Purpose: Recent studies have revealed that the expression of cancer-associated fibroblast (CAF) activation biomarkers in cancer cells is associated with clinical outcomes in patients with certain types of malignant tumors. However, whether the expression of CAF activation biomarkers affects the prognosis of colorectal cancer (CRC) has not been fully elucidated. This study aimed to evaluate the association between the expression of CAF activation biomarkers in cancer cells with cancer invasion and long-term oncological outcomes in patients with CRC. Methods: Cancer specimens obtained from 135 patients with stage I–III CRC were examined using immunohistochemical staining to evaluate the expression of fibroblast specific protein-1 (FSP-1), fibroblast activation protein α (FAPα), α-smooth muscle actin (α-SMA), and vimentin in cancer cells. Results: FSP-1 expression in cancer cells was significantly associated with lymphatic invasion, perineural invasion, tumor (T) status, and lymph node (N) status. FAPα expression in cancer cells was significantly associated with lymphatic invasion. On univariate and multivariate analyses, FSP-1 and α-SMA expression in cancer cells were associated with a short 10-year overall survival (OS) and high 10-year systemic recurrence (SR), respectively. Tumor budding was associated with a short 10-year OS. However, FAPα and vimentin did not contribute to the prognosis in this study. Conclusion In this study, we found that FSP-1 expression in cancer cells was related to cancer invasion. Additionally, FSP-1 and α-SMA expression in cancer cells was associated with 10-year OS and SR, respectively. Therefore, these markers may be used as predictors of long-term oncological outcomes in patients with CRC.

Background: A healthy microbiome helps maintain the gut barrier and mucosal immune tolerance. Previously, we demonstrated that acute kidney injury (AKI) provoked dysbiosis, gut inflammation, and increased permeability. Here, we investigated the renoprotective effects of the probiotic Bifidobacterium bifidum BGN4 and the underlying mechanisms thereof. Methods: C57BL/6 mice were subjected to bilateral renal ischemia-reperfusion injury (IRI) or sham operation. In the probiotic-treated group, BGN4 was administered by gavage once daily, starting 2 weeks before injury. Results: Administration of BGN4 significantly increased gut microbiome diversity and prevented expansion of the Enterobacteriaceae and Bacteroidetes that were the hallmarks of AKI-induced dysbiosis. Further, BGN4 administration also significantly reduced other IRI-induced changes in the colon microenvironment, including effects on permeability, apoptosis of colon epithelial cells, and neutrophil and proinflammatory macrophage infiltration. Mononuclear cells co-cultured with BGN4 expressed significantly increased proportions of CD103+/CD11c+ and CD4+ CD25+ Treg cells, suggesting a direct immunomodulatory effect. BGN4 induced Treg expansion in colon, mesenteric lymph nodes (MNL), and kidney. BGN4 also reduced CX3CR1intermediateLy6Chigh monocyte infiltration and interleukin (IL)-17A suppression in the small intestine, which may have attenuated AKI severity, kidney IL-6 messenger RNA expression, and AKI-induced liver injury. Conclusion Prior supplementation with BGN4 significantly attenuated the severity of IRI and secondary liver injury. This renoprotective effect was associated with increased Foxp3 and reduced IL-17A expression in the colon, MNL, and kidney, suggesting that BGN4-induced immunomodulation might contribute to its renoprotective effects. Probiotics may therefore be a promising strategy to reduce AKI severity and/or remote organ injury.

