Perineural invasion (PNI) is known as a poor prognostic factor in colorectal cancer (CRC). Although histopathological evaluation of PNI is usually conducted on hematoxylin and eosin (HE)‐stained ...sections (HE‐PNI), it remains controversial whether PNI can be precisely evaluated only by HE‐staining, and its concise mechanisms causing worse prognosis remains elusive. In this study, we examined the impact of PNI evaluated by S‐100‐immunostaining (S100‐PNI) on postoperative mortality in 279 consecutive CRC patients and further investigated its association with the tumor immune microenvironment. S100‐PNI was present in 67.3% of tumors whereas HE‐PNI was present in 18.5%. A 5‐year cumulative incidence of death in the S100‐PNI‐positive group was significantly higher than that in the S100‐PNI‐negative group. Further statistical analyses revealed that S100‐PNI was an independent prognostic factor of all‐cause mortality in stage I/II but not in stage III/IV. Importantly, S100‐PNI was associated with the altered tumor immune microenvironment. Infiltrating immune cell profiling revealed that stromal lymphocytic reaction, which was inversely correlated with postoperative mortality, was significantly reduced in S100‐PNI‐positive tumors compared to S100‐PNI‐negative tumors in stage I/II. These results indicated that S100‐PNI was a poor prognostic factor in stage I/II CRC with possible association with immunosuppression in the tumor.
Expanding the inclusion criteria for active prostate cancer surveillance to include cases with a Gleason score (GS) of 3 + 4 = 7 has been discussed. GS 3 + 4 = 7 cases with a percentage of Gleason ...pattern 4 (%GP4) <5% were shown to be associated with similar outcomes with those of GS 6 cases. We examined the clinicopathological significance of %GP4 ≥5% with a limited amount of GP4. A total of 315 radical prostatectomy cases with GS 6 or 3 + 4 = 7 in a prior biopsy, were reviewed. The cases with the highest %GP4 ≥5% were subcategorized using the total length of GP4 (GP4‐TL) and number of GS 3 + 4 = 7 cores. As outcome measures, the frequency of adverse pathology (AP) and the risk of biochemical recurrence (BCR) were compared between the GS 6 and 3 + 4 = 7 subgroups. In the %GP4 ≥5% subgroup, only cases with both GP4‐TL <0.5 mm and 1 core of GS 3 + 4 = 7 showed similar outcome measures with those of GS 6 cancers. However, all other subgroups showed a higher frequency of AP and/or risk of BCR than GS 6 cancers. Our results suggest that cases with %GP4 ≥5% with a limited amount of GP4 should be considered for inclusion in the active surveillance category.
Angiofibroma of soft tissue is a recently described soft tissue tumor that is characterized by fibroblastic spindle tumor cells with arborizing capillary proliferation. Cytogenetically, it harbors a ...specific fusion gene involving the nuclear receptor coactivator 2 (NCOA2) gene. We report here additional new pathological and cytogenetic features. A soft tissue tumor in the left thigh of 73‐year‐old female was investigated. Microscopically, histiocytoid tumor cells were scattered in an edematous background with branching capillary proliferation. Immunohistochemically, we identified that the tumor cells were positive for histiocytic markers such as CD68 and CD163. Rearrangement of the NCOA2 gene was detected successfully by chromogenic in situ hybridization; however, abnormal signal patterns were observed in only a small subset of tumor cells. Unlike typical tumors with bland spindle cells, the present tumor needs to be distinguished from myxoid, dendritic and clear cell tumors. This case may suggest that angiofibroma of soft tissue is not in the center of the fibroblastic/myofibroblastic tumor group, but rather shows a fibrohistiocytic nature. We also found intratumor genetic heterogeneity, which is uncommon for a translocation‐associated tumor. Therefore, careful evaluation is required to detect the gene rearrangement in this tumor entity.
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An inhibitor of the complex of factor VIIa and tissue factor (fVIIa/TF), 2-substituted-4-amidinophenylpyruvic acid
1a, was structurally modified with the aim of increasing its potency ...and selectivity. The lead compound
1a was originally found in our factor Xa (fXa) inhibitor library on the basis of structural similarity of the primary binding sites of fVIIa and fXa. The design was based on computational docking studies using the extracted active site of fVIIa. Compound
1j was found to inhibit factor VIIa/TF at nanomolar concentration with improved selectivity versus fXa and thrombin and it preferentially prolonged the clotting time in the TF-dependent extrinsic pathway.
