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We studied the effects of jump training in 15 mature female Fischer 344 rats (12 month old). The animals were divided into two groups: sedentary (S; n = 7) or jump (J; n = 8) group. The animals in the J group were trained with vertical jumps (40 cm high, 100 repetitions/day, 5 days/week) for 8 weeks. This training involves a movement similar to so-called “stepping” to absorb the impact of a fall. The rat’s body sinks while the rat’s lower limbs exert muscle force. This causes the lower limb skeletal muscles to become eccentric. After 8-weeks of training, the soleus muscle (SOL) was isolated, and crude myosin was extracted. Myosin heavy chain (MyHC) isoform composition was analyzed by sodium dodecyl sulfate polyaclylamidegel electrophoresis. The final body weights of each group were not significantly different. SOL weight of the J group was not significantly higher than those of the S group. Relative SOL weight of the J group was significantly higher than those of the S group. The value of the type I MyHC isoform in the J group was relatively lower than that of the S group. On the contrary, the value of the type IIa MyHC isoform in the J group was relatively higher than that of the S group.These results indicated that the MyHC isoform composition of the SOL muscle changed with jump training with shock-absorbing action during descent.

This study aimed at investigating antimicrobial resistance (AMR) profile of Vibrio parahaemolyticus (V. parahaemolyticus). The bacteria were isolated from wild-caught and farmed Japanese horse mackerel (Trachurus japonicus), and examined for the antimicrobial drug resistance. Furthermore, the serotype, and the genes of thermostable direct hemolysin (tdh) and cholera toxin transcriptional activator (toxR) of the isolates were investigated by using a serotype testing kit and PCR method. Eighty-eight and 126 V. parahaemolyticus strains were isolated from wild-caught and farmed Japanese horse mackerel, respectively. Ten and 18 distinct serotypes were detected from wild-caught and farmed Japanese horse mackerel. All strains were negative for tdh genes but positive for toxR genes. Resistances to ampicillin (ABP) and to both ABP and fosfomycin (FOM) were observed in 54 and 23 strains from the wild-caught fish, while those resistant strains from farm fish were 112 and 7 strains. Multidrug-resistance to three or four drugs including ABP was observed in one or two strains from the wild-caught fish. These results strongly suggest that the environmental exposure of antimicrobial drugs results in the spread of resistant genes in Japanese horse mackerel. This study highlights the need for monitoring the spread of resistance genes to the human intestinal flora as well as to other bacteria in the environment.

The purpose of this in vitro study was to evaluate the shaping ability of reciprocating and continuous rotary systems after root canal retreatment. After preparation and root canal filling, mesial canals of 54 mandibular molars were distributed into 3 groups (n=18), according to the filling material removal and re-instrumentation protocols: WOG group - WaveOne Gold system; PTN group - ProTaper Next system; and PTU group - ProTaper Universal system. Cone-beam computed tomographic (CBCT) images acquisition of the mesial root canals was performed at different moments: (1) before instrumentation (unprepared root canals), (2) after preparation and filling, (3) after filling material removal and (4) re-instrumentation. The apical transportation (AT), centering ability (CA) and change in root canal diameter were assessed by CBCT analysis. The remaining filling material quantification was performed by radiographic examination. The statistical analyses were performed using the 3-way ANOVA, Tukey-Kramer, Kruskal-Wallis and Dunn multiple Comparison tests (p0.05). The tested systems provided minimal alteration in root canal morphology at the apical portion after root canal retreatment. However, WOG promoted greater change in root canal diameter. Resumo O objetivo deste estudo in vitro foi avaliar a capacidade de modelagem de sistemas rotatórios e reciprocantes após o retratamento do canal radicular. Após o preparo e obturação do canal radicular, os canais mesiais de 54 molares inferiores foram distribuídos em 3 grupos, de acordo com os protocolos de remoção do material obturador e re-instrumentação: (n=18): grupo WOG - sistema WaveOne Gold; Grupo PTN - sistema ProTaper Next; e grupo PTU - sistema ProTaper Universal. A análise das imagens de tomografia computadorizada de feixe cônico foi realizada em diferentes momentos: (1) antes da instrumentação (canais radiculares não preparados), (2) após o preparo e obturação, (3) após a remoção do material obturador e (4) re-instrumentação. O transporte apical (TA), a capacidade de centralização (CC) e a mudança no diâmetro do canal radicular foram avaliados por análise tomográfica. A quantificação do restante do material obturador foi realizada por exame radiográfico. As análises estatísticas foram realizadas utilizando os testes de ANOVA de 3 fatores, Tukey-Kramer, Kruskal-Wallis e Comparações Múltiplas de Dunn (p0,05). Os sistemas testados proporcionaram alteração mínima na morfologia do canal radicular na porção apical após o retratamento do canal radicular. No entanto, WOG promoveu maior alteração no diâmetro do canal radicular.

