Postoperative relative decrease in skeletal muscle mass as a predictor of quality of life in patients with gastric cancer.

Low skeletal muscle mass reflects poor nutritional condition, which may impair the functional status and quality of life (QOL) of survivors of gastrectomy. The present cross-sectional study examined the association between a relative change in skeletal muscle mass and perceived postoperative health and QOL in patients with gastric cancer. The study comprised 74 patients (48 men and 26 women; median age, 68.5 years) who underwent surgery for stage I-III gastric cancer. Outcomes were measured using the Postgastrectomy Syndrome Assessment Scale-45, which was specifically developed to measure post-gastrectomy symptoms, living status, dissatisfaction with daily life and generic QOL. The skeletal muscle mass index (SMI) was estimated using computed tomography by tracing the area of the psoas major muscle to calculate the ΔSMI, defined as: (SMI before surgery-SMI at completion of the PGSAS-45 survey)/SMI before surgery x100. Associations between ΔSMI and health outcomes were assessed using univariate and multivariate analyses. The mean ΔSMI (SD) was 8.64% (10.6%). The effect size (Cohen's d) of ΔSMI <10% compared with ΔSMI ≥10% was 0.50 (95% CI: 0.02 to 0.97) for total symptom scores, -0.51 (-0.98 to -0.03) for general health, and -0.52 (-0.99 to -0.05) for the physical component summary (PCS). Multiple regression analysis showed that ΔSMI was significantly associated with PCS decline, and its standardized regression coefficient was -0.447 (-0.209 to -0.685). Determining ΔSMI may help clinicians to facilitate the objective evaluation of low skeletal mass, which reflects poor nutritional condition that can impair functional status and QOL of postoperative patients surviving gastrectomy.

Functional Characteristics of Aldehyde Dehydrogenase and Its Involvement in Aromatic Volatile Biosynthesis in Postharvest Banana Ripening.

Butanol vapor feeding to ripe banana pulp slices produced abundant butyl butanoate, indicating that a portion of butanol molecules was converted to butanoate/butanoyl-CoA via butanal, and further biosynthesized to ester. A similar phenomenon was observed when feeding propanol and pentanol, but was less pronounced when feeding hexanol, 2-methylpropanol and 3-methylbutanol. Enzymes which catalyze the cascade reactions, such as alcohol dehydrogenase (ADH), acetyl-CoA synthetase, and alcohol acetyl transferase, have been well documented. Aldehyde dehydrogenase (ALDH), which is presumed to play a key role in the pathway to convert aldehydes to carboxylic acids, has not been reported yet. The conversion is an oxygen-independent metabolic pathway and is enzyme-catalyzed with nicotinamide adenine dinucleotide (NAD+) as the cofactor. Crude ALDH was extracted from ripe banana pulps, and the interference from ADH was removed by two procedures: (1) washing off elutable proteins which contain 95% of ADH, but only about 40% of ALDH activity, with the remaining ALDH extracted from the pellet residues at the crude ALDH extraction stage; (2) adding an ADH inhibitor in the reaction mixture. The optimum pH of the ALDH was 8.8, and optimum phosphate buffer concentration was higher than 100 mM. High affinity of the enzyme was a straight chain of lower aldehydes except ethanal, while poor affinity was branched chain aldehydes.

[Two Cases of Chemotherapy after Self-Expandable Metallic Stent Placement for Obstructive Sigmoid Cancer with Unresectable Liver Metastasis].

Immediate decompression and induction of chemotherapy are exceedingly critical for obstructive colorectal cancer patients with unresectable liver metastasis. Systematic chemotherapy was administered after self-expandable metallic stent(SEMS) placement in 2 patients with obstructive sigmoid cancer with unresectable liver metastasis. Chemotherapy-induced tumor shrinkage led to SEMS migration, enabling the use of an anti-VEGF drug. Eventually, both patients underwent successful management without restenosis.

[A Case of Resection of Para-Aortic Lymph Node Recurrence following Rectal Cancer Surgery].

