Circulating monocytes and polymorphonuclear leukocytes (PMNLs) are considered as central regulators controlling systemic inflammatory response after severe insults. Recently, activated monocytes and ...PMNLs have been reported to produce microparticles (MPs) in vitro. The objective of this study was to evaluate production of MPs and changes of cytoskeleton in monocytes from severe systemic inflammatory response syndrome (SIRS) patients, and to compare them with those in PMNLs.
Twenty severe SIRS patients (SIRS criteria and serum C-reactive protein > 10 mg/dL) and 15 healthy volunteers were included. MP formation and F-actin content in monocytes and PMNLs were measured by flow cytometry in the presence or absence of lipopolysaccharide or formylmethionyl-leucyl-phenylalanine (FMLP). The membrane expression of human leukocyte antigen-DR and CD64 in monocytes and O2- production in PMNLs were also measured by flow cytometry.
In severe SIRS patients, MP formation with and without lipopolysaccharide in monocytes significantly decreased in comparison with those in normal controls (p < 0.05), whereas those with and without FMLP in PMNLs increased (p < 0.05). F-actin content with and without FMLP in monocytes also significantly decreased in patients (p < 0.05), whereas those in PMNLs increased as compared with normal controls (p < 0.05). The expression of human leukocyte antigen-DR in monocytes significantly decreased in patients (p < 0.05), which indicated monocyte modulation. The O2- production in PMNLs increased in patients (p < 0.05), which showed PMNL activation.
The changes of MP formation and cytoskeleton in circulating monocytes and PMNLs were paradoxically different in severe SIRS patients.
We report a case of gastrointestinal stromal tumor (GIST) of the pylorus ring which is a rare site. A 71-year-old woman was admitted to the hospital because of anemia detected by a mass screening. We ...had great difficulty in decision making of tumor location. On CT and magrotic resonance imaging, a movable tumor measuring 6cm seemed to be located in the stomach. But, on endoscopy and gastroduodenography, the tumor was considered to be a submucosal lesion in the duodenum. We perform a laparotomy under a diagnosis of submucosal tumor near the pylorus. A gouse egg sized mass was found and resection of the antrum and duodenal bulb was performed. The resected speciemen showed a solid mass measuring 7.5×5.5cm on the pylorus ring. Pathological examination showed that the tumor was GIST positive for CD34 and c-kit and negative for actin-SM and S-100. GIST on the pylorus ring has not yet been reported so far. This rare case is presented with some bibliographical discussion.
We report a small cholangiocellular carcinoma found during a hepatectomy for hepatocellular carcinoma (HCC). A 64-year-old man was referred to the hospital with a diagnosis of multiple HCCs in S4, S5 ...and S7, while he was followed-up for liver cirrhosis. During operation, we found a white hard mass near the HCC in S5. So partial resections of S4 and S7 and a S5 segmentectomy including the new 4th lesion were performed. Pathological study demonstrated three HCCs, and one moderately differentiated adenocarcinoma that was tumor-forming small cholangiocellular carcinoma (CCC). This CCC showed perineural and lymphatic invasion. We report this rare case of double cancer with HCC and CCC, in which the CCC exhibited features of advanced cancer despite it was as small as 1cm in diameter.
SKK-47029 ((-)4-amino-N-2-(1-azabicyclo 3.3.0octan-5-yl)ethyl -5-chloro-2,3 -dihydro-2-methoxylbenzofuran-7-carboxamide hemifumarate) is a new benzofuran derivative which has 5-HT_4 receptor ...agonistic activity in gastrointestinal tract. We investigated the pharmacological profile of SKK47029 on binding affinity for several receptors, relaxation of rat esophageal tunica muscularis mucosae(TMM) and guinea-pig intestine contractions in vitro. In radioligand binding studies at 5-HT_1 , 5-HT_2 , 5-HT_3 , 5-HT_4 , and dopamine(D)_1 , D_2 receptors In rat brain tissues, the IC_50 values were >100, 17.5, >100, 0.4, >100 and >100μM, respectively. SKK-47029 relaxed TMM with EC_50 of 38nM and this relaxation was inhibited with GR113808(selective 5-HT_4 receptor antagonist). SKK-47029(0.01-100 μM) contracted the isolated jejunum and proximal colon of guinea-pig. In electrically stimulated longitudinal muscle myenteric plexus(LMMP) preparations of guinea-pig, SKK-47029 enhanced twitch response in a concentration-dependent manner, but did not affect the baseline tension. The concentration-response curve of SKK-47029 for twitch response was monophasic, and GR113808 shifted this curve to right. Furthermore, SKK-47029 was Ineffective on increase in baseline tension by 5-HT. The present results indicate that SKK-47029 has high potency f or 5-HT_4 receptor agonistic properties, but does not have potency for other receptors. In conclusion, SKK-47029 is a potent and selective 5-HT_4 receptor agonist.
