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Aims The aim of this study was to clarify whether worsening of independence in activities of daily living (ADL) and also difficulties in ADL are triggered by hospitalization in older patients with heart failure (HF) and whether difficulties in ADL can predict readmission for HF regardless of independence in ADL in these patients. Methods and results We enrolled 241 HF patients in the present multi-institutional, prospective, observational study. The patients were divided according to age into the non-older patient group ( Conclusions Worsening of both independence and difficulties in ADL was triggered by hospitalization in older HF patients, and difficulties in ADL were relevant factors for risk of rehospitalization regardless of independence in ADL. These findings indicate the importance of preventing not only decreased independence but also increased difficulties in ADL during and after hospitalization.

Background Lower leg strength at hospital discharge is strongly associated with poor prognosis in older patients with acute decompensated heart failure (ADHF). Improving leg strength is important in acute-phase cardiac rehabilitation (CR). Aims This study aimed to clarify whether a change in leg strength occurs during hospitalization of older ADHF patients receiving CR and whether it affects leg strength at discharge. Methods and results We enrolled 247 ADHF patients who underwent CR during hospitalization. They were divided into the non-older patient group ( Conclusions Leg strength was not improved in older ADHF patients during hospitalization even if they received CR, and this affected leg strength at discharge, suggesting that careful skeletal muscle intervention should be provided during hospitalization, and patients need to continue exercise after discharge.

PURPOSE It is recommended that patients with myocardial infarction (MI) be prescribed exercise by target heart rate (HR) at the anaerobic threshold (AT) via cardiopulmonary exercise testing (CPX). Although percent HR reserve using predicted HRmax (%HRRpred) is used to prescribe exercise if CPX or an exercise test cannot be performed, %HRRpred is especially difficult to use when patients take β-blockers. We devised a new formula to predict HR at AT (HRAT) that considers β-blocker effects in MI patients and validated its accuracy. METHODS The new formula was created using the data of 196 MI patients in our hospital (derivation sample), and its accuracy was assessed using the data of 71 MI patients in other hospitals (validation sample). All patients underwent CPX 1 mo after MI onset, and resting HR, resting systolic blood pressure (SBP), and HRAT were measured during CPX. RESULTS The results of multiple regression analysis in the derivation sample gave the following formula (R2 = 0.605, P < .001): predicted HRAT = 2.035 × (≥65 yr:-1

This study aimed to evaluate the rectal dose reduction with hydrogel spacer in 3D conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), helical tomotherapy (HT), CyberKnife (CK) and proton therapy. Twenty patients who had hydrogel spacer for prostate radiotherapy were retrospectively enrolled. Computed tomography (CT) images with or without hydrogel spacer were used to evaluate rectal dose reduction. In total, 200 plans (20 patients × 2 CT images × 5 techniques) were created using the following criteria: 3DCRT, VMAT and HT [76 Gy/38 fractions (Fr), planning target volume (PTV) D50%], CK (36.25 Gy/5 Fr, PTV D95%) and proton therapy (63 GyE/21 Fr, PTV D50%). Rectal dose reduction was evaluated using low-/middle-dose (D20%, D50% and D80%) and high-dose (D2%) ranges. Rectal dose reduction of each dose index was compared for each technique. Significant rectal dose reduction (P

AIM: To evaluate the target dose coverage for lung stereotactic body radiotherapy (SBRT) using helical tomotherapy (HT) with the internal tumor volume (ITV) margin settings adjusted according to the degree of tumor motion. BACKGROUND: Lung SBRT with HT may cause a dosimetric error when the target motion is large. MATERIALS AND METHODS: Two lung SBRT plans were created using a tomotherapy planning station. Using these original plans, five plans with different ITV margins (4.0–20.0 mm for superior-inferior [SI] dimension) were generated. To evaluate the effects of respiratory motion on HT, an original dynamic motion phantom was developed. The respiratory wave of a healthy volunteer was used for dynamic motion as the typical tumor respiratory motion. Five patterns of motion amplitude that corresponded to five ITV margin sizes and three breathing cycles of 7, 14, and 28 breaths per minute were used. We evaluated the target dose change between a static delivery and a dynamic delivery with each motion pattern. RESULTS: The target dose difference increased as the tumor size decreased and as the tumor motion increased. Although a target dose difference of

