Background and purpose
High blood pressure (BP) at presentation is associated with poor outcomes in acute ischaemic stroke, but serial BP measurements may better delineate the clinical implications ...of BP. The aim was to investigate the association between various BP parameters and functional outcomes in acute ischaemic stroke patients treated with endovascular thrombectomy (EVT).
Methods
This study reports a retrospective analysis of a prospective registry of a comprehensive stroke centre. Patients treated with EVT due to large vessel occlusion in the anterior circulation were enrolled. BP was measured hourly during the first 24 h after admission. Associations of various BP parameters, including BP variability, with functional outcomes at 3 months, including good outcomes (modified Rankin Scale score of 0–2), were analysed.
Results
Of the 378 enrolled patients (mean age 70 ± 11 years, male 54.2%), 313 (82.8%) achieved successful reperfusion after EVT, and 149 (39.4%) had good outcomes at 3 months. Higher mean systolic BP each 10 mmHg increase, odds ratio 0.82 (0.69–0.97) and higher systolic successive variation (SV) each 10% increase, odds ratio 0.37 (0.18–0.76) were associated with a reduced likelihood of achieving good outcomes. In addition, reperfusion status after EVT moderated the influence of higher systolic SV on good outcomes (Pint = 0.05).
Conclusion
The results showed that a higher mean systolic BP and systolic SV during the first 24 h of EVT reduced the likelihood of good outcomes at 3 months. The effects of these parameters on outcomes are more substantial amongst patients with successful reperfusion after EVT, suggesting that different BP control strategies should be employed according to reperfusion status.
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This study performed three-dimensional transient numerical simulations using the volume of fluid method in a gas metal arc V-groove welding process with and without root gap for flat, overhead, and ...vertical welding positions. The elliptically symmetric arc models for arc heat flux, electromagnetic force and arc pressure were used to describe the more accurate molten pool behaviors. The numerical models not only formed a stable weld bead but also simulated the dynamic molten pool behaviors such as overflow which was not described before. This study analyzed these molten pool flow patterns for various welding positions and validated the numerical models used by comparing the simulation results with experimental ones.
Aim To evaluate the efficacy of prostatic artery embolisation (PAE) in lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH) at short- and mid-term follow-up. Materials ...and methods The current study included 484 BPH patients from seven eligible studies. A meta-analysis was performed to determine the mean differences in parameters associated with LUTS, including the international prostate symptom score (IPSS), peak urinary flow (Qmax), post-void residual volume (PVR), quality of life score (QoL), prostate-specific antigen level (PSA), and prostatic volume (PV), between baseline and follow-up periods. Results Nearly all parameters at follow-up of 3–24 months were significantly improved compared to the baseline. Mean differences in IPSS at 3, 6, 12, and 24 months were −14.06 (95% confidence interval CI: −16.47 to −11.64), −12.32 (95% CI: −15.57 to −9.08), −16.41 (95% CI: −19.81 to −13.02), and −17 (95% CI: −17.91 to −16.09), respectively. In addition, mean differences of Qmax, PVR, PV, and QoL between the follow-up period and baseline were improved significantly; however, there were no significant differences in PSA at 24 months. Conclusion The present data shows that PAE could improve LUTS by BPH after short- and mid-term follow-up; however, more cumulative studies for long-term follow-up and comparison with other therapeutic modalities will be needed.
Objective: To evaluate the impact of neurological and medical complications on 3‐month outcomes in acute ischaemic stroke patients.
Methods: We prospectively investigated complications for all the ...consecutive acute ischaemic stroke patients admitted within 7 days from onset in four university hospitals during a 1‐year period. Baseline data and 3‐month outcomes were collected. Poor outcome was defined as a modified Rankin Scale score 3–6.
