Large-scale cranial window for in vivo mouse brain imaging utilizing fluoropolymer nanosheet and light-curable resin

Two-photon microscopy enables in vivo imaging of neuronal activity in mammalian brains at high resolution. However, two-photon imaging tools for stable, long-term, and simultaneous study of multiple brain regions in same mice are lacking. Here, we propose a method to create large cranial windows covering such as the whole parietal cortex and cerebellum in mice using fluoropolymer nanosheets covered with light-curable resin (termed the 'Nanosheet Incorporated into light-curable REsin' or NIRE method). NIRE method can produce cranial windows conforming the curved cortical and cerebellar surfaces, without motion artifacts in awake mice, and maintain transparency for >5 months. In addition, we demonstrate that NIRE method can be used for in vivo two-photon imaging of neuronal ensembles, individual neurons and subcellular structures such as dendritic spines. The NIRE method can facilitate in vivo large-scale analysis of heretofore inaccessible neural processes, such as the neuroplastic changes associated with maturation, learning and neural pathogenesis.

Photoluminescent Layered Crystal Consisting of Anderson-Type Polyoxometalate and Surfactant toward a Potential Inorganic-Organic Hybrid Laser

The hybridization of inorganic and organic components is a promising strategy to build functional materials. Among several functions, luminescence is an important function which should be considered for practical usage. Inorganic-organic hybrid luminescent materials have been investigated as phosphors, sensors, and lasers. Organic luminescent centers such as dye molecules have often been hybridized with inorganic matrices. Polyoxometalate anions (POMs) are effective inorganic luminescent centers due to their luminescent properties and structural designability. However, most luminescent POM components are limited to lanthanide-based POMs. In this report, a photoluminescent inorganic-organic hybrid crystal based on a non-lanthanide POM was successfully synthesized as a single crystal. Anderson-type hexamolybdochromate ([CrMo6O18(OH)6]3-, CrMo6) anion exhibiting emission derived from Cr3+ was utilized with n-dodecylammonium ([C12H25NH3]+, C12NH3) surfactant cation to obtain a photoluminescent hybrid crystal. The grown single crystal of C12NH3-CrMo6 comprised a distinct layered structure consisting of inorganic CrMo6 layers and interdigitated C12NH3 layers. In the CrMo6 layers, the CrMo6 anions were associated with water molecules by hydrogen bonding to form a densely packed two-dimensional network. Steady-state and time-resolved photoluminescence spectroscopy revealed that the C12NH3-CrMo6 hybrid crystal exhibited characteristic emission from the CrMo6 anion. Preliminary lasing properties were also observed for C12NH3-CrMo6, which shows the possibility of using the C12NH3-CrMo6 hybrid crystal as an inorganic-organic hybrid laser.

Nanosheet coating improves stability of human pluripotent stem cell culture on glass substrates

High-resolution imaging analysis using various types of cells is an essential tool for dissecting cell functions. Generally, obtaining such images requires the cells to be cultured on glass substrates; however, it often results in the unstable status of cells. In this study, we report that coating the glass substrate using nanosheet composed of hydrophobic polystyrene, with Matrigel, significantly improves the viability of human pluripotent stem cells (hPSCs). Moreover, the nanosheet coating does not affect the transcriptome status of hPSC and enables researchers to perform the high-resolution imaging assay. These results indicate that the nanosheet coating is beneficial to the cells vulnerable to glass substrate culture. Using the nanosheet coating, we revealed that the spreading status of lnc RNA XIST, essential for X-chromosome inactivation (XCI) in female cells, in the nuclei significantly differs in each hPSC line. Taken together, our study provides a novel method to investigate biological questions using high-resolution imaging techniques.

