958 research outputs found

    Should hepatomas be treated with hepatic resection or transplantation?

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    BACKGROUND: The aim of this collaborative study was to compare the long term results of hepatic resection (Hx) with those of orthotopic liver transplantation (OLTx) in large numbers of cirrhotic patients with hepatocellular carcinoma (HCC) and to delineate the roles of these two surgical treatments. METHODS: The databases of the National Cancer Center Hospital in Japan and the University of Pittsburgh Medical Center in the U. S. were exchanged and 294 cirrhotic patients who underwent curative Hx and 270 cirrhotic patients who underwent curative OLTx were selected for comparison. RESULTS: The mortality rate within 30 days and that within 150 days after Hx were significantly lower than those after OLTx (P = 0.001 and P = 0.00007, respectively). Overall survival was similar between the Hx group and the OLTx group (P = 0.40). When compared in the HCC patients without macroscopic vascular invasion and lymph node metastases, the overall survival rate after OLTx was significantly higher than that after Hx (P = 0.006). However, this difference was not significant between the patients with Child-Pugh Grade A tumors in the Hx group and all patients (majority with Child-Pugh Grade C tumors) in the OLTx group (P = 0.25). Tumor free survival after OLTx was significantly higher than that after Hx (P 5 cm and those with macroscopic vascular invasion, the tumor free survival rate was similar between the Hx group and the OLTx group. CONCLUSIONS: In the face of organ shortage, HCC developing in a well compensated cirrhotic liver initially may be treated with Hx. However, the authors believe OLTx should be applied selectively to those patients with tumor recurrence and/or progressive hepatic failure

    The lanthanum(III) molybdate(VI) La4Mo7O27

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    Crystals of the ortho­rhom­bic phase La4Mo7O27 (lanthanum molybdenum oxide) were obtained from a non-stoichiometric melt in the pseudo-ternary system La2O3–MoO3–B2O3. In the crystal structure, distorted square-anti­prismatic [LaO8] and monocapped square-anti­prismatic [LaO9] polyhedra are connected via common edges and faces into chains along [010]. These chains are arranged in layers that alternate with layers of [MoO4] and [MoO5] polyhedra parallel to (001). In the molybdate layers, a distorted [MoO5] trigonal bipyramid is axially connected to two [MoO4] tetra­hedra, forming a [Mo3O11] unit

    First examples of polynuclear lanthanide diethylene glycol based coordination clusters

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    Five lanthanide coordination clusters (CCs) [Ln7(μ3-OH)4(deg)2(Hdeg)2(ben)11]·xCH3CN [Ln=Eu (1), Gd (2), Tb (3), Dy (4), Ho (5); H2deg=diethylene glycol, Hben=benzoic acid, x=7 for 1-4 and 6 for 5] with diethylene glycol and benzoic acid as ligands have been prepared and structurally characterized. All CCs consist of a heptanuclear lanthanide core with a scarce tip-sharing double-butterfly topology. Magnetic measurements revealed that CC 4 exhibits slow magnetic relaxation with an energy barrier of about 6K, whereas CC 3 shows outstanding magnetocaloric effect with entropy change of 34.6 J Kg-1 K-1 at 2K and ΔH=7T. The photoluminescent properties of CCs 1, 3 and 4 were also investigated, displaying intense characteristic emission spectra of EuIII, TbIII and DyIII ions

    The Prognostic Significance of Multiple Station N2 in Patients with Surgically Resected Stage IIIA N2 Non-small Cell Lung Cancer

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    Mediastinal (N2) lymph node involvement is heterogenous with huge variation in the extent and grouped together under stage IIIA. However, they showed a different survival even in the same stage. We tried to determine the prognostic implication of the multiple station N2 lymph node metastasis in stage IIIA N2 non-small cell lung cancer (NSCLC). The survival of stage IIIA N2 was analyzed according to the number of N2 station and their survival was compared with that of stage IIIB. In stage IIIA N2 NSCLC, multivariate analysis indicated that multiple station N2 was one of the independent prognostic factors for poor survival. The 5-yr survival of multiple station N2 IIIA (20.4%) was lower than that of single station N2 IIIA (33.8%) significantly (p=0.016). but when it was compared with that of stage IIIB (15.5%), there was no difference. Therefore, we suggest that multiple station N2 should be considered similar to stage IIIB disease with regard to predicting survival and accordingly should receive a new position in the TNM staging system

    Europium(III) Luminescence and Intramolecular Energy Transfer Studies of Polyoxometalloeuropates

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    The photoexcitation in the oxygen-to-metal (M ) Nb or W) charge transfer (OfM lmct) bands of two X-ray crystallographically characterized polyoxometalloeuropates, N

    Coexistence of Non-Lower Body Mass Index and Exercise Habits Reduce Readmission in Older Patients With Heart Failure

