RESUMEN
Hepatocyte growth factor activator inhibitor type 2 (HAI-2), encoded by the SPINT2 gene, is a membrane-anchored protein that inhibits proteases involved in the activation of hepatocyte growth factor (HGF), a ligand of MET receptor. Epigenetic silencing of the SPINT2 gene has been reported in a human glioblastoma cell line (U87) and glioblastoma-derived cancer stem cells. However, the incidence of SPINT2 methylation in tumor tissues obtained from glioma patients is unknown. In this study, we analyzed the methylation status of the SPINT2 gene of eight human glioblastoma cell lines and surgically resected glioma tissues of different grades (II, III, and IV) by bisulfite sequence analysis and methylation-specific PCR. Most glioblastoma lines (7/8) showed methylation of the SPINT2 gene with a significantly reduced level of SPINT2mRNA compared to cultured astrocytes and normal brain tissues. However, all glioblastoma lines expressed mRNA for HGF activator (HGFAC), a target protease of HAI-2/SPINT2. Forced expression of SPINT2 reduced MET phosphorylation of U87 glioblastoma cells both in vitro and in intracranial xenografts in nude mice. Methylation-specific PCR analysis of the resected glioma tissues indicated notable methylation of the SPINT2 gene in 33.3% (2/6), 71.4% (10/14), and 74.3% (26/35) of grade II, III, and IV gliomas, respectively. Analysis of RNA sequencing data in a public database indicated an increased HGFAC/SPINT2 expression ratio in high-grade compared to low-grade gliomas (P = .01). In summary, aberrant methylation of the SPINT2 gene is frequently observed in high-grade gliomas and might confer MET signaling in the glioma cells.
Asunto(s)
Neoplasias Encefálicas/genética , Metilación de ADN/genética , Glioblastoma/genética , Glicoproteínas de Membrana/genética , Proteínas Proto-Oncogénicas c-met/metabolismo , Animales , Astrocitos/patología , Encéfalo/patología , Neoplasias Encefálicas/patología , Línea Celular Tumoral , Silenciador del Gen , Glioblastoma/patología , Humanos , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Trasplante de Neoplasias , Fosforilación , Transducción de Señal/genética , Trasplante HeterólogoRESUMEN
MicroRNA-7 (miR-7)has been characterized as an anti-oncogenic microRNA (miRNA) in several cancers, including hepatocellular carcinoma (HCC). However, the mechanism for the regulation of miR-7 production in tumors remains unclear. Here, we identified nuclear factor 90 (NF90) and NF45 complex (NF90-NF45) as negative regulators of miR-7 processing in HCC. Expression of NF90 and NF45 was significantly elevated in primary HCC tissues compared with adjacent non-tumor tissues. To examine which miRNAs are controlled by NF90-NF45, we performed an miRNA microarray and quantitative RT-PCR analyses of HCC cell lines. Depletion of NF90 resulted in elevated levels of mature miR-7, whereas the expression of primary miR-7-1 (pri-miR-7-1) was decreased in cells following knockdown of NF90. Conversely, the levels of mature miR-7 were reduced in cells overexpressing NF90 and NF45, although pri-miR-7-1 was accumulated in the same cells. Furthermore, NF90-NF45 was found to bind pri-miR-7-1 in vitro These results suggest that NF90-NF45 inhibits the pri-miR-7-1 processing step through the binding of NF90-NF45 to pri-miR-7-1. We also found that levels of the EGF receptor, an oncogenic factor that is a direct target of miR-7, and phosphorylation of AKT were significantly decreased in HCC cell lines depleted of NF90 or NF45. Of note, knockdown of NF90 or NF45 caused a reduction in the proliferation rate of HCC cells. Taken together, NF90-NF45 stimulates an elevation of EGF receptor levels via the suppression of miR-7 biogenesis, resulting in the promotion of cell proliferation in HCC.
