Gemcitabine sensitivity-related mRNA expression in endoscopic ultrasound-guided fine-needle aspiration biopsy of unresectable pancreatic cancer

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to determine a predictive indicator of gemcitabine (GEM) efficacy in unresectable pancreatic cancer using tissue obtained by endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA).</p> <p>Methods</p> <p>mRNAs extracted from 35 pancreatic tubular adenocarcinoma tissues obtained by EUS-FNA before GEM-treatment were studied. mRNAs were amplified and applied to a Focused DNA Array, which was restricted to well-known genes, including GEM sensitivity-related genes, deoxycytidine kinase (dCK), human equilibrative nucleoside transporter 1 (hENT1), hENT2, dCMP deaminase, cytidine deaminase, 5'-nucleotidase, ribonucleotide reductase 1 (RRM1) and RRM2. mRNA levels were classified into high and low expression based on a cut-off value defined as the average expression of 35 samples. These 35 patients were divided into the following two groups. Patients with partial response and those with stable disease whose tumor markers decreased by 50% or more were classified as the effective group. The rest of patients were classified as the non-effective group. The relationship between GEM efficacy and mRNA expression was then examined by chi-squared test.</p> <p>Results</p> <p>Among these GEM sensitivity-related genes, dCK alone showed a significant correlation with GEM efficacy. Eight of 12 patients in the effective group had high dCK expression, whereas 16 of 23 patients in non-effective group had low dCK expressions (<it>P </it>= 0.0398).</p> <p>Conclusion</p> <p>dCK mRNA expression is a candidate indicator for GEM efficacy in unresectable pancreatic cancer. Quantitative mRNA measurements of dCK using EUS-FNA samples are necessary for definitive conclusions.</p

Geology of the Eoarchean, >3.95Ga, Nulliak supracrustal rocks in the Saglek Block, northern Labrador, Canada: the oldest geological evidence for plate tectonics

The Earth is a unique planet, which has been highly evolved, diversified and complicated through geologic time, and underwent many key events, including giant impact, magma ocean, core formation, large-scale mantle differentiation and late heavy bombardment, especially in its dawn. But, our knowledge of early Earth is limited due to the lack of the Hadean supracrustal rocks. The supracrustal rocks with the Eoarchean ages provide key evidence for the Earth's early evolution, but few supracrustal rocks have been comprehensively investigated. Therefore, we mapped in seven areas of the Saglek Block, northern Labrador, where ancient supracrustal sequences are interleaved with a diverse assemblage of orthogneisses. Early studies suggested that some of them have the Mesoarchean ages because of the lack of the Mesoarchean Saglek dyke, but we found the Saglek dykes in the areas to recognize the Eoarchean Nulliak supracrustal rocks and Uivak Gneiss in all the areas. Recent reassessment of U–Pb dating and cathodoluminescence observation of zircons from the oldest suites of the Uivak Gneiss showed that the Uivak Gneiss has the Eoarchean age, > 3.95 Ga, and forms the Iqaluk–Uivak Gneiss series. Because our geological survey clearly showed that the Iqaluk–Uivak Gneisses were intruded into the Nulliak supracrustal belts, the Nulliak supracrustal rocks are the oldest supracrustal rock in the world. The supracrustal belts consist of piles of fault-bounded blocks, which are composed of the ultramafic rocks, mafic rocks and sedimentary rocks in ascending order, similar to modern ocean plate stratigraphy (OPS). In addition, small-scale duplex structures are found over the areas. The presence of duplex structure and OPS indicates that the > 3.95 Ga Nulliak supracrustal belts originate from an accretionary complex. The presence of the accretionary complex, ophiolite and granitic continental crust provides the oldest evidence for the plate tectonics on the early Earth

Cutoff Values of Serum IgG4 and Histopathological IgG4+ Plasma Cells for Diagnosis of Patients with IgG4-Related Disease

IgG4-related disease is a new disease classification established in Japan in the 21st century. Patients with IgG4-related disease display hyper-IgG4-gammaglobulinemia, massive infiltration of IgG4+ plasma cells into tissue, and good response to glucocorticoids. Since IgG4 overexpression is also observed in other disorders, it is necessary to diagnose IgG4-related disease carefully and correctly. We therefore sought to determine cutoff values for serum IgG4 and IgG4/IgG and for IgG4+/IgG+ plasma cells in tissue diagnostic of IgG4-related disease. Patients and Methods. We retrospectively analyzed serum IgG4 concentrations and IgG4/IgG ratio and IgG4+/IgG+ plasma cell ratio in tissues of 132 patients with IgG4-related disease and 48 patients with other disorders. Result. Serum IgG4 >135  mg/dl demonstrated a sensitivity of 97.0% and a specificity of 79.6% in diagnosing IgG4-related disease, and serum IgG4/IgG ratios >8% had a sensitivity and specificity of 95.5% and 87.5%, respectively. IgG4+cell/IgG+ cell ratio in tissues >40% had a sensitivity and specificity of 94.4% and 85.7%, respectively. However, the number of IgG4+ cells was reduced in severely fibrotic parts of tissues. Conclusion. Although a recent unanimous consensus of all relevant researchers in Japan recently established the diagnostic criteria for IgG4-related disease, findings such as ours indicate that further discussion is needed

Interventional endoscopic ultrasonography for pancreatic cancer

Endoscopic ultrasonography (EUS) represents the combination of endoscopy and intraluminal ultrasonography. This allows use of a high-frequency transducer (5-20 MHz) that, due to the short distance to the target lesion, provides ultrasonographic images of higher resolution than those obtained from other imaging modalities, including multiple-detector-row-computed tomography, magnetic resonance imaging, and positron emission tomography. EUS is now a widely accepted modality for diagnosing pancreatic diseases. However, the most important limitation of EUS has been the lack of specificity in differentiating between benign and malignant changes. In 1992, EUS-guided fine needle aspiration (FNA) of lesions in the pancreas head was introduced into clinical practice, using a curved linear-array echoendoscope. Since then, EUS has evolved from EUS imaging to EUS-FNA and wider applications. Interventional EUS for pancreatic cancer includes EUS-FNA, EUS-guided fine needle injection, EUS-guided biliary drainage and anastomosis, EUS-guided celiac neurolysis, radiofrequency ablation, brachytherapy, and delivery of a growing number of anti-tumor agents. This review focuses on interventional EUS, including EUS-FNA and therapeutic EUS for pancreatic cancer

Efficacy of mosapride citrate with polyethylene glycol solution for colonoscopy preparation

AIM: To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy