Background and aims
Eradication of
Helicobacter pylori
reduces the risk of gastric cancer. In this study, we investigated the risk beyond 10 years after eradication of
H. pylori
.
Methods
We ...conducted a retrospective cohort study of 2737 patients who had yearly endoscopic follow-up after cure of
H. pylori
infection. For comparison of gastric cancer risk in the second decade of follow-up with that in the first decade, we calculated standardized incidence ratios (SIRs) by dividing the number of observed cases of gastric cancer in the second decade of follow-up by that of expected cases which was estimated using the incidence rate ratio of age in the first decade.
Results
During the follow-up for as long as 21.4 years (mean 7.1 years), gastric cancer developed in 68 patients (0.35% per year). The SIRs for diffuse-type gastric cancer was infinity (0 expected case and 4 observed cases) in patients with mild gastric mucosal atrophy and 10.9 (95% confidence interval 4.53–26.1) with moderate atrophy, whereas no significant increase of SIRs was observed in intestinal-type cancer regardless of the grade of baseline gastric atrophy or in diffuse-type cancer in patients with severe atrophy even though who had the highest risk.
Conclusions
The longer the follow-up, the greater the risk of developing diffuse-type gastric cancer becomes in patients with mild-to-moderate gastric atrophy at baseline. Endoscopic surveillance should be continued beyond 10 years after cure of
H. pylori
irrespective of the severity of gastric atrophy.
Background
We previously reported that the incidence of hepatocellular carcinoma (HCC) with non-viral etiologies increased rapidly between 1991 and 2010 in Japan.
Methods
To update this ...investigation, we enrolled patients who were initially diagnosed as having non-B, non-C HCC at participating hospitals between 2011 and 2015. In addition to the patient characteristics investigated in the previous report, we also investigated the duration of alcohol consumption. The overall survival rate was analyzed using the Kaplan–Meier method, and the hazard function against the body mass index (BMI) was plotted using cubic splines.
Results
A total of 2087 patients were enrolled. The proportion of patients with non-viral etiologies has continued to increase from 10.0% in 1991 to 32.5% in 2015. Patients were also older (median ages, 70–73 years) and more obese (median BMIs, 23.9–24.2 kg/m
2
), and the proportions of patients with diabetes mellitus (46.1% to 51.6%), hypertension (42.7% to 58.6%), dyslipidemia (14.6% to 22.9%), and fatty liver (24.0% to 28.8%) had all increased significantly. There was a significant inverse relationship between the duration and the amount of daily alcohol consumption. The improvement in the overall survival was relatively small, with a decreased proportion of patients under surveillance (41.3% to 31.6%). A hazard function plot showed a curve similar to that in our previous report, with a lowest hazard of ~ 26 kg/m
2
.
Conclusions
The proportion of HCC patients with non-viral etiologies continues to increase in Japan. Lifetime total amount of alcohol consumption may be a risk factor.
Calcium (Ca
) plays an important role in regulating the differentiation and function of osteoclasts. Calcium oscillations (Ca oscillations) are well-known phenomena in receptor activator of nuclear ...factor kappa B ligand (RANKL)-induced osteoclastogenesis and bone resorption via calcineurin. Many modifiers are involved in the fine-tuning of Ca oscillations in osteoclasts. In addition to macrophage colony-stimulating factors (M-CSF; CSF-1) and RANKL, costimulatory signaling by immunoreceptor tyrosine-based activation motif-harboring adaptors is important for Ca oscillation generation and osteoclast differentiation. DNAX-activating protein of 12 kD is always necessary for osteoclastogenesis. In contrast, Fc receptor gamma (FcRγ) works as a key controller of osteoclastogenesis especially in inflammatory situation. FcRγ has a cofactor in fine-tuning of Ca oscillations. Some calcium channels and transporters are also necessary for Ca oscillations. Transient receptor potential (TRP) channels are well-known environmental sensors, and TRP vanilloid channels play an important role in osteoclastogenesis. Lysosomes, mitochondria, and endoplasmic reticulum (ER) are typical organelles for intracellular Ca
storage. Ryanodine receptor, inositol trisphosphate receptor, and sarco/endoplasmic reticulum Ca
ATPase on the ER modulate Ca oscillations. Research on Ca oscillations in osteoclasts has still many problems. Surprisingly, there is no objective definition of Ca oscillations. Causality between Ca oscillations and osteoclast differentiation and/or function remains to be examined.
