PURPOSE: To evaluate the status of number 3b lymph node (LN) station in patients with adenocarcinoma of the esophagogastric junction (AEG) and to investigate the optimal indications for radical proximal gastrectomy (PG) for AEG. MATERIALS AND METHODS: Data of 51 patients with clinically advanced Siewert types II and III AEG who underwent total gastrectomy (TG) between April 2010 and July 2017 were reviewed. The proportion of metastatic LNs at each LN station was examined. Number 3 LN station was separately classified into number 3a and number 3b. The risk factors for number 3b LN metastasis and the clinicopathological features of number 3b-positive AEG patients were investigated. RESULTS: The incidences of LN metastasis were the highest in number 1 (47.1%), followed by number 2 (23.5%), number 3a (39.2%), and number 7 (23.5%) LN stations. LN metastasis in number 3b LN station was detected in 4 patients (7.8%). A gastric invasion length of more than 40 mm was a significant risk factor for number 3b LN metastasis. All 4 patients with number 3b-positive AEG had advanced cancer with a gastric invasion length of more than 40 mm. The 5-year survival rate of patients with a gastric invasion length of more than 40 mm was 50.0%. CONCLUSIONS: Radical PG may be indicated for patients with AEG with gastric invasion length of less than 40 mm.
Adenocarcinoma* ; Esophagogastric Junction* ; Gastrectomy* ; Humans ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Risk Factors ; Survival Rate

Background/Aims: The use of endoscopic intervention (EI) for acute biliary pancreatitis (ABP) remains controversial because the severity of biliary obstruction/cholangitis/pancreatitis is not reflected in the indications for early EI (EEI). Methods: A total of 148 patients with ABP were included to investigate 1) the differences in the rate of worsening cholangitis/pancreatitis between the EEI group and the early conservative management (ECM) group, especially for each severity of cholangitis/pancreatitis, and 2) the diagnostic ability of imaging studies, including endoscopic ultrasound (EUS), to detect common bile duct stones (CBDSs) in the ECM group. Results: No differences were observed in the rate of worsening cholangitis between the EEI and ECM groups, regardless of the severity of cholangitis and/or the existence of impacted CBDSs. Among patients without impacted CBDSs and moderate/severe cholangitis, worsening pancreatitis was significantly more frequent in the EEI group (18% vs. 4%, p=0.048). In patients in the ECM group, the sensitivity and specificity for detecting CBDSs were 73% and 98%, respectively, for EUS, whereas the values were 13% and 92%, respectively, for magnetic resonance cholangiopancreatography. Conclusions EEI should be avoided in the absence of moderate/severe cholangitis and/or impacted CBDSs because of the high rate of worsening pancreatitis. EUS can contribute to the accurate detection of residual CBDSs, for the determination of the need for elective EI.

AIMChromosome 13 is one of the most frequently altered chromosomes in prostate cancer. The present study was undertaken to examine the role of human chromosome 13 in the progression of prostate cancer.

METHODSHuman chromosome 13 was introduced into highly metastatic rat prostate cancer cells via microcell-mediated chromosome transfer.

RESULTSMicrocell hybrid clones containing human chromosome 13 showed suppression of metastasis to the lung without any suppression of tumorigenicity, except for one clone, which contained the smallest sized human chromosome 13 and did not show any suppression on lung metastasis. Expression of two known tumor suppressor genes, BRCA2 and RB1, which map to chromosome 13, was examined by reverse transcription- polymerase chain reaction analysis. BRCA2 was expressed only in the metastasis-suppressed microcell-hybrid clones, whereas RB1 was expressed in all clones.

CONCLUSIONHuman chromosome 13 contains metastasis suppressor gene(s) for prostate cancer derived from rat. Furthermore, the RB1 gene is unlikely to be involved in the suppression of metastasis evident in this system.

Animals ; Animals, Genetically Modified ; Cell Division ; genetics ; Chromosome Aberrations ; Chromosome Mapping ; Chromosomes, Human, Pair 13 ; Disease Progression ; Genetic Markers ; Humans ; In Situ Hybridization, Fluorescence ; Kinetics ; Male ; Neoplasm Metastasis ; Prostatic Neoplasms ; genetics ; pathology ; prevention & control ; Rats ; genetics

BACKGROUND/AIMS: Although both radial- and convex-arrayed endoscopic ultrasonography (EUS) scopes are widely used for observational EUS examinations, there have been few comparative studies on their power of visualization. The aim of this study was to evaluate the capability of these EUS scopes for observation of the pancreatobiliary junction. METHODS: The rate of successful visualization of the pancreatobiliary junction was retrospectively compared between a radial-arrayed and a convex-arrayed echoendoscope, from a prospectively maintained database. Study periods were defined as January 2010 to December 2012 for the radial group, and February 2015 to October 2016 for the convex group because the respective scope was mainly used during those periods. RESULTS: During the study period, 1,660 cases with radial EUS and 1,984 cases with convex EUS were recruited. The success rates of observation of the pancreatobiliary junction were 80.0% and 89.5%, respectively (p < 0.0001). CONCLUSIONS: The capability of visualization of the pancreatobiliary junction in observational EUS was found to be better with a convex-arrayed than with a radial-arrayed echoendoscope.
Endosonography ; Prospective Studies ; Retrospective Studies

We clarify the effect of combination of low-carbohydrate diet and resistance exercise training on physical characteristics and plasma concentrations of metabolites and hormones in humans. Intervention of low-carbohydrate diet and resistance exercise training were performed on 7 healthy men and 3 women (age 39.6 ± 7.0 year; BMI 25.1 ± 3.6 kg/m2) for 8 - 12 weeks. Physical characteristics and 106 test items including and blood concentrations of metabolites and hormones were measured before and after the intervention. The effects of intervention were analyzed by a paired t-test, in which multiple testing was corrected by the method of Storey (significant variation q <0.1). In both men and women, carbohydrate and energy intake per day were low, and protein intake per day was almost the same as the recommended dietary allowance. Because carbohydrate intake were limited (174 kcal), resulting in reduction of total energy (1186 kcal). After the intervention, body weight, BMI (Body Mass Index), fat mass, body fat, muscle mass and body water content significantly decreased, while muscle mass per body mass significantly increased. Glycine, 3-methyl histidine, inorganic phosphorous, urea nitrogen, urea nitrogen per creatinine, were significantly increased, while HbA1c, white blood cell count, β-aminoisobutyric acid, adrenalin, free T4, blood ammonia, γGTP, cholinesterase, and leptin were decreased.