An Inorganic-Organic Hybrid Framework Composed of Polyoxotungstate and Long-Chained Bolaamphiphile

Surfactants are functional molecules utilized in various situations. The self-assembling property of surfactants enables several molecular arrangements that can be employed to build up nanometer-sized architectures. This is beneficial in the construction of functional inorganic-organic hybrids holding the merits of both inorganic and organic components. Among several surfactants, bolaamphiphile surfactants with two hydrophilic heads are effective, as they have multiple connecting or coordinating sites in one molecule. Here, a functional polyoxotungstate inorganic anion was successfully hybridized with a bolaamphiphile to form single crystals with anisotropic one-dimensional alignment of polyoxotungstate. Keggin-type metatungstate ([H₂W₁₂O₄₀]^6-, H₂W₁₂) was employed as an inorganic anion, and 1,12-dodecamethylenediammonium (C₁₂N₂) derived from 1,12-dodecanediamine was combined as an organic counterpart. A simple and general ion-exchange reaction provided a hybrid crystal consisting of H₂W₁₂ and C₁₂N₂ (C₁₂N₂-H₂W₁₂). Single crystal X-ray structure analyses revealed a characteristic honeycomb structure in the C₁₂N₂-H₂W₁₂ hybrid crystal, which is possibly effective for the emergence of conductivity due to the dissociative protons of C₁₂N₂.

Biodegradable Polymer Nanosheets Incorporated with Zn-Containing Nanoparticles for Biomedical Applications

So far, poly(L-lactic acid), PLLA nanosheets proved to be promising for wound healing. Such biodegradable materials are easy to prepare, bio-friendly, cost-effective, simple to apply and were shown to protect burn wounds and facilitate their healing. At the same time, certain metal ions are known to be essential for wound healing, which is why this study was motivated by the idea of incorporating PLLA nanosheets with Zn²⁺ ion containing nanoparticles. Upon being applied on wound, such polymer nanosheets should release Zn²⁺ ions, which is expected to improve wound healing. The work thus focused on preparing PLLA nanosheets embedded with several kinds of Zn-containing nanoparticles, their characterization and ion-release behavior. ZnCl₂ and ZnO nanoparticles were chosen because of their different solubility in water, with the intention to see the dynamics of their Zn²⁺ ion release in liquid medium with pH around 7.4. Interestingly, the prepared PLLA nanosheets demonstrated quit similar ion release rates, reaching the maximum concentration after about 10 h. This finding implies that such polymer materials can be promising as they are expected to release ions within several hours after their application on skin.

The World Organisation for Animal Health - current and potential roles in safe international trade of bees and other insects

The World Organisation for Animal Health (WOAH, founded as OIE) is the recognised intergovernmental standard-setting organisation for animal health and welfare. The WOAH mandate is to support its members in the prevention of the spread of animal diseases of concern, as listed in the Terrestrial Animal Health Code (Terrestrial Code). Once a disease, infection or infestation is listed, national Veterinary Authorities have the obligation regularly to notify WOAH of the presence or absence of the listed disease. In regard to insects, the scope of the Terrestrial Code limits its recommendations to preserving the health of bees (species of the genus Apis, extended to the genus Bombus and to the stingless bees for one disease). However, it does not include standards to mitigate the potential animal health risks associated with the international trade of other insects. A description of the standard-setting process and a review of the history of the standards for bee health highlight the resources and requirements to expand the scope of the Terrestrial Code to include recommendations for animal health risk mitigation measures for the safety of international trade in insects. Any initiative to develop guidance on insect trade should include WOAH in its role as the sole global standard-setting organisation on animal health and welfare matters. This aligns with the WOAH commitment to a One Health approach.

Potential UV-Protective Effect of Freestanding Biodegradable Nanosheet-Based Sunscreen Preparations in XPA-Deficient Mice