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    Objective To investigate the impact of body mass index (BMI) and exercise habits on readmission rates among older patients with heart failure. Methods Ninety-seven older patients admitted for heart failure (median age: 81 years; 57.7% male) were included in the study. Patients were categorized into four groups based on the presence or absence of lower BMI and/or the absence of exercise habits. Lower BMI was defined as BMI<20.3 kg/m2 at discharge and exercise habits were defined as engaging in 30 or more minutes of moderate or vigorous exercise at least once a week. The primary outcome was all-cause readmission during the 1-year follow-up period. Results The patients were distributed across four groups: lower BMI/non-exerciser (n=24, 24.7%), lower BMI/exerciser (n=22, 22.7%), non-lower BMI/non-exerciser (n=21, 21.6%), and non-lower BMI/exerciser (n=30, 30.9%). Forty-six patients (47.4%) experienced readmission during the 1-year follow-up period. In a cox proportional hazard analysis, non-lower BMI/exerciser remained an independent prognostic factor even after adjusting for confounding factors (non-lower BMI/exerciser vs. lower BMI/non-exerciser: hazard ratio, 0.26; 95% confidence interval, 0.08–0.83; p=0.022). Conclusion The coexistence of non-lower BMI and regular exercise habits may reduce readmission during the 1-year in older patients with heart failure. Therefore, it is imperative to conduct appropriate nutritional assessments for patients with lower BMI at discharge. Additionally, promoting and monitoring sustained physical activity after discharge is crucial for older patients with heart failure

    Differential Expression of Vascular Endothelial Growth Factor (VEGF) and VEGF Receptors in the Sequence of Hyperplastic Polyp, Serrated Adenoma and Adenocarcinoma of Colorectum

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    AIM: The aim of this study was to investigate the role for vascular endothelial growth factor (VEGF) and its receptors, VEGFR-1 and -2, in the hyperplastic polyp (HP)- serrated adenoma (SA)-adenocarcinoma (AC) sequence of the colorectum.Methods: Thirty-six HPs, 33 SAs and 7 ACs (which contained HP and/or SA) were immunohistochemically examined for the expression of VEGF, VEGFR-1, and VEGFR-2.Results: VEGF protein was expressed in the cytoplasm of SA and AC tumor cells, and VEGFR-1 and VEGFR-2 were expressed both in the cytoplasm and on the membrane of these tumors, while there was faint or no expression of VEGF, VEGFR-1 and VEGFR-2 in HPs. Immunohistochemical staining revealed that 8.3% (3 of 36) HPs, 87.9% (29 of 33) SAs and 100% (7 of 7) ACs were positive for VEGF; 2.8% (1 of 36) HPs, 97.0% (32 of 33) SAs and 100% (7 of 7) ACs were positive for VEGFR-1; 16.7% (6 of 36) HPs, 100% (33 of 33) SAs and 100% (7 of 7) ACs were positive for VEGFR-2. The expression of VEGF, VEGFR-1 or VEGFR-2 was statistically correlated with the sequence of HP, SA and AC (P < 0.0001, respectively) Conclusion: Our results suggest that the VEGF pathway may play an important role in the HP-SA-AC sequence

    Immunohistochemical analyses of beta-catenin and cyclin D1 expression in giant cell tumor of bone (GCTB): A possible role of Wnt pathway in GCTB tumorigenesis.

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    Giant cell tumor of bone (GCTB) is a benign neoplasm but occasionally shows local recurrence, and histologically consists of osteoclast-like giant cells (GC) and stromal mononuclear cells (SC), which are capable of proliferation and osteoblastic differentiation. Activation of Wnt signaling can induce osteoblast differentiation and osteoclastgenesis during bone resorption process. This study analyzed the profiles of beta-catenin and cyclin D1 expression in GCTB to elucidate an involvement of Wnt pathway in tumorigenesis. We performed immunohistochemistry for beta-catenin, cyclin D1, and Ki-67 in 16 GCTB tumors, including 5 recurrent cases that were surgically resected. All 16 cases of GCTB displayed beta-catenin, cyclin D1, and Ki-67 expression. Immunoreactivity for beta-catenin was observed in nuclei of SC and GC. Cyclin D1 immunoreactivity was found mainly in nuclei of GC, while Ki-67 immunoreactivity was restricted to nuclei of SC. The nuclear beta-catenin labeling index (LI) in both SC (60.6 vs. 41.8%, p=0.074) and GC (41.7 vs. 20.1%, p=0.095) was higher in recurrent tumors than in primary tumors in all the 4 cases. However, Ki-67 LI in SC (18.8 vs. 19.9%, p=0.851) and cyclin D1 LI in GC (55.4 vs. 70.1%, p=0.225) were not higher in recurrent tumors than in primary tumors. Our results suggested activation of Wnt/ beta-catenin pathway in GCTB tumorigenesis. Since cyclin D1 in GC was never associated with the expression of the well-known proliferative marker Ki-67, cyclin D1 expression might play a role in GC formation instead of promoting cell proliferation during GCTB tumorigenesis. Importantly, it was suggested that the nuclear beta-catenin staining level might be associated with tumor recurrence in GCTB
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