Background Recent studies have shown that the systemic inflammatory response induced by cancer leads to cancer progression. Neutrophil-to-lymphocyte ratio (NLR) is the most reliable marker to detect systemic inflammation. In this study, we investigated the significance of NLR in patients with well-differentiated pancreatic neuroendocrine tumors (PanNETs) according to the World Health Organization 2017 classification. Methods We retrospectively collected data for patients with PanNET who underwent pancreatic resection with curative intent between January 2008 and December 2017 at six institutions. Clinicopathological factors, recurrence, and immunohistochemical staining of tumor-associated macrophages (TAMs) were analyzed in a total of 55 patients in this study. Results High NLR (>3.41) in patients was significantly associated with higher white blood cell count, higher Ki-67 index, higher mitotic count, higher grade, higher incidence of lymph node metastasis, higher incidence of lymphatic and neural invasion, massive blood loss, and a large number of CD163-expressing TAMs. Recurrence-free survival of patients with high NLR was significantly poorer than that of patients with low NLR. Multivariate analysis identified high NLR, NET Grade 2 (G2) or Grade 3 (G3), and synchronous hepatic resection as independent risk factors for recurrence after curative resection. Conclusions NLR is a promising predictor of recurrence after pancreatectomy that needs to be further investigated and that accumulation of TAMs in the tumor could be one of the causes of NLR elevation.

This study aimed at investigating antimicrobial resistance (AMR) profile of Vibrio parahaemolyticus (V. parahaemolyticus). The bacteria were isolated from wild-caught and farmed Japanese horse mackerel (Trachurus japonicus), and examined for the antimicrobial drug resistance. Furthermore, the serotype, and the genes of thermostable direct hemolysin (tdh) and cholera toxin transcriptional activator (toxR) of the isolates were investigated by using a serotype testing kit and PCR method. Eighty-eight and 126 V. parahaemolyticus strains were isolated from wild-caught and farmed Japanese horse mackerel, respectively. Ten and 18 distinct serotypes were detected from wild-caught and farmed Japanese horse mackerel. All strains were negative for tdh genes but positive for toxR genes. Resistances to ampicillin (ABP) and to both ABP and fosfomycin (FOM) were observed in 54 and 23 strains from the wild-caught fish, while those resistant strains from farm fish were 112 and 7 strains. Multidrug-resistance to three or four drugs including ABP was observed in one or two strains from the wild-caught fish. These results strongly suggest that the environmental exposure of antimicrobial drugs results in the spread of resistant genes in Japanese horse mackerel. This study highlights the need for monitoring the spread of resistance genes to the human intestinal flora as well as to other bacteria in the environment.

BACKGROUND: The aim of this study was to assess the diagnostic performance of radiological imaging in differentiating xanthogranulomatous cholecystitis (XGC) from gallbladder cancer (GBC). METHODS: A retrospective analysis of the radiological imaging performed in patients who had pathologically confirmed XGC or GBC between December 2004 to April 2016 was performed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each imaging modality, and combined imaging modalities were calculated. RESULTS: A total of 218 patients (XGC =109, GBC =109) were identified; 19 patients received all of abdominal ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET/CT); 21 received four of these imaging examination types; 45 received three examinations; 58 received two examinations; and 75 received only one examination. The sensitivity and specificity of CEUS was 90% and 93%, respectively, higher than abdominal US (80%, 86%), CT (71%, 92%), MRI (75%, 90%), and PET/CT (55%, 90%) (all values respective). The sensitivity, specificity, NPV, and PPV of the US combined with CEUS were 91%, 90%, 94%, and 85%, respectively. Although the specificity of CEUS + CT and CEUS + MRI were 100% and 92%, respectively, the sensitivity of CEUS + CT and CEUS + MRI were both only 67%. CONCLUSIONS: The Abdominal US is not sufficiently accurate to confidently guide clinical practice, and CEUS showed better diagnostic performance than the other imaging modalities in differentiating XGC from GBC. The combination of abdominal CEUS and CT is helpful for differential diagnosis, as it indicates GBC with better specificity and PPV.

Key Clinical Message We herein report a case of adult intussusceptions induced by a terminal ileum diverticulum. Histological examination confirmed a terminal ileum diverticulum full of feces, and it was considered an infiltrated region. The clinical characteristics of previously reported adult intussusceptions are also discussed, including jejunoileal diverticulum and surgical management.