Xeroderma pigmentosum (XP) is a rare autosomal recessive hereditary disorder. As patients with XP are deficient in nucleotide excision repair, they show severe photosensitivity symptoms. Although skin protection from ultraviolet (UV) radiation is essential to improve the life expectancy of such patients, the optimal protective effect is not achieved even with sunscreen application, owing to the low usability of the preparations. Nanosheets are two-dimensional nanostructures with a thickness in the nanometer range. The extremely large aspect ratios of the nanosheets result in high transparency, flexibility, and adhesiveness. Moreover, their high moisture permeability enables their application to any area of the skin for a long time. We fabricated preparations containing avobenzone (BMDBM) based on freestanding poly (L-lactic acid) (PLLA) nanosheets through a spin-coating process. Although monolayered PLLA nanosheets did not contain enough BMDBM to protect against UV radiation, the layered nanosheets, consisting of five discrete BMDBM nanosheets, showed high UV absorbance without lowering the adhesive strength against skin. Inflammatory reactions in XPA-deficient mice after UV radiation were completely suppressed by the application of BMDBM-layered nanosheets to the skin. Thus, the BMDBM layered nanosheet could serve as a potential sunscreen preparation to improve the quality of life of patients with XP.

Major hepatectomy with combined vascular resection for perihilar cholangiocarcinoma

Background

Hepatectomy with vascular resection (VR) for perihilar cholangiocarcinoma (PHCC) is a challenging procedure. However, only a few reports on this procedure have been published and its clinical significance has not been fully evaluated.

Methods

Patients undergoing surgical resection for PHCC from 2002–2017 were studied. The surgical outcomes of VR and non-VR groups were compared.

Results

Some 238 patients were included. VR was performed in 85 patients. The resected vessels were hepatic artery alone (31 patients), portal vein alone (37 patients) or both (17 patients). The morbidity rates were almost the same in the VR (49.4 per cent) and non-VR (43.8 per cent) groups (P = 0.404). The mortality rates of VR (3.5 per cent) and non-VR (3.3 per cent) were also comparable (P > 0.999). The median survival time (MST) was 45 months in the non-VR group and 36 months in VR group (P = 0.124). Among patients in whom tumour involvement was suspected on preoperative imaging and whose carbohydrate antigen 19-9 (CA19-9) value was 37 U/ml or less, MST in the VR group was significantly longer than that in the non-VR group (50 versus 34 months, P = 0.017). In contrast, when the CA19-9 value was greater than 37 U/ml, MST of the VR and non-VR groups was comparable (28 versus 29 months, P = 0.520).

Conclusion

Hepatectomy with VR for PHCC can be performed in a highly specialized hepatobiliary centre with equivalent short- and long-term outcomes to hepatectomy without VR.

External administration of moon jellyfish collagen solution accelerates physiological wound healing and improves delayed wound closure in diabetic model mice

Introduction

Artificial dermis is an effective therapeutic method for full-thickness dermal defects. However, the currently available artificial dermis made of porcine or bovine type I collagen has several limitations such as incomplete epithelialization and delayed migration of fibrogenic and angiogenic cells into the graft. We previously developed a composite dermal graft containing a mixture of moon jellyfish collagen and porcine type I collagen, and reported its stimulatory effect on both the re-epithelialization of the epidermis and the migration of fibrogenic and angiogenic cells into the graft. In the present study, we examined whether the same effect was observed by administering jellyfish collagen solution externally onto an artificial dermal graft made of bovine type I collagen.

Methods

We used a 6 mm full-thickness wound defect model. Moon jellyfish collagen was prepared as a concentrated 0.5% solution and dripped externally onto a transplanted artificial dermal graft made of bovine type I collagen. Wound repair and long-term dermal tissue remodeling were compared between mice administered jellyfish collagen solution on the bovine collagen graft and those transplanted with a composite dermal graft containing the same amounts of jellyfish and bovine collagens. The stimulatory effect of jellyfish collagen solution was also evaluated using diabetic dB/dB mice.

Results

External administration of jellyfish collagen solution onto the bovine collagen graft significantly accelerated wound closure compared to control saline. It also decreased the number of inflammatory cells infiltrating the wound and suppressed absorption of the transplanted graft, as well as reduced subsequent scar formation. Furthermore, external administration of jellyfish collagen solution onto the bovine collagen graft improved the delayed wound healing in diabetic model mice, and this effect was superior to that of the currently used basic fibroblast growth factor.

