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1.
J Chem Phys ; 160(14)2024 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-38591671

RESUMO

A frequency-dependent dielectric constant characterizes the dielectric response of a medium and also represents the time scale of system's collective dynamics. Although it is valuable not only academically but also practically for developing advanced devices, getting the value of a solution at the interface with a solid or electrode surface is challenging both experimentally and computationally. Here, we propose a computational method that imitates the dielectric spectroscopy and AC impedance measurement. It combines a time-dependent voltage applied molecular dynamics simulation with an equivalent circuit representation of a system composed of a solution confined between two identical electrodes. It gives the frequency-dependent dielectric constants of the bulk solution and the interface simultaneously. Unlike the conventional method, it does not require computation of a dipole autocorrelation function and its Fourier transformation. Application of the method on a system of water confined between polarizable Pt electrodes gives the static dielectric constant and the relaxation time of the bulk water in good agreement with previous simulation results and experimental values. In addition, it gives a much smaller static dielectric constant at the interface, consistent with previous observations. The outline of the dielectric dispersion curve of the interface seems similar to that of the bulk, but the relaxation time is several times faster.

2.
PLoS Comput Biol ; 20(3): e1011848, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38489379

RESUMO

The recent advancements in large-scale activity imaging of neuronal ensembles offer valuable opportunities to comprehend the process involved in generating brain activity patterns and understanding how information is transmitted between neurons or neuronal ensembles. However, existing methodologies for extracting the underlying properties that generate overall dynamics are still limited. In this study, we applied previously unexplored methodologies to analyze time-lapse 3D imaging (4D imaging) data of head neurons of the nematode Caenorhabditis elegans. By combining time-delay embedding with the independent component analysis, we successfully decomposed whole-brain activities into a small number of component dynamics. Through the integration of results from multiple samples, we extracted common dynamics from neuronal activities that exhibit apparent divergence across different animals. Notably, while several components show common cooperativity across samples, some component pairs exhibited distinct relationships between individual samples. We further developed time series prediction models of synaptic communications. By combining dimension reduction using the general framework, gradient kernel dimension reduction, and probabilistic modeling, the overall relationships of neural activities were incorporated. By this approach, the stochastic but coordinated dynamics were reproduced in the simulated whole-brain neural network. We found that noise in the nervous system is crucial for generating realistic whole-brain dynamics. Furthermore, by evaluating synaptic interaction properties in the models, strong interactions within the core neural circuit, variable sensory transmission and importance of gap junctions were inferred. Virtual optogenetics can be also performed using the model. These analyses provide a solid foundation for understanding information flow in real neural networks.


Assuntos
Fenômenos Fisiológicos do Sistema Nervoso , Neurônios , Animais , Neurônios/fisiologia , Encéfalo/diagnóstico por imagem , Junções Comunicantes/fisiologia , Caenorhabditis elegans/fisiologia , Neuroimagem , Modelos Neurológicos
3.
J Chem Phys ; 160(5)2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38341702

RESUMO

The significance of solvent effects in electronic structure calculations has long been noted, and various methods have been developed to consider this effect. The reference interaction site model self-consistent field with constrained spatial electron density (RISM-SCF-cSED) is a hybrid model that combines the integral equation theory of molecular liquids with quantum chemistry. This method can consider the statistically convergent solvent distribution at a significantly lower cost than molecular dynamics simulations. Because the RISM theory explicitly considers the solvent structure, it performs well for systems where hydrogen bonds are formed between the solute and solvent molecules, which is a challenge for continuum solvent models. Taking advantage of being founded on the variational principle, theoretical developments have been made in calculating various properties and incorporating electron correlation effects. In this review, we organize the theoretical aspects of RISM-SCF-cSED and its distinctions from other hybrid methods involving integral equation theories. Furthermore, we carefully present its progress in terms of theoretical developments and recent applications.

