Prognostic Impact of Number of Resected and Involved Lymph Nodes at Complete Resection on Survival in Non-small Cell Lung Cancer

BackgroundLymph node (LN) status is a major determinant of stage and survival in patients with lung cancer. In the 7th edition of the TNM Classification of Malignant Tumors, the number of involved LNs is included in the definition of pN factors in breast, stomach, esophageal, and colorectal cancer, and the pN status significantly correlates with prognosis.MethodsWe retrospectively investigated the prognostic impact of the number of resected LNs (RLNs) and involved LNs in the context of other established clinical prognostic factors, in a series of 928 consecutive patients with non-small cell lung cancer (NSCLC) who underwent complete resection at our institution between 2000 and 2007.ResultsThe mean number of RLNs was 15. There was a significant difference in the total number of RLNs categorized between less than 10 and ≥10 (p = 0.0129). Although the incidence of LN involvement was statistically associated with poor prognosis, the largest statistically significant increase in overall survival was observed between 0 to 3 and ≥4 involved LNs (hazard ratio = 7.680; 95% confidence interval = 5.051–11.655, p < 0.0001). On multivariate analysis, we used the ratio between the number of involved LNs and RLNs. The number of RLNs was found to be a strong independent prognostic factor for NSCLC (hazard ratio = 6.803; 95% confidence interval = 4.137–11.186, p < 0.0001).ConclusionComplete resection including 10 or more LNs influenced survival at complete NSCLC resection. Four involved LNs seemed to be a benchmark for NSCLC prognosis. The number of involved LNs is a strong independent prognostic factor in NSCLC, and the results of this study may provide new information for determining the N category in the next tumor, node, metastasis classification

Occupational risk factors for Parkinson's disease: a case-control study in Japan

<p>Abstract</p> <p>Background</p> <p>The evidence for associations between occupational factors and the risk of Parkinson's disease (PD) is inconsistent. We assessed the risk of PD associated with various occupational factors in Japan.</p> <p>Methods</p> <p>We examined 249 cases within 6 years of onset of PD. Control subjects were 369 inpatients and outpatients without neurodegenerative disease. Information on occupational factors was obtained from a self-administered questionnaire. Relative risks of PD were estimated using odds ratios (ORs) and 95% confidence intervals (CIs) based on logistic regression. Adjustments were made for gender, age, region of residence, educational level, and pack-years of smoking.</p> <p>Results</p> <p>Working in a professional or technical occupation tended to be inversely related to the risk of PD: adjusted OR was 0.59 (95% CI: 0.32-1.06, <it>P </it>= 0.08). According to a stratified analysis by gender, the decreased risk of PD for persons in professional or technical occupations was statistically significant only for men. Adjusted ORs for a professional or technical occupation among men and women were 0.22 (95% CI: 0.06-0.67) and 0.99 (0.47-2.07), respectively, and significant interaction was observed (<it>P </it>= 0.048 for homogeneity of OR). In contrast, risk estimates for protective service occupations and transport or communications were increased, although the results were not statistically significant: adjusted ORs were 2.73 (95% CI: 0.56-14.86) and 1.74 (95% CI: 0.65-4.74), respectively. No statistical significance was seen in data concerning exposure to occupational agents and the risk of PD, although roughly a 2-fold increase in OR was observed for workers exposed to stone or sand.</p> <p>Conclusion</p> <p>The results of our study suggest that occupational factors do not play a substantial etiologic role in this population. However, among men, professional or technical occupations may decrease the risk of PD.</p

Long survival case of trisomy 13 mosaicism in a 7-year-old male

Trisomy 13 is a complication of various congenital abnormalities of the heart, brain, etc. Regarding the vitalprognosis, many die within a year from birth. We herein report on the case of a 7-year 1-month-old boywith mosaicism trisomy 13 with the two considerations mentioned below as the cause for long-term survivalin this case. The first is that there were no serious associated abnormalities to the heart, brain, or otherorgans, and the second is that a tracheotomy was carried out on a repeated respiratory infection with respiratoryfailure. Long-term in-home care was possible for the child and he was observed playing with toys bytouching them. Trisomy 13 has a poor vital prognosis, so some argue that active treatment should be restrained.However, for cases with no severe associated abnormalities, long-term survival may be possiblewith active treatment