A 54-year old man diagnosed with rectal cancer underwent laparoscopic high anterior resection with Japanese D3 lymph node dissection. The pathology results were as follows: pT2pN3M0, pStage Ⅲb(Japanese Classification of Colorectal, 8th edition). Adjuvant chemotherapy with CapeOX regimen was administered 8 courses. 1.5 years after the operation, computed tomography(CT)examination revealed a swollen para-aortic lymph node(PALN). Positron emission tomography (PET)-CT revealed PALN with high FDG uptake. We considered that neo-adjuvant chemotherapy and PALN dissection may be possible for PALN, which was isolated metastasis and curative by surgery. After 6 courses of bevacizumab-FOLFIRI therapy was administered, PALN dissection was performed. Pathological examination of the resected specimen showed adenocarcinoma in 4 of the 16 dissected lymph nodes. Histological treatment effect of preoperative therapy was Grade 1b. Postoperatively 6 courses of FOLFIRI were administered. The patient has been followed up for 7 years and 8 months after the first surgery, 5 years and 9 months after the curative resection, with no recurrence showed complete cure. Multidisciplinary treatment with anticancer drug and R0 resection was an effective treatment for isolated PALN recurrence of rectal cancer.

Time-Varying Pattern of Mortality and Recurrence from Papillary Thyroid Cancer: Lessons from a Long-Term Follow-Up.

Background: Little is known about annual hazard rates of cancer mortality and recurrence for papillary thyroid cancer (PTC). This study investigated the time-varying pattern of cancer death and recurrence from PTC and independent prognostic factors for cause-specific mortality (CSM) and recurrence of PTC. Methods: This retrospective chart review enrolled 466 patients diagnosed with PTC who underwent curative initial surgery between April 1981 and December 1991 with a median follow-up of 18.4 years. Clinical characteristics, cancer mortality (primary endpoint), and recurrence (secondary endpoint) were ascertained. The failure rates of either death or recurrence were estimated using the Kaplan-Meier methods, and annual death/recurrence hazard was depicted using hazard function. Results: In this Japanese cohort where only 1.5% of patients received radioactive iodine therapy, the 10-, 20-, and 30-year CSM rates were 2.7%, 6.2%, and 8.6%, respectively. Eleven (44.0%) cases of death occurred within the first 10 years, whereas 10 (40.0%) and 4 (16.0%) cases occurred within 10-20 and 20-30 years after surgery, respectively. The 10-, 20-, and 30-year recurrence rates were 11.3%, 21.8%, and 29.4%, respectively. Forty-six (54.8%) cases of recurrence occurred within the first 10 years, predominantly within the first five years (31 cases; 36.9%), whereas 29 (34.5%), 7 (8.3%), and 2 (2.4%) cases occurred within 10-20, 20-30, and ≥30 years after surgery, respectively. Age ≥55 years was the only independent prognostic factor for CSM. Age ≥55 years, male, tumor size > 4 cm, extranodal extension, and positive pathological lymph node metastasis were independent prognostic factors for recurrence. The annual hazard curve of cancer mortality presented a double-peaked distribution, with a first peak at the 10th year, and the second peak reaching the maximum at the 20th year after surgery for the entire population. The annual hazard curve of recurrence showed a triple-peaked pattern, with surges at about 12, 22, and 29 years after surgery. Conclusions: Patients with PTC harboring at least one of the prognostic characteristics may be at persistent risk of cancer mortality and recurrence even 10 or more years after initial treatment. Understanding the hazard rate of PTC is key to creating more tailored treatment and surveillance.

Transcranial measurement of diffuse light reflectance from cold-injured brains in rats.

Diagnosis of brain edema is important to manage severe head injuries and diseases, but there is no method of noninvasive bedside monitoring of brain edema. We speculate that brain edema changes the optical properties of brain tissue. To verify this speculation, we perform transcranial measurement of diffuse light reflectance from cold-injured brains in rats. To induce edema, a liquid nitrogen-cooled copper probe of 3 mm diameter was applied to the right parietal bone for 60 s under anesthesia. The rat skull was irradiated with 633-nm HeNe laser light and 532-nm Nd:YVO4 laser light, which were used to investigate changes in light scattering and blood flow, respectively. Reflectance intensity was measured as functions of time and position on the skull. We found that reflectance intensities were significantly decreased around the cold injury at both 633 and 532 nm, while reflectance was increased in the cold injury at 532 nm, indicating that cerebral blood volume was decreased in the cold injury. Under the condition of decreased cerebral blood volume, the decrease in reflectance intensity around the injury suggests that the scattering coefficient of brain tissue was reduced due to edema formation in this area.

