Is Adjuvant Chemotherapy Necessary in Patients with Early Endometrial Cancer?

Background: We investigated whether there was a difference in prognosis between patients with stage IA endometrial cancer with and without lymphovascular space invasion. Methods: We enrolled patients with stage IA (pT1aN0M0) endometrial cancer admitted to our hospital from 2009 to 2018. All patients underwent hysterectomy, bilateral salpingo-oophorectomy, and systematic pelvic lymphadenectomy. We immunopathologically evaluated the presence or absence of lymphovascular space invasion in the tumor tissue using hematoxylin and eosin, Elastica-van Gieson, and podoplanin staining. We analyzed disease-free and overall survival and calculated patients’ survival distribution using the Kaplan–Meier method and log-rank test. The multivariate analysis was performed to determine the prognostic factors. Results: A total of 116 patients were included. The median age of the patients was 57 (range, 30–78) years, and the histological subtype revealed 98 and 18 cases of types 1 and 2, respectively. The median follow-up period was 71.9 (range, 10.8–149) months, and the 3-year disease-free and 3-year overall survival rates were 94% and 99%, respectively. The disease-free and overall survival rates were significantly shorter in type 2 patients than in type 1 patients (type 2 vs. type 1; 77% vs. 97%, P < 0.01, 94% vs. 100%, P = 0.014, respectively). The univariate and multivariate analyses showed that there were no significant differences in disease-free survival between the lymphovascular space invasion-positive and -negative groups among type 1 cases. Conclusion: There was no difference in prognosis between patients with stage IA and type 1 endometrial cancer with and without lymphovascular space invasion

MAML1 Enhances the Transcriptional Activity of Runx2 and Plays a Role in Bone Development

Mastermind-like 1 (MAML1) is a transcriptional co-activator in the Notch signaling pathway. Recently, however, several reports revealed novel and unique roles for MAML1 that are independent of the Notch signaling pathway. We found that MAML1 enhances the transcriptional activity of runt-related transcription factor 2 (Runx2), a transcription factor essential for osteoblastic differentiation and chondrocyte proliferation and maturation. MAML1 significantly enhanced the Runx2-mediated transcription of the p6OSE2-Luc reporter, in which luciferase expression was controlled by six copies of the osteoblast specific element 2 (OSE2) from the Runx2-regulated osteocalcin gene promoter. Interestingly, a deletion mutant of MAML1 lacking the N-terminal Notch-binding domain also enhanced Runx2-mediated transcription. Moreover, inhibition of Notch signaling did not affect the action of MAML1 on Runx2, suggesting that the activation of Runx2 by MAML1 may be caused in a Notch-independent manner. Overexpression of MAML1 transiently enhanced the Runx2-mediated expression of alkaline phosphatase, an early marker of osteoblast differentiation, in the murine pluripotent mesenchymal cell line C3H10T1/2. MAML1-/- embryos at embryonic day 16.5 (E16.5) had shorter bone lengths than wild-type embryos. The area of primary spongiosa of the femoral diaphysis was narrowed. At E14.5, extended zone of collagen type II alpha 1 (Col2a1) and Sox9 expression, markers of chondrocyte differentiation, and decreased zone of collagen type X alpha 1 (Col10a1) expression, a marker of hypertrophic chondrocyte, were observed. These observations suggest that chondrocyte maturation was impaired in MAML1-/- mice. MAML1 enhances the transcriptional activity of Runx2 and plays a role in bone development

Biological Monitoring of human exposure to neonicotinoids using urine samples, and neonicotinoid excretion kinetics

[Background] Neonicotinoids, which are novel pesticides, have entered into usage around the world because they are selectively toxic to arthropods and relatively non-Toxic to vertebrates. It has been suggested that several neonicotinoids cause neurodevelopmental toxicity in mammals. The aim was to establish the relationship between oral intake and urinary excretion of neonicotinoids by humans to facilitate biological monitoring, and to estimate dietary neonicotinoid intakes by Japanese adults. [Methodology/Principal Findings] Deuterium-labeled neonicotinoid (acetamiprid, clothianidin, dinotefuran, and imidacloprid) microdoses were orally ingested by nine healthy adults, and 24 h pooled urine samples were collected for 4 consecutive days after dosing. The excretion kinetics were modeled using one- and two-compartment models, then validated in a non-deuterium-labeled neonicotinoid microdose study involving 12 healthy adults. Increased urinary concentrations of labeled neonicotinoids were observed after dosing. Clothianidin was recovered unchanged within 3 days, and most dinotefuran was recovered unchanged within 1 day. Around 10% of the imidacloprid dose was excreted unchanged. Most of the acetamiprid was metabolized to desmethyl-Acetamiprid. Spot urine samples from 373 Japanese adults were analyzed for neonicotinoids, and daily intakes were estimated. The estimated average daily intake of these neonicotinoids was 0.53-3.66 μg/day. The highest intake of any of the neonicotinoids in the study population was 64.5 μg/day for dinotefuran, and this was <1% of the acceptable daily intake

Standardization of examiners using a dental model for pocket probe training: Adequacy of evaluation with a model and standard accuracy rate of skilled examiners

Objective: To standardize examiners using a dental model, we developed a dental model and conducted a study that found the model was feasible and effective for student practice. However, it remains unclear whether the skill of measuring probing depth (PD) in this model correlates with the skill of measuring PD in patients. Thus, this study was designed to clarify this point and to determine the accuracy rate of a skilled examiner. Material and Methods: Study 1: Fifty-one students measured PD in patients with more than 4 teeth having a pocket equal to or deeper than 4 mm and PD in the model. On the same day, their instructor remeasured PD in these patients. Study 2: Ninety- nine students and 11 Certified Periodontists measured PD in the model. Results: Study 1: The accuracy rate of students measuring patients’ PD equal to or deeper than 4 mm and PD in the model showed a significant positive correlation. Study 2: Based on the receiver operating characteristic curve analysis, the accuracy rate equivalent to the skill level of Certified Periodontists was found to be 84.7%. Conclusion: Standardization of examiners was confirmed with this model. The standard accuracy rate of skilled examiners was found to be 85%