An international, stepped wedge, cluster-randomized trial investigating the 0/1-h algorithm in suspected acute coronary syndrome in Asia: the rational of the DROP-Asian ACS study.

Background: More than half of the world's population lives in Asia. With current life expectancies in Asian countries, the burden of cardiovascular disease is increasing exponentially. Overcrowding in the emergency departments (ED) has become a public health problem.

[ADULT ANAPHYLAXIS AT THE DEPARTMENT OF EMERGENCY MEDICINE OF TEIKYO UNIVERSITY HOSPITAL IN AN URBAN AREA OF TOKYO].

Background: Anaphylaxis is a severe, potentially fatal, systemic allergic reaction. But its real-world evidence is limited. Both treatment of allergic symptoms and prevention of future anaphylactic episodes are clinically important.

[A Case of Uterine Body Metastasis from Sigmoid Colon Adenocarcinoma].

We report a case of metastatic carcinoma to the uterine body from a colorectal adenocarcinoma. A 73-year-old woman underwent laparoscopic sigmoidectomy for sigmoid colon carcinoma 2 years before. In the following study, her serum carcinoembryonic antigen level was elevated, and a uterine body tumor invading the rectal wall was detected via enhanced computed tomography.

[Multi-Line Chemotherapy for Metastatic Colorectal Cancer].

We administered multi-line chemotherapy(ie, more than fifth-line chemotherapy)to 5 patients with metastatic colorectal cancer(age range, 62to 78 years; median age, 68years). Four of the five patients died because of cancer progression; however, the mean overall survival(OS)was 39 months. In our experience, re-challenging with key drugs was associated with clinical benefits.

Red cell and platelet distribution widths in patients with angina pectoris and acute myocardial infarction.

Aim: We aimed to determine the relationship of red cell and platelet distribution widths with the onset of acute myocardial infarction, to enable the early detection and prevention of acute myocardial infarction.

Methods: Red cell and platelet distribution widths were retrospectively determined in 46 patients with stable angina pectoris and 140 patients with acute myocardial infarction who were brought to the emergency department of our institution. Red cell and platelet distribution widths were determined with an automatic blood cell analyzer, and the results were compared between the acute myocardial infarction and angina pectoris groups.

[A case of repeated postoperative recurrence of gastric cancer treated via laparoscopic approach].

A 74-year-old man who had undergone distal gastrectomy was diagnosed with metastasis to the spleen and transverse colon 27 months after the operation, and 6 courses of combination therapy with S-1 and cisplatin (CDDP) were administered. However, both lesions showed progressive disease (PD) after chemotherapy. Massive gastrointestinal hemorrhage from colon metastases was observed following the administration of irinotecan(CPT-11).

Relationship between blood pressure and persistent epistaxis at the emergency department: a retrospective study.

Background: Persistent nosebleed episodes have occurred in patients with idiopathic epistaxis from Kiesselbach's area despite confirmed location of the bleeding site, but the cause remains unclear. We tried to determine whether persistent epistaxis was associated with blood pressure.

Methods And Results: Between May 2009 and May 2010, the records for 133 adult patients with idiopathic epistaxis from Kiesselbach's area were obtained from the emergency department of our hospital.

[The effects of Rebamipide and Polaprezinc mouthwash and uptake on mucositis induced by chemotherapy].

Mucositis is one of the most frequent side effects induced by chemotherapy that damages the patients' QOL and response rate. The efficacy of Rebamipide and Polaprezinc mouthwash and uptake was evaluated. Nine patients who underwent chemotherapy and had some complaints related with mucositis were included as subjects.

[Severe gastric and duodenal ulcer after chemotherapy of mFOLFOX6 and bevacizumab].

A 74-year-old female had metastatic left inguinal lymph nodes 20 months after rectal amputation for cancer, and an attempt to adapt chemotherapy of mFOLFOX6/bevacizumab was made after resection of the nodes. She felt nausea 2 days and continued 1 week after starting chemotherapy. Then, an endoscopic examination revealed both active gastric and duodenal ulcers.

[A case of advanced gastric cancer responding to neoadjuvant chemotherapy with S-1 and CDDP combination].

The patient is a 75-year-old woman who received 2 courses of neoadjuvant chemotherapy (NAC) with S-1/CDDP for advanced gastric cancer and para-aortic lymph node metastasis. After completion of the second course, both the primary tumor and lymph node metastases practically disappeared. Later, total gastrectomy was performed.

Fibroblast growth factor-2 regulates expression of osteopontin in periodontal ligament cells.

Osteopontin is a protein found in the bone-related matrix and plays multiple regulatory roles in mineralizing and non-mineralizing tissue. In osteogenic cell-lines, the expression of osteopontin increases with the progression of differentiation, but both the expression and function of osteopontin vary with the cell type and its activation state. In this study, we examined the expression of osteopontin by clones established from mouse periodontal ligament, in response to inorganic phosphate and fibroblast growth factor (FGF)-2, which can induce periodontal tissue regeneration.

[A case of unresectable advanced gallbladder cancer successfully treated by oral S-1 and hepatic arterial infusion (HAI) of low-dose CDDP therapy].

The patient was a 64-year-old woman. Oral S-1 and hepatic arterial infusion (HAI) of low-dose CDDP therapy were started for unresectable advanced gallbladder cancer associated with liver metastasis and numerous lymph node metastases. Marked regression of the liver metastasis and lymph node metastases was observed by this treatment, and upon completion of the second course they had almost completely resolved.

Angiographic and clinical characteristics associated with the removable plaque components by means of thrombectomy catheters in patients with myocardial infarction.

