Pancreatic juice cytology with immunohistochemistry to detect malignancy and histologic subtypes in patients with branch duct type intraductal papillary mucinous neoplasms of the pancreas

BACKGROUND AND AIMS

The aim of this study was to elucidate the efficacy of pancreatic juice cytology with the cell-block method (CB-PJC) for the determination of surgery in patients with branch duct intraductal papillary mucinous neoplasm (BD-IPMN).

METHODS

In 138 patients with BD-IPMN from whom pancreatic juice was collected under ERCP for CB-PJC, we retrospectively evaluated the following: (1) the rate of successfully evaluated CB-PJC; (2) the ability of CB-PJC to diagnose malignancy and to identify pathologic subtypes in resected BD-IPMNs; (3) the rate of development into invasive cancer and progression of BD-IPMNs in patients with BD-IPMNs diagnosed as benignancy by CB-PJC; and (4) post-ERCP adverse events.

RESULTS

(1) The success rate of CB-PJC was 89.9%. (2) The sensitivity and specificity of CB-PJC for preoperative diagnosis of malignancy were 50% and 100%, respectively, with only hematoxylin and eosin staining, whereas they were 79% and 100%, respectively, by adding immunohistologic staining. The agreement rate of the preoperative subtypes by CB-PJC with the subtypes of resected specimens was 93%. (3) The onset of invasive cancer was not detected at all on imaging studies, whereas the progression of IPMN was detected in 14 patients. Multivariate analysis revealed the risk factor of progression to be non-gastric type. The cumulative 5-year progression rate in this group was 89%. (4) Post-ERCP pancreatitis developed in 13 patients (7.7%).

CONCLUSIONS

The diagnostic efficacy of preoperative CB-PJC for malignant BD-IPMN was excellent. The results may suggest the feasibility of applying preoperative subtyping by CB-PJC for decisions as to whether surgery is indicated.

Automated Estimation of Mouse Social Behaviors Based on a Hidden Markov Model

Recent innovations in sensing and Information and Communication Technology (ICT) have enabled researchers in animal behavior to collect an enormous amount of data. Consequently, the development of an automated system to substitute for some of the observations and analyses that are performed currently by expert researchers is becoming a crucial issue so that the vast amount of accumulated data can be processed efficiently. For this purpose, we introduce a process for the automated classification of the social interactive status of two mice in a square field on the basis of a Hidden Markov model (HMM). We developed two models: one for the classification of two states, namely, indifference and interaction, and the other for three states, namely, indifference, sniffing, and following. The HMM was trained with data from 50 pairs of mice as provided by expert human observers. We measured the performance of the HMM by determining its rate of concordance with human observation. We found that sniffing behavior was segmented well by the HMM; however, following behavior was not segmented well by the HMM in terms of percentage concordance. We also developed software called DuoMouse, an automated system for the classification of social interactive behavior of mice, that was based on the HMM. Finally, we compared two implementations of the HMM that were based on a histogram and a Gaussian mixture model.

Nanoionic devices enabling a multitude of new features

In recent years, interesting nanoscale phenomena caused by physical or chemical effects due to local ion transfers near heterointerfaces using ionic conductors have been discovered, and the so-called "nanoionic devices" (which apply new functionalities gained by exploiting those phenomena) are being proposed. Up until now, nanoionic devices with unique functions that have been unattainable with conventional semiconductor devices have been developed. These devices include brain-type devices, completely solid-state electric-double-layer transistors, multi-functional on-demand-type devices, superconducting elements capable of modulating transition temperature, and so on. As for research and development on nanodevices for next-generation information and communication technologies, expected developments of these devices in the field of solid-state ionics are introduced based on the results of our research.