Although single-incision laparoscopic cholecystectomy is now widely performed in patients with cholecystitis, some cases require an additional port to complete the procedure. In this study, we focused on risk factor of additional port in this surgery. We performed single-incision cholecystectomy in 75 patients with acute cholecystitis or after cholecystitis between 2010 and 2014 at Gunma University Hospital. Surgical indications followed the TG13 guidelines. Our standard procedure for single-incision cholecystectomy routinely uses two needlescopic devices. We used logistic regression analysis to identify the risk factors associated with use of an additional full-size port (5 or 10 mm). Surgical outcome was acceptable without biliary injury. Nine patients (12.0%) required an additional port, and one patient (1.3%) required conversion to open cholecystectomy because of severe adhesions around the cystic duct and common bile duct. In multivariate analysis, high C-reactive protein (CRP) values (>7.0 mg/dl) during cholecystitis attacks were significantly correlated with the need for an additional port (P = 0.009), with a sensitivity of 55.6%, specificity of 98.5%, and accuracy of 93.3%. This study indicated that the severe inflammation indicated by high CRP values during cholecystitis attacks predicts the need for an additional port. J. Med. Invest. 64: 245-249, August, 2017.

The aim of the study was to compare the effect of Ibuprofen and the application of photobiomodulation therapy protocol on the reduction of postoperative pain in endodontically treated teeth using a randomized clinical trial design. Seventy patients, diagnosed with symptomatic irreversible pulpitis, were selected. Treatment was performed by a single operator; a reciprocal system was used to prepare the canals; they were obturated using the Tagger’s hybrid technique and coronally sealed with glass-ionomer cement. After treatment, patients were randomly divided into 2 groups. In the active control group, two Ibuprofen 600 mg tablets were administered within a 12-h interval. In the photobiomodulation therapy group, the irradiation was applied after treatment. The evaluation of postoperative pain was performed by another researcher blinded to the groups at 6, 12, 24, and 72 h intervals after treatment. To measure the outcome, two pain scales were used: numerical rate scale (NRS) and verbal rate scale (VRS). Data were analyzed using the chi-square, Mann-Whitney, and Wilcoxon paired tests. Outcome was superior with photobiomodulation therapy at 6 h (p

Background: Promoting continued physical activity during winter in snowy-cold regions would be of benefit as a health promotion strategy among elderly individuals.Aim: To evaluate the effect of a l...

Understanding the effect of lymph node metastasis (LNM) on prognosis in pancreatic neuroendocrine neoplasm is helpful for surgery and follow-up. In this study, we investigated the significance of LNM in well-differentiated pancreatic neuroendocrine tumors (PanNETs) according to the World Health Organization 2017 classification.We retrospectively collected data for 95 consecutive patients with PanNET who underwent pancreatic resection with curative intent between January 2008 and December 2017 at 6 institutions. The clinicopathological factors were compared in patients with and without LNM, and prognostic factors were analyzed.Lymph node metastasis was significantly associated with malignant potential of PanNET, such as larger tumor size, higher Ki-67 index, higher tumor grade, and higher incidence of lymphatic, vessel, and neural invasion. Lymph node metastasis was also associated with disease-free but not overall survival. Multivariate analysis identified NET grade 2 (G2) and G3 as independent risk factors for recurrence after curative resection.World Health Organization 2017 classification was the most independent prognostic factor in patients with resectable well-differentiated PanNETs. Patients with G2 and higher-grade tumors require lymph node dissection to improve prognosis.

Using immunohistochemistry, we investigated whether daily administration of clenbuterol (CLE; 1 mg/kg body weight per day) accelerates recovery after casted immobilization(IMM)-induced atrophy of fast-twitch plantaris and slow-twitch soleus muscles. Adult male Sprague-Dawley rats were assigned to the control (CON), casted immobilization (IMM), casted immobilization following recovery control (RCON), and casted immobilization following recovery with CLE administration (RCLE) groups. Casted immobilization and recovery periods were 9 and 14days, respectively. Rats of the CON group were subjected to the experiment simultaneously with the IMM group. Nine days of immobilization induced muscle fiber atrophy, which was greater in the soleus muscle than in the plantaris muscle. After the 2-week recovery period, the cross-sectional areas of each fiber type in both muscles were higher in the RCON group than in the IMM group. The cross-sectional areas of each fiber type in both muscles in the RCLE group were larger than those in the RCON group. The myonuclear number of each fiber type of the plantaris muscle in the RCON and RCLE groups was higher than that in the CON group. In contrast, the myonuclear number per fiber of the soleus muscle was not affected by hindlimb immobilization, reloading, and clenbuterol administration regardless of muscle fiber type. These results suggest that CLE accelerates the recovery of atrophied plantaris and soleus muscles fibers and that their mechanisms of responses to CLE in both muscles may be different during recovery period after muscle atrophy.