Conclusions

External administration of moon jellyfish collagen solution onto a bovine collagen graft significantly accelerated physiological wound healing and prevented excessive scar formation. It also improved wound closure in diabetic model mice, confirming its therapeutic application for intractable skin ulcers caused by impaired wound healing.

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Impaired wound healing is frequently observed in elderly and diabetic patients.

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Moon jellyfish collagen accelerates wound closure after full-thickness dermal defect in mice.

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Jellyfish collagen used as an external medicine stimulates the elongation of regenerating epithelial cells.

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Externally applied jellyfish collagen improves wound healing in diabetic model mice.

Protocol for constructing an extensive cranial window utilizing a PEO-CYTOP nanosheet for in vivo wide-field imaging of the mouse brain

Large-scale optical measurements have revealed the anatomical and functional connectivity among brain regions underlying brain functions. Here, we describe how to construct a cranial window utilizing a polyethylene-oxide-coated CYTOP (PEO-CYTOP) nanosheet that suppresses bleeding on the brain surface of mice. We demonstrate in vivo two-photon imaging through the PEO-CYTOP nanosheet at the subcellular resolution in the parietal region of the mouse brain. This protocol improves the surgical procedure and expands the optically observable regions, thereby promoting understanding of brain function.

For complete details on the use and execution of this protocol, please refer to Takahashi et al. (2020).

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Detailed protocol for constructing a vast cranial window for in vivo mouse brain imaging

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Preparation and brain-sealing method of PEO-CYTOP nanosheet

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Instruction to make a large cranial hole with a depressant for intracranial pressure

Utility of remnant liver volume for predicting posthepatectomy liver failure after hepatectomy with extrahepatic bile duct resection

BACKGROUND

Hepatectomy with extrahepatic bile duct resection is associated with a high risk of posthepatectomy liver failure (PHLF). However, the utility of the remnant liver volume (RLV) in cholangiocarcinoma has not been studied intensively.

METHODS

Patients who underwent major hepatectomy with extrahepatic bile duct resection between 2002 and 2018 were reviewed. The RLV was divided by body surface area (BSA) to normalize individual physical differences. Risk factors for clinically relevant PHLF were evaluated with special reference to the RLV/BSA.

RESULTS

A total of 289 patients were included. The optimal cut-off value for RLV/BSA was determined to be 300 ml/m2. Thirty-two patients (11.1 per cent) developed PHLF. PHLF was more frequent in patients with an RLV/BSA below 300 ml/m2 than in those with a value of 300 ml/m2 or greater: 19 of 87 (22 per cent) versus 13 of 202 (6.4 per cent) (P < 0.001). In multivariable analysis, RLV/BSA below 300 ml/m2 (P = 0.013), future liver remnant plasma clearance rate of indocyanine green less than 0.075 (P = 0.031), and serum albumin level below 3.5 g/dl (P = 0.015) were identified as independent risk factors for PHLF. Based on these risk factors, patients were classified into three subgroups with low (no factors), moderate (1-2 factors), and high (3 factors) risk of PHLF, with PHLF rates of 1.8, 14.8 and 63 per cent respectively (P < 0.001).

CONCLUSION

An RLV/BSA of 300 ml/m2 is a simple predictor of PHLF in patients undergoing hepatectomy with extrahepatic bile duct resection.

PEO-CYTOP Fluoropolymer Nanosheets as a Novel Open-Skull Window for Imaging of the Living Mouse Brain

In vivo two-photon deep imaging with a broad field of view has revealed functional connectivity among brain regions. Here, we developed a novel observation method that utilizes a polyethylene-oxide-coated CYTOP (PEO-CYTOP) nanosheet with a thickness of ∼130 nm that exhibited a water retention effect and a hydrophilized adhesive surface. PEO-CYTOP nanosheets firmly adhered to brain surfaces, which suppressed bleeding from superficial veins. By taking advantage of the excellent optical properties of PEO-CYTOP nanosheets, we performed in vivo deep imaging in mouse brains at high resolution. Moreover, PEO-CYTOP nanosheets enabled to prepare large cranial windows, achieving in vivo imaging of neural structure and Ca²⁺ elevation in a large field of view. Furthermore, the PEO-CYTOP nanosheets functioned as a sealing material, even after the removal of the dura. These results indicate that this method would be suitable for the investigation of neural functions that are composed of interactions among multiple regions.

