Background
Various parameters are used to predict perioperative surgical outcomes. However, no comprehensive studies in gastrectomy have been conducted. This study aimed to compare the performance of ...each parameter in patients with gastric cancer.
Methods
The medical records of 1032 gastric cancer patients who underwent curative gastrectomy between 2009 and 2015 were reviewed. Laboratory values and associated parameters (neutrophil count, lymphocyte count, platelet count, albumin level, Prognostic Nutritional Index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and Systemic Immune-Inflammation Index) as well as body weight-related data and associated parameters body mass index (BMI), percentage of weight loss, Nutritional Risk Screening 2002 assessment, the Malnutrition Universal Screening Tool, and the Nutritional Risk Index were measured and calculated. The study end points were major complications, operative mortality, prolonged hospital stay, overall survival (OS), and recurrence-free survival (RFS).
Results
Multivariable logistic regression analysis showed that male gender, total gastrectomy, advanced-stage gastric cancer, and low albumin level were risk factors for major complications. Old age, total gastrectomy, advanced-stage cancer, and high BMI were risk factors for operative mortality. Old age, open approach, and total gastrectomy were risk factors for prolonged hospital stay. Multivariable Cox proportional hazards models showed that old age, total gastrectomy, advanced-stage cancer, and high neutrophil count were unfavorable risk factors for OS. Old age, advanced-stage cancer, high neutrophil count, and high BMI were unfavorable risk factors for RFS.
Conclusions
Albumin level, BMI, and neutrophil count are the most useful parameters for predicting short- and long-term surgical outcomes. Compared with complex parameters, simple-to-measure parameters are better for predicting surgical outcomes for gastric cancer patients.
The strength of the T cell receptor interaction with self-ligands affects antigen-specific immune responses. However, the precise function and underlying mechanisms are unclear. Here, we demonstrate ...that naive CD8
T cells with relatively high self-reactivity are phenotypically heterogeneous owing to varied responses to type I interferon, resulting in three distinct subsets, CD5
Ly6C
, CD5
Ly6C
, and CD5
Ly6C
cells. CD5
Ly6C
cells differ from CD5
Ly6C
and CD5
Ly6C
cells in terms of gene expression profiles and functional properties. Moreover, CD5
Ly6C
cells demonstrate more extensive antigen-specific expansion upon viral infection, with enhanced differentiation into terminal effector cells and reduced memory cell generation. Such features of CD5
Ly6C
cells are imprinted in a steady-state and type I interferon dependence is observed even for monoclonal CD8
T cell populations. These findings demonstrate that self-reactivity controls the functional diversity of naive CD8
T cells by co-opting tonic type I interferon signaling.
Despite advances in cancer therapy, the clinical outcome of patients with gastric cancer remains poor, largely due to tumor heterogeneity. Thus, finding a hidden vulnerability of clinically ...refractory subtypes of gastric cancer is crucial. Here, we report that chemoresistant gastric cancer cells rely heavily on endocytosis, facilitated by caveolin-1, for survival. caveolin-1 was highly upregulated in the most malignant stem-like/EMT/mesenchymal (SEM)-type gastric cancer cells, allowing caveolin-1-mediated endocytosis and utilization of extracellular proteins via lysosomal degradation. Downregulation of caveolin-1 alone was sufficient to induce cell death in SEM-type gastric cancer cells, emphasizing its importance as a survival mechanism. Consistently, chloroquine, a lysosomal inhibitor, successfully blocked caveolin-1-mediated endocytosis, leading to the marked suppression of tumor growth in chemorefractory gastric cancer cells in vitro, including patient-derived organoids, and in vivo. Together, our findings suggest that caveolin-1-mediated endocytosis is a key metabolic pathway for gastric cancer survival and a potential therapeutic target.
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•Bi-RGO was synthesized by one-pot supercritical acetone method.•Unique deoxygenation properties and ultrafast Bi formation of scACT formed Bi-RGO.•Nanosize Bi tightly anchored on ...basal plane of RGO with a heterogeneous nucleation.•Reversible capacity of 170 mAh g−1 and the high volumetric capacity of 60 Ah L−1 were achieved.•Bi transformed to h-Na3Bi or c-Na3Bi phases depending on the Bi particle size.
