Efficacy and safety of cold forceps polypectomy utilizing the jumbo cup: a prospective study

Background/Aims There are few prospective studies on cold forceps polypectomy (CFP) using jumbo cup forceps. Therefore, we examined patients with diminutive polyps (5 mm or smaller) treated with CFP using jumbo cup forceps to achieve an adenoma-free colon and also assessed the safety of the procedure and the recurrence rate of missed or residual polyp after CFP by performing follow-up colonoscopy 1 year later. Methods We included patients with up to 5 adenomas removed at initial colonoscopy and analyzed data from a total of 361 patients with 573 adenomas. One-year follow-up colonoscopy was performed in 165 patients, at which 251 lesions were confirmed. Results The one-bite resection rate with CFP was highest for lesions 3 mm or smaller and decreased significantly with increasing lesion size. Post-procedural hemorrhage was observed in 1 of 573 lesions (0.17%). No perforation was noted. The definite recurrence rate was 0.8% (2/251 lesions). The probable recurrence rate, which was defined as recurrence in the same colorectal segment, was 17%. Adenoma-free colon was achieved in 55% of patients at initial resection. Multivariate analysis revealed that achievement of an adenoma-free colon was significantly associated with number of adenomas and years of endoscopic experience. Conclusions CFP using jumbo biopsy forceps was safe and showed a high one-bite resection rate for diminutive lesions of 3 mm or smaller. The low definite recurrence rate confirms the reliability of CFP using jumbo biopsy forceps. Number of adenomas and years of endoscopic experience were key factors in achieving an adenoma-free colon

ネコブセンチュウ(Meloidogyne incognita)の感染に対する植物体内のジャスモン酸応答遺伝子およびジャスモン酸関連経路の役割

京都大学0048新制・課程博士博士(農学)甲第16137号農博第1873号新制||農||990(附属図書館)学位論文||H23||N4607(農学部図書室)28716京都大学大学院農学研究科地域環境科学専攻(主査)教授 二井 一禎, 教授 天野 洋, 教授 縄田 栄治学位規則第4条第1項該当Doctor of Agricultural ScienceKyoto UniversityDA

Clinical Significance of Soluble CD26 in Malignant Pleural Mesothelioma

<div><p>There is no established single diagnostic marker for malignant pleural mesothelioma (MPM). CD26 is a 110 kDa, multifunctional, membrane-bound glycoprotein that has dipeptidyl peptidase IV (DPPIV) enzyme activity. The aim of this study was to evaluate the clinical significance of soluble CD26 (sCD26) in patients with MPM. The study included 80 MPM patients, 79 subjects with past asbestos exposure (SPE), and 134 patients with other benign pleural diseases (OPD) that were included as a control group. sCD26 levels and DPPIV activity in serum and/or pleural fluid were determined using an ELISA kit. Serum sCD26 levels and DPPIV enzyme activity in patients with MPM were significantly decreased compared with those in the SPE group (P = 0.000). The level of serum sCD26 was significantly decreased in patients with advanced stages of MPM compared with those with earlier stages (P = 0.047). The median OS of patients with MPM who had higher DPPIV enzyme activity was significantly longer than that of those with lower DPPIV enzyme activity (P = 0.032). The sCD26 levels in the pleural fluid of MPM patients with an epithelioid subtype were significantly increased compared with the OPD cohort (P = 0.012). Moreover, DPPIV enzyme activity in the pleural fluid of patients with MPM with an epithelioid subtype were significantly increased compared with those in the OPD cohort (P = 0.009). Patients with MPM who had lower specific DPPIV activity, determined as DPPIV/sCD26, showed significantly prolonged survival compared with those with higher specific DPPIV activity (P = 0.028). Serum sCD26 and DPPIV enzyme activity appear to be useful biomarkers for differentiating patients with MPM from SPE. The sCD26 levels or DPPIV enzyme activity in pleural fluid appear to be biomarkers in patients with an epithelioid subtype of MPM. DPPIV activity in serum or pleural fluid appears to be predictive for the prognosis of patients with MPM.</p></div

Comparison of serum dipeptidyl peptidase IV (DPPIV) enzyme activity levels.

<p>(A) Comparison of serum DPPIV enzyme activity levels in the sera of patients with malignant pleural mesothelioma (MPM) or subjects with past asbestos exposure (SPE). Each dot indicates an individual value and the horizontal bar indicates the median value. (B) Receiver operating curve analysis of serum DPPIV enzyme activity according to the differentiation between patients with MPM and SPE.</p

Overall survival in patients with malignant pleural mesothelioma according to soluble sCD26 levels.

<p>OS according to those with (A) higher (≥0.45 µg/ml, solid line) and lower (<0.45 µg/ml, dashed line) pleural fluid soluble sCD26 (sCD26) values; (B) higher (≥9.0 µM/min, solid line) and lower (<9.0 µM/min, dashed line) pleural fluid DPPIV enzyme activity; and (C) a higher (≥21.0, solid line) and lower (<21.0, dashed line) fraction of DPPIV/sCD26 in the pleural fluid.</p

Correlation between sCD26 levels and DPPIV enzyme activity.

<p>Correlation between sCD26 levels and DPPIV enzyme activity in the serum of patients with (A) an epithelioid subtype and (B) sarcomatous subtype of MPM; and in the pleural fluid of patients with (C) an epithelioid subtype and (D) a sarcomatous subtype of MPM.</p

The levels of sCD26 or DPPIV enzyme activity in pleural fluid.

<p>(A) sCD26 levels and (B) DPPIV enzyme activity in the pleural fluid of patients with an epithelioid subtype of MPM (Epi) or with other pleural diseases (OPD). (C) sCD26 levels in the pleural fluid of patients with an Epi or sarcomatous (Sar) subtype of MPM. Each dot indicates an individual value and the horizontal bars indicate the median value.</p