Early intestinal obstruction after infliximab therapy in Crohn’s disease

There is scarce knowledge on early intestinal obstruction in Crohn’s disease (CD) after infliximab treatment. Therefore, we describe two cases of early intestinal obstruction in a series of 46 CD patients treated with infliximab. Both our two cases were 21-year-old men with newly diagnosed CD who were diagnosed with perianal disease 2 years previously. They were suffering from diarrhea and abdominal pain, but there were no symptoms indicating bowel obstruction. Radiographic studies revealed stenotic sites in the terminal ileum in both cases. In both cases, infliximab 300 mg was infused, after which their abnormal laboratory data as well as symptoms such as diarrhea and abdominal pain clearly improved. However, on the 11th or 13th day post-treatment, they presented abdominal distension with air-fluid levels on imaging studies. Ileocolonic resection was performed in both cases. Early intestinal obstruction after infliximab therapy is characterized by initial improvement of the symptoms and the laboratory data, which is soon followed by clinical deterioration. This outcome indicates that infliximab is so swiftly effective that the healing process tapers the stenotic site, resulting in bowel obstruction. Thus, although unpleasant and severe, the obstruction cannot be considered as a side effect but rather a consequence of infliximab’s efficacy. CD patients with intestinal stricture, particularly the penetrating type with stricture, should be well informed about the risk of developing intestinal obstruction after infliximab therapy and the eventual need for surgical intervention

An Extended ISM for Globally Multimodal Function Optimization by Genetic Algorithms

When attempting to optimize a function where exists several big-valley structures, conventional GAs often fail to find the global optimum. Innately Split Model (ISM) is a framework of GAs, which is designed to avoid this phenomenon called UV-Phenomenon. However, ISM doesn't care about previously-searched areas by the past populations. Thus, it is possible that populations of ISM waste evaluation cost for redundant searches reaching previously-found optima. In this paper, we introduce Extended ISM (EISM) that uses search information of past populations as trap to suppress overlapping searches. To show performance of EISM, we apply it to some test functions, and analyze the behavior

Evolution of Galactic Outflows at z∼0z\sim0-22 Revealed with SDSS, DEEP2, and Keck spectra

We conduct a systematic study of galactic outflows in star-forming galaxies at $z\sim0$-$2$ based on the absorption lines of optical spectra taken from SDSS DR7, DEEP2 DR4, and Keck Erb et al. We carefully make stacked spectra of homogeneous galaxy samples with similar stellar mass distributions at $z\sim0$-$2$, and perform the multi-component fitting of model absorption lines and stellar continua to the stacked spectra. We obtain the maximum (v_\rm{max}) and central (v_\rm{out}) outflow velocities, and estimate the mass loading factors ($\eta$), a ratio of the mass outflow rate to the star formation rate (SFR). Investigating the redshift evolution of the outflow velocities measured with the absorption lines whose depths and ionization energies are similar (Na I D and Mg I at $z\sim0$-$1$; Mg II and C II at $z\sim1$-$2$), we identify, for the first time, that the average value of v_\rm{max} (v_\rm{out}) significantly increases by 0.05-0.3 dex from $z\sim0$ to $2$ at a given SFR. Moreover, we find that the value of $\eta$ increases from $z\sim0$ to $2$ by $\eta \propto (1 + z)^{1.2\pm0.3}$ at a given halo circular velocity v_\rm{cir} , albeit with a potential systematics caused by model parameter choices. The redshift evolution of v_\rm{max} (v_\rm{out}) and $\eta$ is consistent with the galaxy-size evolution and the local velocity-SFR surface density relation, and explained by high-gas fractions in high-redshift massive galaxies, which is supported by recent radio observations. We obtain a scaling relation of \eta \propto v_\rm{cir}^a for $a = -0.2 \pm 1.1$ in our $z\sim0$ galaxies that agrees with the momentum-driven outflow model ($a = -1$) within the uncertainty.Comment: 13 pages, 10 figures, ApJ in pres