4.
J Oleo Sci ; 73(1): 55-63, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38171731

RESUMO

Highly pure 2,3-dioleoyl-1-O-alkyl glyceryl ether (DOGE), whose 1-position is a lipase-tolerant ether bond, was chemically synthesized and its detailed regioselectivity and acyl transfer were confirmed. During ethanolysis using immobilized Candida antarctica lipase B (CAL-B) with DOGE as the substrate, monooleoyl-1-O-alkyl glyceryl ethers (MOGEs) and a few 1-alkyl glyceryl ethers were formed upon consumption of the substrate. The structure of MOGE was confirmed using nuclear magnetic resonance spectroscopy and only the isomer of 2-MOGE was formed, indicating that CAL-B has complete α- regiospecificity. During ethanolysis, 3-MOGE was formed via acyl migration. These results indicate that the formation of 1-alkyl glyceryl ethers is not due to the imperfect regiospecificity of CAL-B, but rather due to ethanolysis of the formed 3-MOGE. The ethanolysis rate at the 3-α-position of DOGE was faster and the rate of acyl transfer was slightly slower for chain lengths greater than 14. These results show for the first time that both deacylation at the 3-position and acyl migration from the 2- to 3-position are affected by the structure of 1-position.


Assuntos
Etanol , Éteres de Glicerila , Etanol/química , Lipase/química , Proteínas Fúngicas/química , Enzimas Imobilizadas/química
5.
J Chem Phys ; 160(3)2024 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-38230813

RESUMO

In quantum chemical calculations of heterogeneous structures in solids, e.g., when an impurity is located on the surface, the conventional cluster model is insufficient to describe the electronic structure of substrates due to its finite size. The open-boundary cluster model (OCM) overcomes this problem by performing cluster calculations under the outgoing-wave boundary condition. In this method, a complex absorbing potential (CAP) is used to impose the boundary condition, but the CAP used in the previous studies required parameter optimization based on the complex variational principle. This study proposes and applies a parameter-free CAP to OCM calculations. This approach makes it possible to uniquely determine the band-specific CAP based on the surface Green's function theory. Using this CAP, we conducted OCM calculations of the tight-binding model of a one-dimensional semi-infinite chain, and we found that the calculated density of states agreed with the exact one. Surface states of the Newns-Anderson-Grimley model were also computed using the CAP, and the projected density of states on the adsorbed atom was successfully reproduced.

6.
Int J Colorectal Dis ; 39(1): 12, 2023 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-38157027

RESUMO

PURPOSE: Transversus abdominis plane (TAP) block is a safe, effective, and promising analgesic procedure, but TAP block only cannot overcome postoperative pain. We conducted a prospective randomized study to evaluate postoperative pain control using multimodal analgesia (MA) combined with a single injection TAP block compared with epidural analgesia (EA) after laparoscopic colon cancer surgery. METHODS: Sixty-seven patients scheduled for elective laparoscopic colon cancer surgery were enrolled in this study and randomized into EA and MA groups. The primary endpoint was the frequency of additional analgesic use until postoperative day (POD) 2. The VAS score, blood pressure, time to bowel movement, time to mobilization, postoperative complications, and length of hospital stay were also compared between the two groups. RESULTS: Sixty-four patients (EA group, n = 33; MA group, n = 31) were analyzed. The patient characteristics did not differ markedly between the two groups. The frequency of additional analgesic use was significantly lower in the MA group than in the EA group (P < 0.001), whereas the VAS score did not differ markedly between the two groups. The postoperative blood pressure on the day of surgery was significantly lower in the MA group than in the EA group (P = 0.016), whereas urinary retention was significantly higher in the EA group than in the MA group (P < 0.001). CONCLUSION: MA combined with a single injection TAP block after laparoscopic colon cancer surgery may be comparable to EA in terms of analgesia and superior to EA in terms of urinary retention.


Assuntos
Analgesia Epidural , Neoplasias do Colo , Laparoscopia , Retenção Urinária , Humanos , Músculos Abdominais , Analgésicos , Analgésicos Opioides , Neoplasias do Colo/cirurgia , Neoplasias do Colo/complicações , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Estudos Prospectivos
7.
Chem Sci ; 14(42): 11914-11923, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37920360

RESUMO

Precise engineering of excited-state interactions between an organic conjugated molecule and a two-dimensional semiconducting inorganic nanosheet, specifically the manipulation of charge-transfer excited (CTE) states, still remains a challenge for state-of-the-art photochemistry. Herein, we report a long-lived, highly emissive CTE state at structurally well-defined hetero-nanostructure interfaces of photoactive pyrene and two-dimensional MoS2 nanosheets via an N-benzylsuccinimide bridge (Py-Bn-MoS2). Spectroscopic measurements reveal that no charge-transfer state is formed in the ground state, but the locally-excited (LE) state of pyrene in Py-Bn-MoS2 efficiently generates an unusual emissive CTE state. Theoretical studies elucidate the interaction of MoS2 vacant orbitals with the pyrene LE state to form a CTE state that shows a distinct solvent dependence of the emission energy. This is the first example of organic-inorganic 2D hetero-nanostructures displaying mixed luminescence properties by an accurate design of the bridge structure, and therefore represents an important step in their applications for energy conversion and optoelectronic devices and sensors.