Diagnosing esophageal squamous cell carcinoma (SCC) depends on individual physician expertise and may be subject to interobserver variability. Therefore, we developed a computerized image-analysis ...system to detect and differentiate esophageal SCC.
A total of 9591 nonmagnified endoscopy (non-ME) and 7844 ME images of pathologically confirmed superficial esophageal SCCs and 1692 non-ME and 3435 ME images from noncancerous lesions or normal esophagus were used as training image data. Validation was performed using 255 non-ME white-light images, 268 non-ME narrow-band images/blue-laser images, and 204 ME narrow-band images/blue-laser images from 135 patients. The same validation test data were diagnosed by 15 board-certified specialists (experienced endoscopists).
Regarding diagnosis by non-ME with narrow-band imaging/blue-laser imaging, the sensitivity, specificity, and accuracy were 100%, 63%, and 77%, respectively, for the artificial intelligence (AI) system and 92%, 69%, and 78%, respectively, for the experienced endoscopists. Regarding diagnosis by non-ME with white-light imaging, the sensitivity, specificity, and accuracy were 90%, 76%, and 81%, respectively, for the AI system and 87%, 67%, and 75%, respectively, for the experienced endoscopists. Regarding diagnosis by ME, the sensitivity, specificity, and accuracy were 98%, 56%, and 77%, respectively, for the AI system and 83%, 70%, and 76%, respectively, for the experienced endoscopists. There was no significant difference in the diagnostic performance between the AI system and the experienced endoscopists.
Our AI system showed high sensitivity for detecting SCC by non-ME and high accuracy for differentiating SCC from noncancerous lesions by ME.
The aim of this study was to clarify whether dental floss clip (DFC) traction improves the technical outcomes of endoscopic submucosal dissection (ESD).
A superiority, randomized control trial was ...conducted at 14 institutions across Japan. Patients with single gastric neoplasm meeting the indications of the Japanese guidelines for gastric treatment were enrolled and assigned to receive conventional ESD or DFC traction-assisted ESD (DFC-ESD). Randomization was performed according to a computer-generated random sequence with stratification by institution, tumor location, tumor size, and operator experience. The primary endpoint was ESD procedure time, defined as the time from the start of the submucosal injection to the end of the tumor removal procedure.
Between July 2015 and September 2016, 640 patients underwent randomization. Of these, 316 patients who underwent conventional ESD and 319 patients who underwent DFC-ESD were included in our analysis. The mean ESD procedure time was 60.7 and 58.1 minutes for conventional ESD and DFC-ESD, respectively (P = .45). Perforation was less frequent in the DFC-ESD group (2.2% vs .3%, P = .04). For lesions located in the greater curvature of the upper or middle stomach, the mean procedure time was significantly shorter in the DFC-ESD group (104.1 vs 57.2 minutes, P = .01).
Our findings suggest that DFC-ESD does not result in shorter procedure time in the overall patient population, but it can reduce the risk of perforation. When selectively applied to lesions located in the greater curvature of the upper or middle stomach, DFC-ESD provides a remarkable reduction in procedure time.
Objectives
Attenuation correction (AC) is crucial for ensuring the quantitative accuracy of positron emission tomography (PET) imaging. However, obtaining accurate μ-maps from brain-dedicated PET ...scanners without AC acquisition mechanism is challenging. Therefore, to overcome these problems, we developed a deep learning-based PET AC (deep AC) framework to synthesize transmission computed tomography (TCT) images from non-AC (NAC) PET images using a convolutional neural network (CNN) with a huge dataset of various radiotracers for brain PET imaging.
