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BACKGROUND Rikkunshito (TJ-43) relieves gastrointestinal disturbance by increases in the levels of acylated ghrelin. AIM To investigate the effects of TJ-43 in patients undergoing pancreatic surgery. METHODS Forty-one patients undergoing pylorus-preserving pancreaticoduodenectomy (PpPD) were divided into two groups; patients took daily doses of TJ-43 after surgery or after postoperative day (POD) 21. The plasma levels of acylated and desacylated ghrelin, cholecystokinin (CCK), peptide YY (PYY), gastric inhibitory peptide (GIP), and active glucagon-like peptide (GLP)-1 were evaluated. Oral calorie intake was assessed at POD 21 in both groups. The primary endpoint of this study was the total food intake after PpPD. RESULTS The levels of acylated ghrelin were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 administration at POD 21, and oral intake was significantly increased in patients treated with TJ-43. The CCK and PYY levels were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 treatment. Furthermore, the GIP and active GLP-1 levels increased and values at POD 21 were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 administration. Insulin secretion tended to increase in patients treated with TJ-43. CONCLUSION TJ-43 may have advantages for oral food intake in patients in the early phase after pancreatic surgery. Further investigation is needed to clarify the effects of TJ-43 on incretin hormones.

BackgroundNicotinamide adenine dinucleotide phosphate (NADPH) Oxidases (NOXs) are transmembrane proteins that generate reactive oxygen species. Recent studies have reported that NOXs play important roles in the progression of various cancers. However, the expression and role of NOX2 in colon cancer is unclear.Therefore, this study aimed to investigate the expression of NOX2 and effects on the prognosis of patients with colon cancer, and also examined the pathophysiological role of NOX2 in cell proliferation and motility. MethodsWe used 116 primary colon cancer samples obtained from patients who underwent curative resection for stage II or III colon cancer for immunohistochemistry to assess the relationship between NOX2 expression and clinicopathological factors and evaluate the prognostic signi cance of NOX2 expression in colon cancer patients. The expression levels of NOX2 protein and mRNA in human colon cancer cell lines were analyzed and two highly NOX2 expressed cell lines (HCT116 and RKO) were used for further study.Knockdown experiments with NOX2 siRNA were performed, and the effects on cell proliferation, cell cycle progression, migration, and invasion were analyzed. ResultsImmunohistochemical staining revealed that NOX2 protein was scarcely expressed in noncancerous tissue compared to cancer tissue, and 45 samples (38.8%) had positive staining for NOX2 expression in cancer tissue. No clinicopathological factor was signi cantly associated with NOX2 expression. The 5year recurrence-free survival rate of the NOX2 positive group was signi cantly lower than that of the NOX2 negative group (61.1% vs. 79.3%, p = 0.029). NOX2 depletion using siRNA signi cantly inhibited cell proliferation, G 1 to S phase cell cycle progression, migration, and invasion in the two cell lines. ConclusionsNOX2 expression affects the prognosis of colon cancer patients, as well as the tumorigenesis of colon cancer cells. NOX2 may be a novel biomarker and therapeutic target for colon cancer patients.

Background/aim: We investigated the postoperative treatment status for diabetes mellitus and perioperative HbA1c levels in patients with diabetes mellitus and examined the effects of clinical factors on the remission of diabetes mellitus. Patients and methods: In this study, 126 patients with gastric cancer were considered to have diabetes mellitus preoperatively, of whom 79 were treated with oral antidiabetic drugs and/or insulin treatment. We compared diabetic treatment status and HbA1c values between the preoperative and postoperative periods in patients who underwent gastrectomy and examined the effects of clinical factors on improving diabetes mellitus. Results: Of the 79 patients treated preoperatively for diabetes mellitus, 34(43%) discontinued all medications for diabetes mellitus and 37 (47%) reduced the therapeutic dose or switched from insulin to oral antidiabetic drugs. Total gastrectomy was an independent factor for the remission of antidiabetic treatments after gastrectomy. Concerning the HbA1c level, only the absence of preoperative insulin use was an independent factor for the improvement. However, reconstruction was not a significant correlated factor for the improvement of postoperative HbA1c levels and the remission of antidiabetic medications after distal gastrectomy. Conclusions: Almost all patients discontinued or reduced the dose of antidiabetic medications after gastrectomy in clinical practice, and special attention should be paid in the management methods for diabetes mellitus in patients who underwent total gastrectomy for gastric cancer.

Background Nicotinamide adenine dinucleotide phosphate (NADPH) Oxidases (NOXs) are transmembrane proteins that generate reactive oxygen species. Recent studies have reported that NOXs play important roles in the progression of various cancers. However, the expression and role of NOX2 in colon cancer is unclear. Therefore, this study aimed to investigate the expression of NOX2 and effects on the prognosis of patients with colon cancer, and also examined the pathophysiological role of NOX2 in cell proliferation and motility. Methods We used 116 primary colon cancer samples obtained from patients who underwent curative resection for stage II or III colon cancer for immunohistochemistry to assess the relationship between NOX2 expression and clinicopathological factors and evaluate the prognostic significance of NOX2 expression in colon cancer patients. The expression levels of NOX2 protein and mRNA in human colon cancer cell lines were analyzed and two highly NOX2 expressed cell lines (HCT116 and RKO) were used for further study. Knockdown experiments with NOX2 siRNA were performed, and the effects on cell proliferation, cell cycle progression, migration, and invasion were analyzed. Results Immunohistochemical staining revealed that NOX2 protein was scarcely expressed in noncancerous tissue compared to cancer tissue, and 45 samples (38.8%) had positive staining for NOX2 expression in cancer tissue. No clinicopathological factor was significantly associated with NOX2 expression. The 5-year recurrence-free survival rate of the NOX2 positive group was significantly lower than that of the NOX2 negative group (61.1% vs. 79.3%, p = 0.029). NOX2 depletion using siRNA significantly inhibited cell proliferation, G1 to S phase cell cycle progression, migration, and invasion in the two cell lines. Conclusions NOX2 expression affects the prognosis of colon cancer patients, as well as the tumorigenesis of colon cancer cells. NOX2 may be a novel biomarker and therapeutic target for colon cancer patients.