Stent-graft detachment from aortic wall after stent-graft repair of acute aortic dissection

AbstractPreliminary studies have demonstrated that stent-graft repair is an attractive method for treatment of aortic dissection. However, few reports have described long-term results. A 72-year-old woman with acute type B aortic dissection underwent stent-graft repair. The entry was closed, and the false lumen disappeared completely. The postoperative course was uneventful for 4 years 5 months, when detachment of the stent graft from the aortic wall was noted. Because the device appears to be stable, follow-up is on an outpatient basis

Acute and contained rupture of the descending thoracic aorta: Treatment with endovascular stent grafts

AbstractPurpose: The purpose of this study was to evaluate feasibility and safety of endovascular stent grafting for the treatment of patients with rupture of the descending thoracic aorta. Methods: Thirteen patients with rupture of the descending thoracic aorta were treated with endovascular stent grafting. Six patients were treated on the day of diagnosis because their vital signs were unstable, and the other seven patients were treated electively. Five patients had infection or potential infection, and the other eight patients did not. Expanded polytetrafluoroethylene-covered or polyester-covered Z stents were used in all patients. Results: Stent grafts were successfully placed in all patients. No endoleaks were observed at the end of the procedure. However, rebleeding was observed within 2 weeks of the procedure in two patients with infection. Six patients (46%) died within 5 months of the procedure (mean survival period, 61 ± 60 days). All five patients with infection (100%) died, and only one of eight patients without infection (13%) died (P <.01). The remaining seven patients are alive during the mean follow-up period of 21 months (overall survival rate, 54%), although additional surgical interventions, including surgical conversion in one case and upper extremity extraanatomic bypass in the other, were necessary in two of these patients. Conclusion: Endovascular stent grafting may be a safe and feasible method for the treatment of rupture of the descending thoracic aorta in selected patients without infection. However, its usefulness in terms of long-term prognosis appears to be extremely limited, especially in patients with infection. (J Vasc Surg 2003;37:100-5.

Generation of Small 32P-Labeled Peptides as a Potential Approach to Colorectal Cancer Therapy

Cancers have been revealed to be extremely heterogenous in terms of the frequency and types of mutations present in cells from different malignant tumors. Thus, it is likely that uniform clinical treatment is not optimal for all patients, and that the development of individualized therapeutic regimens may be beneficial. We describe the generation of multiple, unique small peptides nine to thirty-four amino acids in length which, when labeled with the radioisotope 32P, bind with vastly differing efficiencies to cell lines derived from different colon adenocarcinomas. In addition, the most effective of these peptides permanently transfers the 32P radioisotope to colorectal cancer cellular proteins within two hours at a rate that is more than 150 times higher than in cell lines derived from other cancers or from the normal tissues tested. Currently, the only two FDA-approved radioimmunotherapeutic agents in use both employ antibodies directed against the B cell marker CD20 for the treatment of non-Hodgkin's lymphoma. By using the method described herein, large numbers of different 32P-labeled peptides can be readily produced and assayed against a broad spectrum of cancer types. This report proposes the development and use of 32P-labeled peptides as potential individualized peptide-binding therapies for the treatment of colon adenocarcinoma patients

Three-Tiered Risk Stratification Model to Predict Progression in Barrett's Esophagus Using Epigenetic and Clinical Features

Barrett's esophagus predisposes to esophageal adenocarcinoma. However, the value of endoscopic surveillance in Barrett's esophagus has been debated because of the low incidence of esophageal adenocarcinoma in Barrett's esophagus. Moreover, high inter-observer and sampling-dependent variation in the histologic staging of dysplasia make clinical risk assessment problematic. In this study, we developed a 3-tiered risk stratification strategy, based on systematically selected epigenetic and clinical parameters, to improve Barrett's esophagus surveillance efficiency

Novel Decapeptides that Bind Avidly and Deliver Radioisotope to Colon Cancer Cells

The rapidly growing field of targeted tumor therapy often utilizes an antibody, sometimes tagged with a tumor-ablating material such as radioisotope, directed against a specific molecule.This report describes the discovery of nine novel decapeptides which can be radioactively labeled, bind to, and deliver (32)P to colon cancer cells. The decapeptides vary from one another by one to three amino acids and demonstrate vastly different binding abilities. The most avidly binding decapeptide can permanently deliver very high levels of radioisotope to the adenocarcinoma cancer cell lines at an efficiency 35 to 150 times greater than to a variety of other cell types, including cell lines derived from other types of cancer or from normal tissue.This experimental approach represents a new example of a strategy, termed peptide binding therapy, for the potential treatment of colorectal and other adenocarcinomas

A Multicenter, Double-Blinded Validation Study of Methylation Biomarkers for Progression Prediction in Barrett's Esophagus

Esophageal adenocarcinoma risk in Barrett’s esophagus (BE) is increased 30- to 125-fold versus the general population. Among all BE patients, however, neoplastic progression occurs only once per 200 patient-years. Molecular biomarkers are therefore needed to risk-stratify patients for more efficient surveillance endoscopy and to improve the early detection of progression. We therefore performed a retrospective, multicenter, double-blinded validation study of 8 BE progression prediction methylation biomarkers. Progression or nonprogression were determined at 2 years (tier 1) and 4 years (tier 2). Methylation was assayed in 145 nonprogressors (NPs) and 50 progressors (Ps) using real-time quantitative methylation-specific PCR. Ps were significantly older than NPs (70.6 vs. 62.5 years, p < 0.001). We evaluated a linear combination of the 8 markers, using coefficients from a multivariate logistic regression analysis. Areas under the ROC curve (AUCs) were high in the 2-, 4-year and combined data models (0.843, 0.829 and 0.840; p<0.001, p<0.001 and p<0.001, respectively). In addition, even after rigorous overfitting correction, the incremental AUCs contributed by panels based on the 8 markers plus age vs. age alone were substantial (Δ-AUC = 0.152, 0.114 and 0.118, respectively) in all three models. A methylation biomarker-based panel to predict neoplastic progression in BE has potential clinical value in improving both the efficiency of surveillance endoscopy and the early detection of neoplasia

MicroRNAs in Barrett's esophagus and esophageal adenocarcinoma

The molecular genetics of Barrett's esophagus (BE) and its evolution to esophageal adenocarcinoma (EAC) have been widely studied; however, the molecular mechanism of BE-EAC carcinogenesis has not been completely understood. MicroRNA (miRNA) is now essential to understand the molecular mechanism of cancer progression. Recent findings include the following: firstly, miRNA expression profiles can distinguish between BE and EAC; secondly, miR-196a is upregulated in EAC tissues targeting annexin A1, thereby exerting antiapoptotic effects and contributing to EAC cell survival; miR-196a may also constitute a good biomarker of progression during BE-EAC carcinogenesis; and thirdly, The miR-106b-25 polycistron is activated by genomic amplification and is involved in esophageal neoplastic progression and proliferation via the suppression of two target genes, p21 and Bim

cDNA マイクロアレイ オ モチイタ ショクドウ ガン ニ オケル イデンシ ハツゲン プロファイル

京都大学0048新制・課程博士博士(医学)甲第10105号医博第2615号新制||医||830(附属図書館)UT51-2003-H526京都大学大学院医学研究科分子医学系専攻(主査)教授 小川 修, 教授 藤田 潤, 教授 今村 正之学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDA