Phosphatidylcholine-Plasmalogen-Oleic Acid Has Protective Effects against Arachidonic Acid-Induced Cytotoxicity.

Plasmalogens are a group of glycerophospholipids containing a vinyl-ether bond at the sn-1 position in the glycerol backbone. Cellular membrane plasmalogens are considered to have important roles in homeostasis as endogenous antioxidants, differentiation, and intracellular signal transduction pathways including neural transmission. Therefore, reduced levels of plasmalogens have been suggested to be associated with neurodegenerative diseases such as Alzheimer's disease. Interestingly, although arachidonic acid is considered to be involved in learning and memory, it could be liberated and excessively activate neuronal activity to the excitotoxic levels seen in Alzheimer's disease patients. Here, we examined the protective effects of several kinds of plasmalogens against cellular toxicity caused by arachidonic acid in human neuroblastoma SH-SY5Y cells. As a result, only phosphatidylcholine-plasmalogen-oleic acid (PC-PLS-18) showed protective effects against arachidonic acid-induced cytotoxicity based on the results of lactate dehydrogenase release and ATP depletion assays, as well as cellular morphological changes in SH-SY5Y cells. These results indicate that PC-PLS-18 protects against arachidonic acid-induced cytotoxicity, possibly via improving the stability of the cellular membrane in SH-SY5Y cells.

Biomechanical analysis of the maxillary molar intrusion: A finite element study.

INTRODUCTION: The purpose of this study was to analyze and clarify tooth movement when intruding the maxillary molars using intrusive forces between the maxillary first and second molars. METHODS: A finite element method was used to simulate the long-term orthodontic movement of the maxillary dentition by accumulating the initial displacement of teeth produced by elastic deformation of the periodontal ligament. Intrusive forces of 2 N were applied buccally to the archwire between the maxillary first and second molars. Two different sized transpalatal arches (TPAs) (0.036-in and 0.06-in) and a gradually increased constriction bend and torque toward the posterior teeth were applied to prevent buccal tipping of the posterior teeth when intruding the maxillary posterior teeth. RESULTS: The whole maxillary dentition rotated clockwise as the intrusive force passed posteriorly to the center of resistance. Buccal crown tipping of the maxillary posterior teeth and lingual tipping of the maxillary incisors occurred. Their tipping decreased with a constriction bend and lingual crown torque and when a TPA was applied. CONCLUSIONS: Supplemental procedures such as a constriction bend and lingual crown torque and a TPA could effectively prevent the buccal crown tipping of the maxillary posterior teeth when intruding on them.

Biomechanical analysis for total distalization of the maxillary dentition: A finite element study.

INTRODUCTION: This study aimed to identify the tooth movement patterns relative to various force angulations (FAs) when distalizing the total maxillary dentition. METHODS: Long-term orthodontic movement of the maxillary dentition was simulated by accumulating the initial displacement of teeth produced by elastic deflection of the periodontal ligament using a finite element analysis. Distalization forces of 3 N were applied to the archwire between the maxillary canine and first premolar at 5 different FAs (-30°, -15°, 0°, 15°, and 30°) to the occlusal plane. RESULTS: Maxillary incisors and molars showed lingual and distal tipping at all FAs, respectively. At a force angulation of 30°, almost bodily distalization of the total maxillary dentition occurred, but incisors showed considerable lingual tipping because of the effect of clearance gap (0.003-in, 0.022 × 0.025-in bracket slot, 0.019 × 0.025-in archwire) and elastic deflection of the archwire. Medial displacement of the maxillary anterior teeth occurred because of lingual tipping during distalization. The occlusal plane rotated clockwise at all FAs because of extrusion of the maxillary incisors and intrusion of the maxillary second molars, and the amounts decreased as FA increased. CONCLUSIONS: Tooth movement patterns during distalization of the total maxillary dentition were recognized. With an understanding of the mechanics, a proper treatment plan can be established.

Biomechanical analysis for total mesialization of the maxillary dentition: A finite element study.