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PEO-CYTOP nanosheet enables in vivo deep brain imaging in a vast field of view

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The 130 nm thickness and the hydrophilized surface realize the strong adhesiveness

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Suppressions of bleeding from the surface and inflammation in long-term are achieved

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The vast and transparent cranial window with natural curvature of the surface

Giant magneto-optical responses in magnetic Weyl semimetal Co3Sn2S2

The Weyl semimetal (WSM), which hosts pairs of Weyl points and accompanying Berry curvature in momentum space near Fermi level, is expected to exhibit novel electromagnetic phenomena. Although the large optical/electronic responses such as nonlinear optical effects and intrinsic anomalous Hall effect (AHE) have recently been demonstrated indeed, the conclusive evidence for their topological origins has remained elusive. Here, we report the gigantic magneto-optical (MO) response arising from the topological electronic structure with intense Berry curvature in magnetic WSM Co₃Sn₂S₂. The low-energy MO spectroscopy and the first-principles calculation reveal that the interband transitions on the nodal rings connected to the Weyl points show the resonance of the optical Hall conductivity and give rise to the giant intrinsic AHE in dc limit. The terahertz Faraday and infrared Kerr rotations are found to be remarkably enhanced by these resonances with topological electronic structures, demonstrating the novel low-energy optical response inherent to the magnetic WSM.

A Novel Composite Biomaterial Made of Jellyfish and Porcine Collagens Accelerates Dermal Wound Healing by Enhancing Reepithelization and Granulation Tissue Formation in Mice

Background and Objective: Impaired dermal wound healing represents a major medical issue in today's aging populations. Granulation tissue formation in the dermis and reepithelization of the epidermis are both important and necessary for proper wound healing. Although a number of artificial dermal grafts have been used to treat full-thickness dermal loss in humans, they do not induce reepithelization of the wound, requiring subsequent epithelial transplantation. In the present study, we sought a novel biomaterial that accelerates the wound healing process. Approach: We prepared a composite biomaterial made of jellyfish and porcine collagens and developed a hybrid-type dermal graft that composed of the upper layer film and the lower layer sponge made of this composite biomaterial. Its effect on dermal wound healing was examined using a full-thickness excisional wound model. Structural properties of the dermal graft and histological features of the regenerating skin tissue were characterized by electron microscopic observation and immunohistological examination, respectively. Results: The composite biomaterial film stimulated migration of keratinocytes, leading to prompt reepithelization. The regenerating epithelium consisted of two distinct cell populations: keratin 5-positive basal keratinocytes and more differentiated cells expressing tight junction proteins such as claudin-1 and occludin. At the same time, the sponge made of the composite biomaterial possessed a significantly enlarged intrinsic space and enhanced infiltration of inflammatory cells and fibroblasts, accelerating granulation tissue formation. Innovation: This newly developed composite biomaterial may serve as a dermal graft that accelerates wound healing in various pathological conditions. Conclusion: We have developed a novel dermal graft composed of jellyfish and porcine collagens that remarkably accelerates the wound healing process.

Efficient differentiation and polarization of primary cultured neurons on poly(lactic acid) scaffolds with microgrooved structures