Results: A total of 1 254 patients were recruited: 264 (21.1%) and 303 (24.2%) patients experienced one or more neurological and medical complications, respectively. The most common complications were ischaemic stroke progression (17.1%) and pneumonia (12.0%). Of 1 233 patients with available 3‐month outcomes, 34.9% had a poor outcome. Multivariate analysis revealed that neurological (odds ratio, 95% confidence interval; 5.47, 3.63–8.24) and medical (3.47, 2.30–5.23) complications were independent predictors of the poor outcome. For the individual complications, ischaemic stroke progression (7.48, 4.73–11.84), symptomatic hemorrhagic transformation (3.57, 1.33–9.54), pneumonia (4.44, 2.20–8.99), extracranial bleeding (4.45, 1.88–10.53), and urinary tract infection (2.72, 1.32–5.60) were independently associated with the poor outcome.
Conclusion: Outcome after ischaemic stroke is adversely influenced by complications, especially ischaemic stroke progression, symptomatic hemorrhagic transformation, pneumonia, extracranial bleeding, and urinary tract infection. Interventions to prevent those complications might improve ischaemic stroke outcome.
Summary
Mesenchymal stem cells (MSCs) have the inherent ability to migrate to multiple organs and to exert immunosuppressive activity. The aim of this study was to investigate the anti‐arthritogenic ...effects of interleukin (IL)‐10‐transduced MSCs (IL‐10‐MSC) on the development of inflammatory arthritis. DBA/1 mice were immunized with type II collagen (CII) to induce inflammatory arthritis and then injected weekly three times with IL‐10‐MSCs 21 days after primary immunization. Control mice received vehicle or MSCs alone. Serum anti‐CII antibody and T cell response to CII were determined. The results showed that cultured IL‐10‐MSCs were able to secrete high amounts of IL‐10 in vitro. Injection of IL‐10‐MSCs decreased the severity of arthritis significantly. However, there was no difference in arthritis severity between mice treated with MSC and vehicle alone. Anti‐CII antibody titres in the sera and T cell proliferative response to CII in lymph node cells were decreased significantly in mice treated with IL‐10‐MSCs compared with vehicle‐treated mice. Serum IL‐6 level was also decreased by the administration of IL‐10‐MSCs. In contrast, spleen cells of IL‐10‐MSC‐treated mice produced higher amounts of IL‐4 than those of control mice. Interestingly, although not as potent as IL‐10‐MSCs, injection of naive MSCs alone decreased serum levels of IL‐6 and anti‐CII antibody, while increasing IL‐4 production from cultured splenic cells. Taken together, systemic administration of genetically modified MSCs overexpressing IL‐10 inhibits experimental arthritis not only by suppressing autoimmune response to CII but also by regulating cytokine production, and thus would be a new strategy for treating rheumatoid arthritis.
Summary
Oxidative stress is involved in the pathophysiology of rheumatoid arthritis (RA). We investigated the therapeutic potential of rebamipide, a gastroprotective agent with a property of reactive ...oxygen species scavenger, on the development of inflammatory polyarthritis and the pathophysiological mechanisms by which rebamipide might confer anti‐arthritic effects in SKG mice, an animal model of RA. Intraperitoneal (i.p.) injection of rebamipide attenuated the severity of clinical and histological arthritis. Rebampide treatment reduced the number of T helper type 1 (Th1), Th2, Th17, inducible T cell co‐stimulator (ICOS)+ follicular helper T (Tfh) transitional type (T2) and mature B cells in the spleen, but increased the number of regulatory T (Treg), CD19+ CD1dhigh CD5high, CD19+ CD25high forkhead box protein 3 (FoxP3)+ regulatory B (Breg) cells, memory B cells, and transitional type 1 (T1) B cells. In addition, flow cytometric analysis revealed significantly decreased populations of FAS+GL‐7+ germinal centre B cells and B220− CD138+ plasma cells in the spleens of rebamipide‐treated SKG mice compared to controls. Rebamipide decreased germinal centre B cells and reciprocally induced Breg cells in a dose‐dependent manner in vitro. Rebamipide‐induced Breg cells had more suppressive capacity in relation to T cell proliferation and also inhibited Th17 differentiation from murine CD4+ T cells. Together, these data show that i.p. administration of rebamipide suppresses arthritis severity by inducing Breg and Treg cells and suppressing Tfh and Th17 cells in a murine model of RA.
