Transnasal EGD is safer than transoral EGD as it is associated with fewer adverse effects on cardiopulmonary function and is better tolerated by patients.

Patients with advanced cancer are deficient in monocytes and the type 1 immune response. The measurement of various cytokines reported in this study provides a more sensitive and valuable tool for evaluating the function of cell-mediated immunity in cancer patients than do the usual tests.

Objective: The purpose of this study was to determine the effect of thermal cycling on the enamel bond strengths of two‐step adhesive systems, either self‐etching primers or “one‐bottle” total‐etch systems, to bovine enamel. Materials and Methods: Three self‐etching primer systems–Imperva Fluoro Bond® (Shofu Inc., Kyoto, Japan), Clearfil® Liner Bond II (Kuraray Co. Ltd., Osaka, Japan), and Mac Bond® II (Tokuyama Corp., Tokyo, Japan)–and four total‐etch adhesive systems–One‐Step® (Bisco Inc., Schaumburg, IL, USA), Opti‐Bond Solo® (Kerr Corporation, Orange, CA, USA), Prime & Bond® 2.0 (Dentsply DeTrey, Konstanz, Germany), and Single BondTM (3M ESPE, St. Paul, MN, USA)–were used. Labial enamel surfaces of bovine incisors were exposed by grinding with 240‐grit and 600‐grit wet silicon carbide paper. Enamel was treated according to the manufacturers' instructions. Following the application of adhesive resin, resin composites were condensed into a mold (diameter = 4 mm, depth = 2 mm) and were light‐cured. Bonded specimens were stored in 37°C water for 24 hours. They were divided into a control group (no thermal cycling) and three experimental groups with thermal cycles of 3,000, 10,000, and 30,000 cycles, respectively, between 5°C and 60°C. The shear test was performed at a crosshead speed of 1.0 mm/min. The ultrastructure of resin‐enamel interfaces was observed by SEM at times 3,500 magnification. Results: Self‐etching primer systems had significant decreases in enamel bond strengths with thermal cycling. In contrast, total‐etch systems had no significant differences, except for One‐Step. Mixed failures were predominant in these systems, but adhesive failures tended to increase with a greater number of thermal cycles. SEM observations revealed small cracks at the resin‐enamel interface for self‐etching primer systems when subjected to 30,000 thermal cycles. Conclusions: Enamel shear bond strengths after thermal cycling of self‐etching primer systems appeared to be less stable than were those of total‐etch adhesive systems.

Functional dyspepsia (FD) is a clinical syndrome involving upper abdominal symptoms, the causes of which cannot be identified by conventional diagnostic evaluation. Many pathophysiological factors, such as gastric acid, gastroduodenal motility, gastric accommodation, sensory disturbance, stress and Helicobacter pylori infection, may play a role in the pathogenesis of FD. Dysmotility of the upper gastrointestinal tract has been implicated in the symptoms of FD. In previous studies, antral hypomotility and delayed gastric emptying have been reported as major pathogenetic factors in patients with FD. Although a number of methods have been applied to evaluate gastroduodenal motility in humans, many of them have technical limitations and are too expensive or complex to use in daily clinical practice. Recent technical developments enable one to evaluate gastroduodenal motility by using ultrasonography. Ultrasonography is a simple, noninvasive modality for the assessment of gastric emptying and antral motility in either a liquid or solid meal, along with the examination of duodenogastric reflux.

