Colorectal Carcinoma with Extremely Low CA19-9

Aim. The aim of this study is to determine the significance of postoperative sequential measurements of serum CA19-9 in patients with extremely low serum level. Patients and Methods. Serum level of CA19-9 of 1096 patients who underwent surgery was measured preoperatively and every three months after surgery for 5 years. Patients with CA19-9 level of less than 2 U/mL at the time of diagnosis were defined as Extremely Low CA19-9 (ELCA). Results. One hundred and seven patients (9.8%) were ELCA. Of these, 86 underwent surgery with curative intent. Serum levels of CA19-9 in patients who did not undergo curative resection (N = 12) and who developed recurrence (N = 10) were less than 2.0 U/mL in all occasions during followup. In all patients without recurrence, serum level of CA19-9 also remained less than 2.0 U/mL. Conclusion. In patients with extremely low CA19-9, who consist of 9.8% of colorectal carcinoma cases, postoperative sequential measurement of serum level of CA19-9 contributed neither to assessment of curability of surgical resection nor to detection of recurrence

Study of the Fully Frustrated Clock Model using the Wang-Landau Algorithm

Monte Carlo simulations using the newly proposed Wang-Landau algorithm together with the broad histogram relation are performed to study the antiferromagnetic six-state clock model on the triangular lattice, which is fully frustrated. We confirm the existence of the magnetic ordering belonging to the Kosterlitz-Thouless (KT) type phase transition followed by the chiral ordering which occurs at slightly higher temperature. We also observe the lower temperature phase transition of KT type due to the discrete symmetry of the clock model. By using finite-size scaling analysis, the higher KT temperature $T_2$ and the chiral critical temperature $T_c$ are respectively estimated as $T_2=0.5154(8)$ and $T_c=0.5194(4)$. The results are in favor of the double transition scenario. The lower KT temperature is estimated as $T_1=0.496(2)$. Two decay exponents of KT transitions corresponding to higher and lower temperatures are respectively estimated as $\eta_2=0.25(1)$ and $\eta_1=0.13(1)$, which suggests that the exponents associated with the KT transitions are universal even for the frustrated model.Comment: 7 pages including 9 eps figures, RevTeX, to appear in J. Phys.

The Constrained Maximal Expression Level Owing to Haploidy Shapes Gene Content on the Mammalian X Chromosome.

X chromosomes are unusual in many regards, not least of which is their nonrandom gene content. The causes of this bias are commonly discussed in the context of sexual antagonism and the avoidance of activity in the male germline. Here, we examine the notion that, at least in some taxa, functionally biased gene content may more profoundly be shaped by limits imposed on gene expression owing to haploid expression of the X chromosome. Notably, if the X, as in primates, is transcribed at rates comparable to the ancestral rate (per promoter) prior to the X chromosome formation, then the X is not a tolerable environment for genes with very high maximal net levels of expression, owing to transcriptional traffic jams. We test this hypothesis using The Encyclopedia of DNA Elements (ENCODE) and data from the Functional Annotation of the Mammalian Genome (FANTOM5) project. As predicted, the maximal expression of human X-linked genes is much lower than that of genes on autosomes: on average, maximal expression is three times lower on the X chromosome than on autosomes. Similarly, autosome-to-X retroposition events are associated with lower maximal expression of retrogenes on the X than seen for X-to-autosome retrogenes on autosomes. Also as expected, X-linked genes have a lesser degree of increase in gene expression than autosomal ones (compared to the human/Chimpanzee common ancestor) if highly expressed, but not if lowly expressed. The traffic jam model also explains the known lower breadth of expression for genes on the X (and the Z of birds), as genes with broad expression are, on average, those with high maximal expression. As then further predicted, highly expressed tissue-specific genes are also rare on the X and broadly expressed genes on the X tend to be lowly expressed, both indicating that the trend is shaped by the maximal expression level not the breadth of expression per se. Importantly, a limit to the maximal expression level explains biased tissue of expression profiles of X-linked genes. Tissues whose tissue-specific genes are very highly expressed (e.g., secretory tissues, tissues abundant in structural proteins) are also tissues in which gene expression is relatively rare on the X chromosome. These trends cannot be fully accounted for in terms of alternative models of biased expression. In conclusion, the notion that it is hard for genes on the Therian X to be highly expressed, owing to transcriptional traffic jams, provides a simple yet robustly supported rationale of many peculiar features of X's gene content, gene expression, and evolution