Gene fusion is involved in the development of various types of malignancies. Recent advances in sequencing technology have facilitated identification of gene fusions and have stimulated the research ...of this field in cancer. In the present study, we performed next-generation transcriptome sequencing in order to discover novel gene fusions in gastric cancer. A total of 282 fusion transcript candidates were detected from 12 gastric cancer cell lines by bioinformatic filtering. Among the candidates, we have validated 19 fusion transcripts, which are 7 inter-chromosomal and 12 intra-chromosomal fusions. A novel DUS4L-BCAP29 fusion transcript was found in 2 out of 12 cell lines and 10 out of 13 gastric cancer tissues. Knockdown of DUS4L-BCAP29 transcript using siRNA inhibited cell proliferation. Soft agar assay further confirmed that this novel fusion transcript has tumorigenic potential. We also identified that microRNA-coding gene PVT1, which is amplified in double minute chromosomes in SNU-16 cells, is recurrently involved in gene fusion. PVT1 produced six different fusion transcripts involving four different genes as fusion partners. Our findings provide better insight into transcriptional and genetic alterations of gastric cancer: namely, the tumorigenic effects of transcriptional read-through and a candidate region for genetic instability.
Summary
Background
Operative link on gastritis assessment (OLGA) and Operative link on gastric intestinal metaplasia assessment (OLGIM) staging systems have been proposed for gastric cancer (GC) risk ...estimation.
Aim
To validate the OLGA and OLGIM staging systems in a region with high risk of GC.
Methods
This retrospective study included 474 GC patients and age‐ and sex‐matched health screening control persons in a cancer centre hospital. We classified gastritis patterns according to the OLGA and OLGIM systems using the histological database that a pathologist prospectively evaluated using the updated Sydney system. GC risk according to the OLGA and OLGIM stages was evaluated using logistic regression analysis.
Results
More GC patients had OLGA stages III–IV (46.2%) than controls (26.6%, P < 0.001), particularly among patients with intestinal‐type GCs (62.2%) compared with diffuse‐type GCs (30.9%). OLGA stages III and IV were significantly associated with increased risk of GC odds ratios (ORs), 2.09; P = 0.008 and 2.04; P = 0.014 respectively in multivariate analysis. The association was more significant for intestinal‐type (ORs, 4.76; P = 0.001 and 4.19; P = 0.002 respectively), but not diffuse‐type GC. OLGIM stages from I to IV were significantly associated with increased risk of both intestinal‐type (ORs, 3.64, 5.15, 7.89 and 13.20 respectively) and diffuse‐type GC (ORs, 1.84, 2.59, 5.08 and 6.32 respectively) with a significantly increasing trend.
Conclusion
As high OLGA and OLGIM stages are independent risk factors for gastric cancer, the staging systems may be useful for risk assessment in high‐risk regions, especially for intestinal‐type gastric cancer.
Mycobacterium tuberculosis
(Mtb) in sputum originates from lung cavities in tuberculosis (TB) patients. But drug susceptibility testing (DST) of sputum Mtb can not be conducted the same as in the ...lung because mutagenesis of bacilli may be happening in the lung during treatment and result in the possibility of the presence of heterogeneous drug-resistant subpopulations in the different lung lesions. This could be one of the reasons for low cure rates for multi-drug resistant (MDR)-TB. We studied the resected lungs of nine surgery patients with chronic TB. The isolates isolated from the sputum and different lung lesions of each patient were tested for phenotypic DST and genotyped using restriction fragment length polymorphism (RFLP) typing method. Genetic analysis to resistance to first and second line drugs was also performed. Five of nine patients were MDR-TB and three XDR-TB. DST results for ten anti-TB drugs were in accordance among different lung lesions in eight patients. However, only three of these eight patients showed the concordance of DST with sputum. Even though the isolates were heteroresistant, genotyping them by RFLP showed the clonal population in each individual patient. Six of eight followed-up patients achieved successful cure. In conclusion, the heteroresistance between sputum and lung lesions and a clonal population without mixed infection might provide useful information in establishing treatment regimen and surgery decision for MDR- and XDR-TB.
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