The tumor suppressor FBXW7 has been demonstrated to degrade several oncoproteins, including c-Myc. Although low FBXW7 expression levels are suggested to be a poor prognostic factor in a number of types of solid tumor, the role of FBXW7 in chemosensitivity is controversial. The purpose of the present study was to determine whether FBXW7 expression may be used as a marker for poor prognosis and chemosensitivity in patients with cholangiocarcinoma (CC). FBXW7 expression was investigated by immunohistochemistry in 100 surgically resected CC samples, and the association between FBXW7 expression, clinicopathological factors and prognosis was evaluated. Nuclear FBXW7 expression tended to be lower compared with normal tissues. A total of 54 patients exhibited high expression levels of FBXW7, and 46 patients exhibited low expression levels. Patients with low FBXW7 expression possessed significantly larger tumors (P=0.049), enhanced expression of c-Myc and Ki-67 and significantly poorer prognoses compared with those with high FBXW7 expression (P=0.016). Multivariate analysis revealed that low FBXW7 expression was an independent negative prognostic factor in CC (P=0.043). In patients with high FBXW7 expression levels, the cancer-specific survival times were not significantly different between patients with or without chemotherapy. However, in patients with low FBXW7 expression levels, the cancer-specific survival times were significantly longer in subjects who underwent chemotherapy compared with those who did not (P=0.001). These data suggest that FBXW7 status in CC is a useful predictor of poor prognosis and cancer progression. Additionally, FBXW7 may be a surrogate marker to predict the efficacy of chemotherapy in CC.

// Mariko Tsukagoshi 1, 3 , Kenichiro Araki 1, 3 , Takehiko Yokobori 4 , Bolag Altan 1 , Hideki Suzuki 1 , Norio Kubo 1, 3 , Akira Watanabe 1, 3 , Norihiro Ishii 1 , Yasuo Hosouchi 5 , Masahiko Nishiyama 4 , Ken Shirabe 2, 3 and Hiroyuki Kuwano 1, 3 1 Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan 2 Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan 3 Division of Hepatobiliary and Pancreatic Surgery, Integrative Center of General Surgery, Gunma University Hospital, Maebashi, Gunma 371-8511, Japan 4 Department of Molecular Pharmacology and Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan 5 Department of Surgery and Laparoscopic Surgery, Gunma Prefecture Saiseikai-Maebashi Hospital, Maebashi, Gunma 371-0821, Japan Correspondence to: Hiroyuki Kuwano, email: hkuwano@gunma-u.ac.jp Keywords: KPNA2, cholangiocarcinoma, gemcitabine, MRN complex, DNA repair Received: August 10, 2016 Accepted: January 04, 2017 Published: February 02, 2017 ABSTRACT Cholangiocarcinoma is a highly malignant tumor, and the development of new therapeutic strategies is critical. Karyopherin-α2 (KPNA2) functions as an adaptor that mediates nucleocytoplasmic transport. Specifically, KPNA2 transports one of the important DNA repair machineries, the MRE11-RAD50-NBS1 (MRN) complex, to the nucleus. In this study, we clarified the significance of KPNA2 in cholangiocarcinoma. KPNA2 expression evaluated by immunohistochemical analysis was common in malignant tissue but rare in adjacent noncancerous tissues. KPNA2 overexpression was significantly correlated with poor prognosis and was an independent prognostic factor after surgery. In patients with cholangiocarcinoma who received gemcitabine after surgery, KPNA2 overexpression tended to be a prognostic indicator of poor overall survival. In KPNA2-depleted cholangiocarcinoma cells, proliferation was significantly decreased and gemcitabine sensitivity was enhanced in vitro and in vivo . Expression of KPNA2 and the MRN complex displayed colocalization in the nucleus. In addition, nuclear localization of the MRN complex was regulated by KPNA2 in vitro . These results suggest that KPNA2 expression may be a useful prognostic and predictive marker of gemcitabine sensitivity and survival. The regulation of KPNA2 expression may be a new therapeutic strategy for cholangiocarcinoma.

We studied the effects of jumping training in 15 mature female Fischer 344 rats (12 monthold). The animals were divided into two groups: sedentary (S; n = 7) or jumping (J; n = 8)group. The animals in the J group were trained with vertical jumps (40 cm high， 100repetitions/day， 5 days/week) for 8 weeks. After 8-weeks of training， the plantaris muscle(PLA) was isolated， and crude myosin was extracted. Myosin heary chain (MyHC) isoformcomposition was analyzed by sodium dodecyl sulfate polyaclylamidegel electrophoresis.The final body weights of each group were not significantly different. PLA weight andrelative PLA weight of the J group were significantly higher than those of the S group. Whileno statistical difference was found in the compositions of the MyHC I， IId and IIa isoforms ineither group. However， the value of the type IIb MyHC isoform in the J group was relativelylower than that in the S group.These results indicated that the MyHC isoform composition of the PLA muscle changed withjumping training. We conclude that jumping training during the middle stage of maturationaffected the muscle contractile protein phenotype.

