Background
Extramammary Paget's disease (EMPD) is a rare malignant skin cancer. One of the hallmarks of cancers, including EMPD, is an enhancement of aerobic glycolysis, which is also known as the ...Warburg effect. In the last step of glycolysis, the enzyme lactate dehydrogenase A (LDHA) catalyzes the conversion of pyruvate to lactic acid, the accumulation of which contributes to the creation of an acidic tumour microenvironment. This in turn results in immunosuppression in various types of cancers. However, the contribution of these pathways has not been well‐studied in EMPD.
Objective
To investigate the significance of the Warburg effect and its contribution to the tumour immune microenvironment in EMPD.
Methods
The mRNA expression levels of molecules involved in glycolysis and immune‐related cytokines were examined by ddPCR. The number of immune cells was assessed by immunohistochemistry (IHC).
Results
The levels of two glycolytic enzymes, HK2 and LDHA, in tumour tissues were significantly increased compared to those in paired‐normal tissues. IHC analyses revealed increased numbers of PD‐L1+, PD‐1+, CD163+ M2 macrophages, Iba1+ macrophages and Foxp3+ Tregs that were associated with high LDHA levels in EMPD. ddPCR demonstrated that multiple cytokines including IL‐4, IL‐6, IL‐10, TGF‐β and CCL‐2 were upregulated and associated with high LDHA levels in EMPD. Statistical analyses showed that IL‐6 mRNA expression correlated with the number of CD163+, Iba‐1+ and Foxp3+ cells.
Conclusion
The Warburg effect contributes to immunomodulation in the tumour microenvironment and further elucidation may lead to better understanding of the pathogenesis of EMPD.
The aim of this study was to assess hypertrophy of the extra-articular tendon of the long head of biceps (LHB) in patients with a rotator cuff tear.
The study involved 638 shoulders in 334 patients ...(175 men, 159 women, mean age 62.6 years; 25 to 81) with unilateral symptomatic rotator cuff tears. The cross-sectional area (CSA) of the LHB tendon in the bicipital groove was measured pre-operatively in both shoulders using ultrasound. There were 154 asymptomatic rotator cuff tears in the contralateral shoulder. Comparisons were made between those with a symptomatic tear, an asymptomatic tear and those with no rotator cuff tear. In the affected shoulders, the CSAs were compared in relation to the location and size of the rotator cuff tear.
The mean CSA was 21.0 mm
(4 to 71) in those with a symptomatic rotator cuff tear, 19.9 mm
(4 to 75) in those with an asymptomatic rotator cuff tear and 14.1 mm
(5 to 43) in those with no rotator cuff tear. The mean CSA in patients with both symptomatic and asymptomatic rotator cuff tears was significantly larger than in those with no rotator cuff tear (p < 0.001). In the affected shoulders, there were significant differences between patients with more than a medium sized posterosuperior cuff tear and those with an antero-superior cuff tear.
Regardless of the symptoms, there was significant hypertrophy of the extra-articular LHB tendon in patients with a rotator cuff tear. The values were significantly related to the size of the tear. Cite this article:
2017;99-B:806-11.
In Asians, the risk of irinotecan-induced severe toxicities is related in part to UGT1A1*6 (UGT, UDP glucuronosyltransferase) and UGT1A1*28, variant alleles that reduce the elimination of SN-38, the ...active metabolite of irinotecan. We prospectively studied the relation between the UGT1A1 genotype and the safety of irinotecan-based regimens in Japanese patients with advanced colorectal cancer, and then constructed a nomogram for predicting the risk of severe neutropenia in the first treatment cycle.
Safety data were obtained from 1312 patients monitored during the first 3 cycles of irinotecan-based regimen in a prospective observational study. In development of the nomogram, multivariable logistic regression analysis was used to test the associations of candidate factors to severe neutropenia in the first cycle. The final nomogram based on the results of multivariable analysis was constructed and validated internally using a bootstrapping technique and externally in an independent data set (n=350).
The UGT1A1 genotype was confirmed to be associated with increased risks of irinotecan-induced grade 3 or 4 neutropenia and diarrhoea. The final nomogram included type of regimen, administered dose of irinotecan, gender, age, UGT1A1 genotype, Eastern Cooperative Oncology Group performance status, pre-treatment absolute neutrophil count, and total bilirubin level. The model was validated both internally (bootstrap-adjusted concordance index, 0.69) and externally (concordance index, 0.70).
Our nomogram can be used before treatment to accurately predict the probability of irinotecan-induced severe neutropenia in the first cycle of therapy. Additional studies should evaluate the effect of nomogram-guided dosing on efficacy in patients receiving irinotecan.
Aim
This study aimed to assess the ability of preoperative axial computed tomography (CT) to predict surgical difficulty in bringing the ileal pouch to the level of the anus during restorative ...proctocolectomy (RPC).