INTRODUCTION: The purpose of this study was to analyze and clarify tooth movement during mesialization of the whole maxillary dentition with various force angulations (FAs). METHODS: A finite element method was used to simulate the long-term orthodontic movement of the maxillary dentition by accumulating the initial displacement of teeth produced by elastic deformation of the periodontal ligament. A mesial force of 3 N was applied to the maxillary second molar at 5 different FAs (-30°, -15°, 0°, 15°, and 30°) to the occlusal plane. RESULTS: At an FA of 28°, the line of action of the force passed through the center of resistance of the maxillary whole dentition. With all FAs, the central incisors and molars tipped labially and mesially, respectively. The tipping angles gradually decreased as the FAs shifted from -30° to 30°. The molars tipped lingually with FAs of -30° and -15°, whereas they tipped buccally with FAs of 0°, 15°, and 30°. The molars tended to rotate mesiolingually more as the angle of force increased toward an FA of 30°. The occlusal plane rotated counterclockwise with FAs of -30°, -15°, and 0°, whereas it rotated clockwise with FAs of 15° and 30°. With an FA of 30°, buccal tipping and mesiolingual rotation of the molars, and the change in the occlusal plane angle decreased when the transpalatal arch (TPA) was fixed to the first molars and decreased, even more when the TPA was fixed to the second molars rather than the first molars, when a thicker TPA was used, and when the TPA was fixed to both molars rather than a single molar. CONCLUSIONS: There was a correlation between tooth movement during mesialization of the whole maxillary dentition and the angle at which the force was applied.

Biomechanical analysis for total mesialization of the mandibular dentition: A finite element study.

OBJECTIVES: To clarify the mechanics of tooth movement in mesialization of the whole mandibular dentition when changing the force angulation. SETTING: A finite element method was used to simulate long-term movements of the whole mandibular dentition. MATERIAL AND METHODS: Tooth movement was simulated by accumulating the initial displacement, which was produced by elastic deformation of the periodontal ligament. Mesial forces of 3 N were applied to the second molar bracket at -30°, -15°, 0°, 15° and 30° to the occlusal plane. RESULTS: The whole dentition and occlusal plane were rotated depending on the direction of the force with respect to the centre of resistance (CR). At a force angulation of -30°, the line of action of the force passed near the CR, and the whole dentition translated without rotation of the occlusal plane. The second molar tipped buccally due to a clearance gap between the archwire and bracket slot. When increasing a force angulation from -30°, the line of action of the force passed above the CR, and thereby, the occlusal plane rotated clockwise. This rotation of the whole dentition induced tipping of the individual teeth. Buccal tipping of the molar due to an elastic deformation of the archwire was prevented by using a lingually pre-bent archwire. CONCLUSIONS: Careful selection of force angulation and biomechanics is essential to obtain proper tooth movement in total mesialization of the mandibular dentition.

A retrospective analysis on the utility and complications of upper arm ports in 433 cases at a single institute.

BACKGROUND: We have employed upper arm central venous ports (UACVPs) since 2006 for long-term intravenous chemotherapy (CTx) or fluid supplementation. We evaluated the long-term availability of CVPs implanted in the upper arm to determine whether UACVPs could be one of the treatment options besides chest CVPs in terms of CVP-related complications. METHODS: We reviewed the medical records of all patients who underwent subcutaneous implantation of UACVPs at Kyoto University Hospital from 1 April, 2006 to 30 June, 2009. We assessed the indwelling duration of the UACVPs and the incidences of early and late UACVP-related complications. RESULTS: A total of 433 patients underwent subcutaneous implantation of UACVPs during this time period. The cumulative follow-up period was 251,538 catheter days, and the median duration of UACVP indwelling was 439.0 days (1-2, 24). There was no UACVP-related mortality throughout the study period. A total of 83 UACVP-related complications occurred (19.2 %), including 43 cases of infection (9.9 %, 0.17/1000 catheter days), ten cases of catheter-related thrombosis (2.3 %, 0.040/1000 catheter days), ten cases of occlusion (2.3 %, 0.040/1000 catheter days), nine cases of catheter dislocation (2.0 %, 0.036/1000 catheter days), five cases of port leakage (1.2 %, 0.019/1000 catheter days), four cases of skin dehiscence (0.9 %, 0.015/1000 catheter days) and two cases of port chamber twist (0.5 %, 0.008/1000 catheter days). The removal-free one-year port availability was estimated at 87.8 %. CONCLUSIONS: UACVPs were of long-term utility, with complication rates comparable to those of chest CVPs previously reported.

Relationship between a gum-chewing routine and oral, physical, and cognitive functions of community-dwelling older adults: A Kashiwa cohort study.

