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

Electronic properties of CrF and CrCl in the X 6Sigma+ state: observation of the halogen hyperfine structure by Fourier transform microwave spectroscopy.

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Involvement of 5-HT2A receptor hyperfunction in the anxiety-like behavior induced by doxorubicin and cyclophosphamide combination treatment in rats

We examined whether combination treatment with doxorubicin and cyclophosphamide, a traditional chemotherapy for breast cancer, induced anxiety-like behavior in rats. Furthermore, we evaluated the role of the serotonin (5-HT)2A receptor subtype in the anxiety-like behavior induced by such chemotherapy. Rats were intraperitoneally injected with doxorubicin and cyclophosphamide once a week for 2 weeks. This caused the rats to display anxiety-like behavior during the light–dark test. In addition, we examined the rats' 5-HT2A receptor-mediated behavioral responses. Combination treatment with doxorubicin and cyclophosphamide significantly increased (±)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane, (a 5-HT2A receptor agonist)-induced wet-dog shake activity. This anxiety-like behavior was significantly inhibited by mirtazapine, a 5-HT2A receptor antagonist/5-HT1A receptor agonist, and tandospirone, a partial 5-HT1A receptor agonist, but not by fluoxetine, a selective serotonin reuptake inhibitor. The anxiety-like behavior induced by doxorubicin and cyclophosphamide combination treatment is mediated by hyperfunctioning of the 5-HT2A receptor. Thus, 5-HT2A receptor antagonists or 5-HT1A receptor agonists might be useful for treating chemotherapy-induced anxiety disorders. Keywords: Doxorubicin, Cyclophosphamide, 5-HT2A receptor, Anxiet

Microwave Studies on 1,4-Pentadiene: CH₂CH–CH₂–CHCH₂; Transformations among the Three Rotational Isomers

In order to examine significant roles of conformations played in various research fields, a molecule with two internal-rotation axes of high symmetry, 1,4-pentadiene, was studied in detail through the observation of its rotational spectra by using various types of microwave spectroscopy, Stark modulation and Fourier transform in the centimeter-wave region, direct absorption in the millimeter-wave region, and centimeter-/millimeter-wave combinations for double resonance, along with ab initio molecular orbital calculations. The molecule was confirmed to exist in three rotameric forms: <i>skew</i>–<i>skew</i>, <i>cis</i>–<i>skew</i>, and <i>skew</i>–<i>skew</i>′. For the <i>cis</i>–<i>skew</i> form, rotational spectra not only in the ground vibrational state, but also in three excited C-C torsional states were detected. Rotational and centrifugal distortion constants were precisely determined by the analysis of all the observed spectra, in addition to the relative energies of the three isomers and the torsional frequencies for the <i>cis</i>–<i>skew</i> form, as estimated from the observed spectral line intensities. The <i>skew</i>–<i>skew</i> form was found to be the most stable among the three isomers, the <i>cis</i>–<i>skew</i> form higher in energy than the <i>skew</i>–<i>skew</i> by 172 ± 66 cm^–1, and the <i>skew</i>-<i>skew</i>′ form higher in energy than the <i>cis</i>–<i>skew</i> by 44 ± 26 cm^–1. These experimental results were compared with those derived from a two-dimensional potential energy surface calculated by ab initio molecular orbital methods, in order to obtain a global view of molecular dynamics taking place on the surface, while paying attention to unique features of internal rotation characteristic of two dimensions