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Natural History of Chronic Intestinal Pseudo-obstruction and Need for Palliative Care
Kosuke Tanaka,Hidenori Ohkubo,Atsushi Yamamoto,Kota Takahashi,Yuki Kasai,Anna Ozaki,Michihiro Iwaki,Takashi Kobayashi,Tsutomu Yoshihara,Noboru Misawa,Akiko Fuyuki,Shingo Kato,Takuma Higurashi,Kunihiro 대한소화기 기능성질환∙운동학회 2023 Journal of Neurogastroenterology and Motility (JNM Vol.29 No.3
Background/AimsNatural history of chronic intestinal pseudo-obstruction (CIPO), a rare disease characterized by episodes of non-mechanical obstruction, is unclear in adults. This study evaluates the clinical course of CIPO and palliative care needs of patients. MethodsFrom October 2010 to September 2021, 74 patients who underwent cine MRI and had a definitive diagnosis of CIPO were prospectively included. We investigated disease etiology and outcomes, age at onset, nutritional status at consultation (body mass index and serum albumin), hydrogen breath test results, and total parenteral nutrition (TPN) during the disease course. ResultsForty-seven patients (64%) were women, with a mean age of 44 years at onset and 49 years at diagnosis. Primary CIPO was observed in 48 patients (65%). Secondary CIPO was observed in 26 cases (35%), of whom 18 (69%) had scleroderma. The mean body mass index, serum albumin level, and hydrogen breath test positivity rate were 17 kg/m2, 3.8 mg/dL, and 60%, respectively. TPN and invasive decompression therapy were required by 23 (31%) and 18 (24%) patients, respectively. Intestinal sterilization was performed in 51 (69%) patients and was effective in 33 (65%); of these, 28 (85%) were taking metronidazole. Seven (9%) patients used opioids. There were 9 deaths (12%), including 5 (56%) from infection and 2 (22%) from suicide. Of the deaths, 6 (67%) and 4 (44%) underwent TPN management and decompression therapy, respectively. Fifty-one patients (69%) wanted palliative care. ConclusionCIPO is a rare, severe, and under-recognized disease. Standardization of treatment strategies, including palliative care and psychiatric interventions, is desired.
Tomita, Takeo,Kim, Seung-Young,Teramoto, Kazuya,Meguro, Ayuko,Ozaki, Taro,Yoshida, Ayako,Motoyoshi, Yudai,Mori, Naoki,Ishigami, Ken,Watanabe, Hidenori,Nishiyama, Makoto,Kuzuyama, Tomohisa AMERICAN CHEMICAL SOCIETY 2017 ACS CHEMICAL BIOLOGY Vol.12 No.6
<P>The diterpene cyclase CotB2 catalyzes the cyclization of geranylgeranyl diphosphate (GGPP) to the tricyclic cyclooctat-9-en-7-ol, which is characterized by a 5-8-5-fused ring skeleton. We have previously proposed a cyclization cascade involving a unique carbon-carbon bond rearrangement combined with multiple hydride shifts, all occurring at a single active site. Here, we report the first high-resolution X-ray crystal structure of CotB2 with bound substrate analog geranylgeranyl thiodiphosphate (GGSPP). In the GGSPP-bound form, GGSPP folds into a unique S-shaped conformation that probably reflects the substrate-bound state prior to ionization of the substrate GGPP. The folded framework of GGSPP is surrounded by hydrophobic residues and several aromatic and asparagine residues that are well-positioned to stabilize a series of reactive carbocation intermediates through a combination of cation−π and dipole charge interactions. The combined crystal structures and mutagenesis-based biochemical assays provide a structural basis for exquisite control of ring formation and stereochemistry during CotB2 catalysis.</P> [FIG OMISSION]</BR>
Hiroyuki Kaji,Akira Togayachi,Makoto Ochou,Maki Sogabe,Takashi Okura,Hirofumi Nozaki,Takashi Angata,Yasunori Chiba,Hidenori Ozaki,Atsushi Kuno,Yasuhito Tanaka,Yuzuru Ikehara,Masashi Mizokami,Hisashi N 한국당과학회 2012 한국당과학회 학술대회 Vol.2012 No.1
We present here a high-throughput strategy to discover serological biomarkers for early-detection of hepatocellular carcinoma (HCC). Our strategy is also applicable to assess the progressed liver fibrosis that is associated with virus hepatitis. The glycan structure on glycoproteins derived from cancerous cells is known to be different from that derived from normal cells, specifically, the increased aberrant glycosylation appears in patient serum with virus hepatitis along with either or both the initiation and progression. Based on the above perceptions, in order to identify glycoproteins carrying aberrant glycosylation in serum of liver disease patients, we analyzed lectin-captured glycopeptides by the IGOT method. Many glycoproteins carrying altered glycans were successfully identified. The increased amount of these glycoproteins was clinically relevant to the progression of the liver diseases. We are now selecting appropriate molecules depending on the feasibility to detect an abnormality in the liver, such as the occurrence of liver cell neoplasm.