Benign notochordal cell tumors (BNCTs) are tumors originating in the axial skeleton, where chordomas occur. Although very rare, some cases of extraosseous chordoma, such as in the soft tissue and ...lungs, have been reported. We report a case of a primary tumor showing the notochordal characteristics of BNCTs within the axial skeleton.An asymptomatic 57-year-old woman presented with an abnormal shadow on her chest radiograph; chest computed tomography revealed a well-defined round nodule. The resected sample tissue contained a jelly-like small nodule. Histologically, it was identified as a BNCT, based on minimal nuclear atypia, extremely low mitotic activity within the tumor cells lying in a sheet-like arrangement, and focal immunopositivity for brachyury.This is the third case report of BNCT originating in the lungs; BNCTs are considered asymptomatic tumors that are identified by using highly developed chest imaging technology; however, our findings also suggest that these notochordal tumors may potentially originate from extraosseous sites that lack ideal precursor cells. Our case suggests that notochordal tumors can arise from organs that are unrelated to known notochordal development.
A current issue in Japan is building sustainable living environments in light of its shrinking and aging population. Depopulated regions in particular have seen significant declines in birthrates, ...and face the problem of the consolidation and closure of elementary schools. There are fears that the withdrawal of schools from an area may impoverish the region and make for less sustainable living. Meanwhile, the issue of school consolidation has triggered the development of resident-led efforts for regional preservation in various areas, and these efforts have been recognized as forming part of sustainable living support infrastructure. Accordingly, this study looked at elementary schools with a rural village student-family schooling system to sustain elementary schools and their surrounding regions for the purpose of clarifying the actual conditions of these schemes, and conducted a survey of three areas with a comparatively good record for such a scheme on a national level. The study produced the following findings. 1. The study clarified the processes and operating structures of village schooling schemes in the three areas, from inception to the present. One feature shared by all three areas is that the region's residents participated in the village schooling activities, and got involved with a sense of being interested parties to the scheme. Another characteristic is that the organizational structure is inherent in the three areas, and the members of the organization differs depending on the activity history. 2. As a feature of the content of the initiatives, each organization has a common point in interviewing, offering houses, life counselling and introducing work at the start of schooling. Next, at the stage of the start of schooling, matches such as entrance examination and interview of decision to join schooling system are made by the organization. Thirdly, there are two types of houses to be offered: " Houses for newcomers (vacant houses used)" and " Houses exclusively for mountain village schooling families (public housing)". In the latter, there are one that utilizes existing public housing and the other is newly constructed. 3. The schemes can be considered to have a certain effect towards sustaining schools, as the numbers of pupils at elementary schools were maintained through village schooling students. In addition, part of the improvement of regional power was caught, as the accumulation power of building resources has increased due to the continuation of schools and the utilization of vacant houses, and the formation organization of residents' organizations has improved due to the formation of three groups. However, further research is necessary as to whether the operation of the rural village schooling system will lead to the community sustainable.
Aim
We explored how acculturation and self‐actualization affect depression in the HIV‐positive Asians and Pacific Islanders immigrant population.
Background
Asians and Pacific Islanders are among the ...fastest growing minority groups in the USA. Asians and Pacific Islanders are the only racial/ethnic group to show a significant increase in HIV diagnosis rate.
Design
A mixed‐methods study was conducted.
Methods
Thirty in‐depth interviews were conducted with HIV‐positive Asians and Pacific Islanders in San Francisco and New York. Additionally, cross‐sectional audio computer‐assisted self‐interviews were conducted with a sample of 50 HIV‐positive Asians and Pacific Islanders. Content analysis was used to analyse the in‐depth interviews. Also, descriptive, bivariate statistics and multivariable regression analysis was used to estimate the associations among depression, acculturation and self‐actualization. The study took place from January–June 2013.
Discussion
Major themes were extracted from the interview data, including self‐actualization, acculturation and depression. The participants were then divided into three acculturation levels correlating to their varying levels of self‐actualization. For those with low acculturation, there was a large discrepancy in the Center for Epidemiologic Studies Depression Scale scores between those who had totally lost their self‐actualization and those who believed they could still achieve their ‘American dreams’. Among those who were less acculturated, there was a significant difference in depression scores between those who felt they had totally lost their ability to self‐actualize and those who still believed they could ‘make their dreams come true.’
Conclusion
Acculturation levels influence depression and self‐actualization in the HIV‐positive Asians and Pacific Islanders population. Lower acculturated Asian Americans achieved a lower degree of self‐actualization and suffered from depression. Future interventions should focus on enhancing acculturation and reducing depression to achieve self‐actualization.
The purpose of this paper is to make clear the transformation process for 20 years of the co-operative housing "U-court". In management action, it is based on voluntary management for 20 years. And ...the organization and method are transfigured so that it may correspond to the necessity for community life. In the action for enjoyment, the adult resident took action as enjoyment of oneself first, and it was activated by children being involved in there. The sense of values formed of living together has produced the next activity. The chain for which activity induces the next activity is a factor which the power of living together maintains. The resident's aging will advance further in the future. It will be asked how the power of living together works.