RESUMO
PURPOSES: Subtotal esophagectomy for esophageal cancer (EC) is associated with high morbidity rates. Tight glycemic control using an artificial pancreas (AP) is one of the promising strategies to reduce postoperative inflammation and morbidities. However, the effects of tight glycemic control using AP in patients with EC are yet to be fully elucidated. METHOD: This study reviewed 96 patients with EC who underwent subtotal esophagectomy. The postoperative inflammation parameters and morbidity rates were compared between patients who used the AP (n = 27) or not (control group, n = 69). AP is a closed-loop system that comprises a continuous glucose monitor and an insulin pump. RESULTS: The numbers of white blood cells (WBC) and Neutrophils (Neut) were noted to be lower in the AP group than in the control group, but with no significant difference. The ratio in which the number of WBC, Neut, and CRP on each postoperative day (POD) was divided by those tested preoperatively was used to standardize the results. The ratio of WBC and Neut on 1POD was significantly lower in the AP group than in the control group. The rate of surgical site infection was lower in the AP group than in the control group. CONCLUSION: AP significantly decreased WBC and Neut on 1POD; this suggests the beneficial effects of AP in alleviating postoperative inflammation.
Assuntos
Neoplasias Esofágicas , Pâncreas Artificial , Humanos , Glicemia , Infecção da Ferida Cirúrgica , Inflamação/etiologia , Inflamação/prevenção & controle , Neoplasias Esofágicas/cirurgiaRESUMO
Connective tissue growth factor (CTGF) is a target gene of the Hippo signaling pathway. Its differential role in the histological types of gastric cancer (GC) remains unknown; therefore, the present study aimed to confirm the clinical significance of CTGF expression in cancer and stromal cells in patients with GC depending on the histological type. The present study enrolled 589 patients with GC. Immunohistochemistry was used to analyze CTGF expression in cancer and stromal cells. CTGF mRNA expression data and the corresponding clinical information of GC samples were collected from The Cancer Genome Atlas (TCGA) database. Subsequently, the associations between CTGF expression and several clinicopathological factors were investigated. In the present study, CTGF expression was mainly observed in the cytoplasm of cancer and stromal cells. CTGF expression in stromal cells was significantly associated with CTGF expression in cancer cells (P<0.001). CTGF positivity in stromal cells was also significantly associated with intestinal type, non-scirrhous type, tumor depth (T1-2), lymph node metastasis (negative), lymphatic invasion (negative) and tumor size (<5 cm). Low CTGF expression in stromal cells was independently associated with worse overall survival (OS). Furthermore, the OS of patients with low CTGF expression in stromal cells, especially in patients with diffuse-type GC, was significantly worse than patients with high CTGF expression (P=0.022). This trend was similar to that revealed by TCGA data analysis. In conclusion, low CTGF expression was associated with a significantly worse OS in patients with diffuse-type GC. These data indicated that CTGF, and its control by the Hippo pathway, may be considered potential treatment targets in diffuse-type GC.
RESUMO
The study investigated exercise patterns resulting in the more efficient promotion of amino acid utilization. High-protein snacks (HPS; 15 g protein, 18 g sugar) were ingested by 8 young adult subjects 3 h after the basal meal ingestion. Sixty minutes after the HPS ingestion, the subjects performed arm flex/extend exercises for 15 min. The difference between 2 exercise patterns was compared. Pattern 1: High-number long-interval (HL) arm flex/extend (3+3 s) exercise; the HL group performed 9 sets of 15 exercises with a 10 s interval between sets. Pattern 2: Low-number short-interval (LS) arm flex/extend (3+3 s) exercise; the LS group performed 27 sets of 5 exercises with a 3-4 s interval between sets (135 exercises during 15 min, respectively). The plasma branched-chain amino acid (BCAA) concentrations were measured before the HPS ingestion, before the exercise, and 60 and 90 min after the HPS ingestion. The plasma BCAA concentrations increased significantly after the HPS ingestion. In the HL group, BCAA concentration increased consistently during the period and 60 to 90 min after the HPS ingestion. During the same period in the LS group the BCAA concentration stopped increasing. After HPS ingestion, a significantly greater suppressive effect on plasma BCAA concentration was seen in the LS group compared to the HL group. Results confirmed that the intermittent blood volume fluctuation in muscle tissue during the exercise pattern performed by the LS group had an effect on the utilization of nutritional components (BCAA, glucose) from the blood, and showed the possibility that the group where the blood volume in the muscle tissue increased/lowered with higher frequency was a more effective exercise pattern for nutrient utilization.
Assuntos
Aminoácidos/sangue , Volume Sanguíneo/fisiologia , Proteínas Alimentares/farmacologia , Contração Muscular/fisiologia , Músculo Esquelético/irrigação sanguínea , Treinamento Resistido , Adulto , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Fatores de Tempo , Adulto JovemRESUMO
We have previously reported the preventive effects of light resistance exercise (voluntary tower climbing exercise) after ingestion of a high-protein snack (HPS) on muscle loss in glucocorticoid-injected rats. However, such studies have not been performed in humans. In this cross-over study, we examined the effect of light resistance exercise after ingestion of HPS on plasma branched-chain amino acid (BCAA) concentrations in humans. Seven healthy young adult females (aged 22.1+/-1.2 y) participated in this study. They were assigned to either an exercise group or a control group. Seven days after the first experiment, they were crossed over to the opposite intervention. The subjects ingested HPS (15 g protein, 18 g sugar) 3 h after breakfast (basal meal). The plasma BCAA concentrations increased at 30 min after HPS ingestion. The subjects in the exercise group performed light resistance exercise (15 min dumbbell exercise using 300 g brown-rice-filled fabric dumbbells) when the plasma BCAA concentrations were increased (60 min after the snack ingestion). The control group maintained a resting position during the experiment. Changes in the plasma BCAA concentrations between 60 and 90 min after HPS ingestion increased continuously in the control group (+27 micromol/L) but decreased in the exercise group (-37 micromol/L). Therefore, light resistance exercise after HPS ingestion may be effective for utilization of plasma BCAA in humans.