Resting heart rate (HR) plus 20 or 30 beats per minute (bpm), i.e., a simplified substitute for HR at the anaerobic threshold (AT), is used as a tool for exercise prescription without cardiopulmonary exercise testing data. While resting HR plus 20 bpm is recommended for patients undergoing beta-blocker therapy, the effects of specific beta blockers on HR response to exercise up to the AT (ΔAT HR) in patients with subacute myocardial infarction (MI) are unclear. This study examined whether carvedilol treatment affects ΔAT HR in subacute MI patients. MI patients were divided into two age- and sex-matched groups [carvedilol (+), n = 66; carvedilol (-), n = 66]. All patients underwent cardiopulmonary exercise testing at 1 month after MI onset. ΔAT HR was calculated by subtracting resting HR from HR at AT. ΔAT HR did not differ significantly between the carvedilol (+) and carvedilol (-) groups (35.64 ± 9.65 vs. 34.67 ± 11.68, P = 0.604). Multiple regression analysis revealed that old age and heart failure after MI were significant predictors of lower ΔAT HR (P = 0.039 and P = 0.013, respectively), but not carvedilol treatment. Our results indicate that carvedilol treatment does not affect ΔAT HR in subacute MI patients. Therefore, exercise prescription based on HR plus 30 bpm may be feasible in this patient population, regardless of carvedilol use, without gas-exchange analysis data.

Background and Purpose: We aimed to validate the usefulness of prescriptions based on gross tumor volume for stereotactic body radiotherapy for small peripheral lung tumors. Materials and Methods: Radiotherapy treatment planning data of 50 patients with small peripheral lung tumors (adenocarcinoma: 24, squamous cell carcinoma: 10, other: 1, unknown: 15) receiving breath-hold computed tomography-guided stereotactic body radiotherapy at our institution during 2013–2016 were analyzed. For each case, 3 dose prescription methods were applied: one based on 95% (PTVD95%) of the planning target volume, one based on 50% of the gross tumor volume (GTVD50%), and one based on 98% (GTVD98%) of the gross tumor volume. The maximum (GTVDmax), minimum (GTVDmin), and mean gross tumor volume dose (GTVDmean) and the dose covering 98% of the gross tumor volume were calculated to evaluate variations in the gross tumor volume dose. Results: Upon switching to GTVD50%, the variations in GTVDmax and GTVDmean decreased significantly, compared with variations observed for PTVD95% (p < 0.01), but the variation in GTVDmin increased significantly (p < 0.01). Upon switching to the GTVD98%, the variation in GTVDmean decreased significantly compared with that observed for PTVD95% (p < 0.01). Conclusion: Switching from prescriptions based on 95% of the planning target volume to those based on 98% of the gross tumor volume decreased variations among cases in the overall gross tumor volume dose. Overall, prescriptions based on 98% of the gross tumor volume appear to be more suitable than those based on 95% of the planning target volume in cases of small peripheral lung tumors treated with stereotactic body radiotherapy.

A simplified substitute for heart rate (HR) at the anaerobic threshold (AT), i.e., resting HR plus 30 beats per minute or a percentage of predicted maximum HR, is used as a way to determine exercise intensity without cardiopulmonary exercise testing (CPX) data. However, difficulties arise when using this method in subacute myocardial infarction (MI) patients undergoing beta-blocker therapy. This study compared the effects of &alpha, &beta, blocker and &beta, 1-blocker treatment to clarify how different beta blockers affect HR response during incremental exercise. MI patients were divided into &alpha, blocker (n = 67), &beta, 1-blocker (n = 17), and no-&beta, blocker (n = 47) groups. All patients underwent CPX one month after MI onset. The metabolic chronotropic relationship (MCR) was calculated as an indicator of HR response from the ratio of estimated HR to measured HR at AT (MCR-AT) and peak exercise (MCR-peak). MCR-AT and MCR-peak were significantly higher in the &alpha, blocker group than in the &beta, 1-blocker group (p &lt, 0.001, respectively). Multiple regression analysis revealed that &beta, 1-blocker but not &alpha, blocker treatment significantly predicted lower MCR-AT and MCR-peak (&beta, = &minus, 0.432, p &lt, 0.001, 0.473, p &lt, 0.001, respectively). Based on these results, when using the simplified method, exercise intensity should be prescribed according to the type of beta blocker used.

