Tumorigenicity, Motility and Liver Metastasis of Human Gastric Carcinoma Lines with High Metastatic Potential in the Liver of Nude Mice

To analyze the human gastric carcinoma metastasis to the liver, a human gastric carcinoma line, AZ521 was injected into the spleens of nude mice. Cells from the few liver metastatic foci of injected AZ521 were expanded in vitro and subsequently injected into the spleens of nude mice. By repeating these proce-dures five times, we were able to obtain a cell line, designated AZ-H5c, with high metastatic potential in nude mice. It was observed that animals had liver metastasis in 10 of 12 (83%) cases injected with AZ-H5c, whereas only 14% with parental AZ521. The growth activity in vivo of AZ-H5c cells is much more rapid than that of AZ521 cells, but its growth activity in vitro is slower. The mortile activity in vitro of AZ-H5c is stronger than that of AZ521. These results suggest that our model can provide a new approach to basic and clinical studies of cancer metastasis

Patient-reported dyspnea and health predict waitlist mortality in patients waiting for lung transplantation in Japan

Background: Waitlist mortality due to donor shortage for lung transplantation is a serious problem worldwide. Currently, the selection of recipients in Japan is mainly based on the registration order. Hence, scientific evidence for risk stratification regarding waitlist mortality is urgently needed. We hypothesized that patient-reported dyspnea and health would predict mortality in patients waitlisted for lung transplantation. Methods: We analyzed factors related to waitlist mortality using data of 203 patients who were registered as candidates for lung transplantation from deceased donors. Dyspnea was evaluated using the modified Medical Research Council (mMRC) dyspnea scale, and the health status was determined with St. George's Respiratory Questionnaire (SGRQ). Results: Among 197 patients who met the inclusion criteria, the main underlying disease was interstitial lung disease (99 patients). During the median follow-up period of 572 days, 72 patients died and 96 received lung transplantation (69 from deceased donors). Univariable competing risk analyses revealed that both mMRC dyspnea and SGRQ Total score were significantly associated with waitlist mortality (p = 0.003 and p < 0.001, respectively) as well as age, interstitial lung disease, arterial partial pressure of carbon dioxide, and forced vital capacity. Multivariable competing risk analyses revealed that the mMRC and SGRQ score were associated with waitlist mortality in addition to age and interstitial lung disease. Conclusions: Both mMRC dyspnea and SGRQ score were significantly associated with waitlist mortality, in addition to other clinical variables such as patients' background, underlying disease, and pulmonary function. Patient-reported dyspnea and health may be measured through multi-dimensional analysis (including subjective perceptions) and for risk stratification regarding waitlist mortality

Utility of a simplified ultrasonography scoring system among patients with rheumatoid arthritis: A multicenter cohort study

ABSTRACT: We aimed to evaluate the utility of a simplified ultrasonography (US) scoring system, which is desired in daily clinical practice, among patients with rheumatoid arthritis (RA) receiving biological/targeted synthetic disease-modifying antirheumatic drugs (DMARDs).A total of 289 Japanese patients with RA who were started on tumor necrosis factor inhibitors, abatacept, tocilizumab, or Janus kinase inhibitors between June 2013 and April 2019 at one of the 15 participating rheumatology centers were reviewed. We performed US assessment of articular synovia over 22 joints among bilateral wrist and finger joints, and the 22-joint (22j)-GS and 22-joint (22j)-PD scores were evaluated as an indicator of US activity using the sum of the GS and PD scores, respectively.The top 6 most affected joints included the bilateral wrist and second/third metacarpophalangeal joints. Therefore, 6-joint (6j)-GS and -PD scores were defined as the sum of the GS and PD scores from the 6 synovial sites over the aforementioned 6 joints, respectively. Although the 22j- or 6j-US scores were significantly correlated with DAS28-ESR or -CRP scores, the correlations were weak. Conversely, 6j-US scores were significantly and strongly correlated with 22j-US scores not only at baseline but also after therapy initiation.Using a multicenter cohort data, our results indicated that a simplified US scoring system could be adequately tolerated during any disease course among patients with RA receiving biological/targeted synthetic DMARDs

Structural properties in ruptured mitral chordae tendineae measured by synchrotron-based X-ray phase computed tomography

