In China, esophageal squamous cell carcinoma (ESCC) and gastric cardia adenocarcinoma (GCA) differ in terms of multiple primary cancer (MPC) and male-to-female sex ratio (MFSR).
We studied ...site-specific variation in familial cancer by comparing family history (FH), MPC, age at onset (AO), and MFSR among 8768 patients with ESCC/GCA.
ESCC/GCA patients with a positive FH are associated with a significantly higher rate of MPC and a younger AO than those without (sex-specifically: MPC 1.6% vs. 0.7%,
<0.01 and 3.2% vs. 0.8%,
<0.01; AO 53.1 ± 8.1 vs. 54.5 ± 8.2,
=0.000 and 52.9 ± 7.4 vs. 54.0 ± 8.0,
=0.005). Among patients with a positive FH, MPC decreases significantly from upper-, middle-, and lower-third ESCC to GCA (sex-specifically: 53.6%, 1.8%, 1.6%, 0.8%,
=0.000; and 71.4%, 1.5%, 2.2%, 1.6%,
=0.000). From MPC, upper-, middle-, and lower-third ESCC to GCA, AO increased sex-specifically: 51.9 ± 7.2, 52.8 ± 7.9, 52.1 ± 8.3, 54.3 ± 8.4, 55.6 ± 7.6 (
=0.000) and 49.3 ± 6.5, 51.8 ± 9.8, 52.6 ± 7.8, 54.4 ± 8.0, 55.7 ± 7.2 (
=0.000), and FH decreased: 43.8%, 35.1%, 28.2%, 29.5%, 24.4% (
=0.000) and 55.2%, 26.7%, 25.0%, 24.3%, 22.3% (
=0.000). The preponderance of males, smoking, alcohol consumption, and patients ≥50 years old increased from 2.2:1, 1.7:1, 1.0:1, 2.0:1 in ESCC to 6.1:1, 2.8:1, 2.5:1, 4.0:1 in GCA, yet more MPCs were associated with non-preponderant than preponderant counterparts; particularly in GCA, the difference was statistically significant.
The proportion of familial cancer may decrease from upper-, middle-, and lower-third ESCC to GCA. This entails molecular investigation, and appreciating this may help us devise a better screening strategy or individualize cancer treatment.
In this study, feasibility of RFA procedure and related safety and ipsilateral breast tumor recurrence (IBTR) were examined. RFA in breast cancer is a safe and promising minimally invasive treatment ...for tumors ≤ 2 cm in diameter. Combination of ultrasound-guided RFA of breast cancer with concurrent sentinel lymph node biopsy could potentially become state-of-the-art breast-conservative therapy for early breast cancer.
To validate the safety and efficacy of percutaneous radiofrequency ablation (RFA) of breast carcinomas.
This retrospective study was conducted by the Breast Cancer Society for Minimally Invasive Therapy following approval from institutional review boards, and with the written informed consent of patients. A total of 386 patients with breast cancer treated with RFA at 10 institutions between July 2003 and June 2009 were identified and included in the analysis. Patients underwent a standard RFA procedure with ultrasound guidance and were followed up every 6 to 12 months. In this study, feasibility of RFA procedure and related safety and ipsilateral breast tumor recurrence (IBTR) were examined. Fisher exact or χ2 test evaluated associations between clinicopathological factors and IBTR, and local recurrence-free survival was estimated using the Kaplan-Meier method.
RFA-related adverse events included local pain in 9 patients, skin burns in 15, and nipple retraction in 7. Patients were followed for a median of 50 months. IBTR was more frequently observed in patients with initial tumor sizes > 2 cm (3 of 30, 10%) than in those with initial tumors ≤ 2 cm (8 of 355, 2.3%; P = .015). IBTR-free rates 5 years after RFA were 97%, 94%, and 87% in patients with initial tumor sizes ≤ 1.0 cm, 1.1 to 2.0 cm, and > 2.0 cm, respectively.
RFA in breast cancer is a safe and promising minimally invasive treatment for tumors ≤ 2 cm in diameter. Further studies are needed to optimize the technique and evaluate its future role as local therapy.