Interleukin (IL)-23, which is released by activated monocytes and neutrophils, promotes production of high levels of IL-17 by T-helper 17 cells. Cellulose acetate (CA) beads are used as carriers for granulocyte and monocyte (GM) adsorptive apheresis using Adacolumn. Contact between blood and CA beads induces cytokine release; however, their inflammatory effects on IL-23 release are unclear. We aimed to clarify the effect of CA beads on IL-23 release in vitro. We incubated peripheral blood with and without CA beads and measured IL-23. Compared to blood samples incubated without CA beads, blood samples incubated with CA beads had significantly decreased amounts of IL-23. In conclusion, CA beads inhibited IL-23 release from adsorbed GMs. The biological effects of this decrease in IL-23 release during GM adsorption to CA beads need further clarification.

The distribution of benthic macroinvertebrates was studied in deep Lake Motosu (oligotrophic lake), Japan. Bathymetrical sampling surveys were carried out using a standard Ekman grab at each of 16 stations in the lake on 8 March 2013. The average densities of the benthic community for all the stations were 2185 ind./m2, comprised principally of Tubifex tubifex (Muller) 23.4%, Asellus hilgendorfi Bovallius 4.9% and chironomids 65.8%. T. tubifex and chironomids inhabited the entire lake bottom, with higher densities in the shallower region (25 m>) than in the deeper region (ca. 120 m). On the other hand, the density of A. hilgendorfi increased with water depth and was highest in the deeper regions (>70 m). The densities of chironomid larvae were lower in the deeper region, with fewer chironomid larvae located in the center of the lake (637 ind./m2). The most abundant species, Micropsectra yunoprima Sasa, exhibited the widest distribution from 10.0 m to 121.0 m (mean density 926 ind./m2), followed by Procladius choreusi (Meigen) from 10 m to 74.1 m (mean density 365 ind./m2). The results of this study were compared to previous data by Kitagawa (1973) on chironomid larvae. The densities of these chironomid larvae increased throughout the whole lake in 2013. The water quality has not undergone a major change since the 1970’s. In this study, the number of M. yunoprima larvae has shown a tendency to increase, especially in shallower regions; where they are widely distributed, suggesting the continuation of favorable bottom condition for larvae since the 1970’s., Article, Europian Journal of Environmental Science. 5(1):35-40 (2015)

Cowden syndrome is an uncommon, autosomal dominant disease characterized by multiple hamartomas and hyperplastic lesions in the skin, mucous membrane, brain, breast, thyroid, and gastrointestinal tract. About 30% of Cowden syndrome cases are reportedly complicated by malignant diseases. Hamartomatous polyps occur throughout the gastrointestinal tract, the most common sites being the stomach, colon, esophagus, and duodenum. Small bowel polyps can occur in Cowden syndrome; however, they are difficult to detect by conventional examination, including double-contrast X-ray study. Here, we report three cases of Cowden syndrome with small bowel polyps, which were detected by capsule endoscopy. The small bowel polyps of Cowden syndrome frequently occur at the oral end of the small bowel, especially in the duodenum and jejunum, and their color is similar to that of the surrounding mucosa; additionally, the polyps are relatively small (2–5 mm). Capsule endoscopy is useful for detecting small bowel polyps in Cowden syndrome.

