Genotyping of Citrus Accessions with S<SUB>9</SUB> and/or S<SUB>10</SUB> Alleles for Self-incompatibility and Their Allelic Distribution

Jung-Hee Kim,Mayumi Sato,Akira Wakana,Fuka Takamatsu,Kaori Sakai,Masayoshi Shigyo,Jun-ichiro Masuda 한국원예학회 2021 원예과학기술지 Vol.39 No.6

Gametophytic self-incompatibility, one of the key characteristics for breeding seedless Citrus cultivars, occurs in pummelo (Citrus maxima), mandarin (Citrus reticulata), and their hybrid cultivars. Allelic variation in Citrus was reported for the self-incompatibility gene (S); however, S allele frequencies and S genotypes of full- and semi-self-incompatible cultivars have been reported for a small number of alleles. To extend our knowledge of S alleles, we tested 146 Citrus accessions, including 82 pummelo accessions, for S9 and S10 alleles. Each accession was pollinated with homozygous S₁ seedlings of ‘Hirado Buntan’ pummelo (S9S9 and S10S10). The pollen tube growth arrest in the lower styles of their pollinated pistils indicated that four accessions, including ‘Hirado Buntan [Citrus maxima (Burm.) Merr.]’, have the S9 allele and five accessions, including ‘Hirado Buntan’, have the S10 allele. The percentage of accessions with the S9 allele was 3.2% (4 of 126 accessions examined), and the S9 allele frequency was 1.8% (4 of 217 alleles, excluding the Sf allele). The percentage of accessions with the S10 allele was 3.9% (5 of 127 accessions examined), and the S10 allele frequency was 2.3% (5 of 217 alleles, excluding the Sf allele). Japanese mandarin (another sources of S alleles) and its relatives had neither the S9 nor the S10 allele. Pummelo accessions had S9 and S10 alleles at higher rates of 2.9% (2 of 70 accessions examined) and 7.0% (5 of 71 accessions examined), respectively. ‘Kabusu’ sour orange (a pummelo-mandarin hybrid; Citrus aurantium) and ‘Kikudaidai’ (a sour orange relative; Citrus canaliculata) had S9 alleles. These results suggested that the two alleles originated from pummelo (the main sources of S alleles). The S genotypes with S9 and/or S10 alleles were fully determined in ‘Hirado Buntan’ (S9S10), ‘Kabusu’ sour orange (SfS9), the ‘Kikudaidai’ (S9S11) sour orange hybrid, and two local pummelo plants. The results of our study suggest that in comparison with the other S alleles reported, the pummelo plants with low frequencies of S9 and/or S10 alleles contributed to very low rates of evolution and development of Citrus species and cultivars during the long history of citrus cultivation, except for those generating sour oranges (Citrus auratinum), which are used as root stocks, and for flesh and rind processing and ornamental plants. Finally, we examined the degree of self-incompatibility between S9 and S10 alleles in the lower part of styles of S₁ seedlings of ‘Hirado Buntan’ and Citrus accessions with S9 and/or S10 alleles. The result indicated no difference in the self-incompatibility reaction between the two alleles.

Predictive Value of Localized Stenosis of the Main Pancreatic Duct for Early Detection of Pancreatic Cancer

Yoshihide Kanno,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Keisuke Yonamine,Yujiro Kawakami,Yuki Fujii,Kazuaki Miyamoto,Toji Murabayashi,Fumisato Kozakai,Jun Horaguchi 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.6