Method
Patients who underwent RPC with an ileal pouch–anal anastomosis (or ileal pouch–anal canal anastomosis) in our institution between January 2008 and April 2014 were enrolled. The patients were divided into two groups, including those in whom CT indicated potential difficulty in extending the pouch downwards (extension difficult (ED) group) and patients with no CT evidence of potential difficulty (normal group). The groups were compared for clinical factors and the thickness of the slices of CT showing the root of the superior mesenteric artery, the point of communication of the ileocaecal artery with the marginal artery (tICA) and the anal verge (AV). Receiver‐operating characteristic analysis was performed, and a cut‐off value was calculated for predicting the degree of difficulty in bringing the ileal pouch down to the anal canal.
Results
Thirty‐four patients were entered in the study. The ED group included significantly taller patients and more with familial adenomatous polyposis than the normal group. The distance between tICA and AV was significantly longer in the ED group, with a cut‐off of 21 cm giving a sensitivity of 100% and a specificity of 83.3%.
Conclusion
The distance between tICA and AV measured by axial CT can be a useful predictor for the difficulty in bringing the ileal pouch down to the anus during RPC.
This study proposes a novel technique to visualize ultrasonic waves propagated in a general solid medium. A specimen was scanned by a pulsed laser for generation of ultrasound, and the propagated ...waves were received by a fixed transducer. This technique then provided a snapshot of traveling waves based on the reversibility for the wave propagation, which is confirmed in this paper. We experimentally and numerically investigated and visualized the wave propagation in a steel plate with a slit. Furthermore, we demonstrated inspection of an elbow pipe with an artificial defect, as an application of the proposed technique to a structural component. Non-contact laser scanning for ultrasound excitation enabled us to inspect a wide area of an arbitrarily shaped object. The distinguishing advantages of this technique were determined to be well-suited to the quick and easy wide-range inspection of real structures.
In general, industrial sector consumes high energy. Therefore, efforts to manage the energy usage in this sector are useful as it can reduce significantly total energy consumption mainly for ...electricity. This research aims to observe consumers' perceptions and success factors to improve efficiency of electricity energy usage for industry particularly for manufacturing small-medium enterprises (SMEs) in Makassar as a representative big city in Indonesia. A questionnaire for survey is designed to get data from 127 respondents and analysed using statistical approach. Observed variables related to energy efficiency in SMEs include human resources, production technology, rainfall, and tax. Results shown the developed questionnaire is reliable (Cronbach's alpha value exceeds 0.6). Perception of consumers about energy saving is quite good. From aspect of demographic characteristic, there is a difference in users' perceptions on energy saving. Other results show the significant relationship between human resources, production technology, and rainfall condition to the energy efficiency level at SMEs. Knowledge or findings of this study provide valuable information in relation to strategy to improve efficiency of electricity usage in industries.
The absolute calibration factor of extreme ultraviolet spectroscopic instrument which has recently been determined from absolute radiation profile measurement of bremsstrahlung continuum has been ...investigated by comparing the calculated diffraction efficiency of grating. An overall tendency of the wavelength dependence of the calibration factor from 40 Å to 500 Å can be reproduced by that of the grating efficiency, especially the agreement between the measured calibration factor and the calculated grating efficiency has been found to be fairly good for the wavelength range 200 Å-500 Å.
We have studied the microscopic magnetic state of a double perovskite Sr2FeMoO6 by x-ray magnetic circular dichroism (XMCD). An Fe L3,2-edge XMCD reveals that the formal Fe3+ ions have an appreciable ...orbital moment (morb) parallel to their large spin moment (mspin), showing the charge-transfer-induced, minority-spin (↓) Fe t2g electrons. A weak but undoubted O K-edge XMCD was successfully detected, showing an O 2p-hole morb induced by 2p-3d hybridization. Along with information obtained from the observed Mo M3,2-edge XMCD, our findings verify the partially filled Fe 3d t2g↓-O 2pπ↓-Mo 4d t2g↓ hybridized bands at the Fermi level, which mediates ferrimagnetism.
Because medical records are stored in each medical facility, even records about one disease of one patient are fragmented. To solve this problem, it is desirable to build a Personal Health Record ...(PHR). PHR requires a powerful center system on the cloud, which will be a cost burden. If a private sector run this business, designing of its business model becomes a key issue. We have considered an architecture of PHR centered on a medical information bank, where individuals entrust their personal medical data to the medical information bank that promotes data usage. We classified the data usage into medical use (primary use), non-medical health service use, and secondary use for research. We proposed a business model in which the medical information bank receive payment from beneficiaries depending of the type of the data usage. We tried the PHR service for obstetric patients at Osaka University Hospital. This service was well received by the patients. Based on this experience, we aim to develop PHR project.
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