Methods
The proposed framework is comprised of three steps: (1) NAC PET image generation, (2) synthetic TCT generation using CNN, and (3) PET image reconstruction. We trained the CNN by combining the mixed image dataset of six radiotracers to avoid overfitting, including
18
FFDG,
18
FBCPP-EF,
11
CRacropride,
11
CPIB,
11
CDPA-713, and
11
CPBB3. We used 1261 brain NAC PET and TCT images (1091 for training and 70 for testing). We did not include
11
CMethionine subjects in the training dataset, but included them in the testing dataset.
Results
The image quality of the synthetic TCT images obtained using the CNN trained on the mixed dataset of six radiotracers was superior to those obtained using the CNN trained on the split dataset generated from each radiotracer. In the
18
FFDG study, the mean relative PET biases of the emission-segmented AC (ESAC) and deep AC were 8.46 ± 5.24 and − 5.69 ± 4.97, respectively. The deep AC PET and TCT AC PET images exhibited excellent correlation for all seven radiotracers (
R
2
= 0.912–0.982).
Conclusion
These results indicate that our proposed deep AC framework can be leveraged to provide quantitatively superior PET images when using the CNN trained on the mixed dataset of PET tracers than when using the CNN trained on the split dataset which means specific for each tracer.
Abstract
Circulating microRNAs (miRNAs) in serum extracellular vesicles (EVs) are a promising biomarker in cancer. We aimed to elucidate the serum EVs miRNA biomarkers to identify patients with ...gallbladder cancer (GBC) and to clarify their potential roles. One hundred nineteen serum EVs from GBC and non-GBC individuals were isolated by pure-EVs-yieldable size-exclusion chromatography, and then were analyzed using a comprehensive miRNAs array and RT-qPCR-based validation. The functional roles of the identified miRNAs were also investigated using GBC cell lines. Serum EVs miR-1246 and miR-451a were significantly upregulated and downregulated, respectively in GBC patients (
P
= 0.005 and
P
= 0.001), in line with their expression levels in cancer tissue according to an in silico analysis. The combination of CEA and CA19-9 with miR-1246 showed the highest diagnostic power (AUC, 0.816; Sensitivity, 72.0%; Specificity, 90.8%), and miR-1246 was an independent prognostic marker of GBC (Hazard ratio, 3.05;
P
= 0.017) according to a Cox proportional hazards model. In vitro, miR-1246 promoted cell proliferation and invasion, while miR-451a inhibited cell proliferation and induced apoptosis with the targeting of MIF, PSMB8 and CDKN2D. Taken together, miR-1246 in serum EVs has potential application as a diagnostic and prognostic marker and miR-451a may be a novel therapeutic target in GBC.
Humans are known to possess an “affirming the consequent fallacy,” which assumes that a learned contingency holds true even when the order is reversed. In contrast, non-human animals do not fall for ...this fallacy, as they do not have the contingency symmetry bias. Importantly, language is founded on the symmetrical relationship between symbols and referents, and the contingency symmetry bias plays a key role in word learning. A critical problem for the ontogenesis of language is whether the contingency symmetry bias has been acquired through the experience of word learning or if it is present before infants begin word learning. Using a habituation switch paradigm, 8-month-old human infants and adult chimpanzees were familiarized with two object-then-movement sequences, whereby Object A (or B) was always paired with Movement A (or B). At test, the order of the contingency was reversed. The infants showed surprise when observing the violation of the object-movement pairings in the reversed sequence (Experiment 1). In contrast, despite the chimpanzees being able to detect the violation of the pairings in the original direction (Experiment 2a), they did not discriminate the learned and novel pairings when the order of the contingency was reversed (Experiment 2b). The results suggest that the contingency symmetry bias is a uniquely human cognitive bias, one which plays a critical role for language acquisition ontogenetically. This contingency symmetry bias likely gives humans a great advantage, by enabling them to rapidly expand their knowledge without direct training and making them strikingly different from other animal species. (250 words).
•“Affirming the consequent fallacy” is a representative bias in human thinking.•Language is founded on the bi-directional relation between symbols and referents.•Understanding of the bi-directional relationship is necessary for word learning.•Human 8-month-olds and adult chimpanzees were trained on temporal contingencies.•Preverbal human infants but not chimpanzees showed the contingency symmetry bias.
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