Asunto(s)
Carcinoma Hepatocelular/metabolismo , Proliferación Celular , Neoplasias Hepáticas/metabolismo , MicroARNs/metabolismo , Complejos Multiproteicos/metabolismo , Proteínas de Neoplasias/metabolismo , Proteína del Factor Nuclear 45/metabolismo , Proteínas del Factor Nuclear 90/metabolismo , ARN Neoplásico/metabolismo , Adulto , Carcinoma Hepatocelular/genética , Femenino , Humanos , Neoplasias Hepáticas/genética , Masculino , MicroARNs/genética , Persona de Mediana Edad , Complejos Multiproteicos/genética , Proteínas de Neoplasias/genética , Proteína del Factor Nuclear 45/genética , Proteínas del Factor Nuclear 90/genética , ARN Neoplásico/genéticaRESUMEN
Several studies have reported that activation of nuclear factor-kappa B(NF-kB)leads to resistance to chemotherapy and radiotherapy, whereas inhibition of NF-kB activity decreases malignant manifestations and enhances sensitivity to anticancer drugs. In the present study, we used bile duct cancer(BDC)cell lines HuH28 and HuCCT1 to examine if bortezomib, an inhibitor of NF-kB activity, enhances the sensitivity to the currently used chemotherapy drug gemcitabine. We carried out experiments in the following 4 treatment groups: control, 100 nM gemcitabine, 80 nM bortezomib, and a combination of 80 nM bortezomib and 100 nM gemcitabine. Experimental approaches included the MTT assay, apoptosis assay, and western blotting. Forty-eight hours after the treatment, cytotoxic reaction and apoptosis induction were observed in the gemcitabine only and bortezomib only groups. Furthermore, our experiments revealed that the concurrent use of the 2 drugs further increased cytotoxicity and apoptosis. Therefore, because of the NF-kB-inhibiting properties of bortezomib, antitumor immunity could be effectively enhanced. The use of bortezomib increased antitumor effects through multiple signaling pathways. Thus, higher therapeutic efficacy can be achieved through the concurrent use of bortezomib with chemotherapy drugs.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Neoplasias de los Conductos Biliares/patología , Bortezomib/farmacología , Desoxicitidina/análogos & derivados , Neoplasias de los Conductos Biliares/tratamiento farmacológico , Neoplasias de los Conductos Biliares/metabolismo , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Desoxicitidina/farmacología , Humanos , FN-kappa B/metabolismo , Transducción de Señal/efectos de los fármacos , GemcitabinaRESUMEN
Although the effects on prognosis of blood glucose level variability have gained increasing attention, it is unclear whether blood glucose level variability itself or the manifestation of pathological conditions that worsen prognosis. Then, previous reports have not been published on variability models of perioperative blood glucose levels. The aim of this study is to establish a novel variability model of blood glucose concentration using an artificial pancreas. We maintained six healthy, male beagles. After anesthesia induction, a 20-G venous catheter was inserted in the right femoral vein and an artificial pancreas (STG-22, Nikkiso Co. Ltd., Tokyo, Japan) was connected for continuous blood glucose monitoring and glucose management. After achieving muscle relaxation, total pancreatectomy was performed. After 1 h of stabilization, automatic blood glucose control was initiated using the artificial pancreas. Blood glucose level varied for 8 h, alternating between the target blood glucose values of 170 and 70 mg/dL. Eight hours later, the experiment was concluded. Total pancreatectomy was performed for 62 ± 13 min. Blood glucose swings were achieved 9.8 ± 2.3 times. The average blood glucose level was 128.1 ± 5.1 mg/dL with an SD of 44.6 ± 3.9 mg/dL. The potassium levels after stabilization and at the end of the experiment were 3.5 ± 0.3 and 3.1 ± 0.5 mmol/L, respectively. In conclusion, the results of the present study demonstrated that an artificial pancreas contributed to the establishment of a novel variability model of blood glucose levels in beagles.
