Factors Associated with Inadequate Tissue Yield in EUS-FNA for Gastric SMT

Aims. Our aim was to identify the factors that made the specimens inadequate and nondiagnostic in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsy of suspected submucosal tumors (SMTs). Methods. From August 2001 to October 2009, 47 consecutive patients with subepithelial hypoechoic tumors originating in the fourth sonographic layer of the gastric wall suspected as GIST by standard EUS in Chiba University hospital underwent EUS-FNA for histologic diagnosis. We evaluated patient age, sex, location of lesion, size, pattern of growth in a stomach, and pattern of echography retrospectively. We defined a case of gaining no material or an insufficient material for immunohistological diagnosis as nondiagnostic. Results. The diagnostic yield of EUS-FNA for the diagnosis of gastric SMTs was 74.5%. Multivariate logistic regression analysis identified that age of under 60 years (compared with patients older than 60 years: odds ratio [OR] = 11.91, 95% confidence interval [CI] = 1.761–80.48) and location of SMT at lower third area (compared with upper or middle third area: OR = 10.62, 95% CI = 1.290–87.42) were the predictive factors for inadequate tissue yield in EUS-FNA. Conclusions. The factors associated with inadequate tissue yield in EUS-FNA were younger age and the location of lesion at lower third area in stomach

Kinetic resolution of vic-amino alcohols catalyzed by a chiral Cu(II) complex

Kinetic resolution of N-benzoylated vic-amino alcohols was achieved by benzoylation in the presence of copper triflate and (R,R)-Ph-BOX as catalysts. The observed enantioselectivity was moderate to high. The method was applied to a kinetic resolution of racemic prolinol and piperidinemethanol derivatives as well as an asymmetric desymmetrization of 2-amino-1,3-diol derivatives

Identification of an Anti–Integrin αvβ6 Autoantibody in Patients With Ulcerative Colitis

指定難病「潰瘍性大腸炎」の自己抗体発見 --新たな診断や治療開発へ--. 京都大学プレスリリース. 2021-03-09.Background and Aims: Ulcerative colitis is the most frequent type of inflammatory bowel disease and is characterized by colonic epithelial cell damage. Although involvement of autoimmunity has been suggested in ulcerative colitis, specific autoantigens/antibodies have yet to be elucidated. Methods: Using 23 recombinant integrin proteins, we performed enzyme-linked immunosorbent assays on sera from patients with ulcerative colitis and controls. Integrin expression and IgG binding in the colon tissues of patients with ulcerative colitis and controls were examined using immunofluorescence and coimmunoprecipitation, respectively. The blocking activity of autoantibodies was examined using solid-phase binding and cell adhesion assays. Results: Screening revealed that patients with ulcerative colitis had IgG antibodies against integrin αvβ6. In the training and validation groups, 103 of 112 (92.0%) patients with ulcerative colitis and only 8 of 155 (5.2%) controls had anti–integrin αvβ6 antibodies (P < .001), resulting in a sensitivity of 92.0% and a specificity of 94.8% for diagnosing ulcerative colitis. Anti–integrin αvβ6 antibody titers coincided with ulcerative colitis disease activity, and IgG1 was the major subclass. Patient IgG bound to the integrin αvβ6 expressed on colonic epithelial cells. Moreover, IgG of patients with ulcerative colitis blocked integrin αvβ6–fibronectin binding through an RGD (Arg-Gly-Asp) tripeptide motif and inhibited cell adhesion. Conclusions: A significant majority of patients with ulcerative colitis had autoantibodies against integrin αvβ6, which may serve as a potential diagnostic biomarker with high sensitivity and specificity

Risk Factors for Bleeding After Endoscopic Submucosal Dissection for Gastric Cancer in Elderly Patients Older Than 80 Years in Japan.

Introduction:As the aging of people in a society advances, the number of elderly patients older than 80 years in Japan with gastric cancer continues to increase. Although delayed ulcer bleeding is a major adverse event after endoscopic submucosal dissection (ESD), little is known about characteristic risk factors for bleeding in elderly patients undergoing ESD. This study aimed to evaluate risk factors for delayed bleeding after ESD for gastric cancer in elderly patients older than 80 years.Methods:We retrospectively evaluated the incidence of delayed bleeding after ESD in 10,320 patients with early-stage gastric cancer resected by ESD between November 2013 and January 2016 at 33 Japanese institutions and investigated risk factors for delayed bleeding in elderly patients older than 80 years.Results:The incidence of delayed bleeding in elderly patients older than 80 years was 5.7% (95% confidence interval [CI]: 4.6%-6.9%, 95/1,675), which was significantly higher than that in nonelderly (older than 20 years and younger than 80 years) patients (4.5%, 4.1%-5.0%, 393/8,645). Predictive factors for ESD-associated bleeding differed between nonelderly and elderly patients. On multivariate analysis of predictive factors at the time of treatment, risk factors in elderly patients were hemodialysis (odds ratio: 4.591, 95% CI: 2.056-10.248, P < 0.001) and warfarin use (odds ratio: 4.783, 95% CI: 1.689-13.540, P = 0.003).Discussion:This multicenter study found that the incidence of delayed bleeding after ESD in Japanese patients older than 80 years was high, especially in patients receiving hemodialysis and taking warfarin. Management of ESD to prevent delayed bleeding requires particular care in patients older than 80 years

Orthogonal beamforming using Gram-Schmidt orthogonalization for multi-user MIMO downlink system

<p>Abstract</p> <p>Simultaneous transmission to multiple users using orthogonal beamforming, known as space-division multiple-access (SDMA), is capable of achieving very high throughput in multiple-input multiple-output (MIMO) broadcast channel. In this paper, we propose a new orthogonal beamforming algorithm to achieve high capacity performance in MIMO broadcast channel. In the proposed method, the base station generates a unitary beamforming vector set using Gram-Schmidt orthogonalization. We extend the algorithm of opportunistic SDMA with limited feedback (LF-OSDMA) to guarantee that the system never loses multiplexing gain for fair comparison with the proposed method by informing unallocated beams. We show that the proposed method can achieve a significantly higher sum capacity than LF-OSDMA and the extended LF-OSDMA without a large increase in the amount of feedback bits and latency.</p

Jet-Precipitation Relation and Future Change of the Mei-Yu-Baiu Rainband and Subtropical Jet in CMIP5 Coupled GCM Simulations

Through extensive modeling efforts, it has been established that the ongoing global warming will increase the overall precipitation associated with the East Asian summer monsoon, but the future change of its spatial distribution has not reached a consensus. In this study, meridional shifts of the mei-yu-baiu rainband are studied in association with the subtropical jet by using outputs from atmosphere-ocean coupled climate models provided by CMIP5. The models reproduce observed associations between the jet and precipitation over wide time scales from synoptic to interannual. The same relation is found in intermodel differences in simulated climatology, so that the meridional locations of the jet and baiu precipitation are positively correlated. The multimodel-mean projection suggests that the both are shifted southward by the late twenty-first century. This shift is not inconsistent with the projected tropical expansion, not only because the change is local but also because the projected tropical expansion occurs mainly in the Southern Hemisphere. No significant future change in the continental mei-yu precipitation location is identified, which might be because the jet change is weak there. For comparison, the summertime Atlantic jet position, which shifts northward, is investigated briefly. This study suggests that the future change of the subtropical jet is an important aspect to investigate possible future changes of the baiu rainband, and it prompts further studies including the role of the ocean