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Matsumoto S, Wakatsuki K, Nakade H, Kunishige T, Miyao S, Aoki S, Tsujimoto A, Tatsumi T, Soga M, Sho M. Association of perioperative oral swallowing function with post-esophagectomy outcomes and nutritional statuses in patients with esophageal cancer. Dis Esophagus 2024:doae032. [PMID: 38661378 DOI: 10.1093/dote/doae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/13/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
Dysphagia after esophagectomy is a serious complication; however, no method has been established to accurately assess swallowing function. We evaluated the association of swallowing function tests with patients' post-esophagectomy complications and nutritional statuses. We retrospectively reviewed the data of 95 patients with esophageal cancer who underwent esophagectomy between 2016 and 2021. We performed perioperative swallowing function tests, including the repetitive saliva swallowing test (RSST), maximum phonation time (MPT), and laryngeal elevation (LE). Patients with recurrent laryngeal nerve palsy (RLNP) and respiratory complications (RC) had significantly lower postoperative RSST scores than patients without them; the scores in patients with or without anastomotic leakage (AL) were similar. Postoperative MPT in patients with RLNP was shorter than that in patients without RLNP; however, it was similar to that in patients with or without AL and RC. LE was not associated with any complications. Patients with an RSST score ≤2 at 2 weeks post-esophagectomy had significant weight loss at 1, 6, and 12 months postoperatively compared with patients with an RSST score ≥3. The proportion of patients with severe weight loss (≥20% weight loss) within 1 year of esophagectomy was significantly greater in patients with RSST scores ≤2 than in those with RSST scores ≥3. Multivariate analysis showed that an RSST score ≤2 was the only predictor of severe post-esophagectomy weight loss. RSST scoring is a simple tool for evaluating post-esophagectomy swallowing function. A lower RSST score is associated with postoperative RLNP, RC, and poor nutritional status.
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Affiliation(s)
- Sohei Matsumoto
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Tomohiro Kunishige
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Shintaro Miyao
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Satoko Aoki
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Akinori Tsujimoto
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Takanari Tatsumi
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Masahiro Soga
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
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Migita K, Matsumoto S, Wakatsuki K, Kunishige T, Nakade H, Miyao S, Sho M. Effect of Oral Nutritional Supplementation on the Prognostic Nutritional Index in Gastric Cancer Patients. Nutr Cancer 2020; 73:2420-2427. [PMID: 32996343 DOI: 10.1080/01635581.2020.1826990] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This prospective study was undertaken to investigate whether preoperative oral nutritional supplementation (ONS) would increase the prognostic nutritional index (PNI) in gastric cancer patients undergoing gastrectomy. Before surgery for resectable gastric cancer, Racol® NF (Otsuka Pharmaceutical Factory, Japan) was administered orally at a recommended dose of 600 kcal/600 ml per day to patients with a PNI of <48. The primary endpoint was the change in the PNI, which was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm3). Forty-six patients received Racol® NF. The mean PNI at baseline and before surgery was 44 ± 3.9 and 43 ± 4.4, respectively (p = 0.049). The mean serum albumin level was significantly decreased after the administration of Racol® NF (p = 0.001), while the mean total lymphocyte count (p = 0.001) and body weight (p = 0.004) were significantly increased. The mean daily intake and duration of Racol® NF administration were 340 ml and 22.6 day, respectively. Adverse events during the administration of Racol® NF were observed in 12 (26.1%) patients. The present study indicated that preoperative ONS did not increase the PNI in gastric cancer patients with low PNI values.
