Superficial Depressed Type (IIc) Early Cancer of the Colon : Report of Two Cases

Two cases of superficial depressed type (IIc) early cancer of the colon are reported. Case 1 was a 65-year-old male and case 2 a 69-year old male. The lesion was located in the descending colon in both cases, and was removed by strip biopsy endoscopically in the former and surgically in the latter. The size of the lesion after resection was 6 mm in case 1 and 5 mm in case 2. Histopathologically, both cases were well differentiated adenocarcinoma without adenomatous components, and carcinoma developed de novo by submucosal (sm) invasion. As to the immunohistochemical staining of the cancer tissue by tumor associated antigen, case 1 showed a strong expression of carcinoembrionic antigen (CEA) and partial expression of sialyl Lewisx, and case 2 showed expressions of both CEA and sialyl Lewisx . The nuclear DNA content by flow cytometry was aneuploid only in case 1. Thus, although the two cases were morphologically the same IIc type cancer, the process of carcinogenesis and secondary phenomena varied

Characterization of CYCLOIDEA-like genes in controlling floral zygomorphy in the monocotyledon Alstroemeria

The CYCLOIDEA (CYC) gene controls the development of zygomorphic flowers and the determination of adaxial identity of floral organs in the model developmental system of Antirrhinum majus. However, whether CYC homologue genes also control floral zygomorphy in monocotyledon Alstroemeria plants is yet unknown. In this study, we investigated CYC-like genes in the monocotyledons Alstroemeria aurea, Alstroemeria magenta, and Alstroemeria pelegrina var. rosea, all of which have zygomorphic flowers. Since the CYC gene belongs to the T-complex protein (TCP) gene family of transcription factors, cloning of CYC-like sequences was performed using rapid amplification of cDNA ends (RACE)-polymerase chain reaction (PCR) by using degenerate primers designed for the TCP domain. We cloned 1 CYC-like sequence each from A. aurea (AaTCP1, accession number AB714967 in the GenBank/EMBL/DDBJ databases) and A. magenta (AmTCP1, AB714970), and two CYC-like sequences from A. pelegrina var. rosea (ApTCP1, AB714968; and ApTCP2, AB714969). The deduced amino acid sequences of AaTCP1, AmTCP1, ApTCP1, and ApTCP2 shared 67.7%, 67.7%, 71.0%, and 64.5% identities, respectively, with the TCP domain in CYC. Molecular phylogenetic analysis indicated that three CYC-like genes from Alstroemeria belonged to the ZinTBL1b clade in the CYC-/tb1-like subfamily. Reverse transcription (RT)-PCR and in situ hybridization analyses showed that AaTCP1 transcripts were specifically detected in flower buds and localized in the base of adaxial inner perianth of A. aurea. These results suggest that CYC-like genes are also involved in the development of floral asymmetry and the determination of adaxial identity of floral organs in the monocotyledon Alstroemeria

Morphological Changes in the Foveal Avascular Zone after Panretinal Photocoagulation for Diabetic Retinopathy Using OCTA: A Study Focusing on Macular Ischemia

Background and objectives: This study aimed to analyze the morphological changes in the foveal avascular zone (FAZ) after panretinal photocoagulation (PRP) in patients with diabetic retinopathy, with a particular focus on the presence or absence of comorbid diabetic macular ischemia (DMI), using optical coherence tomography angiography (OCTA). Materials and Methods: Treatment-naïve 25 eyes of 16 patients who received PRP were examined in this retrospective case series. FAZ area, perimeter, and circularity were calculated on a 3 × 3-mm en-face OCTA image before PRP (baseline) and 1 and 3 months after PRP. The patients were divided into two groups according to coexisting DMI, and each group was statistically analyzed. Results: In patients with DMI (9 eyes), FAZ area significantly decreased from the baseline to 3 months after PRP (0.86 ± 0.56 to 0.61 ± 0.31 mm2, p = 0.018), whereas FAZ perimeter and circularity remained unchanged following treatment (p = 0.569 and 0.971, respectively). In patients without DMI (16 eyes), FAZ parameters did not show statistically significant changes across the 3-month follow-up period. Conclusion: PRP significantly reduces FAZ area in patients with DMI

