We examined the effect of various levels of dietary protein on long term prognosis of Adriamycinnephropathy of S-D rat, fed with high protein (30%), intermediately low (10%), and strictly low (5%) protein diet for 15 weeks. 1) In rats fed with strictly low protein diets (5%), proteinuria and serum creatinine decreased and creatinine clearance and histological changes were relatively well preserved. But hypoproteinemia and weight loss were more marked and 2 rats died due to severe ascites and pleural effusion in cachexic state. 2) In rats fed with high protein diets (30%), general health condition and weight gain were relatively well preserved. But there were massive proteinuria, progressive increase in serum creatinine and progressive decrease in creatinine clearance. Focal glomerular sclerosis and severe tubulointerstitial change on histologic examination were marked. 3) With intermediately low protein diet (10%), renal function and pasma protein levels were relatively well preserved compared with high protein diet group. But weight gain did not increase normally. 4) We tentatively conclude that appropriately restricted dietary protein can prevent functional and histological renal damage. But too strict protein restriction aggravate nutitional state and general condition.
Animals ; Ascites ; Creatinine ; Diet ; Diet, Protein-Restricted ; Dietary Proteins* ; Hypoproteinemia ; Pleural Effusion ; Prognosis* ; Proteinuria ; Rats ; Renal Insufficiency ; Sclerosis ; Weight Gain ; Weight Loss

BACKGROUND: Epithelial-mesenchymal transition (EMT) is an important step in the invasion and progression of cancer and in the development of chemoresistance by cancer cells. METHODS: To address the clinical significance of the EMT pathway in lung adenocarcinoma and the association of the pathway with histological subtype, we examined 193 surgically resected lung adenocarcinoma samples for the expression of representative EMT-related proteins (E-cadherin, beta-catenin, and vimentin) by immunohistochemistry. Histological subtypes were classified according to the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification. The results for EMT-related protein expression were analyzed for correlation with clinicopathological features and with survival. RESULTS: The loss of E-cadherin expression and aberrant beta-catenin expression were significantly associated with larger tumor size, pleural invasion, lymphatic/vascular invasion, and advanced pathological stage (p<0.05). The alteration of the E-cadherin/beta-catenin complex was least frequently observed in the lepidic-predominant group, but these associations were not statistically significant. In the multivariate analysis, altered E-cadherin/beta-catenin complex expression was found to be an independent poor prognostic factor (p=0.017; hazard ratio, 1.926; 95% confidence interval, 1.119 to 3.314). CONCLUSIONS: The alteration of the expression of the E-cadherin/beta-catenin complex was associated with aggressive tumor behavior in lung adenocarcinoma.
Adenocarcinoma ; beta Catenin ; Cadherins ; Epithelial-Mesenchymal Transition ; Immunohistochemistry ; Lung ; Lung Neoplasms ; Multivariate Analysis ; Proteins

Among the exotoxins produced by V. vulnificus, hemolysin (HS) has been reported to be the most potent one. To investigate the factors up- or down-regulating HS production in the context of pathogenesis, we observed the effects of salinity or/and temperature shifting, glucose, and acidic pH on the production of HS by V. vulnificus C7184 strain in vitro. Significantly more HS was produced when V. vulnificus was cultured in 0.9% salinity and 37 degrees C than in 2.5% and 25 degrees C. When the culture condition reflecting natural habitat of V. vulnificus (2.5% salinity and 25degrees C) was changed into that reflecting human body (0.9% salinity and 37 degrees C), 2.5 fold or more HS was produced than in the V. vulnificus being cultured continuously in 0.9% NaCl at 37 degrees C. This result suggests that V. vulnificus somehow recognizes the shifting in salinity and temperature and stimulate HS production. Glucose addition in the culture medium resulted in a dose- dependent decrease in the HS production. Glucose itself and acidic pH resulting from its metabolism both appeared to inhibit the HS production. Glucose in itself had more dominant role in suppressing the HS production than the lowered pH accompanying the metabolism of glucose. This result suggests that HS production is down-regulated in the presence of glucose and under environmental acidic pH.
Ecosystem ; Exotoxins ; Glucose* ; Human Body ; Hydrogen-Ion Concentration ; Metabolism ; Salinity* ; Vibrio vulnificus* ; Vibrio* ; Virulence

