Impact of preoperative pathological confirmation on surgical and postoperative outcomes of lung resection for early stage lung cancer

Introduction: The frequency of detection of peripheral pulmonary lesion (PPL) in suspected early lung cancer has been increasing, and whether preoperative pathological diagnosis (PPD) for small PPLs should always be established before their surgical resection can become a worrisome problem for physicians. The aim of the study was to clarify the impact of obtaining PPD on surgical and postoperative outcomes of lung resection for early stage lung cancer.Material and methods: This was a retrospective review of cases that underwent surgical resection for known or suspected primary lung cancer presenting pathological stage 0 or I, enrolled from June 2006 to May 2016. The patients divided into two groups according to PPD group (n = 57) and non-PPD group (n = 157) were compared. The procedure, node dissection, operation time, amount of bleeding, postoperative complications, postoperative length of stay, and postoperative recurrences were analyzed.Results: Among the 214 patients, no significant differences in operation time (248.5 ± 88.6 versus 257.6 ± 89.0, min, mean ± SD, p = 0.328), amount of bleeding (195.3 ± 176.5 vs 188.1 ± 236.1, ml, p = 0.460), postoperative complication (5.2% vs 4.5%, p = 0.728), postoperative length of stay (10.6 ± 6.3 vs 10.4 ± 5.3, days, p = 0.827), or postoperative recurrences (21.0% vs 17.2%, p = 0.550) were seen between PPD and non-PPD groups.Conclusion: Therefore, PPD had less impact on surgical and postoperative outcomes of pathological stage 0 or I lung cancer; direct surgical resection without non-surgical biopsy would be acceptable with careful selection of cases

COMT Val158Met, but not BDNF Val66Met, is associated with white matter abnormalities of the temporal lobe in patients with first-episode, treatment-naïve major depressive disorder: a diffusion tensor imaging study

We investigated the association between the Val158Met polymorphism of the catechol-O-methyltransferase (COMT) gene, the Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF) gene, and white matter changes in patients with major depressive disorder (MDD) and healthy subjects using diffusion tensor imaging (DTI). We studied 30 patients with MDD (17 males and 13 females, with mean age ± standard deviation [SD] =44±12 years) and 30 sex- and age-matched healthy controls (17 males and 13 females, aged 44±13 years). Using DTI analysis with a tract-based spatial statistics (TBSS) approach, we investigated the differences in fractional anisotropy, radial diffusivity, and axial diffusivity distribution among the three groups (patients with the COMT gene Val158Met, those with the BDNF gene Val66Met, and the healthy subjects). In a voxel-wise-based group comparison, we found significant decreases in fractional anisotropy and axial diffusivity within the temporal lobe white matter in the Met-carriers with MDD compared with the controls (P<0.05). No correlations in fractional anisotropy, axial diffusivity, or radial diffusivity were observed between the MDD patients and the controls, either among those with the BDNF Val/Val genotype or among the BDNF Met-carriers. These results suggest an association between the COMT gene Val158Met and the white matter abnormalities found in the temporal lobe of patients with MDD

The effects of culture on ambiguity and connotative meanings of thematic apperception cards

The present research was conducted to determine the influence of cultural factors upon cognitive assessment of Thematic Apperception Test cards. In the first study, a sample, consisting of 100 Japanese students, identified the major perceptual impact of TAT cards by specifying from a list of five alternative categories the one which best described a given card. The data were quantified by the uncertainty measure (H) in order to provide an indication of the ambiguity of each TAT card. The comparative Canadian data were obtained from Kuechler's (1961) study. A comparison of the rank order of the TAT cards for ambiguity yielded a significant correlation between sexes within a given culture; cross-cultural comparisons indicated that only the Japanese male rankings agreed with the male and female Canadian ratings. The Japanese female rankings did not relate to the Canadian rankings. To determine whether the connotative meaning of TAT cards is dependent upon cultural factors, a second study was conducted. Seventy Japanese students and 85 Canadian students rated each TAT card on twelve bipolar semantic scales which represented the general connotative factors of evaluation, potency and activity. The mean judgements for each TAT card against each semantic scale were correlated. Similarly, the rank orders of the general factors were correlated. High correlations obtained from these comparisons provide evidence for the validity of the placements of the semantic scales within their general factors. On the other hand, with the exception of the "meaningful-meaningless" semantic scale for the Japanese sample, the semantic space of connotative meanings generated by the scales of evaluation I and II are dissimilar. Osgood's hypothesis that evaluation, activity and potency are distinct general factors was not upheld. Finally, the correlation between the rankings of the TAT cards, based on the uncertainty measure and the semantic scales, were determined. The results showed that ambiguous cards are viewed as "active" and "potent" by Canadian subjects. Contrary to expectation, evaluation II correlated positively with degree of ambiguity. These findings are, however, unique to the Canadian groups: with one minor exception, Japanese semantic factor rankings did not correlate with ambiguity rankings. Such results most clearly demonstrate cultural influences on the relations between ambiguity and connotative correlates of pictorial stimuli. To provide a comprehensive picture of the influence of culture and sex on the semantic differential results, a Chi square analysis was applied cross culturally and between sexes. It was found that a greater distinction exists between cultures than between sexes in the same culture. An important finding was that cultural differences were expressed more significantly on the semantic scales than on the cards per se. It may be concluded that the semantic correlates of ambiguity only hold for the Canadian sample and that Japanese males are closer than Japanese females to Canadian individuals. The results generally support the hypothesis of cultural influence upon an individual's manner of cognitive responses to perceptual stimuli.Arts, Faculty ofPsychology, Department ofGraduat

Phase I study of BGT226, a pan-PI3K and mTOR inhibitor, in Japanese patients with advanced solid cancers

The phosphatidylinositol 3-kinase (PI3K) pathway is a promising therapeutic target for various cancers. BGT226 is a pan-PI3K and mammalian target of rapamycin (mTOR) inhibitor. The tolerability and pharmacokinetics/pharmacodynamics of BGT226 were investigated in a phase I study in Japanese patients with advanced solid cancers. BGT226 was orally administered on days 1, 3, and 5 of each week. The initial dose of 10 mg was subsequently escalated to 20, 40, 80, and 100 mg in a cohort of three patients. Pharmacokinetics and pharmacodynamics were investigated using plasma, normal skin, and tumor samples. A total of 18 patients were enrolled and evaluated. The most frequently reported toxicities were diarrhea, nausea, decreased appetite, vomiting, and fatigue. They were all grade 1 or 2, and no dose-limiting toxicity was observed. However, all six patients treated at 100 mg experienced diarrhea and nausea, while two experienced a dose reduction and/or interruptions during the study. Two of five patients who exhibited stable disease continued the study treatment for ≥ 16 weeks. The absorption of BGT226 was rapid, and systemic exposure increased in a dose-dependent manner. Treatment with BGT226 did not change any of the biomarkers in neither normal skin nor tumor tissues. BGT226 was tolerated up to 100 mg three times a week in Japanese patients with solid cancers, without difference in toxicity profiles and pharmacokinetics compared to Western patients