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Zheng H.-c.,Shenyang Medical College | Xu X.-y.,Shenyang Medical College | Yu M.,Shenyang University | Takahashi H.,University of Toyama | And 2 more authors.
Human Pathology

Although the biologic function of Reg IV is poorly understood, it has been reported that Reg IV is a potent activator of the epidermal growth factor receptor/Akt/AP-1 signaling pathway in colon cancer cells and closely linked with the inhibition of apoptosis. To clarify the role of Reg IV in gastric carcinogenesis and subsequent progression, we examined its expression by immunohistochemistry and in situ hybridization on tissue microarray containing gastric carcinoma, adjacent nonneoplastic mucosa, adenoma, intestinal metaplasia, or gastritis. Gastric carcinoma cell lines (MKN28, AGS, MKN45, KATO-III, and HGC-27) were studied for Reg IV expression by Western blot and reverse transcriptase-polymerase chain reaction followed by sequencing. Frozen samples of gastric carcinoma and adjacent nonneoplastic mucosa were subjected to Western blot, and patient serum, to enzyme-linked immunosorbent assay for Reg IV. Gastric carcinoma cell lines showed different levels of Reg IV mRNA and its encoding protein. The Reg IV protein expression was gradually decreased from intestinal metaplasia, adenoma, and carcinoma to gastritis (P < .05). The positive rate of its mRNA was higher in intestinal metaplasia than carcinoma or nonneoplastic mucosa (P < .05). Elevated serum Reg IV level in gastric carcinoma patients was detected in comparison with that in health individuals (P < .05). Reg IV expression was significantly correlated with the MUC-2 and MUC-5AC expression (P < .05). Among histologic subtypes of the World Health Organization, signet ring cell carcinoma more frequently expressed Reg IV than the others (P < .05), whereas it is the converse for the poorly differentiated group (P < .05). Our study indicated that Reg IV expression experienced up-regulation in gastric intestinal metaplasia and adenoma and then down-regulation with malignant transformation of gastric epithelial cells. It was suggested that Reg IV expression should be considered as a good biomarker for gastric precancerous lesions and was especially related to the histogenic pathway of signet ring cell carcinoma. © 2010 Elsevier Inc. All rights reserved. Source

Takahashi H.,Kitasato University | Wang J.-P.,Shenyang University | Zheng H.-C.,Shenyang University | Zheng H.-C.,Clinical Research Institute | And 2 more authors.
Histology and Histopathology

Glucose-related proteins (GRPs) are ubiquitously expressed in the endoplasmic reticulum and assist in protein folding and assembly, consequently considered to be molecular chaperones. GRP78 and GRP94 expression was induced by glucose starvation and up-regulated in samples taken from several different malignant tissues. To clarify the roles of both molecules in tumorigenesis and progression of colorectal carcinomas, immunohistochemistry (IHC) was performed on tissue microarrays containing colorectal carcinomas, adenomas and the non-neoplastic mucosa (NNM) using antibodies against GRP78 and GRP94. Their expression was correlated with the clinicopathological parameters of carcinomas. Both proteins were also studied in colorectal carcinoma cell lines (DLD-1, HCT-15, SW480 and WiDr) by IHC and Western blot. There was a gradually increased GRP78 expression from colorectal NNMs, carcinomas, to low-grade and high-grade adenomas (P<0.05), while up-regulated GRP94 expression from NNM, low-grade adenoma, high-grade adenoma, to carcinoma (P<0.05). The expression was similar in all the carcinoma cell lines. GRP78 expression was negatively correlated with lymphatic invasion or low GRP94 expression of the carcinomas (P<0.05), while there was no correlation of GRP94 expression with other parameters of carcinomas (P>0.05). Multivariate analysis showed that venous invasion, lymph node metastasis and UICC staging (P<0.05), but not age, sex, tumor size, differentiation, depth of invasion, lymphatic invasion, GRP78 and GRP94 expression (P>0.05), were independent prognostic factors for carcinomas. It is suggested that up-regulated expression of GRP78 and GRP94 could possibly be involved in the pathogenesis of colorectal carcinomas. Source

Background: The study aimed to identify specific predictors of soft bipolarity (bipolar II disorder or bipolar disorder not otherwise specified) in depressed patients and to evaluate the global predictive performance of combinations of these predictors. Methods: Subjects included 199 patients with a major depressive episode (MDE) due to soft bipolarity or major depressive disorder. Independent predictors of soft bipolar diagnosis were extracted from 12 previously proposed bipolar features using multiple logistic regression analyses, and the global performance of the combination of these predictors was evaluated using a receiver operating characteristic (ROC) curve. Results: Recurrent MDEs, family history of bipolar disorders in first-degree relatives, cyclothymic temperament, early age at onset of first MDE, and depressive mixed state were independent predictors of soft bipolarity diagnosis [odds ratio (95% confidence interval): 11.22 (2.19-57.63), 8.82 (1.31-59.15), 7.32 (2.22-24.19), 6.22 (1.58-24.57), and 5.57 (1.91-16.30), respectively]. The area under the ROC curve for the relationship between soft bipolarity diagnosis and the number of these five predictors in each patient was 0.911 (highly accurate). The presence of one or more predictors in each patient resulted in highest sensitivity (92.5%) and good specificity (73.1%), whereas that of two or more predictors resulted in good sensitivity (70.0%) and highest specificity (97.5%) for soft bipolarity diagnosis. Limitations: Structured/semistructured interviews were not used. Tools for temperament assessments were different between institutions. Conclusions: A combination of these predictors was quite helpful for a precise diagnosis of soft bipolarity in patients with depression. © 2012 Elsevier B.V. All rights reserved. Source

Shibata Y.,Kouseiren Takaoka Hospital
Japanese Journal of Cancer and Chemotherapy

Cisplatin and gemcitabine combination chemotherapy has emerged as the standard treatment for advanced or recurrent biliary tract cancer and has been used in Japan since August 2011. We retrospectively reviewed and evaluated the toxicity and compliance of this combination chemotherapy from electronic medical records. From November 2011 to June 2012, 10 patients with unresectable biliary tract cancer underwent cisplatin and gemcitabine combination chemotherapy at our hospital. Grade 3/4 toxicities of neutropenia and thrombocytopenia were observed in 5 and 4 cases, respectively. Febrile neutropenia was observed in 3 cases. Grade 2 or worse anorexia was relatively common. Dose delays and reductions due to adverse events were needed in 8 patients. Cisplatin and gemcitabine combination chemotherapy for advanced biliary tract cancer can be safely performed with careful attention given to possible hematological toxicity and anorexia. Source

Oshima M.,Kouseiren Takaoka Hospital
Kyobu geka. The Japanese journal of thoracic surgery

A 61-year-old man came to our hospital complained of neck swelling after extracting a tooth. Cervical drainage was performed in the diagnosis of cervical abscess. Two days later, left pleural effusion appeared and its bacteriologic culture showed Streptococcus constellatus. Computed tomography (CT) scan showed massive retained pus in the mediastinum. Thoracic drainage alone wasn't effective and the left thoracotomy was immediately performed to open the mediastinal pleura and curette the thoracic cavity. After surgery, left thoracic cavity was irrigated with a large volume of saline solution via the thoracic drains for a month, resulting in successful recovery. Immediate open drainage and irrigation are very important in case of descending necrotizing mediastinitis rapidly developing empyema. Source

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