Objective: Cognitive reserve (CR) protects against cognitive decline by utilizing functional connectivity (FC) in the brain, such as the default mode network (DMN). We studied whether CR in individuals with predementia would correlate with better cognition and increased DMN FC in the resting brain. Methods: Fifty-four participants with subjective cognitive decline or mild cognitive impairment completed the Cognitive Reserve Index (CRI) questionnaire, and underwent a comprehensive neuropsychological test battery and resting state functional magnetic resonance imaging. Correlation and regression analyses for clinical variables and seed-to-voxel analyses of CR-related FC in the DMN were conducted. Results: CRI total (β=0.42, p=0.001), education (β=0.39, p=0.001), and leisure time (β=0.33, p=0.009) predicted the MiniMental State Examination. The CRI education predicted verbal memory recall (β=0.32, p=0.017), confrontational naming (β=0.57, p<0.001), and phonemic fluency (β=0.43, p=0.004). In the DMN in the resting brain, the CRI total correlated with increased FC, based on the posterior cingulate to both lateral parietal cortices. Conclusion In individuals with predementia, comprehensive CR correlated with an enhanced network in the DMN in the resting state. These results may support the neural correlate of CR during the initial stage of cognitive decline.

Objective: The emergency medical service (EMS) is expected to improve the prognosis of patients suffering from acutemyocardial infarction (AMI). We investigated the impact of utilizing EMS on the clinical outcomes of AMI patients. Methods: From November 2011 to November 2015, a total of 13,102 patients in the Korea Acute Myocardial InfarctionRegistry-National Institute of Health (KAMIR-NIH) registry were enrolled. Patients were divided into two groups: the EMSgroup, first medical contact (FMC) with 119; the non-EMS group, the FMC at local hospitals that were not available forpercutaneous coronary intervention. The authors analyzed the mortality and major adverse cardiac and cerebrovascularevents during one-year of clinical follow-up. Results: A total of 8,863 patients were finally analyzed for this study, and a total of 1,999 patients (22.6%) utilized theEMS as FMC. The patients utilizing EMS were more frequently diagnosed with ST-segment elevation AMI. At presentation,the EMS group had a higher incidence of Killip class IV, and they had a shorter symptom-to-door time than non-EMS group. The patients utilizing EMS had higher incidence of peri-procedural complications and in-hospital mortality.The multivariate logistic regression analysis with backward elimination revealed that utilizing EMS is an independent factorfor predicting lower one-year mortality. Conclusion This study has demonstrated that the high-risk AMI patients can utilize the EMS in Korea. The EMS grouphas more favorable clinical outcome during one-year follow-up after discharge than the non-EMS group, whereas it had ahigher rate of death during hospitalization compared with that of the non-EMS group.

PURPOSE: Increasing evidence suggests that polymorphisms in innate immunity genes are associated with Helicobacter pylori-induced inflammation and may influence susceptibility in developing noncardia gastric cancer. Therefore, we investigate the effect of polymorphisms of innate immunity genes and interactions with environmental factors in the Korean population. MATERIALS AND METHODS: We genotyped four polymorphisms of TLR2 (rs1898830), TLR4 (rs10983755 and rs10759932), and CD14 (rs2569190) in a case-control study of 487 noncardia gastric cancer patients and 487 sex- and age-matched healthy controls. Polytomous logistic regression models were used to detect the effects of genetic polymorphisms and environmental factors, which were stratified by the histological type of gastric cancer. RESULTS: TLR4 rs10983755 A carriers were found to have higher risk of intestinal-type noncarida gastric cancer than G homozygotes (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.01 to 1.97), but other genetic variants showed no association with the risk of noncardia gastric cancer. Among H. pylori-positive participants, smokers carrying TLR4 rs10983755 A had a higher risk of intestinal-type gastric cancer than nonsmoking TLR4 rs10983755 G homozygotes (OR, 4.28; 95% CI, 2.12 to 8.64). In addition, compared with tap water, other drinking water sources during childhood were found to be associated with the elevated risk of intestinal-type gastric cancer, and these associations were slightly stronger among TLR4 rs10983755 A carriers. CONCLUSION: The genetic polymorphisms of innate immunity genes are associated with the development of intestinal-type noncardia gastric cancer and these associations may differ in accordance to an exposure to certain environmental factors.
Case-Control Studies ; Drinking Water ; Helicobacter ; Homozygote ; Humans ; Immunity, Innate* ; Inflammation ; Logistic Models ; Polymorphism, Genetic ; Smoking ; Stomach Neoplasms* ; Water