A high-energy–density Bi-reduced graphene oxide (Bi-RGO) composite was synthesized using the quick one-pot supercritical acetone (scACT) method. The unique deoxygenation properties and ultrafast particle formation in scACT led to the simultaneous reduction of graphene oxide to reduced graphene oxide (RGO) and the formation of heterogeneously nucleated, nanosized Bi particles 10–20 nm in size that were tightly anchored to the basal plane of RGO and homogeneously nucleated, large Bi particles 250–950 nm in size. When tested as the anode of Na-ion batteries, the Bi-RGO composite delivered the high reversible capacity of 200 mAh g−1 at 50 mA g−1 and the high volumetric capacity of 60 Ah L−1. In situ X-ray diffraction analysis revealed that the two-step alloying–dealloying Bi → NaBi → hexagonal Na3Bi or cubic Na3Bi reactions depended on the Bi particle size.
Acute lymphoblastic leukemia (ALL) is one of the most rapidly changing hematological malignancies with advanced understanding of the genetic landscape, detection methods of minimal residual disease ...(MRD), and the development of immunotherapeutic agents with good clinical outcomes. The annual incidence of adult ALL in Korea is 300-350 patients per year. The WHO classification of ALL was revised in 2022 to reflect the molecular cytogenetic features and suggest new adverse- risk subgroups, such as Ph-like ALL and ETP-ALL. We continue to use traditional adverse-risk features and cytogenetics, with MRD-directed post-remission therapy including allogeneic hematopoietic cell transplantation. However, with the introduction of novel agents, such as ponatinib, blinatumomab, and inotuzumab ozogamicin incorporated into frontline therapy, good MRD responses have been achieved, and overall survival outcomes are improving. Accordingly, some clinical trials have suggested a possible era of chemotherapy-free or transplantation-free approaches in the near future. Nevertheless, relapse of refractory ALL still occurs, and some poor ALL subtypes, such as Ph-like ALL and ETP-ALL, are unsolved problems for which novel agents and treatment strategies are needed. In this review, we summarize the currently applied diagnostic and therapeutic practices in the era of advanced genetic analysis and targeted immunotherapies in United States and Europe and introduce real-world Korean data.
This study involved a Reynolds-averaged Navier-Stokes- (RANS-) based computational fluid dynamics (CFD) analysis of the 37-pin wire-wrapped fuel bundle of the PNC Plant dynamics test loop (PLANDTL) ...facility. Previously, mainly the hydrodynamic phenomena of the wire-wrapped fuel bundle were analyzed, but the present study additionally included heat transfer analysis through conjugate heat transfer. The main purpose of the study was to benchmark the experimental data of the PLANDTL 37-pin wire-wrapped fuel bundle to investigate the heat transfer phenomena. In addition, the aim was to verify the accuracy of the RANS-based CFD analysis method using the STAR-CCM+ simulation software in comparison with the experimental data. The grid used for verification was an innovative grid system consisting of hexahedra using Fortran-based code. The development of the RANS-based CFD methodology included grid sensitivity analysis, turbulence model sensitivity analysis, and turbulent Prandtl number sensitivity analysis. Information on the temperature, mass flow rate, and area of the CFD results for each subchannel was provided for the top of the heated section and is expected to serve as a reference for future studies aiming to perform the validation and verification of a PLANDTL facility. In addition, the dependence of the peak temperature on the azimuth angle of each pin was analyzed.
The authors reveal the mechanisms of degradation of capacity, charge voltage, and discharge voltage of commercially‐available high‐nickel cathode material when it is cycled without a voltage margin ...by two different charge protocols: constant‐current charging and constant‐current, constant‐voltage charging. With repeated constant‐current charging, the cathode material changes to a non‐periodic cation‐mixed state, which causes a relatively low voltage degradation, whereas during constant‐current, constant‐voltage charging, the cathode material changes from a layered structure to a periodic cation‐mixed spinel‐like phase, with consequent severe voltage decay. This decay results from a reduction in the equilibrium electrode potential and an increase of overpotential which are aggravated in a periodic cation‐mixed state. The findings provide insights into the use of excess Li without charge‐voltage margin in high‐Ni cathode materials.
Constant voltage step at high voltage (4.3 V) entails periodic cation‐mixed states in high‐nickel cathode materials which leads to severe voltage decay. Thus, constant voltage step at high voltage should be avoided for high‐nickel cathode materials. More fundamentally, structural stability of high‐nickel cathode materials should be improved to alleviate lattice distortion induced by the phase transition between two hexagonal phases.