Many previous reports have indicated that atypical femur fractures (AFFs) are associated with the administration of bisphosphonates (BPs). A number of risk factors and hypotheses regarding the pathogenesis of AFFs have been reported to date. The purpose of the present study was to identify the factors associated with AFFs in Japanese individuals and to elucidate the association between bone metabolism and AFFs by evaluating bone turnover markers (BTMs). We prospectively reviewed all patients with femur fractures and identified the patients with AFFs and typical femur fractures (TFFs). We collected the demographic and clinical data that were relevant to the present study, namely age, gender, affected side, affected site, concomitant medical history, and comorbid conditions, and measured the levels of BTMs within 24h after trauma. Welch's test and Fisher's exact probability test were used for the statistical analyses. A total of 338 patients, including 10 patients with AFFs and 328 patients with TFFs, were analyzed under the inclusion criteria. The use of BPs (p

Intra-articular injection of hyaluronic acid (HA) is used to treat osteoarthritis (OA) as a viscosupplement, yet it only provides short-term benefit because HA is cleaved by hyaluronidase and cleared out of the joint after several days. Therefore, we developed a new polymer biolubricant based on poly-oxanorbornane carboxylate to enhance joint lubrication for a prolonged time. Rheological and biotribological studies of the biolubricant reveal viscoelastic properties and coefficient of friction equivalent and superior to that of healthy synovial fluid, respectively. Furthermore, in an ex vivo bovine cartilage plug model, the biolubricant exhibits superior long-term reduction of friction and wear prevention compared to saline and healthy synovial fluid. ISO 10993 biocompatibility tests demonstrate that the biolubricant polymer is non-toxic. In an in vivo rat medial meniscal tear OA model, where the performance of the leading HA viscosupplement (Synvisc-one®) is comparable to the saline control, treatment with the biolubricant affords significant chondroprotection compared to the saline control.

The natural killer group 2 member D (NKG2D) receptor and its ligands are important mediators of immune responses to tumors. NKG2D ligands are overexpressed in several malignant tumor types; however, the prognostic value of these ligands is unclear. Here, we aimed to elucidate the role of NKG2D ligands in extrahepatic cholangiocarcinoma (EHCC). We therefore investigated the expression of the NKG2D receptor and its ligands MHC class I chain-related proteins A and B (MICA/B), unique long 16 binding protein (ULBP) 1, and ULBP2/5/6 in resected specimens from 82 patients with EHCC. All NKG2D ligands were highly expressed in EHCC. High expression of MICA/B or ULBP2/5/6 correlated with overall and disease-free survival. In contrast, high expression of ULBP1 was significantly associated with improved overall survival, but not disease-free survival. Concurrent high expression of multiple NKG2D ligands revealed significantly better overall and disease-free survival than that observed with the overexpression of any one NKG2D ligand. Co-expression of multiple NKG2D ligands was an independent prognostic indicator of improved survival. Furthermore, co-overexpression of multiple NKG2D ligands was significantly correlated with high expression of the NKG2D receptor. Inhibiting interactions between multiple NKG2D ligands and the NKG2D receptor might be a promising approach for controlling cancer progression and improving patient prognosis in EHCC.

Duodenum mucinous carcinoma is very rare, and the prognosis of the patient is very bad, especially when the tumor is invasive to other organs. In this case, duodenum carcinoma was invasive to common bile duct and transverse colon. Mucinous fluid, which was secreted from a duodenum tumor, was found in the dilatated bile duct. The intraductal papillary neoplasm of the bile duct was considered a differential diagnosis. We performed aggressive resection and had a good prognosis. A 74-year-old woman received a diagnosis of cholangitis and was treated with antibiotic drugs. Endoscopic retrograde cholangiopancreatography revealed a defect in the lower common bile duct with the mucoid fluid. We suspected intraductal papillary neoplasm of the bile duct, but no malignant cells were detected. One year later, gastrointestinal fiberscopy revealed a villous tumor in the postbulbar portion of the duodenum; adenocarcinoma was detected in biopsy specimens. Computed tomography revealed dilatation of the duodenum with an enhanced tumor, and dilatation of both the common and intrahepatic bile ducts. Magnetic resonance cholangiopancreatography revealed that the duodenum was connected with the common bile duct and ascending colon. We resected the segmental duodenum, extrahepatic bile duct, left lobe of liver, a partial of the transverse colon, and associated lymph nodes. Although the advanced duodenal carcinoma had poor prognosis, the patient was alive, without recurrence, 5 years after the operation.