A 62-year-old man was admitted to the hospital because of upper abdominal pain. Abdominal ultrasonography and an abdominal CT scan revealed a hepatic tumor 7cm in diameter in the liver S8. In ...addition, an abdominal angiography showed lateral stricture like compression at the beginning of celiac artery and a dilatation of the pancreatic arcade artery. Hepatocellular carcinoma with celiac artery compression syndrome due to median arcuate ligament was diagnosed. Dissection of the median arcuate ligament and a subsegmentectomy of liver S8 were performed. Histopathological diagnosis was moderately differentiated hepatocellular carcinoma. Angiography after the operation disclosed that the stricture of celiac artery was improved, blood flow in the common hepatic artery and gastroduodenal artery became anterograde, and the dilatation of pancreatoduodenal arcade disappeared. We report the case, because to relieve the compression to the beginning of celiac artery with dissection of median arcuate ligament, which is a relatively easy procedure, is important, in cases in which TAE may be required postoperatively.
A 69-year-old woman was pointed out having an elevated lesion with a shallow concave ulcer 1cm in size in the cecum at a screeming examination for colorectal cancer. A biospy revealed moderately ...differentiated adenocarcinoma. Cecal carcinoma of 0-IIa+IIc type with the tumor incasion depth of sm was diagnosed and an ileocecal resection with group 2 lymph node dissection was performed. Histopathological diagnosis was moderately differentiated adenocarcinoma, m, ly0, and v0. However, two metastatic foci in the No.201 lymph node were confirmed, and a close exploration by a deeper cut was conducted. The tumor cells partially invaded submucosal layer, and submucosal lymph node invasion was demonstrated. Definite diagnosis of smlb, ly1, v0, was made. It is suggested that intramucosal carcinomas diagnosed by usual pathological explorations can involve mimute sm invasive carcinoma with lymph node metastasis. Expecially in instances in which pathological diagnosis of m, ly0, and v0 is made after a local excision, careful observation of the clinical course is required by considering a possible recurrence of the disease.
Background and Aim
The association between liver fibrosis, fatty liver, and cardiovascular disease (CVD) risk is unknown. Hence, this study aimed to investigate the association of liver fibrosis and ...fatty liver with CVD risk independent of already known CVD risk comorbidities.
Methods
This is a prospective study registered with the University Hospital Medical Information Network clinical trial registry (UMIN000036175). Liver fibrosis was assessed by serum fibrosis markers including FIB‐4, nonalcoholic fatty liver disease fibrosis score (NFS), and Wisteria floribunda agglutinin‐positive Mac‐2 binding protein (WFA+‐M2BP), whereas fatty liver was diagnosed by ultrasonography. CVD risk was evaluated using the Framingham risk score (FRS), and a high CVD risk was defined as an FRS ≥ 20%.
Results
A total of 3512 subjects were enrolled, and high CVD risk (FRS ≥ 20%) was observed in 17.5%. Advanced fibrosis (FIB‐4 ≥ 2.67, NFS ≥ 0.675, and WFA+‐M2BP ≥ 1.0) and the presence of fatty liver were significantly associated with high CVD risk independent of diabetes mellitus, dyslipidemia, and hypertension. When subjects were stratified by liver fibrosis and fatty liver, subjects with advanced fibrosis and fatty liver have the highest odds for high CVD risk (odds ratio OR: 5.90–35.6), followed by subjects with advanced fibrosis and without fatty liver (OR: 2.53–9.62) using subjects without advanced fibrosis and fatty liver as a reference.
Conclusions
Liver fibrosis and fatty liver were associated with CVD risk independent of already known CVD risk comorbidities. The assessment of liver fibrosis and fatty liver may be useful to identify high CVD risk subjects.
Aim
Tyrosine kinase inhibitor (TKI) therapy resulted in better prognosis for patients with hepatocellular carcinoma (HCC). However, some cases with Barcelona Clinic Liver Cancer (BCLC) stage C ...disease still had poor prognosis. This study aimed to investigate prognosis and characteristics of patients with HCC treated with TKI based on liver function and the extent of portal vein tumor thrombosis (PVTT).
Methods
Patients receiving TKI therapy (n = 345) were recruited retrospectively. Child–Pugh score and albumin–bilirubin (ALBI) score were used for assessment of liver function. The extent of PVTT was classified from Vp0 to Vp4. Radiotherapy or hepatic arterial infusion chemotherapy were carried out as additional therapy to TKI. The end‐point for this analysis was overall survival (OS).
Results
A total of 291 and 54 patients received sorafenib and lenvatinib as first‐line TKI therapy, respectively. The median OS of patients treated with TKI were significantly stratified by ALBI grade (grade 1, 20.1 months; grade 2a, 16.3 months; grades 2b and 3, 9.8 months; P = 0.0003). The classification of PVTT significantly stratified the prognosis of patients treated with TKI (median OS: Vp0, 18.5 months; Vp1/2, 14.4 months; Vp3/4, 5.5 months; P < 0.0001). In the ALBI 2b/3 and Vp3/4 groups, the median OS of patients treated with TKI and additional therapies was significantly longer than those treated with TKI only (9.2 months vs.. 3.6 months; P = 0.0129).
Conclusion
Liver function and PVTT are useful for stratifying prognosis of HCC patients treated with TKI. The applicative classification could lead to appropriate therapy and better prognosis.
Nonalcoholic fatty liver disease (NAFLD) has affected more than one-fourth of the global population, thus emerging as a worldwide health and economic burden.
The common causes of death in patients ...with NAFLD include cardiovascular disease (CVD), decompensation, and hepatocellular carcinoma (HCC). However, identifying the risk of these complications in patients with NAFLD remains an unmet need in clinical practice.
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