Prognosis of Elderly Patients with Advanced Gastric Cancer without Serosal Invasion

Introduction: The impact of age on the prognosis of patients with gastric cancer is controversial. This study aimed to investigate the clinicopathologic features and prognosis of elderly, advanced gastric cancer patients without serosal invasion compared to their younger counterparts. Materials and Methods: We retrospectively evaluated 43 elderly patients with advanced gastric cancer without serosal invasion. The clinicopathologic findings were compared between the elderly (age >70 years) and young (age <36 years) patients. Results: Significantly higher numbers of elderly patients had tumors with differentiated histology, whereas more young patients had tumors with undifferentiated histology (P < 0.01). Curability (risk ratio, 3.122; confidence interval, 1.242-4.779; P < 0.001) was an independent prognostic factor of survival. The 5-year survival rates were not significantly different between the elderly and the young patients according to the absence of serosal invasion (80.0% vs 77.9%; P = 0.654) and undergoing curative resection (82.0% vs 78.9%; P = 0.312). Meanwhile, among the elderly patients, those who underwent curative resection had a better survival rate than those with non-curative resection (82.0% vs 67.8%; P < 0.001). Conclusion: Elderly patients with advanced gastric cancer without serosal invasion do not have a worse prognosis than their younger counterparts, indicating that age does not impact the prognosis of advanced gastric cancer. The important prognostic factor was whether the patients underwent curative resection

Prognosis of gastric cancer patients with paraaortic lymph node metastasis versus those with distant metastases

Background. It has long been thought that cases of advanced gastric cancer with paraaortic lymph node (PALN) metastasis are impossible to cure. However, several recent reports on the long-term survival of patients with PALN metastasis have reported an increase in the use of gastrectomy with extended lymphadenectomy, involving the dissection of more nodes than those invaded by the tumor, as the standard surgery for advanced gastric cancer. Material and methods. We reviewed the records of 1,015 patients with a confirmed histologic diagnosis of gastric cancer. Among patients with stage IV gastric cancer, 38 had PALN metastasis compared with 233 with peritoneal dissemination and 77 with hepatic metastasis. Results. Based on tumor location, metastasis to the PALNs was more common in upper-third cancer (p < 0.01); hepatic metastasis was more common in well-differentiated adenocarcinoma; and peritoneal dissemination was more common in poorly differentiated cancer (p < 0.001). The 5-year survival in patients with metastasis to the PALNs was significantly higher (28.2%) than in patients with peritoneal dissemination (5.2%) or hepatic metastasis (12.0%) (p < 0.01). Conclusions. The results reveal a better 5-year survival associated with gastric cancer patients with PALN metastasis as compared with those with other distant metastases. Therefore, we recommend performing a more extended lymphadenectomy in patients with gastric cancer, especially those with suspected metastasis to the PALNs.Introduction. It has long been thought that cases of advanced gastric cancer with paraaortic lymph node (PALN) metastasis are impossible to cure. However, several recent reports on the long-term survival of patients with PALN metastasis have reported an increase in the use of gastrectomy with extended lymphadenectomy, involving the dissection of more nodes than those invaded by the tumour, as the standard surgery for advanced gastric cancer. Material and methods. The records of 1,015 patients with a confirmed histologic diagnosis of gastric cancer had been reviewed. Among patients with stage IV gastric cancer, 38 had PALN metastasis compared with 233 with peritoneal dissemination and 77 with hepatic metastasis. Results. Based on tumour location, metastasis to the PALNs was more common in upper-third cancer (p < 0.01); hepatic metastasis was more common in well-differentiated adenocarcinoma, and peritoneal dissemination was more common in poorly differentiated cancer (p < 0.001). The 5-year survival in patients with metastasis to the PALNs was significantly higher (28.2%) than in patients with peritoneal dissemination (5.2%) or hepatic metastasis (12.0%) (p < 0.01). Conclusions. The results reveal a better 5-year survival associated with gastric cancer patients with PALN metastasis as compared with those with other distant metastases. Therefore, performing a more extended lymphadenectomy in patients with gastric cancer is recommended, especially those with suspected metastasis to the PALNs

Suppressed Carrier Clock for Reduction of Electromagnetic Radiated Emission from High-speed Digital System