The prevalence of colorectal malignancies is increasing in the world. The parallel increase of metabolic syndrome gives a speculation between these two conditions, although the precise mechanism is still unclear. Interleukin-6 (IL-6) is a cytokine known to correlate with obesity and serve as a proinflammatory adipokine. In the present study, we investigated the effect of IL-6 signaling blockade on intestinal polyp formation in obesity using a mouse model of adenomatous polyposis coli (Apc). Male C57BL/6J-Apc(Min/+) mice were fed a high-fat diet from 5 weeks of age, and the overweight mice thus obtained were given a weekly intraperitoneal injection of anti-mouse IL-6 receptor antibody (MR16-1) from 6 to 15 weeks of age, while control mice received IgG or phosphate-buffered saline (PBS). The total number of intestinal polyps was significantly decreased in the MR16-1-injected group (53.1 ± 6.8) relative to the control groups (PBS-injected, 81.3 ± 6.1; rat IgG-injected, 74.7 ± 4.8, p = 0.01), and in particular the number of polyps larger than 2 mm in diameter was markedly decreased. In addition, the mean diameter of polyps in the MR16-1-injected group was significantly smaller than that in the control groups. On the other hand, no significant differences in body weight, epididymal fat pad mass, or the plasma levels of glucose, insulin and triglyceride were observed among the three groups. Thus, treatment with anti-IL-6 receptor antibody suppressed polyp growth in obese Apc(Min/+) mice fed the high-fat diet. We suggest that IL-6 signaling may be responsible for the obesity-associated colorectal tumorigenesis.

The purpose of this study was to compare the MLC error sensitivity of various measurement devices for VMAT pre‐treatment quality assurance (QA). This study used four QA devices (Scandidos Delta4, PTW 2D‐array, iRT systems IQM, and PTW Farmer chamber). Nine retrospective VMAT plans were used and nine MLC error plans were generated for all nine original VMAT plans. The IQM and Farmer chamber were evaluated using the cumulative signal difference between the baseline and error‐induced measurements. In addition, to investigate the sensitivity of the Delta4 device and the 2D‐array, global gamma analysis (1%/1, 2%/2, and 3%/3 mm), dose difference (1%, 2%, and 3%) were used between the baseline and error‐induced measurements. Some deviations of the MLC error sensitivity for the evaluation metrics and MLC error ranges were observed. For the two ionization devices, the sensitivity of the IQM was significantly better than that of the Farmer chamber (P

The present report describes a rare case of esophageal carcinoid tumor that was treated by endoscopic resection. A 43-year-old woman underwent esophagogastroduodenoscopy at her family clinic for screening of the upper digestive tract and a small lesion resembling a submucosal tumor was detected in the lower esophagus. A biopsy sample from the lesion was diagnosed as esophageal carcinoid tumor and the patient visited our hospital for detailed examination. The tumor was approximately 3 mm in diameter and its surface appeared to be covered with normal squamous epithelium. The tumor had a shiny reddish surface without ulceration or erosion. Magnifying endoscopy with narrow-band imaging showed structures resembling reticular vessels under the epithelium. Endoscopic ultrasonography depicted the tumor as a low-echoic mass within the lamina propria. Computed tomography did not detect the tumor and no metastatic lesions were evident in other organs. With the patient's informed consent, the tumor was resected using endoscopic submucosal dissection, with a sufficient free margin in both the vertical and horizontal directions. Magnifying endoscopic examination showed the resected tumor to have abundant reticular vessels. Finally, the tumor was diagnosed immunopathologically as an esophageal carcinoid tumor (neuroendocrine cell tumor, grade 1), without lymphatic or vascular invasion.

Tumor necrosis factor-α, (TNF)-α, a proinflammatory cytokine, is produced by activated granulocytes and monocytes (GMs) and implicated as a major factor in inflammatory bowel disease (IBD) pathogenesis. Reduction of TNF-α should improve IBD pathology. GM adsorptive apheresis (GMA) is an effective therapy for inflammatory disorders including IBD. GM adsorption to cellulose acetate (CA) beads induces anti-inflammatory cytokine release, although these effects on TNF-α release are not clarified. We hypothesized that GMA may inhibit TNF-α release. The aim of the present study was to clarify the effects of GM adsorption to CA beads on TNF-α release in vitro. Peripheral blood was incubated with and without CA beads and TNF-α was measured. For comparison, TNF-α was measured in another lipopolysaccharide (LPS)-containing peripheral blood sample incubated similarly. The amount of TNF-α in blood samples incubated with CA beads was significantly higher than in those incubated without beads, although it was significantly lower than TNF-α incubated with LPS-containing sample without beads. The amount of TNF-α after incubation with CA beads positively correlated with GM adsorption ratio. GM adsorption to CA beads induced a small amount of TNF-α release. This is the first report on TNF-α release induced via GM adsorption stimuli. The biological effects of TNF-α release during GM adsorption need to be clarified.

