Effect of etodolac on type-II collagen-induced arthritis in mice

We tested the effect of etodolac on the development of type-II collagen-induced arthritis in DBA/1J mice. It was administered orally once daily for 35 days after the primary immunization with type-II collagen. Etodolac (10 mg/kg) significantly inhibited the development of signs of arthritis on day 28 to day 35. Indomethacin (1 mg/kg) also significantly inhibited it on day 29 to day 34. Radiographic examination showed that etodolac (10 mg/kg) significantly prevented the development of osteopenia, bone erosion and new bone formation of the joints on day 35, while indomethacin (1 mg/kg) significantly prevented only the development of bone erosion. Histopathological examination showed that both etodolac (10 mg/kg) and indomethacin (1 mg/kg) significantly prevented the development of synovitis, erosion of cartilage of the joints and bone destruction of the limbs on day 35. Etodolac and indomethacin did not affect the serum level of anti-type-II collagen antibodies. These results suggest that etodolac and indomethacin suppress type-II collagen-induced arthritis without affecting humoral immune responses.     

Crossed cerebellar hyperperfusion in symptomatic epilepsy--two case reports

A 74-year-old female with cerebral infarction and a 78-year-old female with cerebral glioblastoma suffered complex partial seizure. Ictal perfusion single photon emission computed tomography in these patients showed the interesting phenomenon of 'crossed cerebellar hyperperfusion,' a reversed crossed cerebellar diaschisis. The mechanism is probably spread of electrical seizure through efferent projections, and may be related to the cerebellar atrophy seen in patients with long-standing partial epilepsy.     

Role of FGF10 on tumorigenesis by MS‐K

Murine MS‐K and NFSA cell lines formed tumor after inoculation into mouse and both cell lines expressed high level of vascular endothelial growth factor‐A (vegf‐A) and produced same level of VEGF‐A. However, poor blood vessel formation, and necrosis was significantly observed in NFSA‐tumor, contrary to well‐developed blood vessel formation in MS‐K tumor. The microarray analysis showed high expression of fibroblast growth factor‐10 (fgf‐10) in MS‐K than NFSA. In this report, the role of fgf‐10 on tumor growth was studied. MS‐K enhanced more proliferation of endothelial cells by direct co‐culture than NFSA, and rFGF10 supported the proliferation of HUVEC in combination with VEGF‐A. fgf‐10‐knocked down MS‐K, MS‐K (fgf‐10‐KD), proliferated slower in vitro and the tumorigenicity of them was also slower than control. The blood vessel formation in these MS‐K (fgf‐10‐KD) clones was reduced compared with the MS‐K (normal). qPCR analysis showed the suppression of vegf‐A, vegf‐C and fgfr‐1‐expression in the MS‐K (fgf‐10‐KD) clones. Taken together, these results indicated that FGF10, which was produced from tumor cells, was essential for the proliferation of tumor cell itself and also supports proliferation of endothelial cells. Thus, FGF10 plays an important role for tumor growth by both paracrine and autocrine manner.     

Chronic kidney disease stage stratifies short- and long-term outcomes after aortic root replacement

OBJECTIVESChronic kidney disease (CKD) is prevalent in patients undergoing cardiovascular surgery, and it negatively impacts procedural outcomes; however, its influence on the outcomes of aortic surgery has not been well studied. This study aims to elucidate the importance of CKD on the outcomes of aortic root replacement (ARR).Open in a separate windowMETHODSPatients who underwent ARR between 2005 and 2019 were retrospectively reviewed (n = 882). Patients were divided into 3 groups based on the Kidney Disease: Improving Global Outcomes criteria: Group 1 [estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m², n = 421); Group 2 (eGFR = 30–59 ml/min/1.73 m², n = 424); and Group 3 (eGFR < 30 ml/min/1.73 m², n = 37). To reduce potential confounding, a propensity score matching was also performed between Group 1 and the combined group of Group 2 and Group 3. The primary end point was 10-year survival. Secondary end points were in-hospital mortality and perioperative morbidity.RESULTSSevere CKD patients presented with more advanced overall chronic and acute illnesses. Kaplan–Meier analysis showed a significant correlation between CKD stage and 10-year survival (log-rank P < 0.001). The number of events for Group 1 was 15, Group 2 was 49 and Group 3 was 11 in 10 years. Group 3 had significantly higher in-hospital mortality (13.5% vs 3.5% in Group 2 vs 0.7% in Group 1, P < 0.001) and stroke (8.1% vs 7.1% vs 1.2%, P < 0.001) as well as introduction to new dialysis (27.0% vs 5.4% vs 1.7%, P < 0.001). eGFR was shown to be an independent predictor of mortality (hazard ratio, 0.98; 95% confidence interval, 0.96–0.99). Comparison between propensity matched groups showed similar postoperative outcomes, and eGFR was still identified as a predictor of mortality (hazard ratio, 0.97; 95% confidence interval, 0.95–0.99).CONCLUSIONSHigher stage in CKD negatively impacts the long-term survival in patients who are undergoing ARR.     