Sitafloxacin (STFX) is a newly developed quinolone that has robust antimicrobial activity against periodontopathic bacteria. We previously reported that oral administration of STFX during supportive ...periodontal therapy was as effective as conventional mechanical debridement under local anesthesia microbiologically and clinically for 3 months. The aim of the present study was to examine the short-term and long-term microbiological and clinical effects of systemic STFX and azithromycin (AZM) on active periodontal pockets during supportive periodontal therapy. Fifty-one patients receiving supportive periodontal therapy were randomly allocated to the STFX group (200 mg/day of STFX for 5 days) or the AZM group (500 mg/day of AZM for 3 days). The microbiological and clinical parameters were examined until 12 months after the systemic administration of each drug. The concentration of each drug in periodontal pockets and the antimicrobial susceptibility of clinical isolates were also analyzed. The proportions of red complex bacteria, i.e., Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, which are the representative periodontopathic bacteria, were significantly reduced at 1 month and remained lower at 12 months than those at baseline in both the STFX and AZM groups. Clinical parameters were significantly improved over the 12-month period in both groups. An increase in the MIC of AZM against clinical isolates was observed in the AZM group. These results indicate that monotherapy with systemic STFX and AZM might be an alternative treatment during supportive periodontal therapy in patients for whom invasive mechanical treatment is inappropriate. (This study has been registered with the University Hospital Medical Information Network-Clinical Trials Registry UMIN-CTR under registration number UMIN000007834.).
Background
The collaborative multicenter retrospective study of acute cholecystitis (AC) was performed in Japan and Taiwan. The aim for this study was evaluation of the clinical value of TG13 ...severity grading for AC.
Method
The study was designed as an international multicenter retrospective study of AC from 2011 to 2013. Based on the data, we investigated the TG13 severity grading by analyzing the correlations between grade and prognosis, surgical procedures, histopathology, and organ dysfunction and prognosis.
Results
An investigation revealed that 30‐day overall mortality rate was 1.1% for Grade I, 0.8% for Grade II, 5.4% for Grade III. The mortality rate for Grade III was significantly higher than lower grades (P < 0.001). The greater the number of organ dysfunction, the higher the mortality rate (P < 0.001). However, the mortality rate varied depending on the number of organ dysfunction (3.1–25%). With respect to the surgical procedures, laparoscopic cholecystectomy was performed for Grade I patients (P < 0.001), and the higher the grade, the more likely open surgery would be selected (P < 0.001).
Conclusion
TG13 severity grading criteria for AC are providing great benefits in actual clinical settings. From this study, the position of each severity grade was obviously confirmed.
HighlightIn the first study evaluating the TG13 severity grading using big data from an epidemiological study of acute cholecystitis in Japan and Taiwan, Yokoe and colleagues confirmed the clinical impact. Of particular value is the finding that the mortality rate was significantly higher in Grade III than in lower grades.
Despite great strides in pharmacotherapy for diabetes, there is increasing concern over the risk of hypoglycemia in patients with diabetes receiving pharmacotherapy as they become increasingly older. ...This has prompted the Japan Diabetes Society (JDS) to initiate a survey on the current status of severe hypoglycemia in clinical settings. In July 2015, following approval from the JDS Scientific Survey/Research Ethics Committee, the JDS extended an invitation to executive educators, who represented a total of 631 healthcare facilities accredited by the JDS for diabetes education, to participate in the proposed survey. Of these, those who expressed their willingness to participate in the survey were sent an application form required for obtaining ethical approval at these healthcare facilities and were then asked, following approval, to enter relevant clinical data on an unlinked, anonymous basis in a web‐based registry. The current survey was fully funded by the JDS Scientific Survey/Research Committee. A case registry (clinical case database) was launched after facility‐specific information (healthcare facility database) was collected from all participating facilities and after informed consent was obtained from all participating patients. With severe hypoglycemia defined as the “presence of hypoglycemic symptoms requiring assistance from another person to treat and preferably venous plasma glucose levels at onset/diagnosis of disease or at presentation clearly less than 60 mg/dL (capillary whole blood glucose, less than 50 mg/dL)”, the current survey was