Interleukin (IL)-23, which is released by activated monocytes and neutrophils, promotes production of high levels of IL-17 by T-helper 17 cells. Cellulose acetate (CA) beads are used as carriers for granulocyte and monocyte (GM) adsorptive apheresis using Adacolumn. Contact between blood and CA beads induces cytokine release; however, their inflammatory effects on IL-23 release are unclear. We aimed to clarify the effect of CA beads on IL-23 release in vitro. We incubated peripheral blood with and without CA beads and measured IL-23. Compared to blood samples incubated without CA beads, blood samples incubated with CA beads had significantly decreased amounts of IL-23. In conclusion, CA beads inhibited IL-23 release from adsorbed GMs. The biological effects of this decrease in IL-23 release during GM adsorption to CA beads need further clarification.

Interleukin (IL)-10 is an anti-inflammatory cytokine mainly produced by monocytes and is essential for the induction of anti-inflammatory intestinal macrophages with macrophage colony-stimulating factor (M-CSF). Thus, IL-10- and M-CSF-rich conditions in colonic tissues seem to contribute to the improvement of pathological conditions in patients with inflammatory bowel diseases (IBD). We have already reported that ulinastatin, a serine protease inhibitor, increases M-CSF production during granulocyte/monocyte (GM) adsorption to cellulose acetate (CA) beads (carriers for Adacolumn therapy). However, the effects of ulinastatin on IL-10 production have not been clarified. The aim of the present study was to clarify the effects of ulinastatin on IL-10 production during GM adsorption by in vitro experiments. Peripheral blood was divided into four groups: (Control) no ulinastatin added, no contact with CA beads; (1) no ulinastatin added, contact with CA beads; (2) ulinastatin added, no contact with CA beads; and (3) ulinastatin added, contact with CA beads. After incubation, IL-10 in the plasma was measured. Compared with the level in the Control group, plasma IL-10 was significantly higher only in group 3, in which ulinastatin was added in the presence of CA beads, but did not increase in the absence of CA beads. These results suggest that ulinastatin synergistically increases IL-10 production with monocyte adsorption stimuli. By increasing not only M-CSF but also IL-10, a combination of ulinastatin and Adacolumn therapy may improve clinical efficacy for the treatment of IBD in terms of the induction of anti-inflammatory intestinal macrophages.

The distribution of benthic macroinvertebrate on 8 March 2009 was studied in Lake Saiko (73.2 m maximum depth). The average density of the benthic community for the entire lake was 19 583 individuals m−2, being comprised of oligochaetes and chironomid larvae, with densities of 18 163 (92.8%) and 1274 (6.5%), respectively. The average wet weights of oligochaetes and chironomid larvae were 15.96 and 1.67 g m−2, respectively. The oligochaetes inhabited the entire lake bottom, with their densities being higher in the transitional region (20–40 m) and deeper region (>40 m) than in the shallower region. However, the densities of chironomid larvae were low in the deeper region (>40 m), with only a few chironomid larvae being found in the centre of the lake (>60 m). The most abundant species (Micropsectra chuzeprima) exhibited the widest distribution (from 10.1 to 65.5 m depth), followed by Polypedilum nubeculosum. The results of this study also were compared to previous data on oligochaetes and chironomid larvae reported by Kitagawa (1973). The density of these animals increased throughout the whole lake in 2009. However, the chironomid species compositions did not changed. The larval distribution pattern of chironomid changed since Kitagawa’s study, being distributed from 11 to 68 m in 1973. In contrast, almost all chironomid larvae were found in the transitional (e.g. M. chuzeprima) and shallower (e.g. Procladius choreus and P. nubeculosum) regions in 2009, with only a few individuals being observed in the deeper regions (>60 m). In contrast, the oligochaete density increased in the deeper regions. Large environmental changes must have affected the oligochaetes and chironomids densities, especially in the deeper regions with low dissolved oxygen concentrations. Consequently, the distribution pattern of oligochaetes and chironomids in the lake has changed. These study findings suggest the lake is experiencing increasing eutrophication.

