Multicenter study of early pancreatic cancer in Japan Kanno, Atsushi; Masamune, Atsushi; Hanada, Keiji ...
Pancreatology : official journal of the International Association of Pancreatology (IAP) ... et al.,
January 2018, 2018-Jan, 2018-01-00, 20180101, Letnik:
18, Številka:
1
Journal Article
Recenzirano
The diagnosis of early-stage pancreatic ductal adenocarcinoma (PDAC) is still challenging. We conducted a multicenter study to clarify the clinical features of early-stage PDAC in Japan.
We collected ...patients with stage 0 and stage I PDAC according to the sixth edition of the Japanese Classification of Pancreatic Carcinoma. We retrospectively analyzed the clinical profiles including opportunities for medical examination, imaging modalities and findings, methods of cytological diagnosis, and prognosis according to the stages at diagnosis.
Two hundred cases with Stage 0 and stage I PDAC were reported from 14 institutions, which accounted for approximately 0.7% and 3% of all PDAC cases, respectively. Overall, 20% of the early-stage PDAC cases were symptomatic. Indirect imaging findings such as dilatation of the main pancreatic duct were useful to detect early-stage PDAC. In particular, local fatty changes may be specific to early-stage PDAC. For preoperative pathologic diagnosis, cytology during endoscopic retrograde cholangiopancreatography was more commonly applied than endoscopic ultrasound fine-needle aspiration. Although the overall prognosis was favorable, new PDAC lesions developed in the remnant pancreas in 11.5% cases.
This multicenter study revealed several key points concerning the diagnosis and management of early-stage PDAC, including screening of asymptomatic cases, importance of indirect imaging findings, application of cytology during endoscopic retrograde cholangiopancreatography, and the risk of carcinogenesis in the remnant pancreas.
Aqueous Na-ion batteries are attracting attention as candidates for large-scale rechargeable batteries with a high safety level. We proposed a novel electrolyte composed of NaClO4 dissolved in water, ...along with ethylene glycol, to serve as an innovative solution for aqueous Na-ion batteries. The potential window of NaClO4 aqueous-based electrolyte expanded as the ethylene glycol concentration increased. Specifically, when incorporating ethylene glycol into a 7 m (= mol kg−1) NaClO4 aqueous electrolyte, we observed a favorable cyclability pattern in the context of the NaTi2(PO4)3 anode, akin to that exhibited by a 17 m NaClO4 aqueous electrolyte. Moreover, the irreversible capacity of NaTi2(PO4)3 decreased as the ethylene glycol concentration increased. This effect was evident even at low rates such as 0.2 mA cm−2. Notably, the NaTi2(PO4)3 anode’s capacity, when utilizing a 7 m NaClO4 solution with a higher fraction of ethylene glycol (XE = 0.5), remained stable at 120 mAh g−1 even after the completion of 15 cycles. On the other hand, the Na2MnP2O7 cathode properties 7 m NaClO4 aqueous electrolyte could not be improved by adding a small amount of ethylene glycol.
Abstract
Increased levels of proteases, such as trypsin, in the distal intestine have been implicated in intestinal pathological conditions
1–3
. However, the players and mechanisms that underlie ...protease regulation in the intestinal lumen have remained unclear. Here we show that
Paraprevotella
strains isolated from the faecal microbiome of healthy human donors are potent trypsin-degrading commensals. Mechanistically,
Paraprevotella
recruit trypsin to the bacterial surface through type IX secretion system-dependent polysaccharide-anchoring proteins to promote trypsin autolysis.
Paraprevotella
colonization protects IgA from trypsin degradation and enhances the effectiveness of oral vaccines against
Citrobacter rodentium
. Moreover,
Paraprevotella
colonization inhibits lethal infection with murine hepatitis virus-2, a mouse coronavirus that is dependent on trypsin and trypsin-like proteases for entry into host cells
4,5
. Consistently, carriage of putative genes involved in trypsin degradation in the gut microbiome was associated with reduced severity of diarrhoea in patients with SARS-CoV-2 infection. Thus, trypsin-degrading commensal colonization may contribute to the maintenance of intestinal homeostasis and protection from pathogen infection.