Vascular endoscopic and macroscopic observations after crush stenting of coronary artery bifurcations in pigs.

The crush stent technique has recently been proposed to limit the development of restenosis between drug-eluting stents implanted at coronary artery bifurcations. We studied the stent expansion, apposition to the vessel, and aspect of the overlapping stents after in vivo crush stent implantation. Crush stent implantation was performed at coronary bifurcations in anesthetized swines. The treated sites were examined using intravascular ultrasound and a vascular endoscope. The stents removed from the vessel were analyzed macroscopically. After final kissing balloon inflation, an adequate apposition of the stent to the vessel wall was confirmed by vascular endoscopy and visual inspection. However, the side-branch stent was narrowed at the site of stent overlap, and the overlapping stents in the main branch created a metal mass, which could promote the development of thrombosis. The technique of crush stent implantation with additional kissing balloon inflation is feasible and promising. However, it may be limited by thrombosis and restenosis at the carina because of stent overlapping and potential incomplete apposition. Additional studies are needed to confirm the safety and long-term clinical results of this technique.     

Thyroid calcifications: sonographic patterns and incidence of cancer

We investigated the incidence of cancer in surgically resected 151 thyroid nodules in 101 patients according to their calcification patterns on preoperative ultrasonography (US). Calcification was detected in 57 (38%) nodules, 31 (54%) of which was histologically diagnosed as cancer. According to the calcification types, 9 of 11 nodules with microcalcifications, 15 of 29 nodules with intranodular coarse calcification, 6 of 14 nodules with peripheral calcification and 1 of 3 calcified spots without surrounding tumor were diagnosed as cancer.     

Changes in Smoking Habits and Behaviors Following the Introduction and Spread of Heated Tobacco Products in Japan and Its Effect on FEV1 Decline: A Longitudinal Cohort Study

BackgroundHeated tobacco product (HTP) use in Japan has rapidly increased. Despite this rapid spread, little is known about the health effects of HTP use. We conducted a longitudinal cohort study to investigate the change in smoking habits following the spread of HTP use and its effect on forced expiratory volume in 1 second (FEV₁) decline.MethodsParticipants consisted of a resident population (n = 2,612; mean age, 67.7 years) with FEV₁ measurement in 2012–2014 and 2018–2019, and a worksite population (n = 722; mean age 49.3 years) without FEV₁ data. Participants were categorized as combustible cigarette-only smokers, HTP-only users, dual users, past smokers, and never smokers. The association between smoking group and the change in smoking consumption over a mean 5.6 years was examined. Differences in annual FEV₁ change between smoking groups were examined in the resident population.ResultsPrevalence of HTP-only and dual users in 2018–2019 was 0.8% and 0.6% in the resident population, and 5.0% and 1.9% in the worksite population, respectively. The overall number of tobacco products smoked/used increased in dual users compared to baseline, but not in others. Annual FEV₁ decline in dual users tended to be greater than that in cigarette-only smokers (16; 95% confidence interval, −34 to 2 mL/year after full adjustment). Participants switching to HTP-only use 1.7 years before had a similar FEV₁ decline as cigarette-only smokers.ConclusionsHTP use, including dual use, is prevalent even in a rural region of Japan. Dual users appear to smoke/use tobacco products more and have a greater FEV₁ decline. Tobacco policy should consider dual use as high-risk.Key words: heated tobacco products, electronic nicotine delivery devices, prevention, smoking caused disease     

Sonographically guided core biopsy of the salivary gland masses: safety and efficacy

Over an 8-year period, we performed ultrasonography (US)-guided core biopsy of the salivary gland in 37 patients using an 1l-mm-throw 18-gauge automated biopsy system. The biopsy results were retrospectively compared with the findings of surgical pathology (n=18) or more than 6 months of clinical follow-up (n=19). The sensitivity, specificity, and accuracy of US-guided core biopsy for the diagnosis of malignancy were 75.0%, 96.6%, and 91.9%, respectively. No immediate or delayed complications occurred.