Inhibition of acetate ester biosynthesis in banana (Musa sapientum L.) fruit pulp under anaerobic conditions.

The effect of anaerobic conditions on acetate ester biosynthesis in ripened banana pulp was investigated. Incubation of the pulp in less than 1% O(2) resulted in a significant reduction in the formation of ethyl acetate. Regardless of the presence of a large amount of endogenous ethanol and the remaining exogenous isobutyl alcohol after complete anaerobic incubation with the pulp, the production of acetate ester decreased. The effect of addition of pyruvate, isobutyl alcohol, acetate, and methyl hexanoate on acetate ester formation in 100% N(2) was also investigated. The addition of pyruvate and isobutyl alcohol to the pulp gave lower acetate esters in N(2) than in air, whereas the pulp incubated with acetate and isobutyl alcohol produced more acetate ester in both conditions. Therefore, the lack of acetyl CoA, or more precisely acetate, in the tissue is the main reason for the inhibition of acetate ester formation under anaerobic conditions. The activity of beta-oxidation measured by incubation with methyl hexanoate was detected only in the samples incubated in air. The formation of acetyl CoA, derived from pyruvate through mitochondria and through beta-oxidation, was inhibited by anaerobic conditions, which suggests that mitochondrial activity and/or beta-oxidation are essential for ester biosynthesis.

Reversible and irreversible emission of methanethiol and dimethyl disulfide from anaerobically stored broccoli.

The reversible and irreversible emission of methanethiol (MT) and dimethyl disulfide (DMDS) from broccoli florets was demonstrated during anaerobic storage at 20 degrees C for up to 24 h. Reversible emission of MT and DMDS was feasible only in broccoli stored for between 0 and 12 h under entirely anaerobic condition. Beyond that, the emission was completely irreversible. This irreversible process was demonstrated through significant reductions in the chlorophyll fluorescence values and rate of carbon dioxide production and significant increase in the membrane permeability of induced broccoli tissues after exposure to air and incubation. Irreversible emission was also demonstrated through significant change in color from the characteristic bright green to olive green as well as the conversion of chlorophyll a to pheophytin a and chlorophyll a' contents of the induced florets after hot-water treatment. These findings suggest that the irreversible emission of MT and DMDS is a function of permanent membrane damage and loss of intracellular compartmentation in the broccoli tissues as a result of the anaerobic induction. The off-odor formation can still be reversed if the affected tissue is only temporarily impaired by anaerobic condition, thereby maintaining the quality of stored broccoli.

Formation of methanethiol and dimethyl disulfide in crushed tissues of broccoli florets and their inhibition by freeze-thawing.

The formation of methanethiol and dimethyl disulfide in crushed, homogenized, and frozen-thawed tissues of broccoli florets was investigated. These volatile sulfur compounds were produced in crushed florets, but their formation was inhibited in frozen-thawed tissues. Only dimethyl disulfide was formed in homogenized tissues. High pH treatment triggered the release of dimethyl disulfide in frozen-thawed tissues and also enhanced the action of cysteine sulfoxide lyase in all disrupted tissues. Methyl methanethiosulfinate and methyl methanethiosulfonate were not detected in crushed florets; thus, the favored mechanism for the formation of methanethiol and dimethyl disulfide is the chemical disproportionation of methanesulfenic acid. In contrast, the formation of dimethyl disulfide in frozen-thawed and homogenized tissues occurs from the chemical disproportionation of methyl methanethiosulfinate that was detected in these tissues. The inhibition of dimethyl disulfide production during freeze-thawing must be caused by a sudden drop in the pH of the tissue, adherence of dimethyl disulfide on the tissue surfaces, and weakening of the cysteine sulfoxide lyase activity under acidic conditions.