AIM: As associations between oral function and general health have been reported in community-dwelling older adults, easily implementable preventive measures are urgently required. We focused on the health benefits of gum chewing, as no studies have been carried out on the impact of gum-chewing routines on the health of older adults. This cross-sectional study aimed to determine whether the gum-chewing routine is associated with oral, physical and cognitive functions in community-dwelling older adults. METHODS: This study included 1617 community-dwelling older participants in a health survey carried out in 2021. The gum-chewing routine and weekly chewing time were assessed using a self-administered questionnaire. The outcome measures, including actual measurements of oral function, physical function, cognitive function, dietary intake and lifestyle, were evaluated using self-administered questionnaires or health surveys. RESULTS: We analyzed 1474 (mean age 76.1 ± 5.8 years, 45% women) participants for whom all data were not missing, and 14% of them had a gum-chewing routine for more than 30 min weekly. Oral functions were significantly higher in older adults with a gum-chewing routine, and there were substantially fewer participants with oral frailty (adjusted odds ratio 0.581, 95% confidence interval 0.340-0.993). Additionally, cognitive and physical functions, including grip strength, were significantly higher in the gum-chewing routine group. CONCLUSIONS: Community-dwelling older adults with a gum-chewing routine have higher oral, physical and cognitive functions. These findings indicate that a gum-chewing routine might contribute to maintaining oral function and preventing frailty. Geriatr Gerontol Int 2024; 24: 68-74.

Effect of attachment type on distal bodily movement of the maxillary canine in aligner orthodontics: a finite element study.

OBJECTIVES: To clarify the effect of attachment types on bodily movement of the maxillary canine in aligner orthodontics. MATERIALS AND METHODS: Using an aligner, the canine was moved bodily by 0.1 mm distally as a target position. Orthodontic tooth movement was simulated using the finite element method (FEM). The alveolar socket was displaced in the same manner as the initial movement caused by elastic deformation of the periodontal ligament. First, the initial movement was calculated, and then the alveolar socket was displaced in the same direction and with the same magnitude as the initial movement. These calculations were repeated to move the teeth after placement of the aligner. The teeth and the alveolar bone were assumed to be rigid bodies. A FEM model of the aligner was made based on the crown surfaces. The thickness of the aligner was 0.45 mm, and its Young's modulus was 2 GPa. Three types of attachments-semicircular couple, vertical rectangular, and horizontal rectangular-were placed on the canine crown. RESULTS: Regardless of the type of attachment, upon placement of the aligner on the dentition the crown of the canine moved to the target position, while the apex hardly moved. That is, the canine tipped and rotated. After repeating the calculation, the canine became upright and moved bodily regardless of the attachment type. In the aligner without an attachment, the canine did not become upright. CONCLUSIONS: There was almost no difference among attachment types in terms of achieving bodily movement of the canine.

Oral frailty as a risk factor for mild cognitive impairment in community-dwelling older adults: Kashiwa study.

BACKGROUND: Oral frailty is defined as a slight decline in comprehensive oral function and can predict the onset of adverse health outcomes including morbidity in community-dwelling older adults. Previously, the number of remaining teeth and masticatory status had been suggested to be associated with cognitive decline. The effects of comprehensive oral condition on cognitive decline have not been adequately examined. In this study, we aimed to examine whether oral frailty is associated with new-onset mild cognitive impairment (MCI) among community-dwelling older adults. METHODS: Two thousand and forty-four participants of a longitudinal cohort study in Kashiwa City, Chiba Prefecture, without cognitive decline who participated in at least one follow-up survey, were included. New-onset MCI was assessed using the Mini-Mental State Examination (score < 27 defined as MCI). Oral frailty was evaluated based on six components including the number of remaining teeth, masticatory status, tongue pressure, oral motor skills, and subjective difficulties in eating and swallowing. "Oral non-frailty" was defined as good performance on all six measures, "oral pre-frailty" was defined as poor performance on one or two measures, and "oral frailty" was defined as poor performance on three or more measures. Statistical analysis was performed, mainly using a Cox proportional hazards model. RESULTS: Of the 1410 participants who did not fit the exclusion criteria (mean 72.4 ± 5.2 years; 49 % female), 19 % had new-onset MCI during the follow-up period. When comparing the status of oral frailty (non-frailty, oral pre-frailty, and oral frailty), the oral frailty group had a significantly higher hazard ratio for new-onset MCI than the other groups, even after adjusting for confounding factors. Among the six components, a decrease in the number of remaining teeth, low tongue pressure, and difficulty eating tough foods significantly correlated with new-onset MCI. Additionally, we found individuals with co-existing oral frailty and physical frailty to be associated with an increased risk of MCI. However, no significant increase in hazard ratio was observed in participants with either physical or oral frailty. CONCLUSIONS: The study findings suggest that oral frailty could predict the risk of new-onset MCI in community-dwelling older adults. Further, we found that oral frailty with physical frailty exacerbated this risk, implying the existence of direct or additive effects on cognitive dysfunction. Comprehensive oral health focusing on maintaining eating function can be a strategy to prevent MCI and delay dementia in community-dwelling older adults.