Background/Aims: In this study, we aimed to evaluate the predictive value of localized stenosis of the main pancreatic duct (MPD) forearly detection of pancreatic cancer. Methods: Among 689 patients who underwent endoscopic retrograde pancreatography from January 2008 to September 2018, 19patients with MPD findings were enrolled. These patients showed findings for indicating suspicious pancreatic cancer at an early stage(FiCE); FiCE was defined as a single, localized stenosis in the MPD without a detectable mass (using any other imaging methods) andwithout other pancreatic diseases, such as definite chronic pancreatitis, intraductal papillary mucinous neoplasm, and autoimmunepancreatitis. Final diagnoses were established by examining resected specimens or through follow-up examinations after an interval of>5 years. Results: Among 19 patients with FiCE, 11 underwent surgical resection and 8 were evaluated after a >5-year observation period. Thefinal diagnosis of the MPD stenosis was judged to be pancreatic cancer in 9 patients (47%), including 3 with intraepithelial cancer, andto be a non-neoplastic change in 10. The sensitivity, specificity, and accuracy of preoperative pancreatic juice cytology were 75%, 100%,and 88%, respectively. Conclusions: The predictive value of FiCE for pancreatic cancer prevalence was 47%. Histological confirmation with pancreatic juicecytology is necessary before surgical resection.

Inside Plastic Stents versus Metal Stents for Treating Unresectable Malignant Perihilar Biliary Obstructions: A Retrospective Comparative Study

Yoshihide Kanno,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Keisuke Yonamine,Kazuaki Miyamoto,Toji Murabayashi,Fumisato Kozakai,Jun Horaguchi,Yutaka Noda,Kei Ito 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.6

Background/Aims: The aim of this study was to evaluate outcomes of inside plastic stents (iPSs) versus those of metal stents (MSs) for treating unresectable perihilar malignant obstructions. Methods: For all patients who underwent endoscopic suprapapillary placement of iPS(s) or MS(s) as the first permanent biliary drainage for unresectable malignant perihilar obstructions between January 2014 and August 2019, clinical outcomes using iPSs (n=20) and MSs (n=85), including clinical efficacy, adverse events, and time to recurrence of biliary obstruction (RBO), were retrospectively evaluated. Results: There were no differences in clinical effectiveness (95% for the iPS group vs. 92% for the MS group, p=1.00). Procedure-related adverse events, including pancreatitis, acute cholangitis, acute cholecystitis, and death, were observed for 8% of the MS group, although no patient in the iPS group developed such adverse events. The median time to RBO was 561 days (95% confidence interval, 0–1,186 days) for iPSs and 209 days (127–291 days) for MSs, showing a significant difference (p=0.008). Conclusions: Time to RBO after iPS placement was significantly longer than that after MS placement. IPSs, which are removable, unlike MSs, were an acceptable option.

Predictive Factors for Inaccurate Diagnosis of Swollen Lymph Nodes in Endoscopic Ultrasound-Guided Fine Needle Aspiration

Yuki Fujii,Yoshihide Kanno,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Keisuke Yonamine,Yujiro Kawakami,Toji Murabayashi,Fumisato Kozakai,Yutaka Noda,Hiroyuki Okada,Kei 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.2

Background/Aims: This study aimed to identify the predictive factors for inaccurate endoscopic ultrasound-guided fine needleaspiration (EUS-FNA) diagnosis of swollen lymph nodes without rapid on-site cytopathological evaluation. Methods: Eighty-three consecutive patients who underwent EUS-FNA for abdominal or mediastinal lymph nodes from January2008 to June 2017 were included from a prospectively maintained EUS-FNA database and retrospectively reviewed. The sensitivity,specificity, and accuracy of EUS-FNA for the detection of neoplastic diseases were calculated. Candidate factors for inaccurate diagnosis(lymph node size and location, needle type, puncture route, number of passes, and causative disease) were evaluated by comparisonbetween accurately diagnosed cases and others. Results: The final diagnosis of the punctured lymph node was classified as neoplastic (65 cases: a metastatic lymph node, malignantlymphoma, or Crow-Fukase syndrome) or non-neoplastic (18 cases: a reactive node or amyloidosis). The sensitivity, specificity, andaccuracy were 83%, 94%, and 86%, respectively. On multivariate analyses, small size of the lymph node was the sole predictive factor forinaccurate EUS-FNA diagnosis with a significant difference (odds ratios, 19.8; 95% confidence intervals, 3.15–124; p=0.0015). Conclusions: The lymph node size of <16 mm was the only independent factor associated with inaccurate EUS-FNA diagnosis ofswollen lymph nodes.