Aerosol droplets are fully involved in forming clouds and play a critical role in global climate change. The investigation of the properties, speciation, and structure of aerosol droplets at a ...molecular level is highly needed for understanding the physicochemical behaviors and processes of aerosol droplets. We investigate the composition, speciation, and structure of a single aqueous MgSO
4
droplet of 1 mm size ultrasonically levitated in the air and bulk solutions under ambient conditions by in situ Raman and synchrotron X-ray scattering. The composition and speciation are determined by measuring Raman spectra of the sulfate ion’s S–O band and water’s O–H bands. The X-ray data are subjected to empirical potential structure refinement modeling to extract the site–site pair correlation function, coordination number distribution, and 3-D structure for the ion solvation, association, and solvent water. In situ X-ray scattering measurements observe the crystallization of MgSO
4
hydrates from a droplet.
A 92‐year‐old man died of multiple lobar hemorrhage with amyloid‐β protein (Aβ)‐related angiitis (ABRA) with an unusual pathological appearance. Although he had shown relatively rapid progressive ...dementia, starting 1 year before death, there was no detailed clinical investigation, and no immunosuppressive or anticoagulant therapy, because of his advanced age. The autopsy showed two lobar hemorrhagic lesions in the right parietal lobe and temporal lobes. Microscopically, almost all the brain's blood vessels showed cerebral amyloid angiopathy with many foci of transmural vasculitis. Infiltrating cells were predominantly CD8‐positive T‐lymphocytes, but we observed no granulomatous inflammation with appearance of multinucleated giant cells. We found fibrinoid necrosis in some blood vessels and disruption of these blood vessels in the arachnoid space–cerebral cortex junction in the hemorrhagic lesion at the temporal lobe. We also observed an unusual, neutrophil‐predominant, abscess‐like vasculitis in the subarachnoid space; almost all such unusual vasculitides were located at a short distance from the two lobar hemorrhagic lesions. Serum anti‐neutrophil cytoplasmic myeloperoxidase and proteinase‐3 antibodies were negative, and the genotype of the apolipoprotein E (ApoE) gene (ApoE) was ε2/ε3. Although we did not observe some of ABRA's typical histopathological findings, transmural and vascular destructive inflammation with Aβ deposition was consistent with ABRA. Vulnerability of blood vessels to fibrinoid necrosis might be associated with disruption of the relevant blood vessels, leading to lobar hemorrhage. ABRA exhibits various clinical and histopathological findings, depending on the patient's age, immune function status, treatment, and ApoE genotype. This is the first case and the oldest (92 years old) autopsy of ABRA associated with ApoE‐ε2/ε3 genotype.
Background:
Infliximab (IFX) is effective for remission induction and maintenance of Crohn's disease (CD). This trial assessed the efficacy of scheduled maintenance IFX monotherapy to prevent ...postoperative CD recurrence.
Methods:
Thirty‐one CD patients who had ileocolic resection within the past 4 weeks were randomly assigned to scheduled IFX at 5 mg/kg intravenously every 8 weeks for 36 months (n = 15) or without IFX (control, n = 16). All patients were treated without immunomodulator or corticosteroid following surgery. The primary and secondary endpoints were remission rates at 12 and 36 months, defined as CD Activity Index (CDAI) ≤150, an International Organization for the Study of Inflammatory Bowel Disease (IOIBD) score <2, and C‐reactive protein (CRP) <0.3 mg/dL. Additionally, endoscopic recurrences at 12 and 36 months were evaluated.
Results:
At 12 and 36 months, 100%, and 93.3% of patients in the IFX group were in remission (IOIBD <2), respectively vs. 68.8% and 56.3% in the control arm (P < 0.03). Similarly, 86.7% and 86.7% of patients in the IFX group maintained serological remission (CRP <0.3 mg/dL) vs. 37.5% and 37.5% in the control arm (P < 0.02). Further, the IFX group achieved higher endoscopic remission at 12 months, 78.6% vs. 18.8% (P = 0.004). However, in the Kaplan–Meier survival analysis the CDAI scores between the two arms were not significantly different either at 12 or at 36 months. No adverse event (AE) was observed.
