Background and Aim: The aim of the present study was to elucidate the pathogenesis of anemia associated with pegylated interferon (PegIFN) -based regimens using in-air micro particle-induced X-ray emission (PIXE). Methods: Four chronic hepatitis C (CHC) patients, three CHC patients receiving PegIFN monotherapy, five CHC patients receiving PegIFN+ribavirin (dual therapy), five CHC patients receiving PegIFN+ribavirin+telaprevir (triple therapy), and four healthy controls were enrolled in this study. Elemental distribution in erythrocytes was analyzed using in-air microPIXE. Results and Conclusions: Erythrocyte shrinkage was observed in CHC patients receiving triple therapy. Cl, S, and K dots spread patchily in the erythrocytes of CHC patients receiving monotherapy, and this was more prominent in CHC patients receiving triple therapy. Ca dots formed small dense granules in CHC patients receiving dual and triple therapies. Zn and Cu levels were higher in CHC patients receiving dual and triple therapies. The number of Mn dots was higher in CHC patients receiving triple therapy. In conclusion, PegIFN, ribavirin, and telaprevir may alter the membrane structure of erythrocytes, thereby contributing to anemia associated with PegIFN-based regimens. Furthermore, derangements in the distribution of Ca may play roles in ribavirin-induced anemia.
Background: The WISH-type S-form brace, a type of hip brace, has been shown to improve hip function, functional mobility and gait biomechanics in patients with osteoarthritis of the hip. Aims: The effects of the brace on postural control were evaluated. Methods: The Cross test using a force plate was performed. Results: The hip brace showed a direct beneficial effect of improving the maximum excursions of the center of pressure in both the medial-lateral and anterior-posterior directions. The performance in the Cross test of patients using the brace improved in the later phase, indicating an indirect effect of the brace. Interestingly, the brace also exerted a direct effect on the muscle strength of the braced leg in both hip flexion and adduction. Conclusions: Augmentation of the power output of the adductor and flexor muscles by the brace may support the moment required for resistance against the upper body mass leaning on the braced side and backward, which may allow the excursions to be augmented.
Background & Aims: The correlation between low serum dehydroepiandrosterone sulfate (DHEA-S) levels and coronary artery disease (CAD) is yet unclear. Therefore, we investigated the correlation between DHEA-S levels and the presence or severity of CAD in middle-aged and elderly men. Methods: Fifty-six consecutive middle-aged and elderly men who underwent selective coronary angiography were divided into the CAD group (n= 41) and control group (without CAD; n= 15). CAD was defined as≥75% occlusion in≥1 major coronary arteries. Serum DHEA-S, lipid, and plasma glucose levels were determined after a 12-h fast. Coronary artery stenosis severity was estimated using the Gensini score. Results: DHEA-S levels were significantly lower in the CAD group than in the control group; however, other clinical parameters showed no difference between the groups. An age-adjusted multiple regression analysis revealed that DHEA-S-dependent determinants were significantly correlated with the Gensini score (β=-0.291, p<0.05), but not with other clinical parameters. Conclusions: Middle-aged and elderly men with CAD may have lower serum DHEA-S levels than age-matched men without CAD, and serum DHEA-S levels may negatively correlate with coronary artery stenosis severity in all men, suggesting a cardioprotective effect of DHEA-S.
Although natural-orifice specimen extraction is increasingly performed, no report of total gastrectomy with transvaginal specimen extraction has yet been published. This is the first report to apply this procedure to treat gastric cancer. We applied this procedure to four postmenopausal female patients who previously underwent vaginal delivery. They underwent laparoscopic total gastrectomy and D1+ lymph node dissection for gastric cancer. After posterior colpotomy was performed, an Alexis bundle wound protector with a cap was placed to expand and protect the vaginal incision. The resected specimens were retrieved via the vaginal route. Reconstruction was performed using the intracorporeal Roux-en-Y method. Totally laparoscopic total gastrectomy with transvaginal specimen extraction was successfully accomplished in all patients. No patient developed complications associated with this procedure. We achieved good cosmetic outcomes and patients experienced little pain. Totally laparoscopic total gastrectomy with transvaginal specimen extraction may be safe and feasible in a selected group of patients with gastric cancer.