Alcohol drinking and risk of Parkinson's disease: a case-control study in Japan

<p>Abstract</p> <p>Background</p> <p>Although some epidemiologic studies found inverse associations between alcohol drinking and Parkinson's disease (PD), the majority of studies found no such significant associations. Additionally, there is only limited research into the possible interactions of alcohol intake with aldehyde dehydrogenase (ALDH) 2 activity with respect to PD risk. We examined the relationship between alcohol intake and PD among Japanese subjects using data from a case-control study.</p> <p>Methods</p> <p>From 214 cases within 6 years of PD onset and 327 controls without neurodegenerative disease, we collected information on "peak", as opposed to average, alcohol drinking frequency and peak drinking amounts during a subject's lifetime. Alcohol flushing status was evaluated via questions, as a means of detecting inactive ALHD2. The multivariate model included adjustments for sex, age, region of residence, smoking, years of education, body mass index, alcohol flushing status, presence of selected medication histories, and several dietary factors.</p> <p>Results</p> <p>Alcohol intake during peak drinking periods, regardless of frequency or amount, was not associated with PD. However, when we assessed daily ethanol intake separately for each type of alcohol, only Japanese sake (rice wine) was significantly associated with PD (adjusted odds ratio of ≥66.0 g ethanol per day: 3.39, 95% confidence interval: 1.10-11.0, <it>P </it>for trend = 0.001). There was no significant interaction of alcohol intake with flushing status in relation to PD risk.</p> <p>Conclusions</p> <p>We did not find significant associations between alcohol intake and PD, except for the daily amount of Japanese sake. Effect modifications by alcohol flushing status were not observed.</p

サイタイケツ チュウ D4^+ サイボウ, NKサイボウ ノ キモカインリセプター CXCR3 ハツゲン ノ ケントウ

Th1細胞は造血幹細胞移植後の急性移植片対宿主病(graft-versus-hostdisease:GVHD)の発症に深く関与しているといわれている。今回我々はTh1細胞に発現するとされるキモカインリセプターの1つであるCXCR3を測定し,瞬帯血移植で急性GVHDがなぜ軽度なのかを検討した。臍帯血,成人末梢血と移植後患者末梢血中のリンパ球,NK細胞をモノクローナル抗体(抗CD4,抗CD8,抗CD56,抗HLA-DR,抗CD25)で染色し以下の結果を得た。CD^4+T細胞のCXCR3発現,HLA-DRの発現はいずれも末梢血よりも膀帯血の方が少なかった(p<0.05)。NK(CD56^+)細胞ではCXCR3,HLA-DR発現に有意差はなかった。IL-2で刺激したCD4^+T細胞でのCXCR3発現は培養後5日でも謄帯血では末梢血より発現が少なかった(p<0.05)。IL-2で刺激したNK細胞のCXCR3発現には両者に差がなかったが,HLA-DR発現は末梢血と比べて膀帯血で少なかった(p<0.05)。移植1ヶ月後の末梢血CD^+T細胞のCXCR3発現を膀帯血移植例と対照の同種骨髄移植例で比較すると膀帯血移植例で低値であった(p<0.05)。膀帯血のCD^+T細胞.NK細胞でのCXCR3発現の特徴は膀帯血移植で急性GVHDが発症しにくいということに関与していると考えたIn order to know why the development of acute graft-ver-sus-host-disease (aGVHD) is significantly milder after stem cell transplantation (SCT) using cord blood, we studied the CXCR3 expression on CD4^+T cells and NK (CD 56^+) cells, based on the fact that CXCR3 is one of the chemokine receptors on Th1 cells. Cord blood (CB) and peripheral blood (PB) from healthy volunTFFrs and patients who received SCT were treated with monoclonal antibodies against CD4, CD25, CD56, CXCR3, and HLA-DR and the antigen expression was analyzed using flow cytometry. The percentage of CXCR3 antigen on GB and PB CD4^+ T cells was 2.6 ± 1.4% and 30.8 ± 3.9%, respectively, demonstrating a significant difference (p < 0.05). However, that on GB and PB NK cells was not significantly different. CXCR3 expression on CB and PB CD4^+T cells stimulated by IL-2 for 72h and 120h was significantly different (p < 0.05), but that on NK cells was not significant. CXCR3 expression on CD4^+ T cells from patients who received allo-CB-SCT and allo-bone marrow transplantation from HLA-mismatched donor was significantly different at one-month post-SCT (p < 0.05). We concluded that the lower CXCR3 expression on GB CD^+T cells and absence of difference in CXCR3 expression on cord blood NK cells facilitated a milder aGVHD