CXCL13 expression is prognostic and predictive for postoperative adjuvant chemotherapy benefit in patients with gastric cancer

Abstract

Background

Chemokine (C-X-C motif) ligand 13 (CXCL13/BLC/BCA-1) is a cytokine from C-X-C chemokine family, which is selectively chemotactic for B cells. Previous research has demonstrated that high CXCL13 expression is correlated to poor prognosis in various cancers. However, the association between CXCL13 expression and gastric cancer is still unclear.

Methods

Intratumoral CXCL13 expression was evaluated by immunohistochemistry using a semi-quantitative method (modified H-score) in a testing set of 214 and a validation set of 227 randomly selected gastric cancer patients resected in 2008 in one institution. The median value was used as the cut-off point. We performed correlative analysis of CXCL-13 expression with clinicopathological variables, Kaplan–Meier analysis for association with overall survival (OS), and multivariate modeling.

Results

High CXCL13 expression was associated with larger tumor diameter and shorter OS. By multivariate analysis, CXCL13 expression was associated with OS independently from clinicopathological factors. Within the T2–4 stage patients group, low CXCL13 expression was associated with longer survival, especially in the subgroup of patients (57.6%) who received adjuvant chemotherapy.

Conclusions

Intratumoral CXCL13 expression appears as an independent prognostic marker for patients after gastric cancer resection. In addition, CXCL13 expression may serve as a predictive biomarker of response to postoperative adjuvant chemotherapy in these patients.

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Can gray values derived from CT and cone beam CT estimate new bone formation? An in vivo study

Abstract

Objectives

The main aim of this study was to investigate whether Hounsfield unit derived from computed tomography (HU/CT) and gray value derived from cone beam computed tomography (GV/CBCT) can predict the amount of new bone formation (NBF) in the defects after bone reconstruction surgeries.

Materials and methods

Thirty calvaria defects created in 5 rabbits and grafted with both radiolucent (RL, n = 15) and radiopaque (RO, n = 15) bone substitute materials were evaluated, 8 weeks postoperatively. The defects were scanned by multislice computed tomography (Somatom®, Siemens Healthineers, Erlangen, Germany) and CBCT (NewTom VG®, Qualitative Radiology, Verona, Italy). MSCT and CBCT scans were matched to select the exact region of interest (ROI, diameter = 5 mm and height = 1 mm). HU/CT and GV/CBCT of each ROI were obtained. Mean amount of NBF in whole of the defects was measured using serial histomorphometric assessment. We investigated the correlation between HU/CT and GV/CBCT, HU/CT and NBF, and GV/CBCT and NBF generally, and separately among the RL or RO grafted defects, by linear generalized estimating equation modeling. Receiver operation characteristic analysis was performed to check the accuracy of HU/CT and GV/CBCT in diagnosing more than 10% NBF in the samples.

Results

There were linear correlations between HU/CT and GV/CBCT, HU/CT and NBF, and GV/CBCT and NBF.

Conclusion

According to the results, both HU/CT and GV/CBCT can be considered as fairly good predictors for assessment of the amount of NBF following bone reconstruction surgeries.

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Hemothorax due to Ruptured Mycotic Aneurysm of Intercostal Arteries Associated with Infective Endocarditis

We present a case of hemothorax due to ruptured mycotic aneurysm in three intercostal arteries in a 40-year-old male with methicillin-resistant Staphylococcus aureus infective endocarditis (IE) due to intravenous drug use. Microcoil embolization and thoracotomy successfully achieved hemostasis. Mycotic aneurysm is a rare complication of IE and is usually found in the intracranial vessels. Ruptured mycotic aneurysm in the intercostal arteries can be associated with IE and can present as acute hemothorax.

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CTNNB1 -mutated melanocytic lesions with DPN like features: a distinct subtype of melanocytic tumors? A report of two cases

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Liver volume as a predictor of functional improvement post DAA treatment

Background New direct antiviral agents (DAA) for HCV treatment result in sustained viral response (SVR) in most patients. However, predicting the point of no-return is still an unmet need for those with advanced liver disease. Aim to assess if baseline liver volume is a predictor of post-SVR liver function. Methods Cirrhotic patients assessed for liver transplantation (LT) and consecutively treated with DAA between September 2014 and 2015 who achieved an SVR were included. Pretreatment liver (LV) and spleen (SV) volumes adjusted by Body Surface Area (BSA) were calculated from CT/MR images. Liver function was assessed by Child-Turcotte-Pugh (CTP) and MELD scores and a multivariate mixed regression model was used to identify baseline factors associated with improvement of liver function overtime. Results We included 42 patients with a median age of 58.6 years (Q1-Q3: 52.7 - 68.8); MELD, 14 (11-17); CTP, 9 (8-10); LV, 1400.9 mL (1183.2-1601.4); SV, 782.9 mL (490.6-1118.8). MELD scores at baseline and at last control were 14 (11-17) and 10 (8-12), respectively (p