Asunto(s)
Glucemia/metabolismo , Páncreas Artificial , Animales , Perros , Japón , Masculino , Modelos Animales , Pancreatectomía , PronósticoRESUMEN
BACKGROUND AND AIMS: In recent years, bone marrow (BM)-derived stem cell repopulation of injured organs has been increasingly observed; however, the extent to which it occurs and its clinical relevance remain unclear. Here, we investigated on the potential of extrahepatic stem cells to become hepatocytes using the treatment of the oral supplementation of branched-chain amino acids (BCAA). METHODS: In the first, Sprague-Dawley (SD) rats were administered BCAA to promote liver regeneration; in the second, syngenic liver transplantations using wild-type SD rats that do not express green fluorescent protein (GFP) as syngenic donors and GFP-transgenic SD rats as recipients to confirm that an extrahepatic source of cells (GFP(+)) could repopulate the transplanted (GFP(-)) liver were performed. RESULTS: Treatment of the oral supplementation of BCAA for 2-3 weeks before transplantation to promote liver regeneration resulted in greater than 7 days graft volume, with extensive spotty conversion of a small wild-type graft to the recipient GFP(+) genotype. The treatment by oral supplementation of BCAA resulted in higher levels of CD34+SDF+c-kit+ stem cells in the blood and liver after liver transplantation. Liver repopulation could be achieved with hepatocytes that bone marrow-derived from stem cells proliferated. CONCLUSIONS: We have identified extrahepatic stem cell migration from the BM to the injured liver as a mechanism underlying liver regeneration that supports hepatocyte proliferation in diseased liver. Our results suggested that BCAA is able to mobilize a population of BM-derived cells that contribute to hepatic regeneration.
Asunto(s)
Aminoácidos de Cadena Ramificada/farmacología , Células de la Médula Ósea/citología , Diferenciación Celular/efectos de los fármacos , Hepatocitos , Regeneración Hepática , Hígado/citología , Hígado/fisiología , Trasplante de Células Madre , Células Madre/citología , Células Madre/efectos de los fármacos , Administración Oral , Aminoácidos de Cadena Ramificada/administración & dosificación , Animales , Proliferación Celular/efectos de los fármacos , Células Cultivadas , Regeneración Hepática/efectos de los fármacos , Modelos Animales , Ratas , Ratas Sprague-Dawley , Estimulación Química , Factores de TiempoRESUMEN
A closed-loop glycemic control system using an artificial pancreas has been applied with many clinical benefits in Japan since 1987. To update this system incorporating user-friendly features, we developed a novel artificial pancreas (STG-55). The purpose of this study was to evaluate STG-55 for device usability, performance of blood glucose measurement, glycemic control characteristics in vivo in animal experiments, and evaluate its clinical feasibility. There are several features for usability improvement based on the design concepts, such as compactness, display monitor, batteries, guidance function, and reduction of the preparation time. All animal study data were compared with a clinically available artificial pancreas system in Japan (control device: STG-22). We examined correlations of both blood glucose levels between two groups (STG-55 vs. control) using Clarke's error grid analysis, and also compared mean glucose infusion rate (GIR) during glucose clamp. The results showed strong correlation in blood glucose concentrations (Pearson's product-moment correlation coefficient: 0.97; n = 1636). Clarke's error grid analysis showed that 98.4% of the data fell in Zones A and B, which represent clinically accurate or benign errors, respectively. The difference in mean GIRs was less than 0.2 mg/kg/min, which was considered not significant. Clinical feasibility study demonstrated sufficient glycemic control maintaining target glucose range between 80 and 110 (mg/dL), and between 140 and 160 without any hypoglycemia. In conclusion, STG-55 was a clinically acceptable artificial pancreas with improved interface and usability. A closed-loop glycemic control system with STG-55 would be a useful tool for surgical and critical patients in intensive care units, as well as diabetic patients.
Asunto(s)
Glucemia/análisis , Páncreas Artificial , Animales , Perros , Diseño de Equipo , Femenino , Humanos , Hipoglucemia/sangre , Monitoreo Fisiológico/instrumentaciónRESUMEN
Although sunitinib possesses significant clinical effects on imatinib-resistant gastrointestinal stromal tumors (GISTs), the individuals with GIST eventually become resistant to treatment with this tyrosine kinase inhibitor. The mechanism of resistance to sunitinib is still under investigation. To address this issue, we have established sunitinib-resistant GIST-T1 sublines (designated as GIST-T1R) by culturing cells with increasing concentrations of sunitinib. GIST-T1R cells were also resistant to imatinib-mediated growth inhibition. Examination of intracellular signaling found that Akt/ mammalian target of rapamycin (mTOR) signaling remained activated in GIST-T1R but not in parental GIST-T1 cells, after exposure of these cells to sunitinib, as measured by immunoblotting. Further study found that the phosphatase and tensin homolog deleted on chromosome ten (PTEN) gene was silenced by methylation of the promoter region of the gene. Notably, forced-expression of PTEN in GIST-T1R cells negatively regulated the Akt/mTOR pathways and sensitized these cells to sunitinib-mediated growth arrest and apoptosis. Taken together, epigenetic silence of PTEN might be one of the mechanisms which cause drug-resistance in individuals with GIST after exposure to tyrosine kinase inhibitors. Blockade of the PI3K/Akt signaling with the specific inhibitors could be useful in such a case.