[Chest Wall Reconstruction Using Titanium Plates Sandwiched Between Sheets after Resection of Chest Wall Chondrosarcoma]

Extensive chest wall resection carries the risk of difficult reconstruction and surgical complications. We report our experience on chest wall reconstruction using titanium plates for a wide thoracic defect after tumor resection. A 74-year-old man was diagnosed with chondrosarcoma of the 6th rib on the right. He needed extensive chest wall resection because of skip lesions on 4th rib noted on operative inspection, leaving a defect measuring 33 × 20 cm. Reconstruction using 5 transverse titanium plates sandwiched between an expanded polytetrafluoroethylene patch and a polypropylene mesh sheet stabilized the chest wall. This reconstruction allowed successful separation from ventilatory support after operation. The postoperative course was uneventful, and he was discharged on postoperative day 20. The advantages of this form of reconstruction over conventional prostheses are rigidity, and stability and usability.

In Situ Tuning of Magnetization and Magnetoresistance in Fe3O4 Thin Film Achieved with All-Solid-State Redox Device

An all-solid-state redox device composed of Fe3O4 thin film and Li(+) ion conducting solid electrolyte was fabricated for use in tuning magnetization and magnetoresistance (MR), which are key factors in the creation of high-density magnetic storage devices. Electrical conductivity, magnetization, and MR were reversibly tuned by Li(+) insertion and removal. Tuning of the various Fe3O4 thin film properties was achieved by donation of an electron to the Fe(3+) ions. This technique should lead to the development of spintronics devices based on the reversible switching of magnetization and spin polarization (P). It should also improve the performance of conventional magnetic random access memory (MRAM) devices in which the ON/OFF ratio has been limited to a small value due to a decrease in P near the tunnel barrier.

Peptidomics for Studying Limited Proteolysis

Limited proteolysis is a pivotal mechanism regulating protein functions. Identifying physiologically or pathophysiologically relevant cleavage sites helps to develop molecular tools that can be used for diagnostics or therapeutics. During proteolysis of secretory and membrane proteins, part of the cleaved protein is liberated and destined to undergo degradation but should retain original cleavage sites created by proteolytic enzymes. We profiled endogenous peptides accumulated for 4 h in media conditioned by primary cultured rat cardiac fibroblasts. A total of 3916 redundant peptide sequences from 94 secretory proteins and membrane proteins served to identify limited cleavage sites, both annotated and unannotated, for signal peptide or propeptide removal, peptide hormone processing, ectodomain shedding, and regulated intramembrane proteolysis. Incorrectly predicted signal cleavage sites are found in typical proteins such as extracellular matrix proteins and the peptide hormone precursor adrenomedullin ADM. The revealed signal peptide cleavage site for ADM was experimentally verified by identifying the major molecular form of flanking proadrenomedullin N-terminal peptide. We suggest that profiling of endogenous peptides, like transcriptome sequence reads, makes sense in regular cells such as fibroblasts and that peptidomics provides insight into proteolysis-regulated protein functions.

Randomized phase III trial of treatment duration for oral uracil and tegafur plus leucovorin as adjuvant chemotherapy for patients with stage IIB/III colon cancer: final results of JFMC33-0502

While adjuvant chemotherapy is preferable for colon cancer, treatment duration is controversial. This phase III trial is investigated optimal duration of adjuvant chemotherapy for Stage IIB/III colon cancer. Eighteen-month treatment with UFT/LV did not improve DFS compared with 6-month UFT/LV treatment. This study suggests that 6 months treatment duration is enough for Stage IIB/III colon cancer.

Background

While adjuvant chemotherapy is preferable for high-risk colon cancer, treatment duration is controversial. Oral uracil and tegafur (UFT)/leucovorin (LV) is widely used as a standard adjuvant chemotherapy for colon cancer in Japan. We conducted a phase III trial to investigate the optimal duration of adjuvant chemotherapy for stage IIB/III colon cancer.

Patients and methods

Patients with curatively resected stage IIB/III colon cancer were eligible for enrollment in this trial. Patients were registered within 6 weeks after surgery and were randomly assigned to receive UFT/LV for 28 of 35 days for 6 months in the control group or for 5 consecutive days per week for 18 months in the study group. The primary end point was the disease-free survival (DFS), and the secondary end points were overall survival (OS) and safety.