Finite element analysis of the effect of force directions on tooth movement in extraction space closure with miniscrew sliding mechanics.

INTRODUCTION: Miniscrews placed in bone have been used as orthodontic anchorage in extraction space closure with sliding mechanics. The movement patterns of the teeth depend on the force directions. To move the teeth in a desired pattern, the appropriate direction of force must be selected. The purpose of this article is to clarify the relationship between force directions and movement patterns. METHODS: By using the finite element method, orthodontic movements were simulated based on the remodeling law of the alveolar bone. The power arm length and the miniscrew position were varied to change the force directions. RESULTS: When the power arm was lengthened, rotation of the entire maxillary dentition decreased. The posterior teeth were effective for preventing rotation of the anterior teeth through an archwire. In cases of a high position of a miniscrew, bodily tooth movement was almost achieved. The vertical component of the force produced intrusion or extrusion of the entire dentition. CONCLUSIONS: Within the limits of the method, the mechanical simulations demonstrated the effect of force direction on movement patterns.

Tooth Movement Efficacy of Retraction Spring Made of a New Low Elastic Modulus Material, Gum Metal, Evaluated by the Finite Element Method.

The aim of this study was to evaluate the tooth movement efficacy of retraction springs made of a new ß-titanium alloy, "gum metal", which has a low Young's modulus and nonlinear super elasticity. Using double loop springs incorporated into an archwire made of gum metal (GUM) and titanium molybdenum alloy (TMA), the maxillary anterior teeth were moved distally to close an extraction space. The long-term movements were simulated by the finite element method. Its procedure was constructed of two steps, with the first step being the calculation of the initial tooth movement produced by elastic deformation of the periodontal ligament, and in the second step, the alveolar socket was moved by the initial tooth movement. By repeating these steps, the tooth moved by accumulating the initial tooth movement. The number of repeating calculations was equivalent to an elapsed time. In the GUM and TMA springs, the anterior teeth firstly tipped lingually, and then became upright. As a result of these movements, the canine could move bodily. The amount of space closure in GUM spring was 1.5 times that in TMA spring. The initial tipping angle of the canine in the GUM spring was larger than that in the TMA spring. The number of repeating calculations required for the bodily movement in the GUM spring was about two times that in the TMA spring. It was predicted that the speed of space closure in the GUM spring was smaller than that in the TMA spring.

Prevalence and risk factors of sarcopenia in community-dwelling older adults visiting regional medical institutions from the Kadoma Sarcopenia Study.

This study aimed to investigate risk factors for sarcopenia in community-dwelling older adults visiting regional medical institutions. We retrospectively analyzed medical records of 552 participants (mean age: 74.6 ± 6.7 years, males 31.3%) who underwent body composition evaluation between March 2017 and December 2018 at one of 24 medical institutions belonging to the Kadoma City Medical Association in Japan. We collected the participant's characteristics and laboratory data. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019. Sarcopenia, including severe sarcopenia, was detected in 22.3% of all participants, 17.3% of men, and 24.5% of women; rates increased with age. Multivariate logistic regression analysis revealed age (odds ratio [OR]: 2.12; 95% confidence interval [CI] 1.20-3.75), obesity (OR: 0.15; 95% CI 0.07-0.32), hypertension (OR: 0.44; 95% CI 0.25-0.76), certification of long term care (OR: 3.32; 95% CI 1.41-7.81), number of daily conversations (OR: 0.44; 95% CI 0.25-0.77), and malnutrition (OR: 2.42; 95% CI 1.04-5.60) as independent predictors of sarcopenia. Receiver operating characteristic curve analysis demonstrated that the cut-off for daily conversations defining sarcopenia was 4.8 persons. The prevalence of sarcopenia in this study was 22.3%. Besides traditional risk factors for sarcopenia, the number of daily conversations was an independent factor.

Rapid progression of submucosal invasive micropapillary carcinoma of the colon in progressive systemic sclerosis: report of a case.