Purpose: It is widely acknowledged that chronic low-grade inflammation plays a key role in the development of obesity-related insulin resistance and type 2 diabetes. The level of circulating interleukin-6 (IL-6), one of the major proinflammatory adipokines, is correlated with obesity and insulin resistance, which are known to be risk factors for colorectal adenoma. We examined the association between the circulating level of IL-6 and the presence of colorectal adenoma. Experimental Design: In a total colonoscopy-based cross-sectional study conducted between January and December 2008, serum levels of IL-6 were measured in samples of venous blood obtained from 336 male participants attending health checkups (118 individuals with colorectal adenoma and 218 age-matched controls) after an overnight fast. Results: In the colorectal adenoma group, the median levels of serum IL-6 (1.24 vs. 1.04 pg/mL; P = 0.01), triglyceride, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) were to be significantly higher than those in the control group. When restricted to individuals with adenoma, levels of IL-6 were positively correlated with body mass index, insulin, and HOMA-IR. Multiple logistic analyses adjusted to include insulin or HOMA-IR showed that high levels of IL-6 were associated with the presence of colorectal adenoma. There was no significant interaction of IL-6 with HOMA-IR to modify this association. Conclusions: Our findings suggest that increased serum levels of IL-6 are positively associated with the presence of colorectal adenoma in men, independently of insulin and HOMA-IR. Clin Cancer Res; 18(2); 392–9. ©2011 AACR.

Obesity and insulin resistance are thought to be risk factors for colorectal adenoma. Glucose-dependent insulinotropic polypeptide (GIP) stimulates insulin secretion from the pancreas and promotes fat accumulation in adipocytes. The association between serum GIP and the risk of colorectal adenoma has not been examined previously. We investigated this association in 370 subjects who underwent total colonoscopy during thorough physical checkups between January and December 2008. We used a cross-sectional design and classified the subjects into a colorectal adenoma group and a control group without adenoma according to their endoscopic findings. Serum GIP concentrations in samples of venous blood obtained after an overnight fast were measured using a sandwich enzyme-linked immunosorbent assay kit. The mean levels of fasting GIP (34.9 ± 49.5 vs 25.0 ± 20.1 pg/mL, P = .04), triglyceride, glucose, and insulin and the values of the homeostasis model assessment of insulin resistance in the colorectal adenoma group were significantly higher than those in the control group. Multiple logistic regression analysis showed that the highest quartile of fasting GIP levels was associated with a significantly high risk of colorectal adenoma (odds ratio, 2.1; 95% confidence interval, 1.08-3.96; P = .01) in comparison with the lowest quartile. Quartile analysis demonstrated that increased levels of GIP were related to increased levels of fasting insulin and values of homeostasis model assessment β-cell. These results suggest that an increased level of fasting GIP is associated with an increased risk of colorectal adenoma.

