Optimal direct oral anticoagulant for upper gastrointestinal endoscopic submucosal dissection.

Background: The patients taking direct oral anticoagulants (DOACs) are at high risk for developing ischemic stroke and delayed bleeding in upper gastrointestinal endoscopic submucosal dissection (ESD). We aimed to identify the optimal DOAC based on both adverse events in upper gastrointestinal ESD.

Methods: A retrospective population-based cohort study was conducted using the Diagnosis Procedure Combination database in Japan.

Guanfacine poisoning resulting in transient ST-segment elevation: a case report.

Background: Guanfacine is an alpha-2 adrenergic agonist that decreases norepinephrine release and sympathetic outflow. With the increased use of guanfacine for attention-deficit hyperactivity disorder (ADHD), reports of guanfacine poisoning have also risen.

Case Presentation: A 15-year-old male (height: 170 cm, weight: 48 kg), who was taking 2 mg/day of guanfacine for ADHD, was brought to our emergency department after ingesting 40 tablets of guanfacine due to poor exam results.

Kerosene condenses in the trachea following inhalation.

Purpose: We have investigated the absorption dynamics of petroleum fuel components from the analytical results of autopsy samples.

Methods: Post-mortem samples of the severely burned case, including femoral blood, intratracheal contents (mucus) and intratracheal gas-phase samples were collected, and analysed by gas chromatography-mass spectrometer with head-space solid-phase microextraction.

Results: The composition of flammable substances in the tracheal gas phase differed slightly from that in mucus.

Sedanolide Activates KEAP1-NRF2 Pathway and Ameliorates Hydrogen Peroxide-Induced Apoptotic Cell Death.

Sedanolide is a bioactive compound with anti-inflammatory and antitumor activities. Although it has been recently suggested that sedanolide activates the nuclear factor E2-related factor 2 (NRF2) pathway, there is little research on its effects on cellular resistance to oxidative stress. The objective of the present study was to investigate the function of sedanolide in suppressing hydrogen peroxide (HO)-induced oxidative damage and the underlying molecular mechanisms in human hepatoblastoma cell line HepG2 cells.

Similar Effect of Vonoprazan and Oral Proton Pump Inhibitors for Preventing Rebleeding in Cases of Upper Gastrointestinal Bleeding.

Objective The use of a proton pump inhibitor (PPI) reduces rebleeding and mortality in patients with upper gastrointestinal bleeding (UGIB). Vonoprazan is a novel oral agent with strong and sustained acid-inhibitory activity. We clarified the effect of vonoprazan compared with oral PPIs in such patients.

Case report: Fatal poisoning caused by additive effects of two barbiturates.

A case of fatal poisoning involving multiple psychotropic drugs is presented. Quantitative toxicological analysis showed femoral blood concentrations of pentobarbital, phenobarbital, duloxetine, acetaminophen and tramadol were 10.39, 22.

A case of refractory bleeding from duodenal angioectasia with acquired hemophilia A.

Acquired hemophilia A (AHA) is a coagulation disorder related to the factor VIII inhibitors, which might cause intractable bleeding of gastrointestinal tracts. However, its scarcity makes it difficult to recognize AHA as a pitfall of endoscopic hemostasis failure. An 81-year-old female with a history of endoscopic treatment for colon polyps visited a local hospital with chief compliments of bloody stool and severe anemia.

Case report: An autopsy case of pilsicainide poisoning.

We present a fatal case of pilsicainide poisoning. Quantitative toxicological analysis revealed that the concentrations of pilsicainide in femoral blood and urine samples were 17.5 μg/mL and 136.

Superior Adhesion of a Multifunctional Protein-Based Micropatch to Intestinal Tissue by Harnessing the Hydrophobic Effect.

Drug delivery systems comprising drug carriers capable of adhering to intestinal tissue have considerable potential to realize more sophisticated systemic drug delivery and topical drug treatments in the intestinal tract. The development of innovative strategies for improving the adhesion efficiency of carriers is of high importance for the advancement of this field. Herein, a novel approach to achieving high adhesion efficiency of drug carriers is presented, where the accessibility of the carrier to the intestinal surface and its subsequent adhesion to the intestinal tissue are promoted by utilizing the thermodynamic tendency of the hydrophobic carrier and its dispersion solvent, triacetin, to be excluded from the aqueous environment.

Immunolocalization of CD80 and CD86 in Non-Small Cell Lung Carcinoma: CD80 as a Potent Prognostic Factor.