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Affiliation(s)
- Kazuhiro Migita
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | | | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Shintaro Miyao
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
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Wakatsuki K, Matsumoto S, Migita K, Kunishige T, Nakade H, Miyao S, Sho M. Risk Factors and Risk Scores for Predicting Early Recurrence After Curative Gastrectomy in Patients with Stage III Gastric Cancer. J Gastrointest Surg 2020; 24:1758-1769. [PMID: 31325135 DOI: 10.1007/s11605-019-04327-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/08/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND We revealed patients with pathological stage (pStage) III gastric cancer (GC) who had early recurrence within 12 months after curative surgery. We identified risk factors for predicting early recurrence in patients with pStage III GC who underwent curative gastrectomy. METHODS Between January 2007 and December 2016, 758 patients underwent gastrectomy in our institution. This retrospective study included 96 patients with pStage III who were divided into two groups: early recurrence within 12 months (ERec) and non-ERec (nERec). We investigated clinicopathological differences between ERec and nERec and extracted risk factors, and constructed risk scores for ERec. RESULTS Of the 96 patients, 20 (20.8%) were ERec and 76 (79.2%) were nERec. Pathological lymph node metastasis (pN) ≥ 14 (P = 0.03), preoperative carbohydrate antigen 19-9 (CA19-9) ≥ 37 IU/ml (P = 0.02), and blood loss (BL) ≥ 445 ml (P < 0.01) were independent risk factors for ERec in the multivariate analysis. In subgroup analysis, tumor size, clinical lymph node metastasis (cN), and CA19-9 were extracted for preoperative predictors for ERec. Risk scores were assigned to tumor size (< 65 mm, 0; ≥ 65 mm, 1), cN (cN-, 0; cN+, 2), and CA19-9 (< 37 IU/ml, 0; ≥ 37 IU/ml, 2). High-risk group (score, 4, 5) for ERec had significantly shorter relapse-free survival than those with low-risk group (score, 0-3) (P = 0.02). CONCLUSIONS We found pN ≥ 14, CA19-9 ≥ 37 IU/ml, and BL ≥ 445 ml were independent risk factors for ERec after curative gastrectomy in pStage III GC. Our risk score system may be useful to select patients with high risk of ERec preoperatively.
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Affiliation(s)
- Kohei Wakatsuki
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kazuhiro Migita
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Tomohiro Kunishige
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Shintaro Miyao
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
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Kunishige T, Migita K, Matsumoto S, Wakatsuki K, Nakade H, Miyao S, Kuniyasu H, Sho M. Ring box protein-1 is associated with a poor prognosis and tumor progression in esophageal cancer. Oncol Lett 2020; 20:2919-2927. [PMID: 32782608 PMCID: PMC7400995 DOI: 10.3892/ol.2020.11840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 05/28/2020] [Indexed: 12/24/2022] Open
Abstract
Ring box protein-1 (RBX1) is an essential component of the S-phase kinase-associated protein, Cullin and F-box containing ubiquitin ligases. Overexpression of RBX1 has been reported in several cancer types; however, little is known regarding the prognostic value and role of RBX1 in esophageal cancer. The present study examined 120 patients with esophageal cancer (EC) who underwent curative esophagectomy and 61 patients with EC who underwent neoadjuvant combination chemotherapy with docetaxel, cisplatin and 5-fluorouracil (5-FU; DCF) using immunohistochemistry. All specimens were classified into two groups according to the percentage of RBX1-positive tumor cells. In addition, the impact of RBX1 expression on cancer cell proliferation was analyzed in vitro using a small interfering RNA silencing technique. RBX1 expression levels showed significant differences according to tumor size (P<0.001), tumor depth (P=0.002), lymph node metastasis (P=0.004), pathological stage (P=0.001), lymphatic invasion (P=0.001) and venous invasion (P=0.001). The overall survival (OS) rate in the RBX1 high expression group was significantly lower compared with that in the low group (P=0.004). Multivariate analysis demonstrated that RBX1 status was an independent prognostic factor. RBX1 gene silencing inhibited the proliferation of human EC cells and enhanced the antitumor effect of 5-FU. Among patients who underwent neoadjuvant DCF therapy, the RBX1 high expression group had a significantly lower OS rate compared with that of the RBX1-low group (P<0.001). In conclusion, RBX1 has notable prognostic value, and RBX1 may serve an important function in the tumor progression of EC.
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Affiliation(s)
- Tomohiro Kunishige
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Kazuhiro Migita
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Shintaro Miyao
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Hiroki Kuniyasu
- Department of Molecular Pathology, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
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Migita K, Matsumoto S, Wakatsuki K, Kunishige T, Nakade H, Miyao S, Sho M. RNF126 as a Marker of Prognosis and Proliferation of Gastric Cancer. Anticancer Res 2020; 40:1367-1374. [PMID: 32132033 DOI: 10.21873/anticanres.14078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 01/25/2020] [Accepted: 01/28/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Ring finger protein 126 (RNF126) belongs to the family of RING E3 ubiquitin ligases. Although RNF126 has been reported to be overexpressed in several cancers, the role of RNF126 in gastric cancer remains unclear. MATERIALS AND METHODS We investigated the RNF126 expression in 170 primary gastric cancer tissues by immunohistochemistry, and explored its prognostic impact. The effect of the RNF126 expression on the proliferation of cancer cells was evaluated in vitro. RESULTS The RNF126 expression was significantly associated with tumor depth and presence of venous invasion. The RNF126 status was identified as an independent prognostic factor (p<0.001). RNF126 gene silencing significantly inhibited the proliferation of gastric cancer cells, induced G1 phase arrest and increased the p21 protein level. CONCLUSION RNF126 expression has a significant prognostic value in gastric cancer. RNF126 may play an important role in tumor progression of gastric cancer.