8.
Commun Chem ; 6(1): 248, 2023 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-37968322

RESUMO

Pathway selection principles in reversible reaction networks such as molecular self-assembly have not been established yet, because achieving kinetic control in reversible reaction networks is more complicated than in irreversible ones. In this study, we discovered that coordination squares consisting of cis-protected dinuclear rhodium(II) corner complexes and linear ditopic ligands are assembled under kinetic control, perfectly preventing the corresponding triangles, by modulating their energy landscapes with a weak monotopic carboxylate ligand (2,6-dichlorobenzoate: dcb-) as the leaving ligand. Experimental and numerical approaches revealed the self-assembly pathway where the cyclization step to form the triangular complex is blocked by dcb-. It was also found that one of the molecular squares assembled into a dimeric structure owing to the solvophobic effect, which was characterized by nuclear magnetic resonance spectroscopy and single-crystal X-ray analysis.

9.
J Surg Case Rep ; 2023(7): rjad432, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37525751

RESUMO

A prospective pilot study was conducted on 11 patients with rectal cancer to investigate fecal calprotectin (FC) as a diagnostic tool for detecting anastomotic leakage (AL) after low anterior resection. Among the 11 patients, 1 patient (9.1%) experienced AL (Clavien-Dindo Grade IIIa). During the post-operative course until post-operative day (POD) 5, the white blood cell count of the patient with AL was within the normal range. The C-reactive protein level in the AL and non-AL groups showed a similar time course. On the other hand, the FC level in patient with AL dramatically increased on POD5, while the FC level of the non-AL group remained relatively stable. There was no significant correlation between the preoperative FC level and the tumor circumference rate, tumor size, depth of invasion or stage. This pilot study showed the possibility of FC as a useful diagnostic tool for the detection of AL after low anterior resection for rectal cancer.

10.
Eur J Pharmacol ; 956: 175936, 2023 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-37541363

RESUMO

Upacicalcet (formerly SK-1403/AJT240) is a novel non-peptide calcimimetic agent that acts as a calcium-sensing receptor (CaSR) agonist for the treatment of secondary hyperparathyroidism (SHPT) in chronic kidney disease (CKD). We compared upacicalcet with other calcimimetics (etelcalcetide or cinacalcet) and examined its in vitro and in vivo characteristics in terms of its human CaSR agonistic activity, its efficacy in normal and CKD rats after a single administration, and its effect on gastric emptying in rats. Upacicalcet activated human CaSR depending on the extracellular calcium (Ca2+) concentration without exhibiting an agonistic action when the extracellular Ca2+ level was below the physiological level. On the other hand, etelcalcetide had an agonistic activity even in the absence of physiological levels of extracellular Ca2+. The intravenous administration of upacicalcet to normal and double-nephrectomized rats dose-dependently (0.03-3mg/kg and 0.3-30mg/kg, respectively) decreased the serum intact parathyroid hormone (iPTH) and serum Ca2+ levels; however, the effect of upacicalcet on the reduction in serum Ca2+ disappeared at extracellular Ca2+ levels below the physiologically range, even when administered at a dose higher (100-fold) than the effective dose. Furthermore, upacicalcet did not affect gastric emptying in normal rats when administered up to a dose of 10mg/kg (300-fold higher than the dose affecting serum iPTH levels), while the administration of cinacalcet significantly slowed gastric emptying by approximately 50%. These findings suggest that upacicalcet has potential as an alternative calcimimetic agent with good pharmacological properties and a lower risk of hypocalcemia and gastrointestinal complications.