conducted between April 1, 2014 and March 31, 2015, during which facility‐specific information was collected from a total of 193 facilities with a total of 798 case reports collected from 113 facilities. Of the 193 respondent facilities, 149 reported having an emergency department as well, with the median number of patients who required emergency transportation services to reach these facilities totaling 4,962 annually, of which those with severe hypoglycemia accounted for 0.34% (17). The respondent facilities accommodated a total of 2,237 patients with severe hypoglycemia annually, with the number of patients thus accommodated being 6.5 patients per site. A total of 1,171 patients were admitted for severe hypoglycemia, with the number of patients thus admitted being 4.0 per site, who accounted for 52.3% of all patients visiting annually for severe hypoglycemia. A review of the 798 case reports collected during the survey revealed that 240, 480 and 78 patients had type 1 diabetes, type 2 diabetes, and other types of diabetes, respectively; those with type 2 diabetes were shown to be significantly older (median interquartile range, 77.0 68.0–83.0) than those with type 1 diabetes (54.0 41.0–67.0) (P < 0.001); and the BMI was shown to be significantly higher for those with type 2 diabetes (22.0 19.5–24.8 kg/m2) than for those with type 1 diabetes (21.3 18.9–24.0 kg/m2) (P = 0.003). It was also found that the median estimated glomerular filtration rate (eGFR) was significantly lower among those with type 2 diabetes (50.6 mL 31.8–71.1/min/1.73 m2) than among those with type 1 diabetes (73.3 53.5–91.1 mL/min/1.73 m2) (P < 0.001). Again, the median HbA1c value at onset of severe hypoglycemia was shown to be 7.0 (6.3–8.1)% among all patients examined, 7.5 (6.9–8.6)% among those with type 1 diabetes, and 6.8 (6.1–7.6)% among those with type 2 diabetes, with the HbA1c value at onset of hypoglycemia being significantly lower among those with type 2 diabetes (P < 0.001). Antecedent symptoms of severe hypoglycemia were shown to be present, absent and unknown in 35.5, 35.6, and 28.9% of all patients, respectively, with the incidence of symptomatic hypoglycemia being significantly lower among those with type 1 diabetes (41.0%) than among those with type 2 diabetes (56.9%). The antidiabetic agents used in those with type 2 diabetes were insulin preparations (292 patients including 29 receiving concomitant sulfonylureas SUs) (60.8%), SUs (159 insulin‐naïve patients) (33.1%), and no insulin preparations or SUs (29 patients) (6.0%). Of the 798 patients surveyed, 296 patients (37.2%) were shown to have required emergency transportation services for severe hypoglycemia before. Thus, the survey revealed, for the first time, the current status of treatment‐related severe hypoglycemia in Japan and clearly highlights the acute need for implementing preventive measures against hypoglycemia not only through education on hypoglycemia but through optimization of antidiabetic therapy for those at high risk of severe hypoglycemia or those with a history of severe hypoglycemia.
This survey revealed the current status of treatment‐related severe hypoglycemia in Japan and clearly highlights the acute need for education on hypoglycemia and optimization of antidiabetic therapy for those at high risk of severe hypoglycemia.
It has been widely recognized that mastication behaviors are related to the health of the whole body and to lifestyle-related diseases. However, many studies were based on subjective questionnaires ...or were limited to small-scale research in the laboratory due to the lack of a device for measuring mastication behaviors during the daily meal objectively. Recently, a small wearable masticatory counter device, called bitescan (Sharp Co), for measuring masticatory behavior was developed. This wearable device is designed to assess objective masticatory behavior by being worn on the ear in daily life.
This study aimed to investigate the relation between mastication behaviors in the laboratory and in daily meals and to clarify the difference in mastication behaviors between those with metabolic syndrome (MetS) and those without (non-MetS) measured using a wearable device.
A total of 99 healthy volunteers (50 men and 49 women, mean age 36.4 SD 11.7 years) participated in this study. The mastication behaviors (ie, number of chews and bites, number of chews per bite, and chewing rate) were measured using a wearable ear-hung device. Mastication behaviors while eating a rice ball (100 g) in the laboratory and during usual meals for an entire day were monitored, and the daily energy intake was calculated. Participants' abdominal circumference, fasting glucose concentration, blood pressure, and serum lipids were also measured. Mastication behaviors in the laboratory and during meals for 1 entire day were compared. The participants were divided into 2 groups using the Japanese criteria for MetS (positive/negative for MetS or each MetS component), and mastication behaviors were compared.
