Background Daijokito (DJKT), a classical traditional Kampo andChinese medicine, has been used to treat acute pancreatitis in China. In ourprevious study, DJKT was found to reduce the area under the plasmaconcentration-time curve (AUC) of ranitidine in humans. Therefore, weestablished a novel rat model to examine the direct absorption of ranitidineafter daijokito administration.
Methods An in situ intestinal injection with portal vein sampling(IIPS) model was created to determine the rate of intestinal drug absorption.Rats were divided into two groups: the ranitidine group (R, n =6) or the ranitidine and daijokito group (RD, n = 6). Blood wascollected after intestinal injection of drugs. After the experiment, theconcentrations of ranitidine were measured by LC/MS/MS analysis.
Results The concentrations of ranitidine increased linearly withtime in both groups. Compared with the R group, the concentrations of ranitidinein RD group significantly decreased throughout the experiment.
Conclusion Co-administration of ranitidine with DJKT resulted insignificant decreases in intestinal absorption in rats. The reduction of thesystemic ranitidine concentration by co-administration of DJKT may be due, atleast in part, to the inhibition of intestinal absorption of ranitidine.
Background The neutrophil lymphocyte ratio (NLR) has been proposed to be a surrogate marker of inflammation and immunological status and to have prognostic value in various malignancies. This study was conducted to clarify the prognostic significance of preoperative NLR in hepatocellular carcinoma (HCC).
Methods We enrolled 135 patients with histologically-proven HCC who underwent initial curative hepatectomy. Based on the median NLR values, patients were divided into: NLR ≥ 2.0 (NLR-high, n = 69) and NLR < 2.0 (NLR-low, n = 66).
Results In univariate analysis, the 5-year overall survival (OS) rates were 59.8 % ± 6.7% and 75.6% ± 6.5% (P = 0.028) in the NLR-high and NLR-low groups, respectively. Furthermore, the 5-year disease specific survival rates were 68.6% ± 6.7%, and 81.2 ± 6.4% (P = 0.048) in the NLR-high and NLR-low groups, respectively.
Conclusion Our results showed that high NLR was an independent predictor for OS in hepatectomy-treated HCC, suggesting that NLR may be a novel prognostic biomarker for HCC. On the other hand, NLR also has a limitation to predict postoperative prognosis of HCC patients by itself.
Background Weight loss in patients with cancer is caused by cancercachexia and chemotherapy-induced nausea and vomiting (CINV). Recentdevelopments in antiemetic drugs have substantially improved CINV, butnutritional intervention did not improve body weight. This study aimed toinvestigate the effects of nutrition intervention with appropriate antiemetictreatment in patients with non-small-cell lung cancer during chemotherapy.
Methods Patients received individualized nutrition counseling by aregistered dietitian and were provided with oral supplements for 90 days. Bodyweight and other parameters were measured at baseline and after 90-dayintervention. To evaluate this nutrition intervention, patients were alsoretrospectively set as control, and then body weight change was compared withinverse probability of treatment weights (IPTW) analysis.
Results Ten patients received individualized nutrition counselingand were provided with oral supplements for 90 days. Of them, 7 patientsconsumed nutritional supplements, and the mean intake was 130 kcal/day. After90-day intervention, the patients did not show significant weight and BMI lossduring the course of cytotoxic chemotherapy. A total of 38 patients wereretrospectively enrolled as controls. The number of the patients who gain thebody weight after 90 days in the study cohort was significantly larger than thatin the retrospective controls with the IPTW analysis (Odds Ratio (OR) = 8.4; 95%Confidence Interval (CI): 1.6–42; P = 0.01).
Conclusion Early intensive nutrition intervention with appropriateantiemetic treatment prevents weight loss. Nutrition interventions might be alsobeneficial for quality of life, treatment response and survival.
Background Bile leakage after hepatectomy is a common complication. The purpose of the present study was to retrospectively evaluate the usefulness of non-surgical management of bile leakage after hepatectomy, using 12-year data from a single center study.
Methods Data from 15 patients (13 men, two women; mean age 67.1 ± 7.0 years) who had undergone non-surgical management for bile leakage between January 2005 and November 2017 were retrospectively reviewed.
Results We categorized bile leakage as central (n = 5) or peripheral (n = 10) leakage based on communication with the biliary tree. Percutaneous bile leakage drainage and/or endoscopic naso-biliary drainage (ENBD) (n = 2) or the rendezvous technique (n = 3) was successfully performed in five central-type cases, while all peripheral-type cases were treated with drainage alone; only one case required additional ethanol ablation. Bacterial bile cultures were positive in 11 cases and negative in four cases. The drainage catheters were removed after complete resolution in 13 cases (86.7%), while two patients with cases of peripheral-type leakage died due to cancer progression while the drain was in place. No case needed conversion to reoperation. The mean duration of drainage therapy in all cases was 210.1 ± 163.0 days (range 17–531 days), with 316.8 ± 180.8 days in the central type and 156.7 ± 131.5 days in the peripheral type; this duration was not significantly different (P = 0.129).
Conclusion Non-surgical treatment is a minimally invasive and effective management strategy for postoperative bile leakage and the modality used depends on the type of bile leakage encountered.
Background This study aims to elucidate the effect of isolated cerebellar lesions sparing the brainstem on the auditory brainstem responses in children.
Methods We enrolled 10 children (aged 1–16 years) with cerebellar lesions on neuroimaging but lacking clinical brainstem involvement signs and with normal brainstem volumes on magnetic resonance imaging.
Results The interpeak latency of waves I and V was normal in 9 patients and was marginally prolonged in 1 patient. While amplitudes of waves I and III were normal, we noted a decreased amplitude of wave V and/or an increased I/V amplitude ratio in 6 patients; these included 5 of 8 patients with cerebellar hypoplasia/atrophy and 1 patient with acute cerebellar ataxia.
Conclusion Our results support the hypothesis of an inhibitory input from the cerebellar fastigial nucleus on the inferior colliculus, which might be disinhibited because of Purkinje cells dysfunction due to cerebellar cortex lesions, especially within the cerebellar vermis.
Background Musculoskeletal infections are often seen in the daily practice of orthopedics. Several markers [white blood cell (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT)] have been used for diagnosing these infections. However, these markers may be elevated due to surgery or trauma, and may not be infection-related. These markers also show drug-dependent dynamics during infection that differ from its usual dynamics. Such situations make diagnosis of infections difficult, and Cluster of Differentiation 64 (CD64) has been brought to attention. This study aimed to clarify the utility of CD64 on neutrophils by comparing it with conventional infection markers (CRP, PCT) in musculoskeletal infection.
Methods Forty-four patients who were suspected of having musculoskeletal infection between May 2010 and November 2013 in our hospital were enrolled in this study. Patients were divided into subgroups according to their culture results, antibiotics administration, measurement timing, and if they were immunocompromised. The measurements of the infection markers were compared between each group. In addition, the positive rates of each infection marker were compared between groups.
Results There was no difference in the infection marker measurements between several groups. There was no statistically significant difference between groups for the positive rates of CD64, CRP, and PCT.
Conclusion We evaluated the utility of CD64 on neutrophils in musculoskeletal infection. CD64 showed the utility that was equivalent to conventional infection markers in diagnoses of various musculoskeletal infections.