Background Argon plasma coagulation (APC) followed by subepithelial ablation (termed APC-SEA) is an effective means of treating early esophageal squamous cell carcinomas (EESCCs). However, the mechanism of tissue exfoliation after the first ablation was unknown. This study aimed to determine the characteristics of the exfoliated esophageal mucosa after the first ablation. Methods We examined 13 EESCC lesions. We then marked them by APC. We removed the epithelium exfoliated by the initial ablation procedure and performed magnifying endoscopy with blue laser imaging for the exfoliated area and a second ablation procedure for subepithelial degeneration. The exfoliated tissue was examined histopathologically. Results The basement membrane was not visible on the surface of the exfoliated samples. Among the 13 exfoliated specimens, 9 were confirmed to have viable carcinoma. The basal cell layer was exposed homogeneously on most of the surface of the exfoliated esophagus. In the intraepithelial papillae, basement membrane was dissected at the same level as the exfoliated surface surrounding it, or preserved intact. Conclusion The basal cell layer containing carcinoma in situ was exposed homogeneously on most of the surface of the esophagus just before the second ablation procedure. A second ablation procedure was found to be essential for treating EESCC.

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Purpose: This study aimed to provide the data to establish the national cervical cancer prevention program by studying the knowledge and attitude regarding cervical cancer and its prevention among Lao female workers in Vientiane, capital city of Laos. Methods: This cross-sectional study was conducted among 356 female workers in Vientiane, the capital of Laos. They were interviewed by means of a structured questionnaire. The data were analyzed and compared between the medical worker (MW) group, office worker (OW) group, and factory worker and cleaner (FWC) group. Results: Participants who had heard of cervical cancer, human papillomavirus (HPV), and HPV vaccine comprised 89.9%, 34.0%, and 27.8%, respectively. The average knowledge score of FWC was lower than that of the MW or OW group. Only 3.4% of the participants knew that HPV infection was the cause of cervical cancer. Among the 175 women who felt at a risk of cervical cancer, 84 had never undergone a Pap smear. The main reasons for not undergoing a Pap smear were the absence of symptoms (28.8%) and the feeling of shame or embarrassment (24.6%). Conclusions: Female workers, especially in the FWC group, had little knowledge regarding cervical cancer and its prevention. Thus, cervical cancer education for female workers and the cultivation of health professionals are most efficient steps to overcome this situation.

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Background: This study aimed to clarify whether or not switching lenograstim for pegfilgrastim enables the sustained effects of decreasing neutropenia and shortening the length of hospitalization in patients receiving taxane-based chemotherapy. Methods: Patients being treated docetaxel and nedaplatin therapy in our facility were enrolled in this study. In the first courses of therapy, we administered lenograstim when grade 3 neutropenia occurred (group A). In the second or subsequent courses of therapy, we administered lenograstim when grade 2 neutropenia occurred through March 2015 (group B) and then administered pegfilgrastim on day 2 of chemotherapy from April 2015 (group C). We retrospectively evaluated the incidence of severe neutropenia and febrile neutropenia (FN), length of hospitalization, and other adverse events. Results: FN was observed in 10% (4/41) of group B and 0% (0/36) of group C (p=0.0511). Grade 3-4 neutropenia occurred in 76% (31/41) of group B and 3% (1/36) of group C (p<0.0001). The median length of hospitalization was 12 days in group B and 6 days in group C (p<0.0001). Conclusion: Pegfilgrastim significantly reduced the incidence of neutropenia and the length of hospitalization. Pegfilgrastim may therefore improve the quality of life of these patients.

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Background: Image-enhanced endoscopy has been increasingly useful for esophageal cancer screening. Although iodine staining is currently the standard modality for the early diagnosis of esophageal cancer, conventionally used concentrations often induce mucosal irritation, leading to discomfort. The aim of the study was to determine the optimal FICE setting and iodine concentration required for maximum color enhancement for the endoscopic diagnosis of superficial esophageal cancer. Methods: Four esophageal specimens with squamous cell carcinoma that were surgically resected were investigated. The color difference between iodine-stained and background mucosa was evaluated using the 10 preset flexible spectral imaging color enhancement (FICE) wavelength combinations. In addition, the optimum wavelength that best reflected the widest color difference was calculated with and without FICE, and the color differences elicited by different iodine concentrations (from 0.1% to 0.8%) were evaluated with FICE and compared to 1% iodine without FICE (the control). Results: Maximum color differences were observed using the FICE7 wavelength values. Color enhancement with FICE0, 1, 5 and 7 using a concentration of 0.2% iodine solution or greater was significantly higher than that with the standard 1% iodine concentration (p < 0.05). Conclusions: Low-concentration iodine staining with image-enhanced endoscopy is a useful diagnostic modality that can reduce the degree of discomfort experienced by patients.

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We have previously demonstrated that kelch-like protein 2 (KLHL2) forms a complex with Cullin3 that functions as an E3 ligase in the degradation of with-no-lysine kinases (WNKs). KLHL2 physiologically mediates the WNK3‒SPAK‒NKCC1 phosphorylation cascade in vascular smooth cells, thereby regulating vascular tone. A high-potassium diet can attenuate hypertension by reducing peripheral vascular resistance. In addition, we have reported that extracellular potassium can negatively regulate the WNK‒OSR1/SPAK‒NCC phosphorylation cascade in COS7 cells. However, the effect of high-potassium concentrations on the role of WNKs in vascular tone regulation has not yet been clarified. In the present study, we investigated whether the WNK‒SPAK‒NKCC1 cascade in mouse vascular smooth muscle (MOVAS) cells could be regulated by high potassium concentrations. We confirmed that the WNK3‒SPAK‒NKCC1 phosphorylation cascade was significantly inhibited in high-potassium medium but that the protein level of WNK1 remained unchanged. Furthermore, KLHL2 levels increased when MOVAS cells were incubated in a high-potassium medium. KLHL2-knockdown experiments confirmed that the inhibition of the WNK3‒SPAK‒NKCC1 phosphorylation cascade induced by high potassium concentrations was attributable to KLHL2-mediated degradation of WNK3. Thus, the present study could explain one of the mechanisms underlying antihypertensive effects of high dietary potassium intake.

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