Herein, we introduce a smartphone-integrated immunosensor based on non-spectroscopic optical detection. Sedimentation of the retroreflector and gentle inversion of the microfluidic chip was chosen as ...biosensing principles to ensure minimal human involvement. To realize this, wash-free immunosensing was implemented on a polymeric microfluidic chip device fabricated for light signal penetration in retroreflection signal acquisition. Applying a transparent chip and passive modulation of retroreflectors enabled the minimization of human error during sensing. In addition, a retroreflection-detectable optical gadget was constructed for integration with the commercial smartphone. The gadget had an optical chamber that induced retroreflection by integration with a smartphone. When the micro-sized reflector, named the retroreflective Janus microparticle, reacted on the sensing surface, the incident light was retroreflected towards the image sensor and quantified by a smartphone-installed Android application package. The developed application package features include time-lapse image capture performed by manipulating LED flash and camera modules, and quantification of retroreflected signal counts by image processing of time-lapse images. With this platform, the user could independently commence optical signal processing without a complicated optical setup and running software on a PC, and sensitive and reproducible immunosensing results could be obtained. The applicability test for creatine kinase-myocardial band detection from the buffer to serum was conducted and presented a calibration curve of 0–1000 ng/mL within 1 h. With the developed system, we believe that the applicability of the platform in bioanalytical detection can be expanded.
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•The retroreflection-based optical immunosensor has been developed to operate on smartphone.•A non-spectroscopic optical setup was constructed on a smartphone without additional optical components.•A wash-free immunosensing was demonstrated using the sedimentation of optical probe to minimize human involvement.•Time-lapse image acquisition and image processing algorithms were developed and installed on the Android APP.•CK-MB spiked serum sample was analyzed on a smartphone APP for quantitative POCT.
We investigated microsatellite instability (MSI) status and programed cell death ligand 1 (PD-L1) expression as predictors of prognosis and responsiveness to chemotherapy for stage II/III gastric ...cancer.
The clinical implications of MSI status and PD-L1 expression in gastric cancer have not been well-elucidated.
Tumor specimens and clinical information were collected from patients enrolled in the CLASSIC trial-a randomized controlled study of capecitabine plus oxaliplatin-based adjuvant chemotherapy. Five quasi-monomorphic mononucleotide markers were used to assess tumor MSI status. PD-L1 expressions of tumor and stromal immune cells were evaluated using immunohistochemistry.
Of 592 patients, 40 (6.8%) had MSI-high (MSI-H) tumors. Among 582 patients available for immunohistochemistry evaluation, PD-L1 was positive in tumor cells (tPD-L1) of 16 patients (2.7%) and stromal immune cells (sPD-L1) of 165 patients (28.4%). Multivariable analysis of disease-free survival (DFS) showed that MSI-H and sPD-L1-positivity were independent prognostic factors hazard ratio 0.301 (0.123-0.736), 0.714 (0.514-0.991); P = 0.008, 0.044), as were receiving chemotherapy, age, tumor grade, and TNM stage. Although adjuvant chemotherapy improved DFS in the microsatellite-stable (MSS) group (5-year DFS: 66.8% vs 54.1%; P = 0.002); no benefit was observed in the MSI-H group (5-year DFS: 83.9% vs 85.7%; P = 0.931). In the MSS group, sPD-L1-negative patients, but not sPD-L1-positive patients, had significant survival benefit from adjuvant chemotherapy compared with surgery only (5-year DFS: 66.1% vs 50.7%; P = 0.001).
MSI status and PD-L1 expression are clinically actionable biomarkers for stratifying patients and predicting benefit from adjuvant chemotherapy after D2 gastrectomy for stage II/III gastric cancer.
With advances in gastric cancer chemotherapy, conversion surgery has drawn attention as a new strategy to improve the outcome of stage IV disease. We investigated the efficacy of conversion surgery ...following chemotherapy for patients with stage IV gastric cancer.
We retrospectively reviewed clinico-pathologic variables and oncologic outcomes for 101 patients with stage IV gastric cancer who were treated with systemic chemotherapy followed by gastrectomy with intension of curative resection from January 2005 to December 2012.
In terms of the best response from palliative chemotherapy, complete or partial response were observed in 65 patients (64.4%) in overall. Complete response of metastatic site were observed in 72 (71.3%) and 66 (65.3%) patients as best and pre-operative response, respectively. The overall complete macroscopic resection, rate was 56.4%. Eleven patients (10.9%) received combined metastasectomy. There was no postoperative surgery-related mortality for 1 month. The median overall survival time was 26.0 months. Multivariable analysis identified complete macroscopic resection, chemotherapy response (complete response/partial response) of metastatic sites, and change in CEA level as independent prognostic factors contributing to overall survival.
Patients with stage IV gastric cancer who exhibit a good clinical response to chemotherapy might obtain greater survival benefit from gastrectomy following chemotherapy compared with patients who exhibit a poor response to chemotherapy. Prospective, randomized trials are required to determine the best strategy for combining initial chemotherapy with subsequent gastrectomy.
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