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Affiliation(s)
| | | | | | | | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, Nara, Japan
| | - Shintaro Miyao
- Department of Surgery, Nara Medical University, Nara, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Nara, Japan
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Kunishige T, Migita K, Matsumoto S, Wakatsuki K, Nakade H, Miyao S, Sho M. Risk factors for stage underestimation in patients with clinical T1N0 gastric cancer. Surg Today 2020; 50:1074-1080. [PMID: 32107643 DOI: 10.1007/s00595-020-01984-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/14/2020] [Indexed: 01/13/2023]
Abstract
PURPOSE Limited gastrectomy has been generally performed in clinical T1N0 gastric cancer. The aim of this study was to identify risk factors for stage underestimation in clinical T1N0 gastric cancer. METHODS This study reviewed the medical records of 566 patients who underwent gastrectomy for clinical T1N0 gastric cancer. RESULTS The tumor stage was underestimated in 122 (21.6%) patients. The relapse-free survival rate was significantly lower in the patients with pathological stage II (P = 0.021) and III (P < 0.001) disease than in those with pathological stage IA disease. In the multivariate analysis, a location in the upper third of the stomach, tumor size of ≥ 30 mm, undifferentiated adenocarcinoma and clinical tumor depth of SM were identified as independent risk factors for pathological stages II and III. The rate of pathological stages II and III was 0% in the patients with no risk factors, 3% in those with 1 risk factor, 10.5% in those with 2 risk factors, 19.8% in those with 3 risk factors and 50% in those with 4 risk factors. CONCLUSIONS Location, tumor size, undifferentiated adenocarcinoma and clinical tumor depth were independent risk factors for pathological stages II and III in clinical T1N0 gastric cancer.
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Affiliation(s)
- Tomohiro Kunishige
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
| | - Kazuhiro Migita
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Shintaro Miyao
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
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Nakade H, Migita K, Matsumoto S, Wakatsuki K, Kunishige T, Miyao S, Sho M. Overexpression of Cullin4A correlates with a poor prognosis and tumor progression in esophageal squamous cell carcinoma. Int J Clin Oncol 2019; 25:446-455. [PMID: 31535245 DOI: 10.1007/s10147-019-01547-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/10/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cullin4A (CUL4A), which is a component of E3 ubiquitin ligase, is implicated in many cellular events. Although the altered expression of CUL4A has been reported in several human cancers, the role of CUL4A in esophageal cancer remains unknown. METHODS We investigated the CUL4A expression in primary esophageal squamous cell carcinoma (ESCC) tissue specimens from 120 patients by immunohistochemistry and explored its clinical relevance and prognostic value. Furthermore, the effect of the expression of CUL4A on cancer cell proliferation was analyzed in vitro using an siRNA silencing technique. RESULTS The higher expression of CUL4A was significantly associated with a deeper depth of tumor invasion (P < 0.001) and the presence of venous invasion (P = 0.014). The disease-specific survival (DSS) rate in patients with tumors that showed high CUL4A expression levels was significantly lower than that in patients whose tumors showed low CUL4A expression levels (P = 0.001). Importantly, the CUL4A status was identified as an independent prognostic factor for DSS (P = 0.045). Our results suggested that the CUL4A expression has significant prognostic value in ESCC. Furthermore, CUL4A gene silencing significantly inhibited the proliferation of ESCC cells in vitro. In addition, the knockdown of the CUL4A expression induced G1 phase arrest and increased the p21 and p27 protein levels. CONCLUSIONS CUL4A might play an important role in regulating the proliferation of ESCC cells and promoting the development of postoperative recurrence.
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Affiliation(s)
- Hiroshi Nakade
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan.