The use of imatinib mesylate has influenced survival in patients with advanced gastrointestinal stromal tumors (GISTs). However, whether a combination of imatinib and surgical resection can further prolong survival in these patients has not yet been fully elucidated. We report a case of a 59-year-old woman with multiple liver metastases from a jejunal GIST. The patient received imatinib therapy after partial resection of the jejunum, and she subsequently underwent right hepatic trisectionectomy. However, liver metastasis was detected again after surgery. Secondary imatinib therapy was started, and the patient underwent partial hepatectomy at the left lateral segment. Postoperatively, the patient underwent imatinib treatment and has survived without recurrence for 3 years. Imatinib is recommended for the treatment of advanced GIST; however, a complete response is rare, and approximately half of all patients develop resistance to imatinib. Aggressive surgical resection combined with imatinib may be effective for the control of advanced GIST.

Background Cholangiocellular carcinoma is characterized by elevated glucose consumption, resulting in an increased uptake of 18F-2-fluoro-2-deoxy- d -glucose (18F-FDG). This study investigates the relationship between 18F-FDG uptake and tumour glucose metabolism. Methods This was a retrospective analysis of 19 patients with cholangiocellular carcinoma. Immunohistochemistry for glucose transporter 1 and pyruvate kinase type M2 were performed. Overall tumour glucose metabolism was evaluated by measuring 18F-FDG uptake and the protein expression levels of glucose transporter 1 and pyruvate kinase type M2. Results 18F-FDG uptake had a strong positive correlation with histological differentiation. Both tumour status (p = 0.044) and tumour size (p = 0.011) were correlated with primary tumour 18F-FDG uptake. Glucose transporter 1 expression correlated with histological differentiation (p = 0.017), while pyruvate kinase type M2 expression tended to correlate with lymph node metastasis (p = 0.051). Glucose transporter 1 expression was strongly related to the standard uptake value (p = 0.001), but that of pyruvate kinase type M2 was not (p = 0.461). Conclusions Glucose transporter 1 expression exhibits a strong correlation with 18F-FDG uptake in cholangiocellular carcinoma tissue, while pyruvate kinase type M2 expression was not associated with fluoro-2-deoxy- d -glucose uptake. In addition to its glycolytic function, pyruvate kinase type M2 has a variety of roles and its expression may enhance tumour cell invasion and promote the lymph node metastasis of intrahepatic cholangiocarcinoma.

The objective of this study is to diminish postoperative complications after pylorus-preserving pancreaticoduodenectomy. Pylorus-preserving pancreaticoduodenectomy is still associated with major complications, especially leakage at pancreatojejunostomy and delayed gastric emptying. Traditional pylorus-preserving pancreaticoduodenectomy was performed in group A, while the novel procedure, an antecolic vertical duodenojejunostomy and internal pancreatic drainage with omental wrapping, was performed in group B (n = 40 each). We compared the following characteristics between the 2 groups: operation time, blood loss, time required before removal of nasogastric tube and resumption of food intake, length of hospital stay, and postoperative complications. The novel procedure required less time and was associated with less blood loss (both P < 0.0001). In the comparison of the 2 groups, group B showed less time for removal of nasogastric tubes and resumption of food intake, shorter hospital stays, and fewer postoperative complications (all P < 0.0001). The novel procedure appears to be a safe and effective alternative to traditional pancreaticoduodenectomy techniques.

Introduction Anterior pontine cavernomais a rare pathology with difficult access it predominantly occurs in middle aged patients with a high risk of bleeding and rebleeding There is a direct association with genetic inheritance due to the CCM CCM and CCM genes and if it is associated there is a higher risk of severity Materials and Methods Analysis of PUBMED publications about ventral pontine cavernomas anterolateral pontine cavernomas and main surgical approaches Results and Discussion Pontine cavernomas have a bleeding risk of per year and rebleeding of per year therefore it is a surgical pathology in which most authors approach from four to six weeks after bleeding for total resection and curative purposes There are different approaches and they depend on the topography of the lesion and the surgeon s ability technologies such as monitoring neuronavigation and tractography must be used to reduce the risk of lesions The most used approaches are retrosigmoid presigmoid and anterior transpetrosal the use of endoscopic approaches has been increasing recently Conclusion Anterior pontine cavernoma is a severe pathology that must be surgically treated to decrease the risk of bleeding and rebleeding

Glioblastomas (GBMs) are resistant to current therapy protocols and identification of molecules that target these tumors is crucial. Interaction of secreted heat-shock protein 70 (Hsp70)-Hsp90-organizing protein (HOP) with cellular prion protein (PrP(C)) triggers a large number of trophic effects in the nervous system. We found that both PrP(C) and HOP are highly expressed in human GBM samples relative to non-tumoral tissue or astrocytoma grades I-III. High levels of PrP(C) and HOP were associated with greater GBM proliferation and lower patient survival. HOP-PrP(C) binding increased GBM proliferation in vitro via phosphatidylinositide 3-kinase and extracellular-signal-regulated kinase pathways, and a HOP peptide mimicking the PrP(C) binding site (HOP230-245) abrogates this effect. PrP(C) knockdown impaired tumor growth and increased survival of mice with tumors. In mice, intratumor delivery of HOP230-245 peptide impaired proliferation and promoted apoptosis of GBM cells. In addition, treatment with HOP230-245 peptide inhibited tumor growth, maintained cognitive performance and improved survival. Thus, together, the present results indicate that interfering with PrP(C)-HOP engagement is a promising approach for GBM therapy.