BACKGROUND: This study was conducted to develop a pre-discharge group education program for liver transplant patients, and to contribute to improving the knowledge and performance of self-management after discharge. METHODS: This investigation was a methodological study consisting of analysis, design, development, operation, and evaluation stages. RESULTS: The constituent items of the pre-discharge group education program for liver transplant patients include medication management, infection management, emergency management, outpatient management, complication management, nutrition management, exercise management, wound and drainage management, disability registration, and sex life. The pre-discharge group education program for liver transplant patients was conducted once a week, 30 minutes for the coordinator, 40 minutes for the clinical nurse specialist (including 10 minutes for wound and drainage management), 30 minutes for pharmacists, 20 minutes for the nutritionist, and 20 minutes for social workers. Additionally, the contents of the lecture announced by PowerPoint were made the same as the booklet. The overall knowledge level before and 3 months after the pre-discharge group education program for liver transplantation patients increased significantly from 17.32±1.53 to 19.74±0.89. At the 3-month time point, the overall compliance was 77.39±3.04 out of 80. Overall satisfaction was 9.32±0.93 on a scale of 10. Finally, the need for medication was the highest at 3 months. CONCLUSIONS: It is expected that this program can be utilized in the clinical field as an effective nursing education intervention.
Compliance ; Drainage ; Education* ; Education, Nursing ; Emergencies ; Humans ; Liver Transplantation ; Liver* ; Methods ; Nurse Clinicians ; Nutritionists ; Outpatients ; Pamphlets ; Pharmacists ; Self Care ; Social Work ; Social Workers ; Wounds and Injuries

OBJECTIVES: This study was designed to investigate the distribution of Helicobacter pylori(HP), the relationship between HP colonization and gastritis scores graded according to the Sydney system, epithelial damage, and lymphoid follicles, and to assess the effect of eradication of HP infection on the different histological parameters. METHODS: Gastritis scores, epithelial damage, and lymphoid follicles were assessed in gastric antral, body, and fundic biopsy specimens before and 4 weeks after antiHP triple therapy in 32 patients with HP-related gastritis. RESULTS: The mean initial scores of all histological parameters were higher in the antrum compared with the body and fundus. A significant, positive correlation was noted between HP score and the score for inflammation, for activity, and for mucus depletion. After eradication of HP infection, significant improvement in activity, chronic inflammation, and mucus depletion was detected in responders with a successful HP eradication ; the activity return to normal in follow-up, and chronic inflammation and mucus depletion was decreased significally in severity in responders(p<0.05). No significant reduction in severity of gastritis and mucus depletion was detected in the non-responders with persistent HP infection following anti-HP triple therapy. CONCLUSIONS: The eradication of HP results in a rapid, significant histopathological improvement in the gastritis scores and epithelial damage in gastric mucosa.
Biopsy ; Colon ; Follow-Up Studies ; Gastric Mucosa ; Gastritis* ; Helicobacter ; Helicobacter pylori ; Humans ; Inflammation ; Mucus

BACKGROUND: Alterations in the phosphatase and tensin homolog (PTEN) are correlated with tumor progression. Downregulation of PTEN is related to drug resistance of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the prognostic significance of PTEN in patients with NSCLC and its correlation with EGFR. METHODS: Two hundred eighty eight surgically resected NSCLC samples, including 168 adenocarcinomas (ADCs), 99 squamous cell carcinomas (SCCs) and 21 other NSCLCs were analyzed for the PTEN. The results were correlated with other clinicopathological variables including EGFR amplification and mutation. RESULTS: Loss of PTEN was detected in 42.4% of NSCLCs, specifically 28.6% of ADCs, 66.7% of SCCs, and 38.1% of others. Loss of PTEN was significantly associated with SCC, smoking, male gender, and higher stage. In a multivariate analysis, loss of PTEN was significantly associated with short progression-free survival (p=0.037). No association between PTEN and EGFR was observed. CONCLUSIONS: These results suggest that loss of PTEN results in shorter progression-free survival in patients with NSCLC, and loss of PTEN is more associated with SCC, smoking, male gender, and higher T stage by the 7th tumor, node and metastasis staging system but not EGFR status.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Disease-Free Survival ; Down-Regulation ; Drug Resistance ; Humans ; Immunohistochemistry ; Male ; Microfilament Proteins ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor ; Smoke ; Smoking