地域自立高齢者の口腔の主観的健康感と医療費との関係

Objectives: The increasing medical expenses of elderly persons in Japan’s rapidly ageing society have become a major concern. It is therefore important to elucidate the factors associated with such escalation. Here, we focused on the relationship between subjective self-assessment of oral health, as an index of general health, and medical expenses (excluding dental repair) under the hypothesis that oral health contributes to general medical expenses. Several studies have shown that oral health status is correlated with general health status among elderly persons. We speculated that oral health status might show a relation with medical costs among elderly persons. However, few studies have investigated this relationship to date. Materials and Methods: Participants were 259 elderly subjects (range: 65–84 years; 120 men, 139 women) residing independently. Subjective assessment of oral health was evaluated by their responses (‘Good’, ‘Not good’ and ‘Not at all good’) on a survey questionnaire. The correlation between subjective assessment of oral health and medical expenditure was analysed using Spearman’s rank method, the Mann–Whitney U-test and the Kruskal–Wallis test. Medical expenses were used as the dependent variable in multinomial logistic regression analysis with background and intraoral factors as independent variables. Results: A slight yet statistically significant correlation was observed between subjective assessment of oral health and outpatient treatment fees. Conclusion: The findings revealed that subjective assessment of oral health is significantly and independently related to the medical expenses of community-dwelling elderly persons after adjusting for social background, living environment and physical factors.掲載誌情報：Gerodontology. Vol.29(2), pp. e246-e252, June 2012.doi: 10.1111/j.1741-2358.2011.00459.x

Self-assessed Impairment of Masticatory Ability and Lower Serum Albumin Levels Among Community-dwelling Elderly Persons

Background: Serum albumin is considered a key nutrient that is significantly related to general health among elderly persons. The aim of the present study was to determine the relationship between masticatory ability and serum albumin levels in the elderly. Methods: A total of 768 persons were enrolled in the study. Data on background factors and the self-assessed masticatory ability were collected by means of questionnaires. An intraoral examination was performed to examine the pattern of occluding pairs of natural teeth, and blood samples were collected from the cutaneous vein to measure serum albumin levels. A forward stepwise multivariate logistic model was constructed with serum albumin levels as the dependent variable and the self-assessed masticatory ability as the principal independent variable, to adjust for potential confounding variables. Results: Sex, current employment status, social interaction, and self-assessed masticatory ability were retained in the final model, and they were significantly associated with serum albumin levels. The odds ratios for lower levels of serum albumin (≤ 40 g/L) were 1.88 for males, 1.70 for non-working status, 1.55 for low social activity status, and 1.43 for the self-assessed impairment of masticatory ability. Conclusion: A weak, statistically significant relationship may exist between self-assessed impairment of masticatory ability and lower levels of serum albumin in the elderly living independently

An Asian multi-national multi-institutional retrospective study comparing intracavitary versus the hybrid of intracavitary and interstitial brachytherapy for locally advanced uterine cervical carcinoma.

This study is an international multi-institutional retrospective study comparing the clinical outcomes between intracavitary brachytherapy (ICBT) and the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients treated with definitive radiation therapy. Locally advanced cervical cancer, the initial size of which is larger than 4 cm and treated by concurrent chemoradiotherapy and image-guided adaptive brachytherapy, were eligible for this retrospective study. Patients who received HBT at least once were included in the HBT group, and patients who received only ICBT were included in the ICBT group. Anonymized data from 469 patients from 13 institutions in Japan, one from Korea and one from Thailand, were analyzed. Two hundred eighty and 189 patients were included in the ICBT group and the HBT group, respectively. Patients in the HBT group had more advanced stage, non-Scc histopathology, a higher rate of uterine body involvement, larger tumor at diagnosis, larger tumor before brachytherapy and a lower tumor reduction ratio. With a median follow-up of 51.3 months (2.1-139.9 months), 4-y local control (LC), progression-free survival (PFS) and overall survival (OS) for the entire patient population were 88.2%, 64.2% and 83%, respectively. The HBT group received a higher HR-CTV D90 than that of the ICBT group (68.8 Gy vs 65.6 Gy, P = 0.001). In multivariate analysis, the non-Scc histological subtype, HR-CTV D95 ≤ 60 Gy, reduction ratio ≤ 29% and total treatment time (TTT) ≥ 9 weeks were identified as the independent adverse prognostic factors for LC. Regarding LC, no difference was found between ICBT and HBT (4-y LC 89.3% vs 86.8%, P = 0.314). After adjustment for confounding factors by propensity score matching, no advantage of applying HBT was demonstrated regarding LC, PFS, or OS. Despite the fact that HBT patients had more adverse clinical factors than ICBT patients, HBT delivered a higher dose to HR-CTV and resulted in comparable LC