Result

A total of 1071 patients were registered from 233 centers. A statistically significant difference in DFS was not observed between the study group and the control group; the 5-year DFS was 69% in the study group and 69% in the control group. The 5-year OS was 85% in the study group and 85% in the control group.

Conclusion

Eighteen-month treatment with UFT/LV did not improve DFS or OS compared with 6-month UFT/LV treatment in patients with stage IIB/III colon cancer. The important finding from this study is that not 18 months but 6 months of treatment is enough for postoperative UFT/LV for stage IIB/III colon cancer.

Clinical trial number

UMIN-CTR C000000245.

Size-Controlled AgI/Ag Heteronanowires in Highly Ordered Alumina Membranes: Superionic Phase Stabilization and Conductivity

Nanoscaled ionic conductors are crucial for future nanodevices. A well-known ionic conductor, AgI, exhibited conductivity greater than 1 Ω(-1) cm(-1) in α-phase and transformed into poorly conducting β-/γ-phase below 147 °C, thereby limiting applications. Here, we report that transition temperatures both from the β-/γ- to α-phase (Tc↑) and the α- to β-/γ-phase (Tc↓) are tuned by AgI/Ag heteronanowires embedded in anodic aluminum oxide (AAO) membranes with 10-30 nm pores. Tc↑ and Tc↓ shift to correspondingly higher and lower temperature as pore size decreases, generating a progressively enlarged thermal hysteresis. Tc↑ and Tc↓ specifically achieve 185 and 52 °C in 10 nm pores, and the final survived conductivity reaches ∼8.3 × 10(-3) Ω(-1) cm(-1) at room temperature. Moreover, the low-temperature stabilizing α-phase (down to 21 °C, the lowest in state of the art temperatures) is reproducible and survives further thermal cycling. The low-temperature phase stabilization and enhancement conductivity reported here suggest promising applications in silver-ion-based future nanodevices.

Laser-shock compression of magnesium oxide in the warm-dense-matter regime

Magnesium oxide has been experimentally and computationally investigated in the warm-dense solid and liquid ranges from 200 GPa to 1 TPa along the principal Hugoniot. The linear approximation between shock velocity and particle velocity is validated up to a shock velocity of 15 km/s from the experimental data, this suggesting that the MgO B1 structure is stable up to the corresponding shock pressure of ∼350 GPa. Moreover, our Hugoniot data, combined with ab initio simulations, show two crossovers between MgO Hugoniot and the extrapolation of the linear approximation line, occurring at a shock pressures of approximately 350 and 650 GPa, with shock temperatures of 8000 and 14,000 K, respectively. These crossover regions are consistent with the solid-solid (B1-B2) and the solid-liquid (B2-melt) phase boundaries predicted by the ab initio calculations.

Effect of Ionic Conductivity on Response Speed of SrTiO3-Based All-Solid-State Electric-Double-Layer Transistor

An all-solid-state electric-double-layer transistor (EDLT) with a Y-stabilized ZrO₂ (YSZ) proton conductor/SrTiO₃ (STO) single crystal has been fabricated to investigate ionic conductivity effect on the response speed, which should be a key parameter for development of next-generation EDLTs. The drain current exhibited a 4-order-of-magnitude increment by electrostatic carrier doping at the YSZ/STO interface due to ion migration, and the behavior strongly depended on the operation temperature. An Arrhenius-type plot of the ionic conductivity (σ(i)) in the YSZ and t(c)⁻¹, which is a current-rise time needed for charge accumulation at the YSZ/STO interface, shows a synchronized variation, indicating a proportional relationship between the two parameters. Analysis of the σ(i)-t(c) diagram shows that, in contrast to conventional EDLTs, the response speed should reach picosecond order at room temperature by using extreme miniaturization and superionic conductors. Furthermore, the diagram indicates that plenty of solid electrolytes, which have not been used due to the lack of criteria for evaluation, can be a candidate for all-solid-state EDLTs exceeding the carrier density of conventional EDLTs, even though the response speed becomes comparably lower than those of FETs.