Patients with extrahepatic cholangiocarcinoma (EHCC) have a poor prognosis; postoperative survival depends on cancer progression and therapeutic resistance. The mechanism of EHCC progression needs to be clarified to identify ways to improve disease prognosis. Stathmin1 (STMN1) is a major cytosolic phosphoprotein that regulates microtubule dynamics and is associated with malignant phenotypes and chemoresistance in various cancers. Recently, STMN1 was reported to interact with p27, an inhibitor of cyclin-dependent kinase complexes. Eighty EHCC cases were studied using immunohistochemistry and clinical pathology to determine the correlation between STMN1 and p27 expression; RNA interference to analyze the function of STMN1 in an EHCC cell line was also used. Cytoplasmic STMN1 expression correlated with venous invasion (P = 0.0021) and nuclear p27 underexpression (P = 0.0011). Patients in the high-STMN1-expression group were associated with shorter recurrence-free survival and overall survival than those in the low-expression group. An in vitro protein-binding assay revealed that cytoplasmic STMN1 bound to p27 in the cytoplasm, but not in the nucleus of EHCC cells. Moreover, p27 accumulated in EHCC cells after STMN1 suppression. STMN1 knockdown inhibited proliferation and increased the sensitivity of EHCC cells to paclitaxel. STMN1 contributes to a poor prognosis and cancer progression in EHCC patients. Understanding the regulation of p27 by STMN1 could provide new insights for overcoming therapeutic resistance in EHCC.

Hepatic resection of metastatic colorectal cancer (CRC) has become the treatment of choice for patients after resection of the primary CRC. However, some patients do not benefit from immediate resection because of rapidly progressive disease. The aim of this study was to examine the prognostic value of extracapsular invasion (ECI) of lymph node (LN) metastasis of CRC with liver metastases following liver resection.All patients who underwent resection for CRC with liver metastases between 1995 and 2011 were reviewed. All of those with metastasis from primary CRC were included in this study. Preoperative, intraoperative, and postoperative data, including primary tumor pathology results, were retrospectively reviewed. All resected LNs from primary CRC were re-examined to assess ECI. Associations between clinicopathologic factors, survival, and the nodal findings were evaluated.ECI was identified in 47 (48%) patients. ECI was correlated with the number of positive LNs (p = 0.0022), timing of liver metastasis (p = 0.0238), and number of liver metastases (p = 0.0001). Univariate analysis indicated that the number of positive LNs (p = 0.0014), ECI (p = 0.0203), and adjuvant chemotherapy (p = 0.0423) were significant prognostic factors. Patients with ECI had a significantly worse survival (p = 0.0024) after liver resection than patients with LN-negative and ECI-negative groups.In patients with hepatic CRC metastases, ECI in regional LNs reflects a particularly aggressive behavior, such as a greater number of liver metastases. In CRC patients with liver metastases, ECI in regional LNs might be correlated with poor prognosis following liver resection.

We studied the effects of cast immobilization on the weight of visceral organs and adipose tissue in mature male Sprague-Dawley rats (8 weeks old). The animals were divided into four groups: 10 weeks sedentary control (10S;n=7) ， 10 days cast-immobilized (CAS;n=7) ， 10 weeks sedentary control + 1 week sedentary recovery corresponding to the recovery period of the casted groups (11S;n=4)， and 1 week recovery after cast removal (RCAS;n=6) . In the CAS and RCAS groups. the cast immobilized the knee and foot joints. For the RCAS group， the casts were removed after 10 days， and the animals were allowed to move freely during 7 days. Groups 10S and CAS were introduced in this study after 10 days of cast immobilization. Groups 11S and RCAS were introduced in this study after 7 days after cast removal. The visceral organs (heart ， liver ， spleen ， adrenal gland ， and kidney) and adipose tissue［intracapsular brown adipose tissue (IBAT) as well as perirenal， epididymal and subcutaneous tissues of the groin] were isolated and weighed. The lipid and protein contents of IBAT were also measured.At the end of the treatment periods， heart weight was significantly lower in the RCAS group than in the CAS group . There was no statistical difference between the groups for the weights of the other visceral organs and IBAT. The mean and relative weights of epididymal white adipose tissue were significantly higher in the 11S group than in the CAS group. The IBAT composition was not significantly different between the groups.Collectively， these data indicate that the effects of cast immobilization and removal differ between visceral organs or adipose tissues.