Mastication behaviors in the laboratory and during daily meals were significantly correlated (number of chews r=0.36; P<.001; number of bites r=0.49; P<.001; number of chews per bite r=0.33; P=.001; and chewing rate r=0.51; P<.001). Although a positive correlation was observed between the number of chews during the 1-day meals and energy intake (r=0.26, P=.009), the number of chews per calorie ingested was negatively correlated with energy intake (r=-0.32, P=.002). Of the 99 participants, 8 fit the criteria for MetS and 14 for pre-MetS. The number of chews and bites for a rice ball in the pre-MetS(+) group was significantly lower than the pre-MetS(-) group (P=.02 and P=.04, respectively). Additionally, scores for the positive abdominal circumference and hypertension subgroups were also less than the counterpart groups (P=.004 and P=.01 for chews, P=.006 and P=.02 for bites, respectively). The number of chews and bites for an entire day in the hypertension subgroup were significantly lower than in the other groups (P=.02 and P=.006). Furthermore, the positive abdominal circumference and hypertension subgroups showed lower numbers of chews per calorie ingested for 1-day meals (P=.03 and P=.02, respectively).
These results suggest a relationship between masticatory behaviors in the laboratory and those during daily meals and that masticatory behaviors are associated with MetS and MetS components.
University Hospital Medical Information Network Clinical Trials Registry R000034453; https://tinyurl.com/mwzrhrua.
Annexin A11 is a Ca2+-dependent phospholipid-binding protein that possesses an N-terminal low-complexity domain and C-terminal repeated annexin domains, being involved in Ca2+ signaling, cell ...division, apoptosis, and vesicle trafficking 3, 5, 8. SEE PDF Genetic screening of ALS-related mutations through whole-exome sequencing revealed a heterogeneous splice site mutation, c. 1086+1G>A, in the ANXA11 gene (Fig. 2a), which has an allele frequency of 0.08% in the Human Genetic Variation Database (HGVD), and has not been documented in the Exome Aggregation Consortium (ExAC). SEE PDF On the other hand, genetic screening revealed the novel splicing mutation in the C-terminal of ANXA11, and the in silico analysis and cellular experimental findings indicated that the aberrantly spliced transcript induced cytoplasmic accumulation and enhanced the aggregation propensity of annexin A11, suggesting that the mutation had pathogenicity. Interestingly, annexin A11 was aggregated predominantly in neurons and only very sparsely in glial cells, and topographically, in the brainstem motor nuclei and spinal anterior horns rather than the motor cortex, whereas TDP-43 was aggregated in both neurons and glial cells, and frequently in both the upper and lower motor systems. ...TDP-43 aggregated even in annexin A11-negative cells, especially glial cells.
Introduction: Postoperative infection is a major cause of morbidity and prolonged hospitalization in patients undergoing gastrointestinal surgery. This observational study aimed to investigate the ...risk factors associated with postoperative infection and to develop a prediction model for postoperative infections that occur after gastrointestinal surgery. Methods: The study population comprised 1637 patients who underwent gastrointestinal surgery at Niigata University Medical and Dental Hospital between June 2013 and May 2017. Observational data from 1883 surgical procedures were used in the statistical analyses (including 198 patients who underwent several operations). Results: The generalized estimating equation (GEE) was used to detect significant risk factors, including older age, history of smoking, body temperature greater than 38 °C, non-endoscopic surgical procedures, surgery in the thoracic or lower gastrointestinal tract, and use of medical nutritional products during surgery. The sensitivity and specificity of the GEE model were 88.2% and 55.1%, respectively. Conclusion: This study established a predictable GEE model, incorporating the data of patients who were hospitalized several times into a prediction analysis, even though the sensitivity was not sufficiently high. The GEE model, which is considered clinically useful, can be constructed using a variety of variables, including those obtained from electronic health records.
Risk factors for chemotherapy-induced nausea and vomiting (CINV) with anthracycline-containing regimen for breast cancer patients remain unknown. The risk factors for CINV with FEC100 were ...investigated.
Data on CINV events and patient backgrounds of 180 patients were collected from the first cycle of FEC100 treatment. In this regimen, patients were administered various antiemetics (ADs). The combinations of ADs were classified into four categories, while body mass index (BMI) was stratified into three categories. Risk factors were selected based on patient characteristics and combination of ADs. Risks for CINV were analyzed by univariate and multivariate analyses.
In the univariate analysis of nausea, BMI was a significant factor, while BMI and combination of ADs were significant in vomiting. In the multivariate analysis concerning nausea, BMI was a significant factor. In the analysis concerning vomiting, the combination of ADs and BMI were significant.
BMI was the most important risk factor for nausea and vomiting, while the combination of ADs was for vomiting.
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