Association of dental occlusal support with the Prognostic Nutritional Index in patients with esophageal cancer who underwent esophagectomy

Background The Prognostic Nutritional Index is useful for predicting surgical risk and overall survival based on preoperative immunological and nutritional status in patients undergoing digestive organ cancer surgery. The purpose of this study was to examine the association between the Prognostic Nutritional Index and dental status in patients with esophageal cancer who underwent esophagectomy. Methods This retrospective case–control study included 73 patients who underwent resection of esophageal cancer (69 males, 4 females; age 36–83). General and dental status were evaluated. The Prognostic Nutritional Index was calculated based on the serum albumin concentration and the total lymphocyte count, and subjects were divided into two groups based on index scores: a higher group, characterized by scores ≥ 45 (n = 54); and a lower group, characterized by scores Results Total protein, C-reactive protein, the number of sound and total decayed, missing and filled teeth, and the rate of patients with poor dental occlusal support showed significant differences between the lower and higher Prognostic Nutritional Index groups (p  Conclusion Dental status, especially dental occlusal support and the number of sound teeth, showed a positive relationship with the Prognostic Nutritional Index in esophageal cancer patients who underwent esophagectomy

Change in tongue pressure and the related factors after esophagectomy: a short-term, longitudinal study.

BACKGROUND: Dysphagia is a prominent symptom after esophagectomy and may cause aspiration pneumonia. Swallowing evaluation after esophagectomy can predict and help control the incidence of postoperative pneumonia. The aim of this study was to clarify whether the change in tongue pressure was associated with any related factor and postoperative dysphagia/pneumonia in patients with esophageal cancer after esophagectomy. METHODS: Fifty-nine inpatients (41 males and 18 females; 33-77 years old) who underwent esophagectomy participated in this study. Measurement of tongue pressure and the repetitive saliva swallowing test (RSST) was performed before esophagectomy (baseline) and at 2 weeks postoperatively. The general data were collected from patients' medical records, including sex, age, type of cancer, cancer stage, location of cancer, operative approach, history of previous chemotherapy, surgical duration, amount of bleeding during surgery, incidences of postoperative complications, intubation period, period between surgery and initiation of oral alimentation, and intensive care unit (ICU) stay, blood chemical analysis, and lifestyle. RESULTS: Tongue pressure decreased significantly after esophagectomy (p = 0.011). The decrease of tongue pressure was significantly associated with length of ICU stay and preoperative tongue pressure on multiple regression analysis (p  CONCLUSIONS: The decrease in tongue pressure was significantly associated with the length of ICU stay, preoperative tongue pressure, and the incidence of dysphagia and pneumonia among inpatient after esophagectomy

Clinical Results of Flow Diverter Treatments for Cerebral Aneurysms under Local Anesthesia

Flow diverters (FD) have become the mainstay for the endovascular treatment of unruptured intracranial aneurysms (UIA). Most FD procedures are performed under general anesthesia, and the influence of local anesthesia (LA) on outcomes remains unknown. This study evaluated the results of FD placement under LA. Data of patients treated for FD under LA between August 2016 and January 2022 were analyzed retrospectively. A good outcome was defined as a modified Rankin scale score of 0–2. Major stroke, steno-occlusive events of FD, mortality, and satisfactory aneurysm occlusion were also evaluated. In total, 169 patients undertook 182 treatments (139 [82%) female, mean age 61 ± 11 years). The median maximum aneurysm size was 9.5 mm (interquartile range 6.1-14 mm). A flow re-directed endoluminal device and pipeline embolization device were used in 103 (57%) and 78 (43%) treatments. One patient (0.59%) experienced major stroke, and steno-occlusive events were observed in four patients (2.4%). A good outcome at 90 days was obtained in 164 patients (98%), and one patient died (0.59% mortality). During the median follow-up period of 345 days (interquartile range 176–366 days), satisfactory aneurysm occlusion was observed in 126 of 160 aneurysms (79%). Our results suggest that FD placement under LA is a safe and effective treatment for UIA

Endovascular Treatment of Acute Ischemic Stroke: Honolulu Shock and Thereafter

Recently, use of mechanical clot retrievers for acute stroke has gradually spread. However, 3 recent randomized controlled trials failed to show superiority of endovascular treatment compared to intravenous recombinant tissue plasminogen activator (IV rt-PA) alone or standard care. On the other hand, a Japanese nationwide survey demonstrated the efficacy of endovascular treatment in the IV rt-PA failed and ineligible patients, especially with the proximal artery occlusion such as the internal carotid artery. Earlier initiation and higher reperfusion of endovascular treatment seemed to be the main reason for the better result in this survey compared with the reported randomized studies. Because next-generation devices such as stent retrievers have been shown to provide better effects in terms of clinical outcomes compared with the Merci retriever, the efficacy of endovascular treatment is expected to be confirmed again by randomized controlled trials in the near future

Intravenous Administration of Human Amniotic Mesenchymal Stem Cells in the Subacute Phase of Cerebral Infarction in a Mouse Model Ameliorates Neurological Disturbance by Suppressing Blood Brain Barrier Disruption and Apoptosis via Immunomodulation

Neuro-inflammation plays a key role in the pathophysiology of brain infarction. Cell therapy offers a novel therapeutic option due to its effect on immunomodulatory effects. Amniotic stem cells, in particular, show promise owing to their low immunogenicity, tumorigenicity, and easy availability from amniotic membranes discarded following birth. We have successfully isolated and expanded human amniotic mesenchymal stem cells (hAMSCs). Herein, we evaluated the therapeutic effect of hAMSCs on neurological deficits after brain infarction as well as their immunomodulatory effects in a mouse model in order to understand their mechanisms of action. One day after permanent occlusion of the middle cerebral artery (MCAO), hAMSCs were intravenously administered. RT-qPCR for TNFα, iNOS, MMP2, and MMP9, immunofluorescence staining for iNOS and CD11b/c, and a TUNEL assay were performed 8 days following MCAO. An Evans Blue assay and behavioral tests were performed 2 days and several months following MCAO, respectively. The results suggest that the neurological deficits caused by cerebral infarction are improved in dose-dependent manner by the administration of hAMSCs. The mechanism appears to be through a reduction in disruption of the blood brain barrier and apoptosis in the peri-infarct region through the suppression of pro-inflammatory cytokines and the M2-to-M1 phenotype shift