Mucinous Carcinoma of the Breast: Clinicopathological Features and Long-term Prognosis in Comparison with Invasive Ductal Cancer; A Single Hospital’s 30+-Year Experience

Mucinous carcinoma (MC) of the breast is a rare and special type of malignancy, with a substantial amount of extracellular mucin. We compared the clinicopathological features and the long-term survival of MC patients with those of invasive ductal carcinoma-no special type (IDC-NST) patients, and we examined prognostic factors of MC. A total of 116 patients with mucinous carcinoma and 3,258 patients with IDC-NST who underwent surgery at our hospital (1977-2008) were enrolled. The 10-year overall survival rate and breast cancer-specific survival rate (BSS) of the MC patients (88.3%, 93.7%) were both significantly higher than those of IDC-NST patients (81.6%, 85.0%) (p=0.015, p=0.005, respectively). A Cox regression analysis demonstrated that MC tended to be an independent prognostic factor (hazard ratio 0.44, p=0.098). The BSS of the MC patients with positive lymph node (LN) metastasis was significantly poorer than that of the patients without it, by univariate analysis (p=0.002). The tumor size in the MC patients with positive LN metastasis (mean 3.2 cm) was significantly larger than that in the patients without it (mean 1.9 cm) (p=0.0004). Although a Cox regression analysis revealed no independent factor, MC patients with positive LN metastasis should be treated for advanced invasive ductal breast cancer

Diminished Gastric Resection Preserves Better Quality of Life in Patients with Early Gastric Cancer

Using the Postgastrectomy Syndrome Assessment Scale (PGSAS)-45, we compared the surgical outcomes and the quality of life (QOL) between patients undergoing limited gastrectomies and those undergoing conventional gastrectomies. In Oomoto Hospital between January 2004 and December 2013, a total of 124 patients who met the eligibility criteria were enrolled. Using the main outcome measures of PGSAS-45, we compared 4 types of limited gastrectomy procedures (1/2 distal gastrectomy [1/2DG] in 21 patients; pylorus-preserving gastrectomy [PPG] in 15 patients; segmental gastrectomy [SG] in 26 patients; and local resection [LR] in 13 patients) with conventional gastrectomy (total gastrectomy [TG] in 24 patients and 2/3 or more distal gastrectomy [WDG] in 25 patients). The TG group showed the worst QOL in almost all items of the main outcome measures. The 1/2DG, PPG, and SG groups showed better QOL than the WDG group in many of the main outcome measures, including the body weight ratio, total symptom score, ingested amount of food per meal, and the dissatisfaction for daily life subscale. The LR group showed a better intake of food than the 1/2DG, PPG, and SG groups. The body weight ratio of the LR group was better than that of the SG group. Diminished gastric resection preserved better QOL in patients with early gastric cancer

CDK8/19 inhibition plays an important role in pancreatic β-cell induction from human iPSCs

サイクリン依存性キナーゼCDK8/19阻害はヒトiPS細胞からの膵島様細胞への分化誘導において重要な役割を果たす. 京都大学プレスリリース. 2023-02-27.A safer method of generating pancreatic islet-like cells from human iPS cells by inhibiting cyclin-dependent kinase CDK8/19. 京都大学プレスリリース. 2023-03-08.[Background] Transplantation of differentiated cells from human-induced pluripotent stem cells (hiPSCs) holds great promise for clinical treatments. Eliminating the risk factor of malignant cell transformation is essential for ensuring the safety of such cells. This study was aimed at assessing and mitigating mutagenicity that may arise during the cell culture process in the protocol of pancreatic islet cell (iPIC) differentiation from hiPSCs. [Methods] We evaluated the mutagenicity of differentiation factors used for hiPSC-derived pancreatic islet-like cells (iPICs). We employed Ames mutagenicity assay, flow cytometry analysis, immunostaining, time-resolved fluorescence resonance energy transfer-based (TR-FRET) cell-free dose–response assays, single-cell RNA-sequencing and in vivo efficacy study. [Results] We observed a mutagenic effect of activin receptor-like kinase 5 inhibitor II (ALK5iII). ALK5iII is a widely used β-cell inducer but no other tested ALK5 inhibitors induced β-cells. We obtained kinase inhibition profiles and found that only ALK5iII inhibited cyclin-dependent kinases 8 and 19 (CDK8/19) among all ALK5 inhibitors tested. Consistently, CDK8/19 inhibitors efficiently induced β-cells in the absence of ALK5iII. A combination treatment with non-mutagenic ALK5 inhibitor SB431542 and CDK8/19 inhibitor senexin B afforded generation of iPICs with in vitro cellular composition and in vivo efficacy comparable to those observed with ALK5iII. [Conclusion] Our findings suggest a new risk mitigation approach for cell therapy and advance our understanding of the β-cell differentiation mechanism