Risk estimation tools can be used in clinical practice to promote the counseling, prevention, or increase the surveillance against breast cancer development. The present study aimed to estimate the risk for breast cancer and the odds for BRCA1/2 mutations, and to correlate the values found by the different models. Breast cancer risk was determined by the models of Gail, Claus, BRCAPRO and Boadicea; and for the mutations, Myriad II, Penn II BRCAPRO, and Boadicea models were utilized, in women who have or had the disease (n = 16) and their respective first degree female relatives unaffected (n = 25). Considering non affected women 16% were categorized as high risk for breast cancer development in five years by the Gail model, and all values presented significant correlation among the models (p < 0.05). Among the participants, 12% (5/41) were considered high risk for BRCA mutations. All the models presented significant correlation between the odds of BRCA1/2 mutation risk, except between Myriad II and Boadicea models. Since there is no model that includes all the variables influencing the development of this disease, it is essential to estimate the risk by more than one model before initiating any clinical intervention.

Pancreatic intraductal papillary mucinous neoplasms (IPMNs) are a type of pancreatic tumor, which have been identified following improvements in diagnostic imaging. However, the malignant transformation of IPMN has been difficult to diagnose clinically. To date, the mechanisms driving the progression of IPMN to cancer remain to be fully elucidated. The present study focused on Stathmin 1 (STMN1), a protein that is associated with the development of various types of cancer. The expression of STMN1 was examined immunohistochemically in tissues from cases of IPMN. The correlation between the STMN1 staining and clinical pathological factors was evaluated, and the expression of STMN1, p27 and S-phase kinase-associated protein 2 (SKP2) were compared. High expression levels of STMN1 were significantly correlated with regions of malignancy, and was associated with high expression of SKP2, low expression of nuclear p27 and a high Ki-67 index. High expression levels of STMN1 and SKP2 were significantly correlated with the transformation of IPMN to carcinoma. In addition, within the regions of carcinoma, the expression of STMN1 was weak in regions of adenoma and high in the cancerous regions. It was concluded that the high expression of STMN1 contributed to tumor proliferation and malignant transformation in the patients with IPMN. These results suggested that characterization of the expression of STMN1 may be a promising approach for predicting malignant transformation of pancreatic intraductal papillary mucinous adenoma.

We studied the effects of hind limb cast immobilization on brown adipose tissues in 14 male mature Sprague? Dawley rats (8 -weeks -old). The animals were divided into the following two groups: sedentary control (S; n = 7) and cast -immobilized (CAS; n = 7) groups. Animals in the CAS group were immobilized at the knee and foot joints for 10 days. Interscapular brown adipose tissue (IBAT) was isolated after 10 days of immobilization and weighed. In addition， IBAT lipid and protein content were measured. IBAT weight and relative IBAT weight in the CAS group were not significantly different from those in the S group.No statistical differences were found between the two groups for protein concentration or protein content of IBAT. However， significant correlations were observed among IBAT weight， protein concentration (negative， r = -0.702) and protein content (positive， r = 0.863). IBAT lipid concentration did not differ significantly between the two groups. However， IBAT lipid content was significantly lower in the CAS group than in the S group. A significant positive correlation was observed between IBAT weight and the lipid content (r = 0.904). These results indicate that the amount of lipid decreased in IBAT independent of protein content during cast immobilization.

Background/objectives Intraductal papillary mucinous neoplasms (IPMN) can become malignant. Karyopherin-α2 (KPNA2) plays a central role in nucleocytoplasmic transport and is associated with various types of cancer. The current study examined pancreatic KPNA2 expression in cancer patients and evaluated its association with clinicopathological factors, cancer cell proliferation. Methods KPNA2 expression was investigated by immunohistochemistry in 40 surgically resected IPMN samples and its association with clinicopathological factors and Ki-67 expression were examined. Results Eighteen IPMN samples (45% of patients) showed positive KPNA2 expression. KPNA2 expression levels in IPMN tissue with invasive carcinoma were significantly higher than those in adjacent normal tissues and in IPMN tissue with low-to high-grade dysplasia. KPNA2 expression correlated with pathological malignancy and Ki-67 labeling index and KPNA2 and Ki-67 expression was co-localized in nuclei. E2F were co-localized with KPNA2 in the IPMN tissues with high expression of KPNA2. KPNA2 expression was enhanced in the invasion front and in proliferating Ki-67-positive cells. In addition, KPNA2 expression in IPMN tissues was associated with older age, dilation of main pancreatic duct diameter, the presence of nodules, and histological type. Conclusion KPNA2 expression is associated with carcinogenesis of IPMN through the adenoma-carcinoma sequence.