| | - Kazuhiro Migita
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
| | - Tomohiro Kunishige
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
| | - Shintaro Miyao
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan
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Migita K, Matsumoto S, Wakatsuki K, Kunishige T, Nakade H, Miyao S, Sho M. Postoperative Serum C-Reactive Protein Level Predicts Long-term Outcomes in Stage I Gastric Cancer. J Surg Res 2019; 242:323-331. [PMID: 31129241 DOI: 10.1016/j.jss.2019.04.075] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/16/2019] [Accepted: 04/25/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The aim of this study was to investigate the prognostic impact of postoperative systemic inflammation in patients with stage I gastric cancer. METHODS This study reviewed the medical records of 470 patients with stage I gastric cancer who underwent gastrectomy. The postoperative serum C-reactive protein (CRP) level on postoperative days (PODs) 1 and 3 and its peak value were evaluated as prognostic factors. A receiver operating characteristics curve analysis was performed to determine their cut-off values. RESULTS The CRP level on POD 3 (P = 0.001) and the peak CRP level (P = 0.007) were significantly associated with the overall survival rate. In the multivariate analysis, the CRP level on POD 3 (P = 0.002) and the peak CRP level (P = 0.008) were identified as independent predictors of the overall survival. The high CRP on POD3 group had significantly higher mortality rate from relapse of gastric cancer (P = 0.001) and infectious disease (P = 0.003) than the low CRP on POD 3 group. The CRP level on POD 3 was significantly associated with the patient sex, surgical procedure, duration of the operation, amount of blood loss, postoperative infectious complication, and peak CRP level. CONCLUSIONS The serum CRP level during the early postoperative period predicts the long-term outcomes in stage I gastric cancer. The present study suggests a significant influence of postoperative systemic inflammation on the survival of patients with stage I gastric cancer.
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Affiliation(s)
- Kazuhiro Migita
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan.
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | | | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Shintaro Miyao
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
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Wakatsuki K, Matsumoto S, Migita K, Kunishige T, Nakade H, Miyao S, Sho M. Prognostic value of the fibrinogen-to-platelet ratio as an inflammatory and coagulative index in patients with gastric cancer. Surg Today 2018; 49:334-342. [PMID: 30411155 DOI: 10.1007/s00595-018-1734-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/22/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE We assessed the prognostic value of the fibrinogen-to-platelet ratio (FPR) as an inflammatory and coagulative index by examining its clinicopathologic and prognostic efficiency in patients with gastric cancer (GC). METHODS The subjects of this retrospective study were 182 GC patients whose FPR was measured preoperatively between January, 2001 and December, 2006. The FPR was defined as the plasma fibrinogen divided by the platelet counts. RESULTS Patients aged ≥ 65 years and with venous invasion had a significantly higher FPR (p = 0.02 and p < 0.01, respectively) than those aged < 65 years and without venous invasion. We found a correlation between the FPR and all recurrences (p < 0.01). Patients with a low FPR had significantly better overall survival (OS) and relapse-free survival (RFS) rates than patients with a high FPR (p = 0.001 for both). Furthermore, the FPR was an independent predictor of OS and RFS (p = 0.02 and 0.001, respectively), but the fibrinogen level was not. In a subgroup analysis, the FPR was a significant prognostic factor for OS and RFS in patients with pathological stages II/III disease and in patients aged < 65 years. CONCLUSION The FPR can be calculated easily and is more useful than the fibrinogen level for predicting the prognosis of GC patients. Patients with a high FPR, particularly those with undifferentiated tumors, those with pStage II/III disease, and those aged < 65 years, require more intensive chemotherapy.
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Affiliation(s)
- Kohei Wakatsuki
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kazuhiro Migita
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Tomohiro Kunishige
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Shintaro Miyao
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
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Migita K, Matsumoto S, Wakatsuki K, Ito M, Kunishige T, Nakade H, Sho M. The Prognostic Significance of the Geriatric Nutritional Risk Index in Patients with Esophageal Squamous Cell Carcinoma. Nutr Cancer 2018; 70:1237-1245. [PMID: 30235009 DOI: 10.1080/01635581.2018.1512640] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The aim of this study was to investigate the impact of the geriatric nutritional risk index (GNRI) on the long-term outcomes in 137 esophageal squamous cell carcinoma (ESCC) patients who underwent curative esophagectomy. The GNRI was calculated from the serum albumin value and the body weight. The cutoff value of the GNRI was set at 98. A multivariate analysis was performed to identify prognostic factors for the overall survival (OS). The mean preoperative GNRI was 99.9 ± 7.8. Forty-five (32.8%) patients had a GNRI of <98. The GNRI was significantly associated with the tumor depth (p = 0.001), level of carcinoembryonic antigen (CEA; p = 0.009) and level of C-reactive protein (CRP; p = 0.028). The GRNI was significantly associated with the OS (p < 0.001). The multivariate analysis identified the GNRI as an independent predictor for the OS. Death due to EC was more frequent in the patients with a low GNRI than in the patients with a high GNRI (p = 0.004). Our results suggest that the GRNI is a simple and reliable predictor of the postoperative survival in ESCC patients. A low preoperative GNRI may indicate a higher risk of EC death.