Increased blood viscosity in ischemic stroke patients with small artery occlusion measured by an electromagnetic spinning sphere viscometer

Background and Purpose: High blood viscosity causes blood stagnation and subsequent pathological thrombotic events, resulting in the development of ischemic stroke. We hypothesize that the contribution of blood viscosity may differ among ischemic stroke subtypes based on specific pathological conditions. We tried to verify this hypothesis by measuring blood viscosity in acute ischemic stroke patients using a newly developed electromagnetic spinning sphere (EMS) viscometer. Methods: Measurements in acute ischemic stroke patients were performed 4 times during admission and data were compared with those obtained from 100 healthy outpatient volunteers. Results: We enrolled 92 patients (cardioembolism [CE]: 25, large-artery atherosclerosis [LAA]: 42, and small artery occlusion [SAO]: 25) in this study. Comparisons of blood viscosity between the ischemic stroke subgroups and control group revealed that blood viscosity at the date of admission was significantly higher in the SAO group (5.37±1.11 mPa・s) than in the control group (4.66±0.72 mPa・s) (p<0.01). Among all subtype groups showing a reduction in blood viscosity after 2 weeks, the SAO group showed the highest and most significant reduction, indicating that SAO patients had the most concentrated blood at the onset. Conclusions: Blood viscosity was significantly increased in the SAO group at the date of admission, which indicated the contribution of dehydration to the onset of ischemic stroke. The importance of dehydration needs to be emphasized more in the pathogenesis of SAO. The clinical application of the EMS viscometer is promising for understanding and differentiating the pathogenesis of ischemic stroke

Voice Activity Detection Applied to Hands-Free Spoken Dialogue Robot based on Decoding using Acoustic and Language Model

ROBOCOMM2007: the 1st International Conference on Robot Communication and Coordination , October 15-17, 2007, Athens, Greece.Speech recognition and speech-based dialogue are means for realizing communication between humans and robots. In case of conventional system setup a headset or a directional microphone is used to collect speech with high signal-to-noise ratio (SNR). However, the user must wear a microphone or has to approach the system closely for interaction. Therefore it's preferable to develop a hands-free speech recognition system which enables the user to speak to the system from a distant point. To collect speech from distant speakers a microphone array is usually employed. However, the SNR will degrade in a real environment because of the presence of various kinds of background noise besides the user's utterance. This will most often decrease speech recognition performance and no reliable speech dialogue would be possible. Voice Activity Detection (VAD) is a method to detect the user utterance part in the input signal. If VAD fails, all following processing steps including speech recognition and dialogue will not work. Conventional VAD based on amplitude level and zero cross count is difficult to apply to hands-free speech recognition, because speech detection will most often fail due to low SNR. This paper proposes a VAD method based on the acoustic model (AM) for background noise and the speech recognition algorithm applied to hands-free speech recognition. There will always be non-speech segments at the beginning and end of each user utterance. The proposed VAD approach compares the Iikelihood of phoneme and silence segments in the top recognition hypotheses during decoding. We implemented the proposed method for the open-source speech recognition engine Julius. Experimental results for various SNRs conditions show that the proposed method attains a higher VAD accuracy and higher recognition rate than conventional VAD

Development and Evaluation of Hands-Free Spoken Dialogue System for Railway Station Guidance

INTERSPEECH2008: 9th Annual Conference of the International Speech Communication Association, September 22-26, 2008, Brisbane, Australia.In this paper, we describe development and evaluation of handsfree spoken dialogue system which is used for railway station guidance. In the application at the railway station, noise robustness is the most essential issue for the dialogue system. To address the problem, we introduce two key techniques in our proposed hands-free system; (a) blind spatial subtraction array (BSSA) as a preprocessing, which can efficiently reduce nonstationary and diffuse noises in real-time, and (b) robust voice activity detection (VAD) based on speech decoding for further improvement of speech recognition accuracy. The experimental assessment of the proposed dialogue system reveals that the combination of real-time BSSA and robust VAD can provide the recognition accuracy of more than 80% under adverse railway-station noise conditions