Two cases of retroperitoneal hematoma caused by combination of anticoagulant therapy and 5-fluorouracil

We reported two cases of retroperitoneal hematoma in patients who received a combination of anticoagulant therapy and5-fluorouracil (5-FU). We should be aware of the possible interaction of this combination therapy and monitor prothrombin time (PT) prolongation. CT is useful for evaluation of the disease

Associations between Sleep-Disordered Breathing and Metabolic Risk Factors beyond Obesity

金沢大学附属病院代謝内科Objective. Individuals with multiple metabolic risk factors often experience concomitant sleep-disordered breathing (SDB). We aimed to determine the associations of SDB with individual components of metabolic syndrome independent of obesity. Methods. A cross-sectional study was conducted in 1137 employees aged 30–64 years. Apnea-hypopnea index (AHI) was assessed using a portable monitor for obstructive sleep apnea by admission. Of these, 451 participants took an oral glucose tolerance test to assess homeostatic model assessment of insulin resistance (HOMA-IR) and Matsuda insulin sensitivity index (ISI). Results. The odds ratio (OR) of the highest category of the AHI (≥15 episodes per hour) compared to the lowest one (<5 episodes per hour) was significantly elevated for hypertension, for hypertriglyceridemia, and for low HDL-cholesterolemia when adjusted for age, sex, and alcohol and smoking status (). After further adjustment for body mass index (BMI) or waist circumference, the associations for hypertension still remained statistically significant () while those for hypertriglyceridemia and low HDL-cholesterolemia were no longer significant. The association between higher insulin resistance as assessed by HOMA-IR and Matsuda ISI and higher categories of the AHI was also lost after adjustment for BMI. Conclusion. Obesity was a strong confounding factor in the association between SDB and most metabolic risk factors including insulin resistance, except for hypertension. Further longitudinal study is needed to examine the temporal or causal relationships between SDB and metabolic risk factors. This trial is registered with UMIN-CTR UMIN000028067

Rebleeding rate after interventional therapy directed by capsule endoscopy in patients with obscure gastrointestinal bleeding

<p>Abstract</p> <p>Background</p> <p>The precise role of capsule endoscopy in the diagnostic algorithm of obscure gastrointestinal bleeding has yet to be determined. Despite the higher diagnostic yield of capsule endoscopy, the actual impact on clinical outcome remains poorly defined. The aim of this study was to evaluate the follow-up results of patients with obscure gastrointestinal bleeding to determine which management strategies after capsule endoscopy reduced rebleeding.</p> <p>Methods</p> <p>All patients in whom the cause of obscure gastrointestinal bleeding was investigated between May 2004 and March 2007 were studied retrospectively. We evaluated the clinical outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy using the rebleeding rate as the primary outcome.</p> <p>Results</p> <p>Seventy-seven patients with obscure gastrointestinal bleeding underwent capsule endoscopy. Capsule endoscopy identified clinically significant findings that were thought to be the sources of obscure gastrointestinal bleeding in 58.4% of the patients. The overall rebleeding rate was 36.4%. The rebleeding rate was significantly higher among patients with insignificant findings than among those with significant findings (<it>p </it>= 0.036). Among the patients in whom capsule endoscopy produced significant findings, the rebleeding rate of the patients who underwent therapeutic interventions was significantly lower than that in those who did not undergo intervention (9.5% vs 40.0%, <it>p </it>= 0.046).</p> <p>Conclusion</p> <p>Follow-up and further aggressive interventions are necessary for patients with obscure gastrointestinal bleeding and significant capsule endoscopy findings to reduce the chance of rebleeding.</p