Synthetic biodegradable polymers including poly(lactic acid) (PLA) are attractive cell culture substrates because their surfaces can be micropatterned to support cell adhesion. The cell adhesion properties of a scaffold mainly depend on its surface chemical and structural features; however, it remains unclear how these characteristics affect the growth and differentiation of cultured cells or their gene expression. In this study, we fabricated two differently structured PLA nanosheets: flat and microgrooved. We assessed the growth and differentiation of mouse primary cultured cortical neurons on these two types of nanosheets after pre-coating with poly-D-lysine and vitronectin. Interestingly, prominent neurite bundles were formed along the grooves on the microgrooved nanosheets, whereas thin and randomly extended neurites were only observed on the flat nanosheets. Comparative RNA sequencing analyses revealed that the expression of genes related to postsynaptic density, dendritic shafts, and asymmetric synapses was significantly and consistently up-regulated in cells cultured on the microgrooved nanosheets when compared with those cultured on the flat nanosheets. These results indicate that microgrooved PLA nanosheets can provide a powerful means of establishing a culture system for the efficient and reproducible differentiation of neurons, which will facilitate future investigations of the molecular mechanisms underlying the pathogenesis of neurological disorders.

Porous nanosheet wrapping for live imaging of suspension cells

In the field of cell imaging, it is still a practical challenge to obtain the high quality live imaging of suspension cells, mainly due to undesirable cell movement in the imaging field during observation. This study describes a porous nanosheet wrapping method to noninvasively immobilize suspension cells for their live imaging. Perforated nanopores are fabricated on a nanosheet to enable the addition of external chemicals to cells, ranging from small molecules to macromolecules. Through several case studies, such as the live imaging of membrane staining of liposomes, transferrin endocytosis of B cells, and activation of platelets, it is verified that the confined space made by the nanosheet could provide a hydrodynamically stable environment for suspension cells, even if an aqueous stimulus is added through the nanopores in a static or a flowing condition. With this method, the live imaging of the whole activation process on a specific suspension cell in the imaging field is achieved, which is not feasible with the existing cell immobilization methods. This study suggests that the method of porous nanosheet wrapping will facilitate the visualization of the dynamic functions of suspension cells.

Propagation dynamics of spin excitations along skyrmion strings

Magnetic skyrmions, topological solitons characterized by a two-dimensional swirling spin texture, have recently attracted attention as stable particle-like objects. In a three-dimensional system, a skyrmion can extend in the third dimension forming a robust and flexible string structure, whose unique topology and symmetry are anticipated to host nontrivial functional responses. Here we experimentally demonstrate the coherent propagation of spin excitations along skyrmion strings for the chiral-lattice magnet Cu₂OSeO₃. We find that this propagation is directionally non-reciprocal and the degree of non-reciprocity, as well as group velocity and decay length, are strongly dependent on the character of the excitation modes. These spin excitations can propagate over a distance exceeding 50 μm, demonstrating the excellent long-range ordered nature of the skyrmion-string structure. Our combined experimental and theoretical analyses offer a comprehensive account of the propagation dynamics of skyrmion-string excitations and suggest the possibility of unidirectional information transfer along such topologically protected strings.

Nanosheet wrapping-assisted coverslip-free imaging for looking deeper into a tissue at high resolution

In order to achieve deep tissue imaging, a number of optical clearing agents have been developed. However, in a conventional microscopy setup, an objective lens can only be moved until it is in contact with a coverslip, which restricts the maximum focusing depth into a cleared tissue specimen. Until now, it is still a fact that the working distance of a high magnification objective lens with a high numerical aperture is always about 100 μm. In this study, a polymer thin film (also called as nanosheet) composed of fluoropolymer with a thickness of 130 nm, less than one-thousandth that of a 170 μm thick coverslip, is employed to replace the coverslip. Owing to its excellent characteristics, such as high optical transparency, mechanical robustness, chemical resistance, and water retention ability, nanosheet is uniquely capable of providing a coverslip-free imaging. By wrapping the tissue specimen with a nanosheet, an extra distance of 170 μm for the movement of objective lens is obtained. Results show an equivalently high resolution imaging can be obtained if a homogenous refractive index between immersion liquid and mounting media is adjusted. This method will facilitate a variety of imaging tasks with off-the-shelf high magnification objectives.