Conclusions:
An early intervention with IFX monotherapy should prevent clinical, serological, and endoscopic CD recurrence following ileocolic resection. Thiopurine naivety and eliminating the initial loading dose of IFX might minimize serious AEs. (Inflamm Bowel Dis 2012)
A single liquid droplet in the air generated by ultrasonic levitation provides such analytical advantages as a small sample volume (~ μL) for expensive proteins, container-free condition for deeply ...supercooling and supersaturation, time-dependent observation, and homogeneous rapid mixing. The investigation of the properties and structure of a droplet at a molecular level is highly needed for understanding the physicochemical behaviors of a droplet and an underlying mechanism of processes in the droplet. We develop in situ Raman and synchrotron X-ray scattering methods of a single liquid droplet of ~ 1 mm size ultrasonically levitated. The composition of a supersaturated Mg(NO
3
)
2
droplet and speciation in the droplet are determined by analyzing the nitrate N–O and the water O–H stretching vibrational Raman bands. The X-ray interference function of an supersaturated Mg(NO
3
)
2
droplet is subjected to an empirical potential structure refinement modeling to reveal the ion solvation, association, and solvent water structure. Furthermore, crystallization of Mg(NO
3
)
2
⋅
n
H
2
O from a saturated droplet is observed and identified.
Graphical abstract
Down syndrome (DS) is frequently associated with Alzheimer's disease (AD)-related neuropathological changes. There are few observations on the spectrum of mixed proteinopathies in DS patients.
This ...study aimed to evaluate multiple disease-associated proteinopathies in a series of DS cases.
We analyzed the distribution of neurodegenerative disease associated proteins in postmortem brain samples from 11 DS cases (6 females, median age 57, range 38-66 years). Sections were stained for phosphorylated tau, 3-repeat and 4-repeat tau, amyloid-β, alpha synuclein, phosphorylated TDP-43, and p62. A comprehensive anatomical mapping and staging were applied for all proteins.
Tau and amyloid-β pathology was prevalent in all cases and compatible with that typically seen in AD with some subtle deviations. Four of 11 cases presented with Lewy-related pathology (LRP). Two cases followed the Braak staging (stage 4 and 5) whereas 2 cases presented with an atypical distribution. Two cases showed limbic predominant age-related TDP-43 encephalopathy (LATE) (stage 1 and stage 2) neuropathologic change. Two cases exhibited aging-related tau astrogliopathy (ARTAG).
In addition to subtle deviations from AD regarding the morphology of amyloid-β deposition and distribution of neuronal tau pathology, we find that the spectrum of mixed-pathologies in DS show distinctive features such as deviations from the Braak staging of LRP and that LATE neuropathologic change and ARTAG pathology can be seen in individuals younger than in sporadic AD cases. Our observations support the notion that DS has distinctive pathogenic pathways from sporadic AD.
X-ray diffraction measurements are performed on a 1
m
(= mol kg
−1
) CeCl
3
aqueous solution over a temperature range of 300–600 K and a pressure range of 0.1 MPa to 4 GPa. The experimental ...interference functions are analyzed by an empirical potential structure refinement (EPSR) modeling. The Ce
3+
coordinates water molecules in a tricapped trigonal prism configuration under the ambient condition. The number of water molecules around Ce
3+
changes from 8.8 at 0.1 MPa/300 K to 11.5 at 4 GPa/600 K. The number of water molecules around Cl
−
changes drastically from 10 under the ambient condition to 17 at 4 GPa/600 K. The tetrahedral-like network structure of water under the ambient condition is transformed toward a simple liquid-like packing in the GPa pressure range. The corresponding coordination number is increased from 4.3 in the ambient condition to 9.7 at 4 GPa/600 K. The Ce
3+
–Cl
−
association decreases with increasing pressure.
Graphical abstract
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