Background: Previous studies have demonstrated that atheroembolism during percutaneous coronary intervention is associated with myocardial damage. The purpose of this study is to investigate the clinical and angiographic characteristics related to removable plaque elements in patients undergoing thrombectomy for myocardial infarction.

Methods: Eighty consecutive lesions in 80 patients (M/F=58/22, age 65.

Basic fibroblast growth factor regulates expression of heparan sulfate in human periodontal ligament cells.

Heparan sulfate (HS) proteoglycan is a widely distributed biological molecule that mediates a variety of physiological responses in development, cell growth, cell migration, and wound healing. We examined the effects of basic fibroblast growth factor-2 (FGF-2), which is known to modulate extracellular matrix (ECM) production of various cell types, on the production of HS proteoglycan by human periodontal ligament (HPDL) cells. We also examined the effects of FGF-2 on the expression of syndecans, a major family of membrane-bound HS proteoglycans.

Activation of adenosine receptor on gingival fibroblasts.

CD73 (ecto-5'-nucleotidase) on human gingival fibroblasts plays a role in the regulation of intracellular cAMP levels through the generation of adenosine, which subsequently activates adenosine receptors. In this study, we examined the involvement of ecto-adenosine deaminase, which can be anchored to CD26 on human gingival fibroblasts, in metabolizing adenosine generated by CD73, and thus attenuating adenosine receptor activation. Ecto-adenosine deaminase expression on fibroblasts could be increased by pre-treatment with a lysate of Jurkat cells, a cell line rich in cytoplasmic adenosine deaminase.

[A case of synchronous gastric and hepatocellular carcinoma successfully treated by TS-1 and hepatic arterial infusion chemotherapy (HAI) of low-dose CDDP].

A 75-year-old man underwent distal gastrectomy for advanced gastric cancer with liver and lymph node metastases and synchronous hepatocellular carcinoma in April 2004. HAI with low-dose CDDP/TS-1 combination therapy was initiated after gastrectomy. Liver and lymph node metastases decreased significantly, with achievement of a partial response (PR) and a complete response (CR), respectively, and the hepatocellular carcinoma was reduced to 54.

Fibroblast growth factor-2 stimulates hyaluronan production by human dental pulp cells.

Hyaluronan (HA), is a high molecular mass extracellular matrix constituting connective tissue and plays a critical role in not only homeostasis but also inflammatory and wound-healing responses. In this study, we investigated the effect of fibroblast growth factor (FGF)-2 on the production of HA by human dental pulp cells (HDPC). An inhibition binding-protein assay showed that FGF-2 increased HA production by HDPC.

Fibroblast growth factor-2 regulates the synthesis of hyaluronan by human periodontal ligament cells.

Basic fibroblast growth factor (FGF-2) can enhance biological potentials of periodontal ligament cells and its topical application induces considerable periodontal tissue regeneration in vivo. In this study, we examined the effect of FGF-2 on the production of hyaluronan (HA), an extracellular matrix playing important roles in homeostasis and inflammatory/wound healing responses, by human periodontal ligament (HPDL) cells. An inhibition binding-protein assay revealed that FGF-2 significantly increased HA production by HPDL cells in a dose dependent manner.

[A case of recurrent stomach cancer treated with 5-fluorouracil responding to weekly paclitaxel therapy].

We report a patient with unresectable stage IV stomach cancer with metastasis to the paraaortic lymph nodes who achieved an effective response to neoajuvant chemotherapy, which allowed curability-B resection, and in whom weekly paclitaxel (TXL) therapy for postoperative recurrence was very effective in improving QOL. The patient was a 65-year-old man. After preoperative PMFE therapy, CEA decreased from 68.

[A case of advanced descending colon cancer with peritoneal dissemination responding to weekly high-dose l-leucovorin/5-fluorouracil combination therapy].

We report a case in which l-leucovorin/5-fluorouracil (l-LV/5-FU) combination therapy was remarkably effective for non-resectable advanced descending colon cancer with carcinomatous peritonitis. A 65-year-old man complained of severe abdominal distension, abdominal pain and pulmonary failure, and was diagnosed as having ileus due to descending colon cancer. The patient underwent urgent open laparotomy to release the ileus condition on March 5, 2002.

[Complete response to treatment with low-dose FP therapy in a patient with stage IVB primary hepatocellular carcinoma with multiple lung and bone metastases].

We report a case in which low-dose FP (5-fluorouracil/cisplatin, 5-FU/CDDP) therapy was remarkably effective for stage IVB advanced hepatocellular carcinoma (HCC) with lung and bone metastases. 5-FU of 250 mg/body/day was continuously infused over 24 hours and CDDP of 10 mg/body/day was infused over 30 minutes from day 1 to day 5 in a week. Administration was continued for 4 weeks as 1 cycle.

Early detection of doxorubicin-induced myocardial damage by ultrasound tissue characterization with integrated backscatter.

Doxorubicin (DXR) is one of the most effective antineoplastic agents, but its use is limited by its myocardial toxicity. Myocardial injury reduces the cyclic variation of integrated backscatter (CV-IBS) and so the present study was designed to investigate whether CV-IBS can be used to detect the early phase of myocardial damage in patients receiving DXR. Thirty-four subjects constituted the study population, none of whom showed clinically evident heart failure.

Involvement of CD73 (ecto-5'-nucleotidase) in adenosine generation by human gingival fibroblasts.

Adenosine has various biological effects on human gingival fibroblasts (HGF) and epithelial cells closely associated with inflammation, such as cytokine production and cell adhesion. However, the mechanism of adenosine formation in periodontal tissues is not yet defined. In this study, we examined the involvement of CD73 (ecto-5'-nucleotidase) in adenosine generation by HGF.