Asunto(s)
Antineoplásicos/uso terapéutico , Epigénesis Genética , Neoplasias Gastrointestinales/tratamiento farmacológico , Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Indoles/uso terapéutico , Fosfohidrolasa PTEN/antagonistas & inhibidores , Pirroles/uso terapéutico , Benzamidas , Línea Celular Tumoral , Resistencia a Antineoplásicos , Neoplasias Gastrointestinales/genética , Tumores del Estroma Gastrointestinal/genética , Humanos , Mesilato de Imatinib , Fosfohidrolasa PTEN/genética , Piperazinas/uso terapéutico , Pirimidinas/uso terapéutico , SunitinibRESUMEN
Oxidative stress (OS) plays an important role in the progression of chronic liver disease including organ injury and hypoalbuminemia. Long-term oral supplementation with branched-chain amino acids (BCAAs) can inhibit liver dysfunction but their role in the prevention of liver fibrosis and injury to the liver is unclear. The aim of this study was to assess how BCAAs preserve liver function from OS. To investigate how BCAAs specifically prevent OS, we evaluated the effect of oral supplementation with BCAAs on OS using a rat liver cirrhosis model. Liver cirrhosis was induced in ten male Sprague-Dawley rats by administering carbon tetrachloride for 12 weeks. Five of the ten carbon tetrachloride-treated rats were assigned to a control group and five to a BCAA group. BCAA-supplementation significantly preserved plasma albumin concentrations and significantly inhibited the occurrence of organ injury as determined by blood chemistry analysis. Hepatic expression of OGG1 mRNA was increased in the BCAA group compared to the control group. In the BCAA group, increased hepatic levels of OGG1 protein were found by western blot. On the other hand, the number of 8-OHdG-positive cells was significantly higher in liver sections taken 1 month after carbon tetrachloride treatment. Furthermore, OGG1-positive cells were significantly increased in the hepatocytes around the central vein. BCAA was found to reduce OS, which could possibly lead to a decrease in the occurrence of hypoalbuminemia and organ injury. Our results indicate that BCAA-enriched nutrients stimulate antioxidant DNA repair in a rat model of liver injury induced by carbon tetrachloride.
Asunto(s)
Aminoácidos de Cadena Ramificada/farmacología , Aminoácidos de Cadena Ramificada/uso terapéutico , Antioxidantes/farmacología , Reparación del ADN/efectos de los fármacos , Suplementos Dietéticos , Hepatopatías/tratamiento farmacológico , Hepatopatías/patología , 8-Hidroxi-2'-Desoxicoguanosina , Animales , Biomarcadores/metabolismo , Western Blotting , Tetracloruro de Carbono , Citocinas/metabolismo , ADN Glicosilasas/metabolismo , Desoxiguanosina/análogos & derivados , Desoxiguanosina/metabolismo , Modelos Animales de Enfermedad , Alimentos , Inmunohistoquímica , Hígado/efectos de los fármacos , Hígado/enzimología , Hígado/patología , Hepatopatías/sangre , Masculino , Estrés Oxidativo/efectos de los fármacos , Ratas , Ratas Sprague-DawleyRESUMEN
BACKGROUND: The effects of sivelestat on endotoxin-induced lung injury, postperfusion lung injury, and ischemia-reperfusion are known, yet the benefits of sivelestat during liver surgery have yet to be elucidated. The aim of the present study was to assess the effects of sivelestat, with a focus on postoperative chemical data, in hepatectomized patients. PATIENTS AND METHODS: A prospective clinical study was conducted in 50 patients undergoing hepatic resection. Patients were randomly assigned to receive Elaspol, sivelestat (ELP group, n = 25) or placebo (control group, n = 25). Perioperative blood chemistry values in both groups, including high-mobility group box 1 (HMGB1) and interleukin (IL)-6, were monitored. RESULTS: The HMGB1 levels increased immediately after the operation (from the intraoperative period to the second postoperative day [POD]) in the control group. Compared to the control group, the levels of HMGB1 in the ELP group were significantly suppressed by the perioperative administration of sivelestat. At POD 1, the levels of IL-6 in the ELP group decreased more rapidly than those before the operation compared to the control group. CONCLUSIONS: A human clinical study demonstrated the effect of polymorphonuclear leukocyte elastase inhibitor on the earliest markers of liver injury. The present study showed that patients who received sivelestat had reduced release of HMGB1, and that IL-6 levels decreased more rapidly in patients treated with sivelestat than in those who received the placebo. The most appropriate dose, timing, and duration of sivelestat in humans remain unclear; however, it may have therapeutic potential for various liver injuries.