A 71-year-old woman presented with hematochezia and narrowing of the stool. She suffered from progressive systemic sclerosis for 12 years and underwent home oxygen therapy due to pulmonary fibrosis and moderate pulmonary hypertension. Colonoscopy revealed a pedunculated, cauliflower-like polyp with a depressed surface in the sigmoid colon. The polyp was regarded as early colon cancer with possible submucosal invasion, and subsequent computed tomographic (CT) scans showed no evidence of lymph node involvement or distant metastases. Because of perioperative risks due to moderate pulmonary hypertension, she underwent an endoscopic resection of the early colon cancer. Pathological examination of the resected specimen of 20 mm diameter revealed the peculiar morphology of an adenocarcinoma with moderate lymphatic invasion. Immunohistochemical analysis for epithelial membrane antigen showed the specific 'inside-out growth pattern' indicative of invasive micropapillary carcinoma (IMPC). Taking the perioperative risks into consideration, she opted to undergo close follow-ups without an additional sigmoidectomy. At 6 months after the resection, the follow-up colonoscopy revealed a local recurrence of the colon cancer, and subsequent CT scans revealed multiple distant metastases including the lung, liver, lymph nodes and spleen. This is a rare case of a pure, submucosal IMPC of the colon. Furthermore, pure IMPC of the colon may represent a reliable predictor of lymphogenous and/or hematogenous metastases. Therefore, one should recommend an additional colectomy after endoscopic mucosal resection treatment when pathological findings confirmed IMPC of the colon and should continue a close follow-up for IMPC patients even when curative resections were performed at an early stage.

Intracorporeal esophagojejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer.

BACKGROUND: To facilitate acceptance of laparoscopic total gastrectomy (LTG) for patients with upper gastric cancer, a simple, secure technique of reconstruction is necessary. The authors developed a new technique for intracorporeal esophagojejunal anastomosis that does not require hand sewing. METHODS: From September 2006 to January 2008, 16 patients (11 men and 5 women) with gastric cancer underwent LTG at the authors' institution. Laparoscopic esophagojejunal anastomosis using the following method was attempted for all patients. The esophagus was transected while being rotated by about 45 degrees counterclockwise to make the subsequent anastomosis easier. After the Y-anastomosis was created, an endoscopic linear stapler was applied to create a side-to-side anastomosis between the left dorsal side of the esophagus and the jejunal limb. The entry hole was first closed roughly with hernia staplers. Subsequently, an endoscopic linear stapler was applied so that all hernia staplers could be removed and the closure completed. RESULTS: Laparoscopic esophagojejunal anastomosis was successfully performed for 15 patients. Intracorporeal anastomosis failed for one patient because a nasogastric tube was caught between the jaws of an endostapler, which resulted in a conversion to open procedure. No postoperative anastomotic complications occurred. CONCLUSIONS: Using the new technique, intracorporeal linear-stapled esophagojejunal anastomosis can be performed easily and securely. This technique could become one of the standard methods for reconstruction after LTG, facilitating the acceptance of LTG as a surgical option for patients with upper gastric cancer.

A finite element analysis of the effects of archwire size on orthodontic tooth movement in extraction space closure with miniscrew sliding mechanics.

BACKGROUND: Sliding mechanics with miniscrews is recently used for extraction space closure. The purpose of this study was to elucidate how and why the archwire size affects long-term tooth movement in miniscrew sliding mechanics. METHODS: Long-term orthodontic tooth movements were simulated based on a remodeling law of the alveolar bone by using a finite element method, in which the bracket rotated freely within a clearance gap (a play) of the archwire-bracket slot. The archwire size was changed to 0.021, 0.018, and 0.016 in. for the 0.022-in. bracket. RESULT: Lingual crown tipping and extrusion of the incisors increased with decreasing the archwire size. Movements of the posterior teeth were approximately the same irrespective of archwire size. CONCLUSIONS: When decreasing the archwire size, a play of the archwire-bracket slot, as well as the elastic deformation of the archwire, resulted in lingual tipping of the incisors. This tipping led to extrusion of the incisors.

Effects of Attachment of Plastic Aligner in Closing of Diastema of Maxillary Dentition by Finite Element Method.

The aim of this study was to clarify the effect of attachment on tooth movement produced by a plastic aligner. Closing of a diastema, in which the maxillary right and left central incisors moved bodily, was simulated using a finite element method. Long-term orthodontic movements of the maxillary dentition were simulated by accumulating the initial displacement of teeth produced by elastic deformation of the periodontal ligament. The incisor tipped and rotated just after placement of the aligner irrespective of the attachment. After a sufficiently long time, the incisor was upright and moved bodily in the aligner with attachment, but the incisor remained tipped in the aligner without attachment. It was demonstrated that the attachment was effective for achieving bodily movement.

