Despite the importance of masticatory performance in health promotion, assessment of masticatory performance has not been widely conducted to date because the methods are labour intensive. The purpose of this study is to investigate the accuracy of a novel system for automatically measuring masticatory performance that uses β-carotene-containing gummy jelly. To investigate the influence of rinsing time on comminuted jelly pieces expectorated from the oral cavity, divided jelly pieces were treated with two types of dye solution and then rinsed for various durations. Changes in photodiode (light receiver) voltages from light emitted through a solution of dissolved β-carotene from jelly pieces under each condition were compared with those of unstained jelly. To investigate the influence of dissolving time, changes in light receiver voltage resulting from an increase in division number were compared between three dissolving times. For all forms of divided test jelly and rinsing times, no significant differences in light receiver voltage were observed between any of the stain groups and the control group. Voltages decreased in a similar manner for all forms of divided jelly as dissolving time increased. The highest coefficient of determination (R(2) = 0·979) between the obtained voltage and the increased surface area of each divided jelly was seen at the 10 s dissolving time. These results suggested that our fully automatic system can estimate the increased surface area of comminuted gummy jelly as a parameter of masticatory performance with high accuracy after rinsing and dissolving operations of 10 s each.
An 84-year-old man was admitted to our hospital with a 1-month history of epigastralgia. Upper gastrointestinal endoscopy revealed gastric cancer and a gastric submucosal tumor (SMT) on the greater curvature of the gastric body. By endoscopic ultrasonography, SMT was demonstrated as a well-circumscribed, smooth-bordered and hypoechoic mass localized in the submucosal layer. Total gastrectomy was performed. The histology of the resected specimen revealed a gastric lipoma and an early gastric cancer widespread to the surface on the lipoma. Two lesions were present in the same lesion, but not linked. We report a rare case of gastric lipoma complicated with early gastric cancer.
BackgroundThe clinical course of liver injury induced by immune checkpoint inhibitors (ICIs) varies among individuals, and there were few reports on the therapeutic effects of corticosteroids based on the patterns of liver injury.
MethodsWe evaluated the characteristics and clinical course of immune-related liver injury in 1087 patients treated with ICIs for advanced malignancies between August 2014 and December 2020.
ResultsDuring the follow-up period (median, 270 days), 56 patients (5.2%) had immune-related liver injury (≥Grade 3). The liver-injury patterns were hepatocellular (n = 25, 44.6%), mixed (n = 10, 17.9%), or cholestatic (n = 21, 37.5%), and the median time to onset of liver injury was 36, 85, and 53 days, respectively; the hepatocellular pattern occurred earlier than the other types (P = 0.036). Corticosteroids were administered to 29 (51.8%) patients. While liver injury was improved in almost all patients with the hepatocellular pattern (n = 13/14, 92.9%), that failed to show improvement in over half of the patients with the non-hepatocellular patterns (mixed, n = 8; cholestatic, n = 7), and three patients with mixed patterns needed secondary immunosuppression with mycophenolate mofetil. Liver biopsies performed in 13 patients mainly showed lobular injury, endothelialitis, and spotty necrosis with in ltration of T cells positive for CD3 and CD8, but not CD4 or CD20.
ConclusionThe incidence pattern and therapeutic response to corticosteroids in immune-related liver injury differs according to the injury type. Although corticosteroids were effective for the hepatocellular pattern, an additional strategy for refractory non-hepatocellular patterns is needed.
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