TSLP発現と血清TSLP高値は胃癌患者の予後不良と関係する

Joji Watanabe, Hiroaki Saito, Kozo Miyatani, Masahide Ikeguchi and Yoshihisa Umekita. TSLP expression and high serum TSLP level indicate a poor prognosis in gastric cancer patients. Yonago acta medica. 2015;58:137-413

Prognostic Impact of Pre- and Post-operative P-CRP Levels in Pancreatic Cancer Patients

Background: C-reactive protein (CRP) levels reflect ongoing inflammation and/or tissue damage, and studies suggest that platelets play a role in tumor invasion and metastasis. P-CRP is defined as the multiplied product of serum CRP and platelet levels. Here the prognostic value of pre- and post-operative P-CRP levels in pancreatic cancer (PC) patients was assessed. Methods: This retrospective study used data from 107 consecutive PC patients who had undergone either pancreaticoduodenectomy or distal pancreatectomy. Clinicopathological parameters and pre/post-operative laboratory data derived from patient records were used for analyses. P-CRP was defined as the product of peripheral thrombocyte count (/uL) × serum CRP level (mg/dL) divided by 104; the optimal P-CRP cut-off value was defined using receiver operating characteristic curves. Results: PC patients were classified as either P-CRPLow (< 1.782; n = 49) or P-CRPHigh (≥ 1.782; n = 58), based on the cut-off value of 1.782. Univariate analysis revealed that performance status, clinical stage, pathological T and N stages, P-CRP, and carbohydrate antigen 19-9 (CA19-9) significantly affected overall survival (OS). Multivariate analysis revealed that independent risk factors for OS were pathological N stage, P-CRP, and CA19-9. Additionally, 103 PC patients for whom postoperative data were available were classified into four groups (P-CRPLow-Down, P-CRPLow-Up, P-CRPHigh-Down and P-CRPHigh-Up), based on preoperative P-CRP and postoperative trend of P-CRP, and we found that prognosis, in terms of OS, was significantly different among these groups (P = 0.012). Conclusion: Pre- and post-operative P-CRP values are a potential predictor of prognosis in PC patients

Reasons for the delays in the definitive diagnosis of lung cancer for more than one year from the recognition of abnormal chest shadows

金沢大学医薬保健研究域医学系Objective. Primary lung cancer generally has a poor prognosis if not diagnosed at an early stage. But some lung cancers grow very slowly. In particular, adenocarcinoma is sometimes observed for years with no change of tumor size. In this study, we examined the reasons for the delays in reaching a definitive diagnosis of lung cancer. Methods. We retrospectively reviewed primary lung cancer cases between January 1995 and December 1999 and examined those whose definitive diagnoses were delayed for more than a year. Results. A total of 222 primary lung cancers were diagnosed. Of those, 19 patients (group A, 8.6%) were diagnosed after more than a year, and the other 203 (group B, 91.4%) were diagnosed within one year. The proportion of women in group A was significantly higher than that in group B (p<0.05). The mean age of group A was significantly younger than that of group B (p<0.05). The Brinkman Index of group A was significantly lower than that of group B (p<0.05). The histologic types were significantly different between the two groups (p<0.05). In group A, 18 patients (94.7%) had adenocarcinomas. Five primary reasons for the delays in group A were identified: 1) Four patients were tentatively diagnosed as inflammation or benign tumor on CT and were consequently not followed-up. 2) The chest CT shadows in 6 patients were suspected lung cancers but transbronchial lung biopsy findings did not show malignancy. 3) Four patients were tentatively diagnosed as inflammation or benign tumor on CT, but the tumors showed only very slow growth or no change at all. 4) The chest CT shadows of 2 patients were suspected lung cancer, but the patients refused to undergo video-assisted thoracic surgery (VATS) or closer examination. 5) Three patients did not consult medical facilities for a second examination. Conclusions. Many of the adenocarcinomas reviewed in our study grew slowly or remained unchanged for years. Doctors are mainly responsible for the delays in the definitive diagnosis and should aggressively perform VATS or closer examinations without hesitation

Operative Procedure for Laparoscopy-Assisted Vagus Nerve and Pylorus-Preserving Gastrectomy (LAVNPPG) for Early Gastric Cancer

Laparosocpy-assisted pylorus-preserving gastrectomy (LAPPG) is a widely accepted surgical procedure for the treatment of early gastric cancer in the middle third of the stomach. We have been performing this operation since 2007. Compared with traditional distal gastrectomy, LAPPG has postoperative nutritional benefits for patients. However, this procedure preserves only the pyloric branch of the vagus nerve and not the celiac branch. We found that patients retain a large amount of residual food in the gastric remnant, which interferes with the detection of secondary cancer on endoscopic follow-up. To improve the pyloric function and postoperative gastrointestinal motility, we changed our procedure during 2009 to preserve both the pyloric and celiac branches of the vagus nerve, and we named this new procedure laparoscopy-assisted vagus nerve and pylorus-preserving gastrectomy (LAVNPPG). From 2009 to 2011, 11 patients underwent LAVNPPG at our hospital. Retrospective comparison of the safety of operation, postoperative complications, and condition of the gastric remnant between LAPPG (n = 13) and LAVNPPG (n = 11) found that the occurrence of postprandial stasis and food residue in the gastric remnant tended to be lower following LAVNPPG, though the differences were not significant. These findings indicate that LAVNPPG may be an operative procedure that could replace LAPPG

イオノゾンデ ヲ モチイタ オーロラ サブストーム ジ ノ デンリケン ヘンドウ

荷電降下粒子が電離圏に与える影響をよりよく理解するため,本研究では,オーロラサブストーム時の降下電子の影響が,イオノゾンデ観測データにどのように現れるかの検証を試みた.1997年10月1日からの1年間を対象として,地磁気変動をもとにオーロラサブストームのイベントを72例選出し,成長相,爆発相,回復相の各フェーズで時間軸を規格化した.選出した全イベントと同時観測されたイオノグラム読み取りデータ(fmin,ftEs,h\u27Es)を規格化された時間軸で整理し,それぞれのフェーズでの特徴を検討した.その結果,成長相から爆発相にかけて,fminとftEsの平均値は増加し,h\u27Esの平均値は下降する傾向が見られた.以上のことから,イオノグラムにみるオーロラサブストーム時の電離圏変動は,成長相から爆発相にかけて10-100keV程度のエネルギーをもつ電子の降下量の増大を反映した可能性が大きいと結論した.In order to obtain a better understanding of the influence of precipitating electrons on the ionosphere, we tried to estimate their effect from ionosonde observation data (ionograms) during an aurora substorm. In this analysis we used 72 aurora substorm events identified from the geomagnetic variation for one year beginning from October 1st,1997. We have adjusted the time axis of the growth phase, the expansion phase, and the recovery phase of each event so that different events can be expressed on a common time axis. Observed ionogram data (fmin, ftEs, h\u27Es) are plotted on this normalized time axis and the features of the ionogram are examined in each phase. As a result, the mean values of fmin and ftEs increased, and the mean values of h\u27Es decreased from the growth phase to the expansion phase. We have concluded that there is a high possibility of an increase of the flux of 10-100keV precipitating electrons from the growth phase to the expansion phase