Endoscopic Ultrasonography-Guided Gallbladder Drainage as a Treatment Option for Acute Cholecystitis after Metal Stent Placement in Malignant Biliary Strictures

Fumisato Kozakai,Yoshihide Kanno,Kei Ito,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Toji Murabayashi,Keisuke Yonamine,Yujiro Kawakami,Yuki Fujii,Kazuaki Miyamoto,Yutak 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.3

Background/Aims: It is often diffcult to manage acute cholecystitis after metal stent (MS) placement in unresectable malignant biliarystrictures. The aim of this study was to evaluate the feasibility of endoscopic ultrasonography-guided gallbladder drainage (EUS-GBD)for acute cholecystitis. Methods: The clinical outcomes of 10 patients who underwent EUS-GBD for acute cholecystitis after MS placement between January2011 and August 2018 were retrospectively evaluated. The procedural outcomes of percutaneous transhepatic gallbladder drainage(PTGBD) with tube placement (n=11 cases) and aspiration (PTGBA) (n=27 cases) during the study period were evaluated as a reference. Results: The technical success and clinical effectiveness rates of EUS-GBD were 90% (9/10) and 89% (8/9), respectively. Severe bileleakage that required surgical treatment occurred in one case. Acute cholecystitis recurred after stent dislocation in 38% (3/8) of thecases. Both PTGBD and PTGBA were technically successful in all cases without severe adverse events and clinically effective in 91% and63% of the cases, respectively. Conclusions: EUS-GBD after MS placement was a feasible option for treating acute cholecystitis. However, it was a rescue techniquefollowing the established percutaneous intervention in the current setting because of the immature technical methodology, includingdedicated devices, which need further development.

Capability of Radial- and Convex-Arrayed Echoendoscopes for Visualization of the Pancreatobiliary Junction

Yoshihide Kanno,Kei Ito,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Kaori Masu,Toshitaka Sakai,Toji Murabayashi,Sho Hasegawa,Fumisato Kozakai,Yujiro Kawakami,Yuki Fujii,Yutaka Noda 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.3

Background/Aims: Although both radial- and convex-arrayed endoscopic ultrasonography (EUS) scopes are widely used forobservational EUS examinations, there have been few comparative studies on their power of visualization. The aim of this study was toevaluate the capability of these EUS scopes for observation of the pancreatobiliary junction. Methods: The rate of successful visualization of the pancreatobiliary junction was retrospectively compared between a radial-arrayedand a convex-arrayed echoendoscope, from a prospectively maintained database. Study periods were defined as January 2010 toDecember 2012 for the radial group, and February 2015 to October 2016 for the convex group because the respective scope wasmainly used during those periods. Results: During the study period, 1,660 cases with radial EUS and 1,984 cases with convex EUS were recruited. The success rates ofobservation of the pancreatobiliary junction were 80.0% and 89.5%, respectively (p<0.0001). Conclusions: The capability of visualization of the pancreatobiliary junction in observational EUS was found to be better with aconvex-arrayed than with a radial-arrayed echoendoscope

Safety and Recipient Satisfaction of Propofol Sedation in Outpatient Endoscopy: A 24-Hour Prospective Investigation Using a Questionnaire Survey

Yoshihide Kanno,Tetsuya Ohira,Yoshihiro Harada,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Yoshiki Koike,Taku Yamagata,Toshitaka Sakai,Kaori Masu,Keisuke Yonamine,Kazuaki Miyamoto,Megumi Tanaka,T 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.3

Background/Aims: The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepinedrugs in outpatient endoscopy. Methods: In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextdayquestionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24hours, and examinee satisfaction were evaluated. Results: Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performedbetween November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopicultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. Themean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination withpropofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia,in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of thepatients desired propofol sedation in future examinations. Conclusions: Propofol sedation was found to be safe-without severe adverse events or accidents-for outpatient endoscopy on thebasis of the patients’ next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painlessendoscopic screening.