It has been demonstrated that tumor cells express programed cell death protein 1 (PD-L1) to escape T lymphocytes that express programed cell protein 1 (PD-1), and PD-1/PD-L1 immune checkpoint inhibitors have been regarded in lung cancer patients. CD80 and CD86 are members of B7 superfamily which regulates T lymphocyte activation and tolerance. However, immunolocalization of CD80 and CD86 has not been examined in the lung carcinoma tissues and their clinical significance remains unknown.

Parietal Cell Dysfunction: A Rare Cause of Gastric Neuroendocrine Neoplasm with Achlorhydria and Extreme Hypergastrinemia.

A 69-year-old woman with multiple neuroendocrine neoplasms (NENs) was referred to our hospital. Although she had extreme hypergastrinemia (11,675 pg/mL), no findings that indicated types I to III gastric NENs were found. Although gastric corpus atrophy was suspected on conventional white-light imaging, findings on magnifying endoscopy with narrow-band imaging indicated no severe atrophy.

Biomarker profiling of postmortem blood for diabetes mellitus and discussion of possible applications of metabolomics for forensic casework.

Acute metabolic disorders of diabetes mellitus (DM), such as diabetic ketoacidosis, hyperosmolar hyperglycemic state, and hypoglycemia, are life-threatening and difficult to diagnose postmortem owing to lack of macroscopic and microscopic findings, especially when the medical history of the patient is not available before autopsy. Although various biochemical tests, including ketone bodies and hemoglobin A1c, have been used to diagnose diabetes in the postmortem setting, each marker has some limitations. Consequently, it would be helpful in forensic practice to find new biomarkers reflecting the decedent's history of DM irrespective of whether the DM was being treated.

Predictors of early and late mortality after the treatment for early gastric cancers.

Objectives: Although many patients with early gastric cancers (EGCs) die of non-gastric cancer-related causes, the association of the risk categories of lymph node metastasis (LNM) with all-cause mortality remains unclear. We aimed to clarify the predictors of early and late mortality, separately.

Methods: Patients with endoscopic resection or gastrectomy for EGCs between 2003 and 2017 were retrospectively enrolled.

Post-clozapine in a clinical setting: A retrospective case note review in Kumamoto, Japan (2009-2019).

Clozapine is commonly prescribed in dopamine supersensitivity psychosis (DSP) cases in Japan. However, limited knowledge on treatment post-clozapine discontinuation use exists. We investigated antipsychotic medications, patient status, and DSP episodes before, during, and after clozapine treatment using medical records of 30 schizophrenia patients (mean age, 51 years; mean illness duration before clozapine treatment, 24 years; mean clozapine treatment duration, 1.

Application of Micropore Device for Accurate, Easy, and Rapid Discrimination of from spp.

Traceability analysis, such as identification and discrimination of yeasts used for fermentation, is important for ensuring manufacturing efficiency and product safety during brewing. However, conventional methods based on morphological and physiological properties have disadvantages such as time consumption and low sensitivity. In this study, the resistive pulse method (RPM) was employed to discriminate between and and and by measuring the ionic current response of cells flowing through a microsized pore.

Prevention of delayed bleeding with vonoprazan in upper gastrointestinal endoscopic treatment.

Background: Delayed bleeding is the major adverse event in upper gastrointestinal endoscopic treatment (UGET). We aimed to investigate the efficacy of vonoprazan, which is the novel strong antisecretory agent, to reduce the risk for delayed bleeding in comparison with proton pump inhibitors (PPIs) in UGET.

Methods: This retrospective population-based cohort study used the Diagnosis Procedure Combination database in Japan.

A rare case of penetration related to ischemic duodenitis after ventricular assist device implantation for dilated cardiomyopathy.

A 66-year-old man with a history of diabetes and dilated cardiomyopathy underwent the implantation of a ventricular assist device (VAD) at the age of 62. He suffered from epigastralgia for a month and then visited our hospital with complaints of severe epigastralgia and hematemesis. A physical examination revealed abdominal distension without rigidity.

Meganuclease-Based Artificial Transcription Factors.

Embedding middle-scale artificial gene networks in live mammalian cells is one of the most important future goals for cell engineering. However, the applications of the highly orthogonal and conventional artificial transcription factors currently available are limited. In this study, we present a scalable pipeline to produce artificial transcription factors based on homing endonucleases, also known as meganucleases.