Asunto(s)
Glicina/análogos & derivados , Hepatectomía , Neoplasias Hepáticas/cirugía , Hígado/patología , Daño por Reperfusión/prevención & control , Inhibidores de Serina Proteinasa/uso terapéutico , Sulfonamidas/uso terapéutico , Anciano , Biomarcadores/sangre , Esquema de Medicación , Femenino , Glicina/uso terapéutico , Proteína HMGB1/sangre , Humanos , Interleucina-6/sangre , Elastasa de Leucocito/antagonistas & inhibidores , Hígado/cirugía , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Daño por Reperfusión/sangre , Resultado del TratamientoRESUMEN
It is reported that shortage of oral magnesium intake increase the incidence of diabetes. In addition, magnesium replacement therapy improves insulin resistance and glycemic control. Low levels of magnesium in the venous blood induce the disturbances of auto-phosphylation on the insulin receptor and deteriorate insulin resistance. Since magnesium is closely related to evolution and development of metabolic syndrome including diabetes mellitus and so on, magnesium is expected as potentially effective ingredient of drug therapy in the future perspectives.
Asunto(s)
Diabetes Mellitus/etiología , Diabetes Mellitus/metabolismo , Deficiencia de Magnesio/complicaciones , Magnesio/metabolismo , Metabolismo de los Hidratos de Carbono , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/fisiopatología , Humanos , Resistencia a la Insulina , Magnesio/administración & dosificación , Magnesio/fisiología , Síndrome Metabólico/tratamiento farmacológico , Síndrome Metabólico/metabolismo , Fosforilación , Receptor de Insulina/metabolismoRESUMEN
Enzootic bovine leucosis (EBL) is a neoplastic disease of cattle caused by Bovine leukaemia virus (BLV). EBL causes great economic losses, so a fast and reliable diagnostic method is critical for understanding the status of BLV. This will allow us to control BLV infections efficiently and mitigate economic losses. In this study, we established a direct diagnostic test for BLV using dried blood-spotted filter papers without sample pre-treatment. The study was based on 159 clinical blood specimens collected in EDTA from one farm in Kyushu, Japan. The blood-spotted filter papers were used as the template for direct filter PCR. When an ELISA was used as the diagnostic gold standard, the sensitivity and specificity of the direct filter PCR were 90.1% and 97.5%, respectively. The kappa value for the direct filter PCR and real-time PCR methods was 0.97. The dried blood samples spotted onto filter papers were stable for at least 10 days at room temperature, even when the samples were from cattle with a low BLV proviral load. Direct filter PCR is a rapid, easy, reliable and cost-effective diagnostic test that directly detects the BLV proviral genome in clinical blood specimens without DNA extraction. Moreover, it simplifies the collection, transportation and storage procedures for clinical blood specimens.