The current prospective randomized study was designed to compare the effects of intracavitary (i.c.) chemotherapy vs immunotherapy vs immunochemotherapy for malignant effusion. Between 1992 and 1995, a total of 42 patients with malignant effusion were registered, and 41 patients were eligible for statistical analysis. The primary diseases of the eligible patients included 27 gastric, four colorectal, four pancreatic, three lung, two liver and one oesophageal cancers. The patients with malignant effusion were randomly assigned into one of three i.c. therapeutic regimens: chemotherapy alone with weekly injection of anticancer agents (ACAs: cisplatin, mitomycin-C, adriamycin, etc.) (Group A, n = 13); immunotherapy alone with weekly injection of streptococcal preparation OK-432 (Group B, n = 14); or immunochemotherapy with ACAs and OK-432 (Group C, n = 14). The response of the effusion, patient survival and the kinetics of cytokines in the effusion were compared. There were no differences in the patients' backgrounds. The side-effects of the regimens included pain, anorexia, fever, leucopenia and anaemia and there were no differences in their incidence among the three groups. One patient died after cisplatin (CDDP) administration in Group A. Cytologic examination revealed that tumour cells in the effusion disappeared in 23% of Group A cases, 36% of Group B cases and 36% of Group C cases. The malignant effusion did not disappear in any of the Group A cases; however, the effusion disappeared in 29% of Group B cases and 43% of Group C cases ( P = 0.03, Group A vs Group C). Furthermore, the 50% survival period was 1.6 months for Group A, 2.4 months for Group B and 3.5 months for Group C. The 6-month survival rate was 7% for Group A, 6% for Group B and 34% for Group C, and the 1-year survival rate was 0%, 0% and 17% respectively ( P = 0.048, Group A vs Group C by the log-rank test). The analysis of the cytokine kinetics revealed a prominent increase in the level of interleukin-6 in the effusion in Group C. These results suggest that i.c. immunochemotherapy with OK-432 and ACAs may be more beneficial than i.c. chemotherapy alone or immunotherapy alone. © 1999 Cancer Research Campaign

No abstract

Background: Impaired gastric accommodation of the proximal stomach is one of the major pathophysiological mechanisms in functional dyspepsia (FD). However, no useful method exists for the clinical evaluation of this phenomenon. Aim: The aim of the present study was to establish a simple and non-invasive method for evaluating the accommodation reflex of the proximal stomach. Methods: Nine healthy subjects received up to 1,700 mL water (stepwise administration in 100-mL increments) using a nasogastric tube while they were in a supine position. To assess the meal-induced gastric accommodation reflex, we measured the cross-sectional area of the proximal stomach via ultrasonography (US) at 3-min intervals after administration of water. We also measured the pressure of the water column using the same tube. Then, we administrated up to 400 mL of water in 100-mL increments and measured the area of the proximal stomach in 44 FD patients with early satiation (the measurements were performed at intervals of 3-min), and we compared the results with those for 44 healthy subjects. Results: The incremental changes in the area of the proximal stomach corresponded well with the amount of water administered. The area of the proximal stomach increased, but the antral area and the intragastric pressure remained relatively stable. After administration of more than 100 ml water, the area of the proximal stomach in healthy subjects was significantly greater than that in FD patients.

Paclitaxel, an antineoplastic agent used for the treatment of ovarian cancer, is metabolized by cytochrome P450 (CYP)3A4 and CYP2C8 and is excreted from cells by ATP-binding cassette (ABCB1) (multi-drug resistance [MDR1], P-glycoprotein). Expression of these proteins is regulated by pregnane X receptor (PXR). Although there are common genetic polymorphisms in the genes encoding these proteins, their effect on the clinical efficacy of paclitaxel is unclear. We therefore examined the relationship of the paclitaxel pharmacokinetics in 13 patients with ovarian cancer to polymorphisms in CYP2C8, CYP3A5, ABCB1, and PXR. We found high interindividual variability in the plasma concentrations of two metabolites, 6alpha-hydroxypaclitaxel and p-3'-hydroxypaclitaxel. All the patients were genotyped as CYP2C8*1/*1. Neither the CYP3A5 A6986G (CYP3A5*3) nor the PXR C-25385T alleles were associated with altered plasma concentrations of paclitaxel and its metabolites. ABCB1 T-129C, T1236C, and G2677(A,T), however, was associated with lower area under the plasma concentration-time curve (AUC) of paclitaxel. We also observed a significant correlation between the AUC (r=-0.721) or the total clearance of paclitaxel (CL(tot)) (r= 0.673) and the ABCB1 mutant allele dosage in each patient. Taken together, our findings suggest that interindividual variability in paclitaxel pharmacokinetics could be predicted by ABCB1 genotyping.