The chironomid fauna in the deep lake, Lake Sai, Japan, was investigated in March, 2009. Thirteen (8 males and 5 females) chironomid midges were collected with a sweeping net around the boat house and 81 (44 males and 37 females) chironomid midges emerged in the laboratory. They were identified as 11 species belonging to four subfamilies, i.e., 7 species of Chironominae, 1 species of Orthocladiinae, 1 species of Prodiamesinae and 2 species of Tanypodinae. At the deepest Station 4 (65.5 m in depth), we could not collect chironomid midges. However, only Micropsectra chuzeprima Sasa, 1984 was collected at Station 5 (56.6 m). At Stations 6 (29.6 m) and 3 (18.8 m), two species, M. chuzeprima and Procladius choreus (Meigen, 1804), were collected. On the other hand, at the shallowest Station 1 (4.9 m), we collected nine chironomid species, and the most numerous species in this collection was Polypedilum nubeculosum (Meigen, 1804) with a total of 41 individuals collected. In previous reports, a total of 16 species were collected from around the lake. We additionally describe 10 species from Lake Sai in this study. Only one species, P. nubeculosum, was common to the earlier report and the present study. As a result, there are 26 species recorded from Lake Sai., Article, Medical Entomology and Zoology. 62(4):243-247 (2011)

In the ABC classification for gastric cancer risk screening, group A (Helicobacter pylori infection-negative, pepsinogen [PG]-negative) patients are assumed to be at low risk, but some patients do have atrophic gastritis and H. pylori infection. This study aimed to identify the characteristics of group A patients. Healthy adults in Yamagata City who underwent barium radiography and ABC classification participated in the survey. Patient radiographs were randomly interspersed and reviewed by two gastroenterologists who were blinded to the H. pylori and PG statuses. Group A patients (n=1462) was subclassified as follows: atrophic gastritis group, 21.5%; intermediate group, 15.7%; and no atrophic gastritis group, 62.8%. Elderly subjects and those with H. pylori antibody titers of 3.0-9.9U/ml should be carefully evaluated while interpreting the results of the ABC classification for gastric cancer risk screening.

Benthic macroinvertebrate distribution was studied on April 9, 1994, and March 2, 2003, in Lake Yamanakako. The average density of the benthic community for the entire lake was 3168 ind. m−2, comprising principally oligochaetes (41.0%) and chironomids (59.0%) in 1994. In 2003, the benthic community for the entire lake was 1847 ind. m−2, principally consisting of oligochaetes (69.9%) and chironomids (30.1%). In 1994, the larval density of Propsilocerus akamusi was 3.5 times that of Chironomus nipponensis and in 2003 the figure was 5.7 times. However, the larval biomass of P. akamusi was 2.1 times greater than that of C. nipponensis in 1994 and 2.8 times greater in 2003. The larval density of Tanypodinae decreased drastically, by about 12-fold, from 1994 to 2003. P. akamusi larvae were particularly abundant at the lake center in 1994, but they inhabited the entire lake bottom in 2003. P. akamusi density was closely related to water depth and ignition loss. C. nipponensis larvae also showed the widest distribution pattern in 2003, whereas their larvae had inhabited the northeastern parts and the lake center in 1994. Recently, the number of C. nipponensis larvae in Lake Yamanakako is tending to decrease, whereas that of P. akamusi larvae is increasing, suggesting ongoing eutrophication.

The distribution of macrophytes in Lake Kawaguchi, Japan, was surveyed in August 1999 using a sampling anchor from a boat. The survey revealed that the present aquatic vegetation was composed of 17 submerged species, and no floating-leaved plants were present. The diversity of submerged plants and their vertical growth limits decreased progressively from the west to the east end of the lake. At the time of the survey, the dominant species was Elodea nuttallii (Planch.) St. John, which had once grown explosively in the mid-1980s in the lake, and except for Vallisneria asiatica Miki, all of the species commonly observed in the lake seem to have diminished their growth greatly. Among them, Potamogeton compressus L., which was the most dominant species in the lake before the invasion of Elodea nuttallii, had decreased most severely. It is suggested that the present state of aquatic vegetation in this lake was much influenced by the persistent growth of Elodea nuttallii as well as by environmental factors.