Nifedipine prevents sodium caprate-induced barrier dysfunction in human epidermal keratinocyte cultures

Tight junctions (TJs) of the epidermis play an important role in maintaining the epidermal barrier. TJ breakdown is associated with skin problems, such as wrinkles and transepidermal water loss (TEWL). Clinical studies have reported that topical nifedipine is effective in reducing the depth of wrinkles and improving TEWL. However, it remains unknown whether nifedipine influences the TJ function in the epidermis. In the present study, we investigated the effect of nifedipine on epidermal barrier dysfunction in normal human epidermal keratinocytes (NHEKs) treated with sodium caprate (C10), a TJ inhibitor. Nifedipine reversed the C10-decreased transepithelial electrical resistance values as a measure of disruption of the epidermal barrier. Immunocytochemical observations revealed that nifedipine improved the C10-induced irregular arrangement of claudin-1, a key protein in TJs. Taken together, these findings suggest that nifedipine prevents epidermal barrier dysfunction, at least in part, by reconstituting the irregular claudin-1 localization at TJs in C10-treated NHEKs.

Treatment Rationale and Study Design for Clinical Trial on the Efficacy of UFT/LV for Stage II Colorectal Cancer With Risk Factors for Recurrence (JFMC46-1201)

BACKGROUND

The usefulness of adjuvant chemotherapy for stage II colon cancer has not been established. Meanwhile, the presence of stage II colon cancer with high-risk factors for recurrence has been reported. To our knowledge, no prospective study of adjuvant chemotherapy for stage II colon cancer with high-risk factors has been implemented to date.

PATIENTS AND METHODS

This study is a prospective nonrandomized controlled study based on patients' selection of treatment option, including randomized therapeutic decision-making, to evaluate the usefulness of adjuvant chemotherapy with tegafur-uracil (UFT) with leucovorin (LV) for stage II colon cancer with high-risk factors for recurrence, compared with surgery alone. Five courses of UFT/LV therapy will be given as follows: UFT (300 mg/m(2)/d) with LV (75 mg/d) will be orally administered in 3 doses per day. Treatment will be received daily for 28 days, followed by a 7-day rest or will be received daily for 5 days, followed by a 2-day rest. For both regimens, 1 course will last 5 weeks, and 5 courses will be given. The primary end point is disease-free survival. A propensity score matching will be conducted based on 7 variables that represent risk factors to minimize selection bias in a comparison between the nonrandomized arms. For this nonrandomized comparison, a target sample size is set at 1200 (400 and 800 patients for the surgery alone and UFT/LV groups, respectively) and 1720 patients will be enrolled. In this study we aim to evaluate the therapeutic usefulness of adjuvant chemotherapy with UFT/LV for stage II colorectal cancer with risk factors for recurrence.

Dipyridamole therapy in the nephrotic syndrome

Dipyridamole was used in 30 cases of nephrotic syndrome, mostly of intractable type. The results indicate that the drug therapy proved to be effective in decreasing urinary protein and controlling nephrotic condition in 40% of the cases after an initial period of treatment. Long-term results of the drug on urinary protein and on nephrotic condition were rated as good in 36.7 and 53.3%, respectively, of the cases treated. The exact mechanism of action of dipyridamole in the nephrotic syndrome is still obscure in many respects. However, the fact that the drug shares its anti-platelet action with the non-steroid anti-inflammatory drugs, e.g. aspirin and indomethacin, and the rapidity with which it produces its urinary protein-decreasing effect, strongly suggests that it inhibits the release of vasoactive amines and other chemical mediators from blood platelets. As far as the present study is concerned, adverse side effects of dipyridamole were few or minimal, even when the drug used in large doses over a prolonged period of time. From these results it is considered that dipyridamole provides a new remedy which is worthy of trying in nephrotic syndrome as a means of reducing the requirement of steroids and immunosuppressive drugs.