Abstract In Keywords Modulation Profile and EM1 Reduction

Role of Matrix Metalloproteinase 3-mediated alpha-Synuclein Cleavage in Dopaminergic Cell Death

Evidence suggests that the C-terminal truncation of alpha-synuclein is equally important as aggregation of alpha-synuclein in Parkinson disease (PD). Our previous results showed that an endopeptidase, matrix metalloproteinase-3 (MMP3), was induced and activated in dopaminergic (DA) cells upon stress conditions. Here, we report that MMP3 cleaved alpha-synuclein in vitro and in vivo and that alpha-synuclein and MMP3 were co-localized in Lewy bodies (LB) in the postmortem brains of PD patients. Incubation of alpha-synuclein with the catalytic domain of MMP3 (cMMP3) resulted in generation of several peptides, and the peptide profiles of WT alpha-synuclein (WTsyn) and A53T mutant (A53Tsyn) were different. Combined analysis using mass spectrometry and N-terminal determination revealed that MMP3 generated C-terminally truncated peptides of amino acids 1-78, 1-91, and 1-93 and that A53Tsyn produced significantly higher quantities of these peptides. Similar sizes of peptides were detected in N27 DA cells under oxidative stress and RNA interference to knock down MMP3-attenuated peptide generation. Co-overexpression of cMMP3 with either WTsyn or A53Tsyn led to a reduction in Triton X-100-insoluble aggregates and an increase in protofibril-like small aggregates. In addition, overexpression of the 1-93-amino acid peptide in the substantia nigra led to DA neuronal loss without LB-like aggregate formation. The results strongly indicate that MMP3 digestion of alpha-synuclein in DA neurons plays a pivotal role in the progression of PD through modulation of alpha-synuclein in aggregation, LB formation, and neurotoxicity

Regularity for Solutions of Second-Order Nonlinear Integrodifferential Functional Equations

We deal with the well-posedness for solutions of nonlinear integrodifferential equations of second-order in Hilbert spaces by converting the problem into the contraction mapping principle with more general conditions on the principal operators and the nonlinear terms and obtain a variation of constant formula of solutions of the given nonlinear equations

When should reverse total shoulder arthroplasty be considered in glenohumeral joint arthritis?

Anatomical total shoulder arthroplasty (TSA) has been used widely in treatment of glenohumeral osteoarthritis and provides excellent pain relief and functional results. Reverse total shoulder arthroplasty (RSA) was created to treat the complex problem of rotator cuff tear arthropathy. RSA also has been performed for glenohumeral osteoarthritis even in cases where the rotator cuff is preserved and has shown good results comparable with TSA. The indications for RSA are expanding to include tumors of the proximal humerus, revision of hemiarthroplasty to RSA, and revision of failed TSA to RSA. The purposes of this article were to describe comprehensively the conditions under which RSA should be considered in glenohumeral osteoarthritis, to explain its theoretical background, and to review the literature

The antifungal activity and membrane-disruptive action of dioscin extracted from Dioscorea nipponica

AbstractDioscin is a kind of steroidal saponin isolated from the root bark of wild yam Dioscorea nipponica. We investigated the antifungal effect of dioscin against different fungal strains and its antifungal mechanism(s) in Candida albicans cells. Using the propidium iodide assay and calcein-leakage measurement, we confirmed that dioscin caused fungal membrane damage. Furthermore, we evaluated the ability of dioscin to disrupt the plasma membrane potential, using 3,3′-dipropylthiadicarbocyanine iodide [DiSC3(5)] and bis-(1,3-dibarbituric acid)-trimethine oxanol [DiBAC4(3)]. Cells stained with the dyes had a significant increase in fluorescent intensity after exposure to dioscin, indicating that dioscin has an effect on the membrane potential. To visualize the effect of dioscin on the cell membrane, we synthesized rhodamine-labeled giant unilamellar vesicles (GUVs) mimicking the outer leaflet of the plasma membrane of C. albicans. As seen in the result, the membrane disruptive action of dioscin caused morphological change and rhodamine leakage of the GUVs. In three-dimensional contour-plot analysis using flow cytometry, we observed a decrease in cell size, which is in agreement with our result from the GUV assay. These results suggest that dioscin exerts a considerable antifungal activity by disrupting the structure in membrane after invading into the fungal membrane, resulting in fungal cell death