Assuntos
Hiperparatireoidismo Secundário , Insuficiência Renal Crônica , Humanos , Ratos , Animais , Cinacalcete/farmacologia , Cinacalcete/uso terapêutico , Receptores de Detecção de Cálcio/agonistas , Hormônio Paratireóideo , Cálcio , Calcimiméticos/farmacologia , Calcimiméticos/uso terapêutico , Insuficiência Renal Crônica/tratamento farmacológico , Diálise Renal/efeitos adversos
11.
J Chem Phys ; 158(21)2023 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-37278474

RESUMO

As in the hierarchy of the Hartree-Fock theory in terms of spin symmetry, the extension of spin functions in a theory of two-electron units or geminal, was developed in this study. A trial wave function is constructed as an antisymmetrized product of geminals, in which singlet and triplet two-electron functions are fully mixed. We present a variational optimization method for this generalized pairing wave function in the strong orthogonality condition. The present method is considered an extension of the antisymmetrized product of strongly orthogonal geminals or perfect pairing generalized valence bond methods, maintaining the compactness of the trial wave function. The obtained broken-symmetry solutions were similar to the unrestricted Hartree-Fock wave functions in terms of spin contamination while giving lower energy due to the inclusion of the electron correlation effect in geminals. The degeneracy of the obtained broken-symmetry solutions in the Sz space is reported for the tested four-electron systems.

12.
BMC Bioinformatics ; 24(1): 254, 2023 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-37328814

RESUMO

BACKGROUND: In the field of neuroscience, neural modules and circuits that control biological functions have been found throughout entire neural networks. Correlations in neural activity can be used to identify such neural modules. Recent technological advances enable us to measure whole-brain neural activity with single-cell resolution in several species including [Formula: see text]. Because current neural activity data in C. elegans contain many missing data points, it is necessary to merge results from as many animals as possible to obtain more reliable functional modules. RESULTS: In this work, we developed a new time-series clustering method, WormTensor, to identify functional modules using whole-brain activity data from C. elegans. WormTensor uses a distance measure, modified shape-based distance to account for the lags and the mutual inhibition of cell-cell interactions and applies the tensor decomposition algorithm multi-view clustering based on matrix integration using the higher orthogonal iteration of tensors (HOOI) algorithm (MC-MI-HOOI), which can estimate both the weight to account for the reliability of data from each animal and the clusters that are common across animals. CONCLUSION: We applied the method to 24 individual C. elegans and successfully found some known functional modules. Compared with a widely used consensus clustering method to aggregate multiple clustering results, WormTensor showed higher silhouette coefficients. Our simulation also showed that WormTensor is robust to contamination from noisy data. WormTensor is freely available as an R/CRAN package https://cran.r-project.org/web/packages/WormTensor .


Assuntos
Encéfalo , Caenorhabditis elegans , Animais , Reprodutibilidade dos Testes , Algoritmos , Análise por Conglomerados
13.
Phys Chem Chem Phys ; 25(21): 14659-14671, 2023 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-37051715

RESUMO

This perspective highlights three theoretical and computational methods to capture the coordination self-assembly processes at the molecular level: quantum chemical modeling, molecular dynamics, and reaction network analysis. These methods cover the different scales from the metal-ligand bond to a more global aspect, and approaches that are best suited to understand the coordination self-assembly from different perspectives are introduced. Theoretical and numerical researches based on these methods are not merely ways of interpreting the experimental studies but complementary to them.

14.
J Phys Ther Sci ; 35(3): 217-222, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36866009

RESUMO

[Purpose] Walking ability should be predicted as early as possible in acute stroke patients. The purpose is to construct a prediction model for independent walking from bedside assessments using classification and regression tree analysis. [Participants and Methods] We conducted a multicenter case-control study with 240 stroke patients. Survey items included age, gender, injured hemisphere, the National Institute of Health Stroke Scale, the Brunnstrom Recovery Stage for lower extremities, and "turn over from a supine position" from the Ability for Basic Movement Scale. The National Institute of Health Stroke Scale items, such as language, extinction, and inattention, were grouped under higher brain dysfunction. We used the Functional Ambulation Categories to classify patients into independent (four or more the Functional Ambulation Categories; n=120) and dependent (three or fewer the Functional Ambulation Categories; n=120) walking groups. A classification and regression tree analysis was used to create a model to predict independent walking. [Results] The Brunnstrom Recovery Stage for lower extremities, "turn over from a supine position" from the Ability for Basic Movement Scale, and higher brain dysfunction were the splitting criteria for classifying patients into four categories: Category 1 (0%), severe motor paresis; Category 2 (10.0%), mild motor paresis and could not turn over; Category 3 (52.5%), with mild motor paresis, could turn over, and had higher brain dysfunction; and Category 4 (82.5%), with mild motor paresis, could turn over, and no higher brain dysfunction. [Conclusion] We constructed a useful prediction model for independent walking based on the three criteria.

