We induced arterial balloon injuries twice via a hyperdiastolic balloon catheter inserted into the carotid artery of Wister rats in order to observe the changes in the intima and the media. The thickness of the intima reached a maximum by 14 days after the injury. In a comparison of the thickness of the intima with samples having a once-induced arterial balloon injury, the samples with twice-induced arterial balloon injuries were found to have thickened more significantly. When the proliferating cells of the intima were observed, many proliferative smooth muscle cells were found. In the models of the twice-induced arterial balloon injuries, the area of the media decreased, while the area of the intima increased. In the models of the twice-induced arterial balloon injuries, intimal hyperplasia with positive remodeling1 was observed, and findings were obtained that were substantially similar to lesions due to either intimal hyperplasia of arteriosclerosis lesions or intimal hyperplasia of restenotic lesions after PTA or stent placement.

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Insulin is a major autoantigen responsible for the pathogenesis of type 1 diabetes, and its B-chain peptide B:9-23 has been suggested to contain critically important epitopes in the NOD mouse. We have previously demonstrated that the altered peptide ligand of B:9-23 peptide with alanine substitutions at positions 16 and 19 (A^16,19APL) suppresses insulitis and reduces the incidence of diabetes when administered intranasally together with cholera toxin (CT). In this study, we extended the previous findings to determine whether mucosal administration of the A^16,19APL without the use of toxic CT is efficacious for diabetes prevention. To this end, we linked the A^16,19APL to the C-terminus of non-toxic cholera toxin (CTB) B subunit and the chimeric fusion protein was produced in methyloprophic yeast Pichia pastoris. Although intranasal administration of the recombinant CTB-A^16,19APL fusion protein extracted from the yeast cells failed to prevent the progression to diabetes, oral administration of the live yeast cells producing the chimeric protein resulted in more than 50% reduction of the development of diabetes, albeit the fact that protective efficacy did not reach the significance level by life table analysis (P = 0.08). Furthermore, the expression of insulin autoantibodies was not altered throughout the course of oral immunization experiment. These results demonstrated that the efficacy of recombinant CTB-A^16,19APL for oral immunization has much room for improvement. Nevertheless, oral administration of recombinant yeast or other edible materials such as food plants engineered to produce altered autoantigenic peptide could potentially become a novel non-invasive immunotherapeutic strategy for type 1 diabetes. (250 word)

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Objective: The incidence of obesity has been increasing in the Asia-Pacific region, but many areas do not have access to expensive medical devices for evaluating body composition. Bioelectrical impedance analysis (BIA) can precisely and easily estimate percentage body fat (%BF), regardless of social environment. The purpose of this study was to evaluate differences in body composition among ethnic groups living in rural areas in the Asia-Pacific region, and to analyze associations between body mass index (BMI) and %BF as measured by BIA. Methods: A total of 869 middle-elderly adults (Japanese: 131 men, 435 women; Palauan: 42 men, 49 women; Thai: 106 men, 106 women; mean age, 58 years; range, 40-69 years) were recruited from rural areas in Thailand, Koror Island in Palau, and Goto Island in Japan. Weight and %BF were estimated using BIA. Height was measured and BMI was calculated. Results: Weight, BMI, and %BF clearly differed among ethnic groups and by gender (p<0.0001). In each ethnic group, %BF was significantly correlated with BMI for each sex (men: Japanese, r=0.691, p<0.0001; Palauan, r=0.892, p<0.0001; Thai, r=0.842, p<0.0001; women: Japanese, r=0.892, p<0.0001; Palauan, r=0.892, p<0.0001; Thai, r=0.779, p<0.0001). Conclusions: BIA offers a reliable option for measuring %BF and a strong association exists between %BF and BMI for individuals in rural areas of the Asia-Pacific region, regardless of ethnicity.

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Ectopic gastric mucosa (EGM) of the jejunum is rare. We report an 81-year-old man with perforated peptic ulcer of the jejunum originating from EGM. Emergency segmental resection of the jejunum was performed with satisfactory immediate results. Diagnosis after surgery was established by histopathology. In addition, sections were examined immunohistochemically using antibodies against MUC5AC, MUC6 and MUC2. Hematoxylin-eosin-stained sections showed glandular differentiated tissue interposed between normal small bowel epithelium. EGM was positive for MUC5AC and MUC6, and negative for MUC2. Histological examination of the resected specimen confirmed that the perforation was caused by a peptic jejunal ulcer associated with EGM. To our knowledge, this is the first reported case of perforated peptic ulcer of the jejunum with EGM in an elderly patient.

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An 80-year-old male was admitted to our hospital on February 16, 2009, complaining of having suffered right lower quadrant pain for a period of 4 days. Abdominal computed tomography (CT) showed a mesenterial abscess adjacent to the terminal ileum, and the possibility of acute appendicitis was excluded from the preoperative diagnosis by this imaging. Upon surgery, the appendix and cecum revealed normal appearance, without the presence of ascites. However, ileocecal resection was performed because of abscess formation that appeared to originate from the terminal ileum or the cecum. Resected specimens showed ileal diverticula, including one that was perforated. Perforation of ileal diverticula should be a candidate for the differential diagnosis of an inflammatory process near the ileocecal region.

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