PURPOSE: The anaplastic lymphoma kinase (ALK) gene is a potential molecular target in non-small cell lung carcinoma (NSCLC). The clinicopathologic implication of a change in the ALK gene copy number (GCN) is unclear. MATERIALS AND METHODS: A total of 434 primary NSCLC samples were analyzed by fluorescence in situ hybridization (FISH) for ALK GCN. RESULTS: Ninety-six cases (22.1%) showed ALK GCN gain with amplification in 16 (3.7%) cases. The cases with ALK GCN gain consisted of 47 adenocarcinomas (49.0%), 41 squamous cell carcinomas (42.7%), 5 adenosquamous carcinomas (5.2%) and 3 other NSCLCs (3.1%). ALK gene amplification was identified in 7 adenocarcinomas (43.7%) and 9 squamous cell carcinomas (56.3%). There was no significant difference between ALK GCN gain/amplification and histologic subtypes. Univariate survival analysis revealed that patients with ALK GCN gain/amplification showed shorter progression-free survival durations and decreased overall survival rates (p<0.001). However, multivariate analysis proved that ALK GCN gain/amplification is not an independent prognostic factor for progression-free survival or overall survival. CONCLUSION: ALK GCN gain is frequently identified in NSCLCs and the incidence is similar among histologic subtypes. Although ALK GCN gain/amplification is not an independent prognostic marker, it is associated with tumor progression in NSCLC.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Disease-Free Survival ; Fluorescence ; Gene Amplification ; Gene Dosage ; Humans ; In Situ Hybridization ; Incidence ; Lung ; Lymphoma ; Multivariate Analysis ; Phosphotransferases ; Receptor Protein-Tyrosine Kinases ; Survival Rate

BACKGROUND: Insulin-like growth factor-1 receptor (IGF1R) is a membrane receptor-type tyrosine kinase that has attracted considerable attention as a potential therapeutic target, although its clinical significance in non-small cell lung cancer (NSCLC) is controversial. This study aimed to clarify the clinical significance of IGF1R expression in human NSCLC. METHODS: IGF1R protein expression was evaluated using immunohistochemistry in 372 patients with NSCLC who underwent curative surgical resection (146 squamous cell carcinomas [SqCCs] and 226 adenocarcinomas [ADCs]). We then analyzed correlations between expression of IGF1R and clinicopathological and molecular features and prognostic significance. RESULTS: Membranous and cytoplasmic IGF1R expression were significantly higher in SqCCs than in ADCs. In patients with SqCC, membranous IGF1R expression was associated with absence of vascular, lymphatic, and perineural invasion; lower stage; and better progression-free survival (PFS) (hazard ratio [HR], 0.586; p = .040). In patients with ADC, IGF1R expression did not have a significant prognostic value; however, in the subgroup of epidermal growth factor receptor (EGFR)-mutant ADC, membranous IGF1R expression was associated with lymphatic and perineural invasion, solid predominant histology, and higher cancer stage and was significantly associated with worse PFS (HR, 2.582; p = .009). CONCLUSIONS: Lung ADC and SqCC showed distinct IGF1R expression profiles that demonstrated prognostic significance. High membranous IGF1R expression was predictive of poor PFS in EGFR-mutant lung ADC, while it was predictive of better PFS in SqCC. These findings will help improve study design for subsequent investigations and select patients for future anti-IGF1R therapy.
Adenocarcinoma* ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cytoplasm ; Disease-Free Survival ; Epidermal Growth Factor* ; Humans ; Immunohistochemistry ; Lung ; Membranes ; Prognosis* ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor*

Purpose: Despite advances in treatment, lung cancer remains the leading cause of cancer mortality. This study aimed to characterise genome-wide tumorigenesis events and to understand the hypothesis of the multistep carcinogenesis of lung adenocarcinoma (LUAD) Materials and Methods: We conducted multiregion whole-exome sequencing of LUAD with synchronous atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ, or minimally invasive adenocarcinoma of 19 samples from three patients to characterize genome-wide tumorigenesis events and validate the hypothesis of the multistep carcinogenesis of LUAD. We identified potential pathogenic mutations preserved in preinvasive lesions and supplemented the finding by allelic variant level from RNA sequencing. Results: Overall, independent mutational profiles were observed per patient and between patients. Some shared mutations including epidermal growth factor receptor (EGFR , p.L858R) were present across synchronous lesions. Conclusion Here, we show that there are driver gene mutations in AAH, and they may exacerbate as a sequence in a histological continuum, supporting the Darwinian evolution model of cancer genome. The intertumoral and intratumoral heterogeneity of synchronous LUAD implies that multi-biomarker strategies might be necessary for appropriate treatment.

Lung cancer with cyst formation is a rare entity. We report a 63-year-old man who underwent surgical treatment of primary lung cancer, which mimics benign solitary cyst. We incidentally found his pulmonary cyst by a low dose chest tomography and followed up for 2 years. Rapid growth of cyst and focal wall thickening evoke us to have a suspicion of its malignancy. Left lower lobectomy via video-assisted thoracoscopic surgery was performed without any preoperative pathologic confirmation. The postoperative pathological finding revealed squamous cell carcinoma with carcinoma in situ on the cyst wall. We emphasize the need for physicians to be aware of the potential of lung cancer in patients with growing pulmonary cyst.
Bone Cysts ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Humans ; Lung ; Lung Neoplasms ; Thoracic Surgery, Video-Assisted ; Thorax