15.
J Phys Chem A ; 127(8): 1849-1856, 2023 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-36800899

RESUMO

COA-Cl is a newly synthesized adenosine analogue that exhibits various physiological activities. Its angiogenic, neurotropic, and neuroprotective potencies make it promising for the development of medicines. In this study, we show Raman spectroscopic study of COA-Cl to elucidate molecular vibrations and related chemical properties. Density functional theory calculations were combined with the Raman spectroscopic data to understand the details of each vibrational mode. Comparative analysis with adenine, adenosine, and other nucleic acid analogues enabled identification of unique Raman peaks originating from the cyclobutane moiety and chloro group of COA-Cl. This study provides fundamental knowledge and crucial insights for further development of COA-Cl and related chemical species.


Assuntos
Adenina , Análise Espectral Raman , Conformação Molecular , Espectroscopia de Infravermelho com Transformada de Fourier , Adenina/química , Teoria Quântica , Vibração
16.
J Hepatobiliary Pancreat Sci ; 30(5): 625-632, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36287104

RESUMO

BACKGROUND/PURPOSE: We evaluated the difficulty score of laparoscopic cholecystectomy (LC) for acute cholecystitis (AC) proposed in the Tokyo guidelines 2018 (TG18) and analyzed the most appropriate scoring method. METHODS: We reviewed 127 patients who underwent LC for AC from January 2018 to March 2022. According to TG18, surgical difficulty was scored for five categories consisting of 25 intraoperative findings. The median, highest, and mean score of the five categories were analyzed for their association with surgical outcomes. RESULTS: The difficulty score distribution (0/1/2/3/4/5/6) was as follows: median (8/34/43/30/12/0/0), highest (1/1/32/42/36/15/0) and mean (19/49/49/10/0/0/0). In all three scoring methods, higher difficulty scores were significantly correlated with longer operative time, more blood loss, and higher occurrence of subtotal cholecystectomy in trend tests. The areas under the curve (AUCs) for prediction of prolonged operative time minutes and increased blood loss were similar in all three scoring methods. For conversion to subtotal cholecystectomy, the AUC was significantly better for the highest than median and mean score (p = .015 and p = .002, respectively). CONCLUSIONS: The difficulty score in TG18 appropriately reflects the surgical difficulty of LC for AC. The median, highest, and mean scores of the five categories are all available, and the highest scores are simple and versatile.


Assuntos
Colecistectomia Laparoscópica , Colecistite Aguda , Humanos , Colecistectomia Laparoscópica/métodos , Tóquio , Colecistite Aguda/cirurgia , Colecistectomia/métodos , Estudos Retrospectivos , Resultado do Tratamento
17.
Neurosci Res ; 186: 33-42, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36252701

RESUMO

Memory-related neuronal responses are often elicited by sensory stimuli that recapitulate previous experience. Despite the importance of this sensory input processing, its underlying mechanisms remain poorly understood. Caenorhabditis elegans chemotax towards salt concentrations experienced in the presence of food. The amphid sensory neurons ASE-left and ASE-right respond to increases and decreases of ambient salt concentration in opposite manners. AIA, AIB and AIY interneurons are post-synaptic to the ASE pair and are thought to be involved in the processing of salt information transmitted from ASE. However, it remains elusive how the responses of these interneurons are regulated by stimulus patterns. Here we show that AIY interneurons display an experience-dependent response to gradual salt concentration changes but not to abrupt stepwise concentration changes. Animals with AIY intact (but AIA and AIB ablated) chemotax towards low salt concentrations similarly to wild-type animals after cultivation with low salt. ASE neurons transmit salt information about the environment through glutamatergic signaling, directing the activity of the interneurons AIY that promote movement towards favorable conditions.