The link between the structural properties and the rupturing of chordae tendineae in the mitral valve complex is still unclear. Synchrotron-radiation-based X-ray phase computed tomography (SR-XPCT) imaging is an innovative way to quantitatively analyze three-dimensional morphology. XPCT has been employed in this study to evaluate the chordae tendineae from patients with mitral regurgitation and to analyze structural changes in the ruptured chordae tendineae in patients with this condition. Six ruptured mitral chordae tendineae were obtained during surgical repairs for mitral regurgitation and were fixed with formalin. In addition, 12 healthy chordae tendineae were obtained from autopsies. Employing XPCT (effective pixel size, 3.5 µm; density resolution, 1 mg cm−3), the density of the chordae tendineae in each sample was measured. The specimens were subsequently analyzed pathologically. The mean age was 70.2 ± 3.0 in the rupture group and 67.2 ± 14.1 years old in the control group (p = 0.4927). All scans of chorda tendineae with SR-XPCT were performed successfully. The mean densities were 1.029 ± 0.004 in the rupture group and 1.085 ± 0.015 g cm−3 in the control group (p < 0.0001). Density based on SR-XPCT in the ruptured mitral chordae tendineae was significantly lower compared with the healthy chorda tendinea. Histological examination revealed a change in the components of the connective tissues in ruptured chorda tendinea, in accordance with the low density measured by SR-XPCT. SR-XPCT made it possible to measure tissue density in mitral chordae tendineae. Low density in mitral chordae tendineae is associated with a greater fragility in ruptured mitral chordae tendineae

Pancreatectomies for Benign or Borderline Malignant Cystic Tumors of the Pancreas

At present, benign or borderline malignant cystic tumors located in the head, uncus, body or tail of the pancreas that are not small and superficial enough to be enucleated are usually resected with a pancreatoduodenectomy (PD) or digital pancreatectomy (DP). Such operations may cause digestive disorders, glucose intolerance. Duodenum-preserving pancreatoduodenectomy (DpPHR), uncinate resection (UR), segmental pancreatectomy (SR) and spleenpreserving distall pancreatectomy (SpDP) are function-preserving procedures. The purpose of this study was to evaluate whether DpPHR, SR and SpDP were valuable procedures in pancreatic surgery. Patients were treated by DpPHR (n=7;1 serous cystadenoma, 1 mucinous cystadenoma, 5 intraductal papillary mucinous tumors), UR (n=1;1 intraductal papillary mucinous tumor), SR (n=4;1 solid and cystic tumor, 1 serous cystadenoma, 2 mucinous cystadenomas) and SpDP (n=7; 5 mucinous cystadenomas, 2 intraductal papillary mucinous tumors), There were no fatalities during or immediately following surgery. All patients but one were not glucose intolerance and digestive disorders.We believe that DpPHR, UR, SR and SpDP were minimally invasive procedures in pancreatic surgery;it is a reliable technique for benign or borderline malignant cystic tumors and has a surgical risk similar to that of standard operations. Its principal advantage is that it preserves pancreatic parenchyma, biliary tract and the spleen better than PD or D

Pancreatectomies for Benign or Borderline Malignant Cystic Tumors of the Pancreas

At present, benign or borderline malignant cystic tumors located in the head, uncus, body or tail of the pancreas that are not small and superficial enough to be enucleated are usually resected with a pancreatoduodenectomy (PD) or digital pancreatectomy (DP). Such operations may cause digestive disorders, glucose intolerance. Duodenum-preserving pancreatoduodenectomy (DpPHR), uncinate resection (UR), segmental pancreatectomy (SR) and spleenpreserving distall pancreatectomy (SpDP) are function-preserving procedures. The purpose of this study was to evaluate whether DpPHR, SR and SpDP were valuable procedures in pancreatic surgery. Patients were treated by DpPHR (n=7;1 serous cystadenoma, 1 mucinous cystadenoma, 5 intraductal papillary mucinous tumors), UR (n=1;1 intraductal papillary mucinous tumor), SR (n=4;1 solid and cystic tumor, 1 serous cystadenoma, 2 mucinous cystadenomas) and SpDP (n=7; 5 mucinous cystadenomas, 2 intraductal papillary mucinous tumors), There were no fatalities during or immediately following surgery. All patients but one were not glucose intolerance and digestive disorders.We believe that DpPHR, UR, SR and SpDP were minimally invasive procedures in pancreatic surgery;it is a reliable technique for benign or borderline malignant cystic tumors and has a surgical risk similar to that of standard operations. Its principal advantage is that it preserves pancreatic parenchyma, biliary tract and the spleen better than PD or D