Prognostic significance of right bundle branch block in patients with acute inferior myocardial infarction

There is little information available concerning the influence of right bundle branch block (RBBB) on the prognosis of patients with inferior myocardial infarction (MI). In this study we evaluated the influence of RBBB on the short-term prognosis of patients with inferior MI. Our study subjects were 1,265 hospitalized patients with Q wave MI. Patients were divided into 4 groups based on the presence or absence of RBBB and on the location of the infarction. RBBB was classified into 4 categories according to the timing of its appearance and its duration as new permanent, transient, old and age indeterminate. In-hospital death and pulmonary congestion were observed more frequently in patients with RBBB than in those without RBBB. Moreover, in inferior MI as in anterior MI, in-hospital death and pulmonary congestion occurred more frequently in new permanent RBBB patients than in patients with other types of RBBB. Multivariate regression analysis reveals that new permanent RBBB was a strong independent predictor for an adverse short-term prognosis in patients with inferior MI, as well as in patients with anterior MI. New permanent RBBB during inferior MI is a strong independent predictor for increased in-hospital mortality, regardless of the infarction location.</p

Physiological Activities of Perilla Frutescens Var. Frutescens Leaf Extracts and Storage Stability in Kneaded Noodles

Perilla (Perilla frutescens var. frutescens) leaves were fractionated based on their chemical properties, and the physiological activities of the fractions were evaluated. The acidic fraction had high radical scavenging ability, whereas the superoxide dismutase-like activities of all fractions were low. A positive correlation was observed between scavenging activity and polyphenol content. The inhibitory effects of the extracts on a-amylase and on a-glucosidase activities were low, indicating a weak suppressive effect of the leaf extracts on diabetes. The acidic and phenolic fractions suppressed pancreatic lipase activity and accelerated lipid hydrolysis in adipocytes differentiated from 3T3-L1 cells. Flour noodles kneaded with leaf powder were prepared, and storage stability was examined. The functional compounds in the leaves were heat-sensitive in the flour noodles. We fractionated perilla leaves to isolate and identify valuable components to provide functionality to processed food and determined that some conditions, such as storage temperature, must be considered to effectively use the compounds

A Comparison of Gastric Cancer Surgery Between Japan and China

Background: The differences in gastric cancer between East and West have been frequently discussed. However, there are few studies that have compared Japan and China in Asia. Methods: Patient characteristics, surgical procedures and pathologic information were compared among gastric cancer patients who underwent curative-intent gastrectomy at two large volume cancer centers in China and Japan. Results: The median age of Japanese patients is 70 years, seven years older than those in China, and more than 25% of Japanese patients were older than 75. In China, the tumor was thicker, and lymph node metastasis was frequently observed. Total gastrectomy was more common in China (35.6% vs 21.9%). Distal gastrectomy rate was 56.0 percent in Japan, compared to 42.2 percent in China. The proportion of patients undergoing proximal gastrectomy was almost equal in China and Japan. Further analysis of the characteristics of patients undergoing total gastrectomy revealed that in China, more advanced gastric cancer patients with larger tumors and more lymph node metastasis underwent total gastrectomy, while in Japan, more early stage gastric cancer patients underwent total gastrectomy. Conclusion: There are some differences in gastric cancer between Japan and China. China needs to learn from Japan by establishing some screening programs for the diagnosis and treatment of early gastric cancer

Congestion Tolls Efficiently Reduce CO2 Emissions from Homes in addition to Urban Transportation in the Long Run

Greenhouse gas emissions caused by urban residents' energy consumption arise from the 1) transportation and 2) housing sectors. This energy consumption depends on the population distribution of the city. This study quantitatively examines the effectiveness of congestion tolls, carbon tax, and land use regulations on the social welfare and the reduction of urban CO2 emissions. Results show that, among the three policies, the congestion toll can increase the social welfare by about 99% of the increase in the first-best scenario, which shows the best among the three policies, and can reduce the amount of total CO2 emissions by about 22%, which is almost the highest level among the three policies. These results suggest that congestion tolling, which is primarily the Pigovian tax for congestion, does not only internalize congestion externalities but also reduce CO2 emissions rather effectively through downsizing transportation distances and housing sizes with the spatial change in population density in the city

Two Cases of Rectal Cancer with Retzius Shunt Treated with Robot-Assisted Surgery

The retroperitoneal intestinal vein-general circulation anastomotic pathway is referred to as a Retzius shunt; however, it is not a well-recognized condition. Here, we describe two patients with a Retzius shunt who underwent robot-assisted surgery for rectal cancer. The first case was an 81-year-old woman who had tested positive for fecal occult blood. A type 0-Is tumor was found in the middle rectum, and we used robot-assisted surgery for resection. Intraoperative findings included a dilated vein between the inferior mesenteric artery (IMA) and inferior mesenteric vein (IMV); further, computed tomography (CT) revealed flow into the inferior vena cava (IVC). We clipped the vein without major bleeding and the tumor-specific mesorectal excision was completed. Thereafter, we reviewed relevant literature and identified the structure to be a Retzius shunt. The second case was 77-year-old man with type 1 advanced cancer in the middle rectum who underwent robot-assisted surgery. In this case, we recognized the Retzius shunt on preoperative CT due to our experience with the first case and surgery was completed without any problems. Preoperative recognition of vascular malformations, such as the Retzius shunt by CT is critical to ensure the safety of robot-assisted surgery