Tumor necrosis factor-α, (TNF)-α, a proinflammatory cytokine, is produced by activated granulocytes and monocytes (GMs) and implicated as a major factor in inflammatory bowel disease (IBD) pathogenesis. Reduction of TNF-α should improve IBD pathology. GM adsorptive apheresis (GMA) is an effective therapy for inflammatory disorders including IBD. GM adsorption to cellulose acetate (CA) beads induces anti-inflammatory cytokine release, although these effects on TNF-α release are not clarified. We hypothesized that GMA may inhibit TNF-α release. The aim of the present study was to clarify the effects of GM adsorption to CA beads on TNF-α release in vitro. Peripheral blood was incubated with and without CA beads and TNF-α was measured. For comparison, TNF-α was measured in another lipopolysaccharide (LPS)-containing peripheral blood sample incubated similarly. The amount of TNF-α in blood samples incubated with CA beads was significantly higher than in those incubated without beads, although it was significantly lower than TNF-α incubated with LPS-containing sample without beads. The amount of TNF-α after incubation with CA beads positively correlated with GM adsorption ratio. GM adsorption to CA beads induced a small amount of TNF-α release. This is the first report on TNF-α release induced via GM adsorption stimuli. The biological effects of TNF-α release during GM adsorption need to be clarified.

The purpose of this study was to record the oligochaete fauna in Lake Kawaguchi and clarify their horizontal distribution. In addition, annual changes in the lake were recorded. Samples were collected between 5 March 1993 and 7 March 2006 by using a standard Ekman-Birge sampler at 22 stations, and multipoint sampling surveys were carried out. As a result of the study, a total of 8 species belonging to 6 genera and 3 subfamilies were identified. The average density of oligochaetes for the entire lake was 5247 +/- 3873 ind m(-2) and the average wet weight of oligochaetes was 25.5 +/- 23.4 g m(-2) in 1993, compared to 1075 +/- 676 ind m(-2) and 2.7 +/- 1.7 g m(-2), respectively, in 2006. Tubifex tubifex had inhabited the entire lake bottom in 1993, but Limnodrilus spp. inhabited only the center of the lake in 2006. In recent years, the total number of oligochaetes has shown a tendency to increase, compared with the past record from the 1970s, suggesting that eutrophication is an ongoing process., Article, TURKISH JOURNAL OF ZOOLOGY. 36(1):39-46 (2012)

Little is known about differences in the risk of poor nutritional status as assessed by the Geriatric Nutritional Risk Index (GNRI) in relation to physical performance in elderly female cardiac inpatients. The present study aimed to determine both differences in physical performance based on the GNRI and physical performance cut-off values according to the GNRI in elderly female cardiac inpatients. We enrolled 105 consecutive female Japanese inpatients aged ≥65 years (mean age, 74.6 years) with cardiac disease in this cross-sectional study. We divided the patients into two groups according to GNRI: high-GNRI group (≥92 points) (n = 71) and low-GNRI group (

We report the case of a 61-year-old female with advanced gastric cancer and mediastinal lymph node metastasis who developed chylothorax. The patient presented with cough, dyspnea and pain in the left lower limb, back, and hips. Her lower limb symptoms were attributed to cellulitis. Computed tomography revealed right-sided pleural effusion, multiple lymph node swelling, and thickening of the gastric wall. Following pleural aspiration, the effusion was identified to be chyle. Cytopathologically, numerous adenocarcinoma cells were detected in clumps, and subsequent esophagogastroduodenoscopy revealed type 3 gastric cancer. We diagnosed multiple lymph node metastases with pleural dissemination. Chemotherapy was administered; however, she eventually succumbed to disease progression. We suspected that the chylothorax resulted from the mediastinal lymph node metastasis that caused thoracic duct obstruction.

This is the first attempt to elucidate the seasonal changes in some physical and chemical parameters in a water column of Lake Sibire. The observation extended from spring to early winter of 1994. At the end of April, the lake water was 12℃, and it began to overturn. In summer start ificication the water near the thermocline was supersatured with oxygen. This study found that autumnal circulation began at the end of October. The pH value of the lake water showed between 6.8 and 8.1.Transparency changed from 2.8m to 5.6m in depth during the investigation. The level's of TP, chl-a and tranceparency in the summer stratification indicate that the lake is on the boundary between oligotrophic and mesotrophic, though the hypolimnetic water in summer was eutrophic. The hypolimnetic D.O. consumption rate seems to have been accelerating for the last 20 years.