Asunto(s)
Leucosis Bovina Enzoótica/diagnóstico , Virus de la Leucemia Bovina/genética , Reacción en Cadena en Tiempo Real de la Polimerasa/veterinaria , Animales , Anticuerpos Antivirales/sangre , Bovinos , ADN Viral/genética , Pruebas Diagnósticas de Rutina , Leucosis Bovina Enzoótica/virología , Ensayo de Inmunoadsorción Enzimática/veterinaria , Japón , Sensibilidad y Especificidad , Carga ViralRESUMEN
BACKGROUND/AIM: One reason of poor survival rate of patients with pancreatic cancer is the development of chemoresistance. The aim of the present study was to investigate the effects of eribulin mesylate in gemcitabine-refractory advanced pancreatic cancer cell lines. MATERIALS AND METHODS: Three human pancreatic cancer cell lines (AsPC-1, Panc-1, and SUIT-2) and human pancreatic endoderm (hPE) cells were used to evaluate the antitumor effects of gemcitabine and eribulin mesylate. Cell viability after treatment of cells with different concentrations of gemcitabine and eribulin mesylate was evaluated using water-soluble tetrazolium salts (WST) assays; cytotoxic effects were evaluated on the basis of morphological changes to cells. RESULTS: Gemcitabine had no effect on cell viability of AsPC-1 nor Panc-1 cells, whereas gemcitabine reduced cell viability of SUIT-2 cells in a dose-dependent manner. Eribulin mesylate significantly reduced cell viability of both AsPC-1 and Panc-1 cells (p<0.001 and p=0.002, respectively), but had no effect on hPE cells. Microscopic examination of AsPC-1 and Panc-1 cells after treatment with eribulin mesylate revealed morphological changes that included cell shrinkage, membrane blebbing, and fragmentation of the cells after drug exposure, and these were concentration-dependent effects. CONCLUSION: The findings of the present study suggest that eribulin mesylate may be a promising potential anticancer drug for gemcitabine-refractory advanced pancreatic cancer.
Asunto(s)
Antineoplásicos/uso terapéutico , Desoxicitidina/análogos & derivados , Furanos/uso terapéutico , Cetonas/uso terapéutico , Neoplasias Pancreáticas/tratamiento farmacológico , Antineoplásicos/farmacología , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Desoxicitidina/uso terapéutico , Resistencia a Antineoplásicos , Furanos/farmacología , Humanos , Cetonas/farmacología , Neoplasias Pancreáticas/patología , GemcitabinaRESUMEN
CONTEXT: Yokukansan (YKS) is a traditional Japanese herbal medicine called kampo medicine in Japan. Its extract comprises seven crude drugs: Atractylodis lanceae rhizoma, Poria, Cnidii rhizoma, Uncariae uncis cum ramulus, Angelicae radix, Bupleuri radix, and Glycyrrhizae radix. YKS is used to treat neurosis, insomnia, as well as behavioral and psychological symptoms of dementia. OBJECTIVE: To confirm the exposure and pharmacokinetics of the active components of YKS in healthy volunteers. DESIGN, SETTING, AND PARTICIPANTS: A randomized, open-label, 3-arm, 3-period, crossover trial was conducted on 21 healthy Japanese volunteers at the Kochi Medical University between May 2012 and November 2012. INTERVENTIONS: Single oral administration of YKS (2.5 g, 5.0 g, or 7.5 g/day) during each period. MAIN OUTCOME MEASURE: Plasma concentrations of three active compounds in YKS, namely 18ß-glycyrrhetinic acid (GA), geissoschizine methyl ether (GM), and hirsuteine (HTE). RESULTS: The mean maximum plasma concentrations (Cmax) of GM and HTE increased dose-dependently (ranges: 0.650-1.98 ng/mL and 0.138-0.450 ng/mL, respectively). The times to maximum plasma concentration after drug administration (tmax) were 0.500 h for GM and 0.975-1.00 h for HTE. The apparent elimination half-lives (t1/2) were 1.72-1.95 h for GM and 2.47-3.03 h for HTE. These data indicate the rapid absorption and elimination of GM and HTE. On the other hand, the Cmax, tmax, and t1/2 of GA were 57.7-108 ng/mL, 8.00-8.01 h, and 9.39-12.3 h, respectively. CONCLUSION: We demonstrated that pharmacologically active components of YKS are detected in humans. Further, we determined the pharmacokinetics of GM, HTE, and GA. This information will be useful to elucidate the pharmacological effects of YKS. TRIAL REGISTRATION: Japan Pharmaceutical Information Center JAPIC CTI-121811.