The effects of accumulated refractory particles and the peak inert mode temperature on semi-continuous organic carbon and elemental carbon measurements during the CAREBeijing 2006 campaign

Two semi-continuous Sunset carbon analyzers, with different peak inert mode temperatures (615 and 740℃), were simultaneously operated to measure fine particulate organic carbon (OC) and elemental carbon (EC) using a thermal optical transmittance method at an urban site in Beijing, China, from 16 August to 3 September 2006 during the CAREBeijing 2006 campaign. Excellent agreements were obtained between the collocated semi-continuous carbon analyzers, with slopes of 1.02 (R2 = 0.91) for OC and 1.06 (R2 = 0.93) for EC, resulting in very similar average EC/total carbon (TC) ratios of ∼0.36. These results imply that the different peak inert mode (100% helium) temperatures did not cause significant biases on the semi-continuous OC and EC measurements. However, it was found that the EC/TC ratio was greatly influenced by the accumulated refractory particles remaining on a quartz filter (PM refractory). Fresh quartz filters, with low PM refractory loadings, which is defined as a laser correction factor ≥0.94, gave ∼8-10% lower EC/TC ratios than aged quartz filters with high PM refractory loadings. The linear regression slope between EC and optically measured EC (OPT-EC) was much higher with fresh quartz filters (slope = 1.03, R2 = 0.96) than aged quartz filters (slope = 0.89, R2 = 0.95), suggesting the underestimation of EC on fresh quartz filters by ∼15% compared to those measured on aged quartz filters. Authentic standard humic-like substances (HULIS) on the clean quartz filter showed the highest extent of pyrolyzed organic carbon (POC) formation (47.4% in total detected carbon mass), followed by those on the Asian dust loaded quartz filter (37%) and the refractory urban pollutant loaded quartz filter (34.1%), indicating that the Asian dust and refractory urban pollutant reduced the POC formation from the HULIS. Thus, this study suggested that the PM refractory loading plays an important role in the semi-continuous OC and EC measurements by altering the degree of POC formation in the inert atmosphere

Acute fulminant pseudomembranous colitis which developed after ileostomy closure and required emergent total colectomy: a case report

Abstract Introduction Pseudomembranous colitis is known to be caused by Clostridium difficile; and, in 3% to 8% of patients, it lapses into an aggressive clinical course that is described as fulminant. We present here a case of extremely rapid and fatal fulminant pseudomembranous colitis that developed after ileostomy closure, a minor surgical procedure. To the best of our knowledge, this is the first case report of fatal fulminant pseudomembranous colitis after closure of a diversion ileostomy in an adult. Case presentation A 69-year-old Japanese man, who had previously undergone low anterior resection and creation of a diverting ileostomy for stage III rectal carcinoma was admitted for ileostomy closure. Preoperatively, he received oral kanamycin and metronidazole along with parenteral cefmetazole. His surgery and postoperative course were uneventful until the third postoperative day, when fever and watery diarrhea became apparent. The next day he presented with epigastric and left lower abdominal pain. Computed tomography revealed a slightly distended colon. Later that night, his blood pressure fell and intravenous infusion was started. In the early morning of the fifth postoperative day, his blood pressure could be maintained only with a vasopressor. Follow-up computed tomography demonstrated severe colonic dilation. A colonoscopy confirmed the presence of pseudomembranous colitis, and so oral vancomycin was administered immediately. However, within three hours of the administration, his condition rapidly deteriorated into shock. Although an emergent total colectomy with creation of an end ileostomy was performed, our patient died 26 hours after the surgery. The histopathological examination was consistent with pseudomembranous colitis. Conclusion It is important to recognize that, although rare, there is a type of extremely aggressive pseudomembranous colitis in which the usual waiting period for medical treatment might be lethal. We consider that colonoscopy and computed tomography are helpful to decide the necessity of emergent surgical treatment without delay.</p