P175 Prognostic value of 99mTc-ECD brain perfusion SPECT in patients with atrial fibrillation and dementia

Background

Atrial fibrillation (AF) is the most common cardiac arrhythmia, and those afflicted have reduced quality of life, functional status, and cardiac performance. The patients with AF have a high risk of coronary heart disease and cardiovascular disease. Although the prevalence of AF is increasing, cognitive disorders are also on the rise in tandem with the aging of the population. The patients with dementia have also experienced lower the quality of life and have increased mortality. Technetium 99m ECD brain perfusion single photon emission computed tomography (99mTc-ECD brain perfusion SPECT) is a useful modality for diagnosing dementia and identifying high risk patients with mild cognitive impairment. However, there are few reports about the relationship between the value of Z score calculated by 99mTc-ECD brain perfusion SPECT and prognosis of patients with AF and dementia.

Purpose

The aim of this study was to evaluate the prognostic values of brain perfusion using 99mTc-ECD SPECT in patients with AF and dementia.

Methods

Among 405 consecutive patients who were diagnosed as AF in cardiac outpatients and subsequently diagnosed as dementia using Mini-Mental State Examination by neurologists or psychiatrists, we identified 170 patients (81 ± 10 years) who underwent 99mTc-ECD brain perfusion SPECT for the current study. Of those, 73, 73, and 24 were diagnosed as Alzheimer’s dementia (AD), vascular dementia (VD), and non-specified dementia respectively. Multivariate Cox model was used to assess if higher Z score by 99mTc-ECD brain perfusion SPECT and clinical parameters were associated with major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction, hospitalization for heart failure, and stroke. Sub-analyses of multivariate Cox models by AD or VD were also assessed. The cut-off values of Z score were determined using area under the curve by a receiver operating characteristic analysis based on MACE occurrences.

Results

During a mean follow-up of 1258 ± 1044 days, 62 MACE occurred. There was not significant difference of MACE between AD and VD (33%, vs. 44%, p = 0.153). By multivariable Cox model, the higher Z score of temporal-occipital-pariental lobe was associated with increased MACE compared to the lower group (HR 2.521, 95% CI 1.465–4.337, p &lt; 0.001). In a sub-analysis of patients with AD, Z score was the most significant prognostic factor for MACE (HR 3.969, 95% CI 1.374–11.468, p = 0.011). The similar trend was observed in those with VD (HR 2.247, 95% CI 1.028–4.913, p = 0.043). Conclusion: This study demonstrated that the Z score of temporal-occipital-pariental lobe by 99mTc-ECD brain perfusion SPECT could be a potential prognostic value among patients with AF and dementia, regardless of type of dementia.

Prognostic role of the length of tumour-vein contact at the portal-superior mesenteric vein in patients having surgery for pancreatic cancer

BACKGROUND

The length of tumour-vein contact between the portal-superior mesenteric vein (PV/SMV) and pancreatic head cancer, and its relationship to prognosis in patients undergoing pancreatic surgery, remains controversial.

METHODS

Patients diagnosed with pancreatic head cancer who were eligible for pancreatoduodenectomy between October 2002 and December 2016 were analysed. The PV/SMV contact was assessed retrospectively on CT. Using the minimum P value approach based on overall survival after surgery, the optimal cut-off value for tumour-vein contact length was identified.

RESULTS

Among 491 patients included, 462 underwent pancreatoduodenectomy for pancreatic head cancer. PV/SMV contact with the tumour was detected on preoperative CT in 248 patients (53·7 per cent). Overall survival of patients with PV/SMV contact exceeding 20 mm was significantly worse than that of patients with a contact length of 20 mm or less (median survival time (MST) 23·3 versus 39·3 months; P = 0·012). Multivariable analysis identified PV/SMV contact longer than 20 mm as an independent predictor of poor survival, whereas PV/SMV contact greater than 180° was not a predictive factor. Among patients with a PV/SMV contact length exceeding 20 mm on pretreatment CT, those receiving neoadjuvant therapy had significantly better overall survival than patients who had upfront surgery (MST not reached versus 21·6 months; P = 0·002).

CONCLUSION

The length of PV/SMV contact predicts survival, and may be used to suggest a role for neoadjuvant therapy to improve prognosis.