ジョウ チョウキュウ ニホンゴ ガクシュウシャ ニオケル ハツワブンセキ ハツワ ナイヨウ リョウイキ トノ カカワリ カラ

本研究は、上・超級日本語学習者の発話の特徴を明らかにすることを目指し、ACTFL (全米外国語教育協会)から日本語の OPI テスト(口頭面接テスト)のテスター認定を受けた試験官が行なったものである。OPI テストの録音テープから、超級、上級の上・中・下の各々の典型的なものを選んで分析対象とし、母語話者とも比較した。まず、話題の種類と述べ方から発話内容領域という概念を設け、それを3つの領域---I.身近な具体的事実を直接的に言う、II.個人的一般的関心事の具体的事実を詳述する、III.抽象的内容を論じる--- に分けた。各被験者の発話について、この発話内容領域を軸として、試験官の要求への対応・発話の構成・談話の形・文法能力(語彙の広がり、誤用、言い直し、接続表現)を分析した結果、上・超級話者の各レベルの発話の特徴を具体的に示した。また、上級から超級への移行の過程が明らかになった。全分析項目において、なだらかな発達がみられるわけではなく、発話の構成・抽象的表現の使用・言い直し・接続表現・誤用などの項目では、上級と超級で大きい違いがみられた。また、発話内容領域によっても、レベル差が大きく現れる項目が異なっていた。これらの結果から、いくつかの分析項目では、ACTFL-OPI の基準で示されているレベル変化とは異なる、大きく変化する段階があることも分かった。さらに今回行なった母語話者との比較から、超級話者のほうが母語話者より論理的に話したり、和語を多く使用することが認められた。This research was conducted by a group of Japanese-language Oral Proficiency Interview (OPI) testers certified by the American Council on the Teaching of Foreign Languages (ACTFL). The purpose of the research is to clarify major characteristics of advanced- and superior-level non-native speakers. This research began by selecting tapes that represent typical lower advanced, middle advanced, upper advanced, and superior speech for detailed analysis. Tapes of Japanese native speakers were also selected and included for comparison. This article first categorizes the topics or themes of conversation into three fields: (1) predictable, familiar topics; (2) topics of personal general interest; and (3) wide range of general-interest topics. Second, in relation to these categorized content fields, this research explains the discourse structure, the rate of success in structuring an extended discourse and a paragraph, the variety of conjunctions, kango, and wago used,idiomatic expressions and onomatopoeic words used, and the number and the types of self-corrections. The result of this research shows a clear picture of major characteristics of advanced and superior-level speakers. It also suggests the feature of the progress from advanced to superior levels. Distinct difference was observed between advanced and superior level speakers in discourse structure, usage of abstract expressions, self-corrections, usage of conjunctions, and grammatical mistakes. In case of accomplishments of the tasks and the text types in treating the second field theme, clear difference was observed between advanced-low and advanced-mid speakers. Whereas in case of the text types in treating the third field theme, there was a clear distinction between advanced-mid and advanced-high speakers. The above results suggest the existence of some other levels than the one described in OPI criteria

The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force

「コロナ制圧タスクフォース」COVID-19患者由来の血液細胞における遺伝子発現の網羅的解析 --重症度に応じた遺伝子発現の変化には、ヒトゲノム配列の個人差が影響する--. 京都大学プレスリリース. 2022-08-23.Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection

Cellular fibronectin 1 promotes VEGF-C expression, lymphangiogenesis and lymph node metastasis associated with human oral squamous cell carcinoma

Lymph node metastasis (LNM) is associated with poor survival in patients with oral squamous cell carcinoma (OSCC). Vascular endothelial growth factor-C (VEGF-C) is thought to be responsible for increased lymphangiogenesis and LNM. Understanding of the mechanism by which VEGF-C expression is regulated in OSCC is thus important to design logic therapeutic interventions. We showed that inoculation of the SAS human OSCC cells expressing the venus GFP (V-SAS cells) into the tongue in nude mice developed LNM. V-SAS cells in LNM were isolated by FACS and re-inoculated into the tongue. This procedure was repeated eight times, establishing V-SAS-LM8 cells. Differential metastasis PCR array between the parental V-SAS and V-SAS-LM8 was performed to identify a molecule responsible for lymphangiogenesis and LNM. Fibronectin 1 (FN1) expression was elevated in V-SAS-LM8 cells compared to V-SAS-cells. V-SAS-LM8 tongue tumor showed increased expression of FN1 and VEGF-C, and promoted lymphangiogenesis and LNM compared with V-SAS tumor. Further, phosphorylation of focal adhesion kinase (FAK), a main downstream signaling molecule of FN1, was up-regulated, and epithelial-mesenchymal transition (EMT) was promoted in V-SAS-LM8 cells. Silencing of FN1 by shRNA in V-SAS-LM8 cells decreased FAK phosphorylation, VEGF-C expression and inhibited lymphangiogenesis and LNM. EMT was also reversed. The FAK phosphorylation inhibitor PF573228 also decreased VEGF-C expression and reversed EMT in V-SAS-LM8 cells. Finally, we detected intense FN1 expression in some clinical specimens obtained from OSCC patients with LNM. These results demonstrate that elevated expression of cellular FN1 and following activation of FAK lead to increased VEGF-C expression, lymphangiogenesis and LNM and promoted EMT in SAS human OSCC cells and suggest that FN1-phosphorylated FAK signaling cascade is a potential therapeutic target in the treatment of LNM in OSCC