BACKGROUND/AIMS: Self-expandable metallic stent (SEMS) placement is effective for dysphagia that results from malignant obstruction of the esophagus or gastric cardia; however, stent-related complications may be life-threatening. Thus, the goal of this study was to identify risk factors associated with complications following esophageal stenting. METHODS: Of the 71 patients who underwent SEMS placement for dysphagia as a result of malignant stricture of the esophagus or gastric cardia, 53 patients with squamous cell carcinoma or adenocarcinoma, without previous SEMS placement, without a fistula, and without recurrent tumor after surgery were retrospectively identified. The occurrence of stent-related complications was used as an endpoint. RESULTS: Stent-related complications were identified in 26 patients (49.1%), and major complications occurred in 14 patients (26.4%). The use of an Ultraflex stent (odds ratio [OR], 6.81; 95% confidence interval [CI], 1.54 to 30.00; p=0.011) and prior chemotherapy (OR, 6.13; 95% CI, 1.46 to 25.70; p=0.013) were significantly associated with stent-related complications. Moreover, the use of an Ultraflex stent (OR, 19.60; 95% CI, 2.26 to 170.00; p=0.007) and prior radiation (OR, 25.70; 95% CI, 2.37 to 280.00; p=0.008) significantly increased the risk of major complications. CONCLUSIONS: The use of an Ultraflex stent and prior radiation and/or chemotherapy may represent risk factors for complications following esophageal SEMS placement.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cardia* ; Constriction, Pathologic ; Deglutition Disorders ; Drug Therapy ; Esophagus* ; Fistula ; Humans ; Retrospective Studies ; Risk Factors ; Stents

BACKGROUND/AIMS: A barbed puncture needle with a side hole was recently developed to improve sample quality and quantity in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). In this study, we retrospectively assessed the usefulness of this puncture needle. METHODS: Factors affecting diagnostic yield, safety, and diagnostic accuracy were investigated in 76 patients who consecutively underwent EUS-FNA for neoplastic lesions at our hospital between January and December 2013. RESULTS: The procedure was successful in all cases; the rates of sample collection and determination of the correct diagnosis were 92.1% and 89.5%, respectively. The mean number of needle passes required for diagnosis was 1.1. Complications included mild intraluminal bleeding in two patients (2.6%). Multivariate analysis revealed that lesion size (< or =20 mm) was significantly associated with a decreased chance of determining the correct diagnosis. CONCLUSIONS: Core biopsy needles with a side hole are safe and provide a satisfactory diagnostic yield. However, the side hole may potentially reduce the rate of making the correct diagnosis in small lesions.
Adult ; Aged ; Aged, 80 and over ; Digestive System Neoplasms/*diagnosis/ultrasonography ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/*instrumentation ; Equipment Design ; Equipment Safety ; Female ; Gastrointestinal Tract/pathology/ultrasonography ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Needles/adverse effects/*statistics & numerical data ; Predictive Value of Tests ; Retrospective Studies ; Sensitivity and Specificity ; Statistics, Nonparametric

Objective: Therapeutic antibodies have few varieties of side effects due to their high specificity; however, many therapeutic antibodies have serious side effects. A thorough understanding of the side effects is crucial for early recognition and optimal management. To facilitate the understanding of the side effects of therapeutic antibodies, this study attempted to classify therapeutic antibodies based on their side effects using principal component analysis (PCA) and cluster analysis. Method: We collected data on the serious side effects of therapeutic antibodies from package inserts and created a therapeutic antibody-side effect matrix, with therapeutic antibodies as indices and side effects as columns. PCA was performed on the therapeutic antibody-side effect matrix, and hierarchical cluster analysis was performed using principal components. Results: The therapeutic antibodies were classified into four clusters. Cluster 1 included immune checkpoint inhibitors, and featured type 1 diabetes, thyroid disorder, and myasthenia gravis. Cluster 2 included antibodies that inhibit the vascular endothelial growth factor pathway, and featured impaired wound healing, nephrotic syndrome, and thrombosis. Cluster 3 included anti-epidermal growth factor receptor antibodies, and featured diarrhea, hypomagnesemia, and skin disorders. Cluster 4 included other therapeutic antibodies, and featured infection, bone marrow suppression, and hypersensitivity. Conclusion: Therapeutic antibodies can be classified based on their side effects. The results of this study make it easier to understand the side effects of therapeutic antibodies with complex profiles. A better understanding facilitates early detection of side effects and enables high-quality management of side effects.

This study aimed to evaluate the effects of ingesting yogurt fermented with Lactobacillus delbrueckii subsp. bulgaricus (OLL1073R-1) on the immune function of healthy university men track and field athletes. Study design Randomized, double-blind, placebo-controlled, parallel-group study. A total of 37 track and field athletes aged ≥18 years were randomly assigned into two groups. For 2 weeks, two bottles of yogurt fermented with OLL1073R-1 and Streptococcus thermophilus OLS3059 or placebo sour milk were ingested daily to the participants. During the intake period, a 1-week training camp was held and participants were subjected to strenuous exercise. Natural killer (NK) cell activity, which is the primary endpoint, was significantly lower in the placebo group after ingestion than that at baseline; however, it remained unchanged during the pre-exercise level of the yogurt group. The two-way repeated measures analysis of variance showed an interaction effect in the NK cell activity change (P=0.018) and a significant difference between the groups after the 2-week ingestion (P=0.015). Among the secondary endpoints, cytokines and chemokines levels involved in activating innate immunity maintained or enhanced only in the yogurt group. ALT, LDH, and CK significantly elevated only in the placebo group. Furthermore, amino acid levels were significantly lower in the placebo group after ingestion than that at baseline; however, it remained unchanged during the pre-exercise level in the yogurt group. Consuming yogurt fermented with OLL1073R-1 prevents the decline in immune function associated with strenuous exercise. Additionally, the yogurt may contribute to stable physical condition.