Asunto(s)
Medicamentos Herbarios Chinos/farmacocinética , Medicina Kampo , Plantas Medicinales/química , Administración Oral , Adulto , Alcaloides/sangre , Área Bajo la Curva , Estudios Cruzados , Relación Dosis-Respuesta a Droga , Medicamentos Herbarios Chinos/administración & dosificación , Medicamentos Herbarios Chinos/química , Femenino , Ácido Glicirretínico/análogos & derivados , Ácido Glicirretínico/sangre , Voluntarios Sanos , Humanos , Alcaloides Indólicos/sangre , Japón , Masculino , Tasa de Depuración Metabólica , Estructura Molecular , Adulto JovenRESUMEN
BACKGROUND: We examined whether perioperative intensive insulin therapy (IIT) using an artificial pancreas (AP) with a closed-loop glycemic control system can be used to prevent hypoglycemia in surgical patients. METHODS: Between 2006 and 2012, perioperative glycemic control using an AP was performed in 427 patients undergoing general surgery. A total of 305 patients undergoing IIT using an AP in the target blood glucose range of 80 to 110 mg/dL were enrolled in the study. Data were collected prospectively and were reviewed or analyzed retrospectively. RESULTS: No patients had hypoglycemia. Perioperative mean blood glucose level and achievement rates in target blood glucose range of 80 to 110 mg/dL were 100.5 ± 11.9 mg/dL and 88.1% ± 16.0%, respectively. For the 3 primary operative methods, including hepatic, pancreatic, and esophageal resections, there were no significant differences in glycemic control stability between the types of surgery. CONCLUSION: Perioperative IIT using an AP with a closed-loop glycemic control system can be used to prevent hypoglycemia and maintain stable glycemic control with less variability of blood glucose concentration.
Asunto(s)
Hipoglucemia/prevención & control , Insulina/uso terapéutico , Páncreas Artificial , Atención Perioperativa , Procedimientos Quirúrgicos Operativos , Glucemia/análisis , Femenino , Humanos , Masculino , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The present study aimed to evaluate the long-term follow-up results of patients with intraductal papillary mucinous neoplasm (IPMN) and to estimate the degree of IPMN malignancy based on pathological and molecular features of resected specimens. The detection rate of IPMN has increased over the last decade; however, the management of this neoplasm remains controversial. This is particularly so for branch duct-type IPMN, which carries a high potential for malignancy and risk of recurrence. We retrospectively reviewed a single institution's prospective pancreatic resection database to identify IPMN patients who underwent pancreatectomy with curative intent. The clinicopathological variables of 100 patients resected for IPMN were analyzed with a detailed review of histopathological results (borderline lesions, non-invasive carcinoma and invasive carcinoma) to determine the grade of IPMN malignancy based on transforming growth factor (TGF)-ß/SMAD4 signaling. The incidence of malignant change was significantly higher in patients with main duct-type IPMN (69.7%) compared with branch duct-type IPMN cases (17.9%). However, patients with an invasive carcinoma had a significantly worse outcome if it was derived from branch duct-type IPMN compared with those derived from main duct-type IPMN, and TGF-ß mRNA expression was significantly increased in the former patient group. Immunohistochemistry also showed higher numbers of SMAD4-positive cells in patients with carcinoma derived from branch duct-type IPMN. Our results demonstrated that invasive carcinoma derived from branch duct-type IPMN is more aggressive than that derived from main duct-type IPMN, once invasive morphological change takes place. Determining TGF-ß and/or SMAD4 status at initial diagnosis may be useful for stratifying IPMN patients into treatment regimens.
RESUMEN
Human carcinosarcomas of esophagus are uncommon malignant neoplasms that are composed both carcinomatous and sarcomatous components. We established a novel cell line, HN-Eso-1, from the metastatic esophageal spindle cell carcinoma (so-called carcinosarcoma). In this study, we estimated the vascular endothelial growth factors (VEGFs) and VEGF receptors (VEGFRs). Reverse transcription polymerase chain reaction (RT-PCR) studies revealed that VEGF-A, -C, -D and VEGFR-1, -2 were upregulated. Cisplatin reduced the cell viability of HN-Eso-1 cells and VEGF attenuated its effect. These results suggest that expression of VEGF-A, VEGF-C, VEGF-D, VEGFR-1, and VEGFR-2 are involved in the cell's autocrine system and that VEGF protected these cells from the anti-tumor agent.