Safety and efficacy of modified FOLFOX6 for treatment of metastatic or locally advanced colorectal cancer. A single-institution outcome study.

BACKGROUND: Although a variety of FOLFOX regimens (5-fluorouracil and L-leucovorin combined with oxaliplatin) are widely used for the treatment of advanced colorectal cancer, the neurotoxicity caused by oxaliplatin is often problematic. The aim of this observational study was to assess the safety and efficacy of a modified version of the FOLFOX6 regimen (mFOLFOX6) when administered using the 'stop-and-go' strategy. PATIENTS AND METHODS: A total of 112 eligible patients treated between June 2005 and July 2007 were identified using the prospective cohort database system of Kyoto University Hospital. RESULTS: The median follow-up was 16.3 months (range 1.6-33.9), and the response rate was 33.3% (95% CI 14.5-52.2), 40.0% (95% CI 22.5-57.5) and 14.0% (95% CI 3.6-24.3) for patients who received mFOLFOX6 as first-line therapy, second-line therapy and third- or later-line therapy, respectively. The estimated median progression-free survival was 8.7 months (95% CI 2.3-15.1) and 8.2 months (95% CI 7.3-9.1) for patients on first-line and second-line therapy, respectively. The median overall survival was not reached as of April 2008 for the patients on first-line therapy, while it was 27.1 months (95% CI 22.0-32.2) for those on second-line therapy. Severe neurotoxicity occurred in only 4 patients (3.6%). CONCLUSION: mFOLFOX6 administered using the stop-and-go strategy significantly reduced oxaliplatin-induced neurotoxicity relative to conventional FOLFOX treatment, without compromising efficacy.

Clinical significance of dysadherin expression in gastric cancer patients.

PURPOSE: Dysadherin, a cancer-associated cell membrane glycoprotein, has been reported to down-regulate E-cadherin expression and promote metastasis. To evaluate the role of dysadherin in gastric cancer, we examined dysadherin and E-cadherin expression in gastric cancer patients. EXPERIMENTAL DESIGN: Dysadherin and E-cadherin expression were evaluated in 276 gastric cancer patients by immunohistochemistry, and the results were compared with the clinicopathological findings of the subjects. RESULTS: Dysadherin was not expressed in normal gastric epithelium. Both dysadherin and E-cadherin were localized to the cell membrane. Dysadherin expression was sometimes largely localized to infiltrating tumor cells or cells dissociating. Ninety gastric cancer patients (32.6%) were positive for dysadherin, and 151 patients (54.7%) showed preservation of E-cadherin expression. Expression of dysadherin was associated with moderately differentiated carcinoma and hematogenous metastasis, whereas reduced expression of E-cadherin showed an association with poorly differentiated carcinoma and peritoneal dissemination. As a result, dysadherin positivity and reduced E-cadherin expression were associated with a poor prognosis. In addition, patients with both dysadherin positivity and reduced E-cadherin had the worst prognosis. Multivariate analysis revealed that reduced E-cadherin expression was an independent prognostic factor, but dysadherin expression was not. CONCLUSION: Combined analysis of dysadherin and E-cadherin expression may help to predict the prognosis and the mode of metastasis in gastric cancer patients. Patients with dysadherin positivity have a higher risk of hematogenous metastasis, whereas patients with reduced E-cadherin expression have an increased risk of peritoneal dissemination.

Video-assisted thoracic surgery for pulmonary aspergilloma in patients with anorexia nervosa.

We report a case of pulmonary aspergilloma in a 27-year-old woman with anorexia nervosa who underwent a video-assisted thoracic surgery (VATS) lobectomy. On admission, she had lost 38% of her original weight but the laboratory data were normal. She had refused treatment for anorexia nervosa for nine years ago and may have been predisposed to opportunistic conditions. The aspergilloma was developed in a simple bulla formed in the course of healing of a lung abscess and a VATS lobectomy was safely and cosmetically performed. Wedge resection was difficult due to the size of the lesion. The residual lobes expanded very well and the postoperative course was uneventful. VATS is considered to be an efficient method in the treatment of pulmonary aspergilloma in patients with better lung function and localized pulmonary disease.