Purpose: Resectable pancreatic ductal adenocarcinoma (PDAC) has a high risk of recurrence after curative resection; despite this, the preoperative risk factors for predicting early recurrence remain unclear. This study therefore aimed to identify preoperative inflammation and nutrition factors associated with early recurrence of resectable PDAC. Methods: From March 2021 to November 2021, a total of 20 patients who underwent curative resection for PDAC were enrolled in this study. We evaluated the risk factors for early recurrence within 1 year by univariate and multivariate analyses using Cox hazard proportional regression. The cutoff values for predicting recurrence were examined using receiver operating characteristic (ROC) curves. Results: In our univariate and multivariate analyses, C-reactive protein (CRP), CRP-albumin ratio, and CRP-prealbumin ratio, as well as sex and age, were significant independent prognostic factors for early recurrence in PDAC. However, known inflammatory factors (neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios), nutritional factors (albumin, prealbumin, ferritin, vitamin D), and inflammatory-nutritional factors (Glasgow Prognostic Score, modified Glasgow Prognostic Score, albumin-bilirubin) showed no association with early recurrence. In addition, using cutoff values by ROC curve analysis, a high preoperative CRP level of >5 mg/L, as well as high CRP-to-albumin (>5.3) and CRP-to-prealbumin (>1.3) ratios showed no prognostic value. Conclusion Our results showed that inflammatory and perioperative nutritional factors, especially CRP-to-prealbumin ratio, have significant associations with early recurrence after curative resection in resectable PDAC. Therefore, for such patients, a cautious approach is needed when inflammation and poor nutritional status are present.

This article was inadvertently omitted Acknowledgments section for grant support.

BACKGROUND: The objective of this study was to investigate the time-course of the expression of TNF-alpha, IL-6, and IL-1beta after L5 spinal nerve transection (SNT), and to determine the effect of small interfering RNA (siRNA) targeting these cytokines on neuropathic pain. METHODS: Rats received control siRNA (CON group, n = 80) or a cocktail of siRNAs targeting these cytokines (COCK group, n = 70). The siRNAs were given via intrathecal catheter 1 d prior to SNT, on the operation day, and 1, 2 and 3 d postoperatively. Behavioral tests and levels of the cytokine mRNAs and proteins as well as glial cell activity were following the L5 SNT. RESULTS: In the CON group, TNF-alpha and IL-1beta mRNA levels increased immediately after SNT and remained high for 6 d, while IL-6 transcripts only began to increase after 12 h. TNF-alpha and IL-1beta mRNA levels in the COCK group were lower than in the CON group at all time points (P < 0.05). In the behavioral tests, allodynia and hyperalgesia were significantly lower in the COCK group from 2 d after SNT (P < 0.05). CONCLUSIONS: The time courses of TNF-alpha, IL-6 and IL-1beta mRNA expression after L5 SNT differ. RNA interference may be a method of reducing the development of mechanical allodynia and hyperalgesia in response to nerve injury.
Animals ; Catheters ; Cytokines ; Hyperalgesia ; Interleukin-6* ; Neuralgia* ; Neuroglia ; Rats* ; RNA Interference* ; RNA, Messenger ; RNA, Small Interfering ; Spinal Nerves* ; Tumor Necrosis Factor-alpha*

Lesch-Nyhan syndrome is an X-linked recessive disorder characterized by hyperuricemia, choreoathetosis, spasticity, mental retardation, and compulsive, self-injurious behavior. This disorder results from a complete deficiency of the purine salvage enzyme, hypoxanthine-guanine phosphoribosyl transferase(HPRT). We report here on a case of Lesch-Nyhan syndrome in a 1-year, 7-month-old male who presented with frequent vomiting, failure to thrive, and developmental delay. The diagnostic work-up revealed hyperuricemia, hyperuricosuria, and medullary nephrolithiasis. The HPRT activity in the erythrocytes was undetectable with a biochemical assay. We also identified de novo mutation which was a deletion of the 649th base, adenosine, in HPRT gene(649delA) by analysis of cDNA using RT-PCR technique coupled with direct sequencing.
Adenosine ; DNA, Complementary ; Erythrocytes ; Failure to Thrive ; Humans ; Hyperuricemia ; Hypoxanthine Phosphoribosyltransferase ; Infant ; Intellectual Disability ; Lesch-Nyhan Syndrome* ; Male ; Muscle Spasticity ; Nephrolithiasis ; Self-Injurious Behavior ; Vomiting

OBJECTIVE: To evaluate the accuracy of predicted birth weight percentile and large for gestational age(LGA) fetuses by the gestation-adjusted projection method using estimated fetal weight. METHODS: From 462 low-risk pregnancies with singleton fetus, fetal biometry including fetal biparietal diameter(BPD), head circumference(HC), abdominal circumference(AC), and femur length(FL) was made from 30 weeks of gestation until term. Estimated fetal weight(EFW) by combinations of fetal biometry were made by Campbell, Hadlock1, Hadlock2, and Shepard formulas respectively. The diagnostic accuracy according to 4 formulas was assessed by correlation between EFW percentile and birth weight percentile, prediction of LGA fetuses, and prediction error(percentile difference between birth weight and EFW). RESULTS: The mean gestational age on ultrasound and on birth, and birth weight were 33.21 +/- 2.08(30-40) weeks, 38.43 +/- 1.72(30-42) weeks, and 3.14 +/- 0.47(0.99-4.38) Kg, respectively. The diagnostic accuracies of gestation-projection method using EFW were similar result to predict birth weight percentile and LGA fetuses according to 4 formulas. Correlation between EFW percentile and birth weight percentile(correlation coefficient, r) were Campbell: 0.644(p <0.001), Hadlock 1: 0.682(p <0.001), Hadlock 2: 0.681(p <0.001), Shepard: 0.638(p <0.001), respectively. Youden's index(sensitivity + specificity - 1) in prediction of LGA fetuses were Campbell: 0.532, Hadlock1: 0.525, Hadlock2: 0.520, Shepard: 0.549, respectively. Prediction error were Campbell: 18.14+/-16.56, Hadlock1: 16.19+/-14.35, Hadlock2: 16.10+/-14.29, Shepard: 19.68+/-17.00, respectively. The prediction error was increased according to increasing of lapse time(p <0.001), gestational weeks on ultrasound, and estimated fetal weight percentile, and decreasing birth weight percentile(p <0.001)(R square=0.411, (p <0.001). But, amniotic fluid index did not affect to prediction error(p=0.199). CONCLUSION: Our study presented relatively accurate prediction for birth weight percentile and LGA fetuses from remote sonographic examination. If LGA fetuses was suspected by antenatal ultrasound, adequate therapy and periodic observation are recommended for good perinatal outcome.
Amniotic Fluid ; Biometry ; Birth Weight* ; Female ; Femur ; Fetal Weight* ; Fetus* ; Gestational Age* ; Head ; Parturition* ; Pregnancy ; Sensitivity and Specificity ; Ultrasonography