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Brain Integrity Changes underlying Cognitive and Functional Recovery Postliver Transplant Continue to Evolve Over 1 Year

Abstract: Background There is evidence of brain recovery on brain MRI early postliver transplant(LT) but the longer-term impact is unclear. Aim of this study was to determine the change in brain MRI parameters, cognition and health-related quality of life (HRQOL) between 6 and 12 months post-LT. Methods Listed cirrhotics underwent cognitive, HRQOL and brain MRI pre, 6 months (post-LT1) and 1-year (post-LT2) post-LT. Assessment of MRI changes between visits was performed for ammonia-associated metabolite changes using spectroscopy (MRS), white matter changes using Tract-based Spatial Statistics (TBSS) analysis on Diffusion Tensor Imaging (DTI) data and grey matter changes using Voxel-based morphometry (VBM) analysis on 3D high resolution T1-weighted images. Results Forty-five patients were included of which, twenty-three were tested at all visits. Cognitive and HRQOL scores improved between all visits compared to pre-LT values. This trend continued on MRS with reduced glutamine+glutamate(Glx) and higher myoinositol(mI), Choline(Cho) between pre-LT/post-LT1 but lower degrees of improvement between post-LT1/post-LT2. On DTI, mean-diffusivity(MD), linear-diffusivity(LD) and mode of anisotropy(MO) continued to increase in the posterior internal capsule at both post-LT visits. On VBM, a continued increase was seen in basal ganglia grey matter between both post-LT visits was seen. Conclusions HRQOL and cognition continue to improve compared to pre-LT values up to 1 year post-LT, although the rate of improvement slows down after 6 months. Grey matter increase is steady over time at 1 year although changes in ammonia-related metabolites and white matter integrity improve at a slower pace at 1 year post-LT. Corresponding Author: Jasmohan S Bajaj, MD, MS, Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, VA, 23221, USA, Phone: (804) 675-5802, Fax: (804) 675 5816. Email: jasmohan.bajaj@vcuhealth.org Author contributions: JSB, VA, JS, FGM, JBW were involved in research design, performance of the research and data analysis, MBW, HSG, DMH, MF, EAG, AF, RKS, RTS, PP, AJS, MSS, SM, VL were involved in performance of the research, LRT was involved in data analysis, All authors participated in the writing of the paper. Funding: Partly supported by NIH RO1DK089713 and VA Merit Review 1I0CX001076 to JSB Disclosure: The authors declare no conflicts of interest Presentation: Portions of this study were presented as an oral presentation at the EASL conference in Amsterdam 2017. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Dermatological and environmental toxicological impact of the sunscreen ingredient oxybenzone/benzophenone-3

Summary

Oxybenzone (Benzophenone-3) is an emerging human and environmental contaminant used in sunscreens and personal care products to help minimize the damaging effects of ultraviolet radiation. The Center for Disease Control fourth national report on human exposure to environmental chemicals demonstrated that approximately 97% of the people tested have oxybenzone present in their urine, and independent scientists have reported various concentrations in waterways and fish worldwide. Oxybenzone can also react with chlorine, producing hazardous by-products that can concentrate in swimming pools and wastewater treatment plants. Moreover, adverse reactions could very well be increased by the closed loop of ingesting fish contaminated with oxybenzone and/or washing the ingredient off our bodies and having it return in drinking water as treatment plants do not effectively remove the chemical as part of their processing protocols. In humans, oxybenzone has been reported to produce contact and photocontact allergy reactions, implemented as a possible endocrine disruptor and has been linked to Hirschsprung's disease. Environmentally, oxybenzone has been shown to produce a variety of toxic reactions in coral and fish ranging from reef bleaching to mortality. Lastly, with the rise in skin cancer rates and the availability of more effective sunscreen actives such as micronized zinc oxide and titanium dioxide, serious doubts about the relative prevention benefit of personal care products containing oxybenzone must be raised and compared with the potential negative health and environmental effects caused by the accumulation of this and other chemicals in the ecosystem.

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