Assuntos
Proteínas de Caenorhabditis elegans , Caenorhabditis elegans , Animais , Caenorhabditis elegans/fisiologia , Ácido Glutâmico , Interneurônios/fisiologia , Células Receptoras Sensoriais/fisiologia , Cloreto de Sódio
18.
Bone ; 167: 116613, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36395959

RESUMO

Secondary hyperparathyroidism (SHPT) is a major comorbidity of chronic kidney disease (CKD). Chronic elevation of PTH levels is associated with cortical bone deterioration and increase in the risk of fractures in CKD patients. Here, we evaluated the effect of repeated administration of upacicalcet, a novel positive allosteric modulator of the calcium-sensing receptor, in a rat model of adenine-induced renal failure, by determining serum levels of intact PTH (iPTH), calcium, phosphorus, creatinine, and urea nitrogen. Furthermore, parathyroid hyperplasia (parathyroid gland weight and Ki-67-positive cell density), ectopic calcification (calcium content in the thoracic aorta, kidney and heart and positive von Kossa staining in the thoracic aorta), and bone morphometry parameters (cortical porosity and fibrosis volume) were evaluated. Rats treated with either 0.2 mg/kg or 1 mg/kg upacicalcet exhibited significantly lower serum iPTH levels than CKD-control rats, as early as 7 days after the first dose. Repeated administration of upacicalcet reduced serum iPTH levels and inhibited parathyroid hyperplasia in rats with adenine-induced severe renal failure. Moreover, it suppressed ectopic calcification and cortical pore formation. In contrast, serum calcium and phosphorus levels were not significantly affected, suggesting a low risk of hypocalcemia, which often occurs with SHPT treatment. In conclusion, repeated administration of upacicalcet decreased serum iPTH levels and suppressed parathyroid hyperplasia in the adenine-induced CKD rat model of SHPT. Furthermore, ectopic calcification and cortical pore formation were suppressed without significant changes in blood mineral parameters. Upacicalcet safely inhibited the progression of SHPT in an adenine-induced CKD rat model.


Assuntos
Doenças Ósseas , Hiperparatireoidismo Secundário , Insuficiência Renal Crônica , Insuficiência Renal , Calcificação Vascular , Ratos , Animais , Cálcio , Receptores de Detecção de Cálcio , Hiperplasia/complicações , Adenina/uso terapêutico , Hiperparatireoidismo Secundário/complicações , Hiperparatireoidismo Secundário/tratamento farmacológico , Calcificação Vascular/induzido quimicamente , Calcificação Vascular/prevenção & controle , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/tratamento farmacológico , Fósforo , Insuficiência Renal/complicações , Hormônio Paratireóideo/uso terapêutico
20.
J Gastrointest Cancer ; 54(2): 506-512, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35486262

RESUMO

PURPOSE: The present study aimed to investigate the clinical implications of apical lymph node metastasis (ALNM) after curative resection of stage III colorectal cancer. METHODS: A retrospective study was conducted of 1403 consecutive colorectal cancer patients who underwent surgical resection at a single institution between April 2008 and January 2020. The characteristics of ALNM, the recurrence status and the relapse-free survival (RFS) were examined. RESULTS: The numbers of patients with stage ≤ I, II, III, and IV disease were 350, 437, 476, and 140 patients, respectively. Among these patients with stage III disease, ALNM was seen in 21 patients (4.4% of stage III patients). Among them, curative resection was performed in 19 patients. Recurrence was observed in 68% (13/19) of the patients with ALNM who received curative resection. The first sites of recurrence included the lymph nodes 53.8% (7/13), liver 30.8% (4/13), lung 15.4% (2/13), brain 7.7% (1/13), bone 7.7% (1/13), and peritoneum 7.7% (1/13). There was no significant difference in the RFS of patients with ALNM who were managed with or without adjuvant chemotherapy (P = 0.207). Furthermore, the RFS of the group managed without adjuvant chemotherapy and the group that received adjuvant chemotherapy with/without oxaliplatin did not differ to a statistically significant extent (P = 0.318). In stage III colorectal cancer patients with ALNM, recurrence was observed significantly more frequently in comparison to stage III colorectal cancer patients without ALNM (P = 0.007). The first site of recurrence in patients with ALNM was most frequently seen in the distant lymph nodes (P = 0.004). CONCLUSION: Our findings suggest that ALNM is strongly associated with recurrence in the distant lymph nodes and that it may lead to the development of systemic disease. The current regimen for stage III colorectal cancer may therefore not be sufficient for patients with stage III ALNM.


Assuntos
Neoplasias Colorretais , Recidiva Local de Neoplasia , Humanos , Estudos Retrospectivos , Metástase Linfática/patologia , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/patologia , Linfonodos/cirurgia , Linfonodos/patologia , Neoplasias Colorretais/patologia , Estadiamento de Neoplasias
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