PURPOSE: The aim of the present study was to assess the association between the pre-operative plasma fibrinogen level and the adjacent organ involvement in advanced gastric cancer. MATERIALS AND METHODS: A total of 923 pre-operative plasma samples were obtained from 923 patients diagnosed clinically as having advanced gastric cancer, and fibrinogen levels were measured by immunoassay. Associations between fibrinogen levels and clinicopathologic findings (depth of tumor, adjacent organ involvement, and lymph node metastasis), along with survival were examined by univariate and multivariate analyses. RESULTS: Tumor size, tumor depth, and the presence of lymph node metastasis were found to be positively correlated with the preoperative plasma fibrinogen levels (P<0.001). Fifty (5.4%) patients had adjacent organ involvement. Lymphatic invasion (P<0.001), tumor size (P<0.001), clinical T (depth of invasion) stage (P<0.001), and clinical nodal stage (P=0.018) were found to be associated with adjacent organ involvement. Univariate and multivariate regression analyses showed that a preoperatively elevated plasma fibrinogen level was associated with adjacent organ involvement (P<0.001, 0.028), and Kaplan-Meier analysis showed that it was associated with poorer survival (P<0.001). CONCLUSIONS: Plasma fibrinogen was found to be a clinically useful marker of adjacent organ involvement and overall survival. When a high fibrinogen level is encountered, preoperatively, adjacent organ involvement should be suspected in clinically advanced gastric cancer.
Fibrinogen ; Gastrectomy ; Humans ; Immunoassay ; Kaplan-Meier Estimate ; Lymph Nodes ; Neoplasm Metastasis ; Plasma ; Stomach Neoplasms

OBJECTIVES: Quality of life (QoL) was a important factor of treatment outcome in alcoholics. This study was to examine the relationship between family support and quality of life among alcoholics, to explore the moderating effect of abstinence self-efficacy on those relationship and to suggest practical implications for intervention services. METHODS: Data for this study were collected through the use of a survey instrument completed by 771 alcohol dependent admitted to inpatient treatment from 20 psychiatric hospital. Subjects were screened using the Family support, Drug Taking Confidence Questionnaire-8, World Health Organization Quality of Life Assessment Instrument. Collected data were analysed by moderated multiple regression and simple slope analysis. RESULTS: Family support was directly associated with QoL. Also the abstinence self-efficacy had moderating effects on relationship between family support and QoL. Simple slope analysis showed that the effects of family support on QoL were significant at low and high levels of abstinence self-efficacy and especially the effects of family support on QoL were more higher at the high levels of abstinence self-efficacy. CONCLUSION: This findings suggest that abstinence self-efficacy is an important factor to QoL among alcohol dependents. Increasing self-efficacy, family support will be improve the QoL and recovering process. Based on these findings suggest practical intervention.
Alcoholics ; Alcoholism ; Hospitals, Psychiatric ; Humans ; Inpatients ; Quality of Life ; Treatment Outcome ; World Health Organization

The purpose of our study was to create a novel rat aorta stent implantation model. Stainless steel bare metal stents (BMS) or paclitaxel-eluting stents (PES) were implanted in male Sprague-Dawley rats (BW 400 +/- 20 g). Two and four weeks after stent implantation, the aorta were collected, fixed with 2% glutaraldehyde, and cut into two segments. One segment was used for scanning electron microscopy analysis to evaluate re-endothelialization, and the other segment was used to calculate the neointimal area. At 2 weeks after stenting, the appearance of neointimal hyperplasia was less in the PES group than in the BMS group. At 4 weeks after stenting, no significant difference in neointimal hyperplasia was observed between two groups. On the other hand, the PES group showed more thrombus formation and less re-endothelialization compared to the BMS group. This study demonstrated the ability of a novel rat model of aorta stenting via a common carotid artery to measure the efficacy and safety of commercially available drug-eluting stents.
Angioplasty/*methods ; Animals ; Aorta, Thoracic/*surgery/ultrastructure ; Coronary Artery Disease/*surgery ; *Drug-Eluting Stents ; Histocytochemistry ; Male ; Microscopy, Electron, Scanning ; Models, Animal ; Neointima/pathology ; Paclitaxel/*administration & dosage ; Rats ; Rats, Sprague-Dawley

