dielectric properties. Especially, smaller ionic radii of rare earth elements such as Yb and Lu were effective dopants to meet the X8R temperature–capacitance characteristics.

Feasibility of Endoscopic Treatment for Rectal Carcinoid Tumors According to Tumor Size Soung Min Jeon, Jin Ha Lee, Sung Pil Hong, Tae Il Kim, Won Ho Kim, Jae Hee Cheon Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea Background/Aims: This study was aimed to assess whether endoscopic treatment for rectal carcinoid tumors larger than 10 mm is feasible in terms of the rates of en bloc resection, histological complete resection, complication incidence, and tumor recurrence. Methods: Endoscopic treatments including conventional endoscopic mucosal resection (EMR), endoscopic mucosal resection using a cap (EMR-C), and endoscopic submucosal dissection (ESD) were performed to 101 patients among 111 patients diagnosed to have rectal carcinoid tumors at Severance Hospital in Seoul, Korea, between January 2005 and December 2009. All patients were confirmed to have no muscular layer invasion, no metastases to the lymph nodes or distal organs, and no atypical histological features. The patients were categorized into three groups by tumor size; (A) 1 10 mm, (B) 11 15 mm, and (C) 16 20 mm. We retrospectively reviewed their endoscopic pictures/video and medical records, and analyzed differences in results of endoscopic treatment and follow-up among the 3 groups. Results: Among the 3 groups, significant differences in baseline characteristics of patients and tumors were not shown except for tumor size. Although the rates of en bloc resection and pathologic complete resection did not differ according to tumor size, complication incidence and the rates of local recurrence, metastasis, and need for additional rescue therapy were higher as tumor size was larger (complication rate; 8.1%, 21.4%, 46.2%, p 0.001/ recurrence rate; 1.4%, 7.1%, 38.5%, p 0.001/ metastasis rate; 1.4%, 7.1%, 23.1%, p 0.004/ need for rescue therapy; 5.4%, 21.4%, 61.5%, p 0.001, in A, B, and C groups, respectively). In multivariate analysis for the risk factors of additional treatment after endoscopic treatment of rectal carcinoids, method of endoscopic treatment, invasion depth, and en bloc resection were not found to be independent risk factors, but only tumor size was an independent risk factor (RR of 11 20 mm to 1 10 mm in tumor size; 13.098, p 0.008/RR of 16 20 mm to 1 15 mm in tumor size; 20.894, p 0.002). ESD was superior to EMR/EMR-C in terms of rates of endoscopically and pathologically complete resection and complication. However, the procedure time of ESD was longer than EMR/EMR-C and the rate of additional rescue therapy after ESD did not reveal statistical differences compared with EMR/EMRC in all groups. Conclusions: In rectal carcinoid tumors with size 10mm, endoscopic treatment might be most feasible and both EMR/EMR-C and ESD showed similar efficacy and safety. However, surgery is still indicated for rectal carcinoid tumors which are larger than 10 mm because of high risk of need for additional rescue therapy and metastasis.

[Background & Aims]The granulocytapheresis (GCAP) for ulcerative colitis (UC) has been developed in Japan. GCAP is a non-pharmacological therapy thereby does not have severe adverse effect. The mechanism of GCAP is expected to reduce inflammatory cytokines and the production of L-selectin by absorbing selected active granulocytes. Weakness of GCAP is the difficulty of the anticipation of treatment effect in early treatment stage. In this study, we focused on adhesion molecules which are thought to be associated with the pathophysiology of UC. We examined 5 SNPs in 3 adhesion molecule genes. [Methods] Twenty eight UC patients (M12, F16, averaged age 37.9y.o.) who received GCAP in past 5 years were examined. These patients were 21 pancolitis, 5 left sided colitis and 2 proctitis. DNA was extracted from all patients by colonic biopsy or blood sample and examined about the polymorphisms by PCR-RFLP. Genes and polymorphisms were L-selectin -642C>T and 725C>T, PECAM-1 codon125 V>L, E-selectin 98G>T in exon2 and S128R in exon4. The differences of the clinical activity index (CAI) scores of preand post-treatment of each 1 course (5 times of GCAP performed) or 2 course (10times of GCAP performed) were used for the evaluation of UC activity. Statistical analysis was done by Mann-Whitney U test. [Results] L-selectin-642C>T C carrier tended to be contributed to better treatment results after 2 course. L-selectin 725C>T polymorphism was not associated with treatment effect. PECAM-1 codon125 V>L, L/L or L/V was significantly associated with better treatment effect within 1 course treatment than V/V (p T and S128R polymorphisms showed no effect about GCAP treatment. [Conclusions] In this study, a significant effect of polymorphisms in PECAM-1 was found. Future study will be needed to confirm this result in next step.