BACKGROUND/AIMS: To evaluate the association between Helicobacter pylori (H. pylori) infection and gastric cancer (GC) according to tumor subtype in Korea. METHODS: H. pylori status was determined serologically using the enzyme-linked immunosorbent assay. In total, 2,819 patients with GC and 562 healthy controls were studied. A logistic regression method was used after adjusting for possible confounders. RESULTS: The prevalence of H. pylori infection was significantly higher in the GC patients (84.7%) than in the controls (66.7%) (odds ratio [OR], 3.13; 95% confidence interval [CI], 2.46-3.97). The adjusted OR was significantly higher in H. pylori-infected patients aged <60 years (OR, 4.69; 95% CI, 3.44-6.38) than in those aged > or =60 years (OR, 1.48; 95% CI, 0.88-2.46; p<0.001). Subgroup analyses revealed no differences in seroprevalence between early gastric cancer (84.8%; OR, 3.01; 95% CI, 2.27-4.01) and advanced gastric cancer (84.6%; OR, 2.94; 95% CI, 2.24-3.85), cardia cancer (83.8%; OR, 2.98; 95% CI, 2.16-4.02) and noncardia cancer (84.8%; OR, 3.17; 95% CI, 2.48-4.04), and differentiated carcinoma (82.7%; OR, 2.99; 95% CI, 2.21-4.04) and undifferentiated carcinoma (86.8%; OR, 3.05; 95% CI, 2.32-4.00). CONCLUSIONS: The seroprevalence of H. pylori was higher in GC patients than in healthy controls, especially in younger patients. H. pylori infection is associated with GC, regardless of the tumor location, stage, or differentiation.
Aged ; Carcinoma ; Cardia ; Enzyme-Linked Immunosorbent Assay ; Helicobacter ; Helicobacter pylori ; Humans ; Korea ; Logistic Models ; Odds Ratio ; Prevalence ; Seroepidemiologic Studies ; Stomach Neoplasms

PURPOSE: To describe the clinical and imaging findings of hepatocellular carcinoma with neuroendocrine differentiation, which is an extremely rare variant of hepatocellular carcinoma. MATERIALS AND METHODS: We collected five patients who had histopathologically proven hepatocellular carcinoma with neuroendocrine differentiation, and described morphologic feature, enhancement pattern of tumors, extrahepatic manifestation and clinical findings. RESULTS: At CT, the tumor size ranged from 8 to 17 cm (mean : 12 cm) in maximum diameter. The tumor margin was well-defined and smooth in four patients and all tumors were heterogeneously hypoattenuating. Four tumor showed rim enhancement on arterial and portal phases. Local invasion to the portal vein, intrahepatic duct and gallbladder were seen. Extrahepatic manifestations included hepatic metastases, lymph node metastasis. At ultrasonography, the tumor showed heterogeneously hyperechoic in all patients and hypoechoic rim was found in four patients. Of four patients who were followed up, one survived for 16 months after initial diagnosis, while the other three died within 3 months after initial diagnosis. CONCLUSION: As described above, clinical and imaging findings of hepatocellular carcinoma with neuroendocrine differentiation were not specific. However, this rare variant of hepatocellular carcinoma could be considered when hepatic tumor is found in an advanced stage and shows persistent rim enhancement at CT.
Carcinoma, Hepatocellular ; Carcinoma, Neuroendocrine ; Gallbladder ; Humans ; Liver Neoplasms ; Lymph Nodes ; Neoplasm Metastasis ; Portal Vein