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Affiliation(s)
- Kazuhiro Migita
- a Department of Surgery , Nara Medical University , Kashihara , Japan
| | - Sohei Matsumoto
- a Department of Surgery , Nara Medical University , Kashihara , Japan
| | - Kohei Wakatsuki
- a Department of Surgery , Nara Medical University , Kashihara , Japan
| | - Masahiro Ito
- a Department of Surgery , Nara Medical University , Kashihara , Japan
| | | | - Hiroshi Nakade
- a Department of Surgery , Nara Medical University , Kashihara , Japan
| | - Masayuki Sho
- a Department of Surgery , Nara Medical University , Kashihara , Japan
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Doi S, Matsumoto S, Wakatsuki K, Migita K, Ito M, Kunishige T, Nakade H, Hatakeyama K, Ohbayashi C, Sho M. A neuroendocrine carcinoma with a well-differentiated adenocarcinoma component arising in Barrett's esophagus: a case report and literature review. Surg Case Rep 2018; 4:103. [PMID: 30159830 PMCID: PMC6115318 DOI: 10.1186/s40792-018-0511-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 08/19/2018] [Indexed: 12/19/2022] Open
Abstract
Background An esophageal neuroendocrine carcinoma arising in Barrett’s esophagus is extremely rare. Here, we report a case of an esophageal neuroendocrine carcinoma with a well-differentiated adenocarcinoma component arising in Barrett’s esophagus and review the literature. Case presentation A 71-year-old man with no symptoms was admitted to our hospital because of the detection of an esophagogastric junction tumor on regular upper endoscopy screening. Endoscopy revealed a sliding hiatal hernia and an approximately 10 mm elevated mass at the esophagogastric junction. Biopsy showed a moderately differentiated tubular adenocarcinoma. Computed tomography did not indicate lymph node metastasis or distant metastasis. Proximal gastrectomy with D1 lymph node dissection was performed along with jejunal interposition. On immunohistochemical staining, the tumor was positive for chromogranin A and synaptophysin. Ki-67 was positive in 40% of the tumor cells. The histological diagnosis was a neuroendocrine carcinoma with a well-differentiated adenocarcinoma component arising in Barrett’s esophagus. The postoperative course was good, and the patient was discharged on the twentieth postoperative day. He has remained free of the disease at 36 months postoperatively. Conclusions Barrett’s esophagus may be related to the development of a neuroendocrine carcinoma.
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Affiliation(s)
- Shunsuke Doi
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kazuhiro Migita
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Masahiro Ito
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Tomohiro Kunishige
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kinta Hatakeyama
- Department of Diagnostic Pathology, Nara Medical University, 840 Shijo-cho,, Kashihara, Nara, 634-8522, Japan
| | - Chiho Ohbayashi
- Department of Diagnostic Pathology, Nara Medical University, 840 Shijo-cho,, Kashihara, Nara, 634-8522, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
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Matsumoto S, Wakatsuki K, Migita K, Ito M, Nakade H, Kunishige T, Kitano M, Nakatani M, Sho M. Predictive Factors for Delayed Gastric Emptying after Distal Gastrectomy with Roux-en-Y Reconstruction. Am Surg 2018; 84:1086-1090. [PMID: 29981653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Delayed gastric emptying (DGE) after distal gastrectomy (DG) followed by Roux-en-Y (R-Y) reconstruction is one of the most worrisome complications, and the course of DGE has not been completely elucidated. This retrospective study aimed to evaluate the frequency of DGE after DG followed by R-Y reconstruction for gastric cancer and identify the risk factors for its development. This study included 266 patients with gastric cancer who underwent DG followed by R-Y reconstruction between 2005 and 2016. We compared clinicopathological characteristics and surgical procedures between the DGE group and non-DGE group. DGE occurred in 24 of the 266 patients. There were no relationships of gender, age, TNM stage, historical grade, surgical approach, extent of lymphadenectomy, preservation of the vagal nerve, and reconstruction route with DGE development. Body mass index (BMI) was higher in DGE patients than in non-DGE patients (P = 0.053). Univariate analysis revealed that a tumor located in the lower third of the stomach (P = 0.005) and isoperistaltic reconstruction (P = 0.043) were significant factors for DGE. Multivariate analysis showed that a tumor located in the lower third of the stomach (P = 0.007), isoperistaltic reconstruction (P = 0.044), and BMI (P = 0.034) were significant predictors of DGE. Our findings suggest that tumor location, the direction of peristalsis for gastrojejunostomy, and BMI are associated with DGE after R-Y reconstruction.
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13
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Matsumoto S, Wakatsuki K, Migita K, Ito M, Nakade H, Kunishige T, Kitano M, Nakatani M, Sho M. Predictive Factors for Delayed Gastric Emptying after Distal Gastrectomy with Roux-en-Y Reconstruction. Am Surg 2018. [DOI: 10.1177/000313481808400670] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Delayed gastric emptying (DGE) after distal gastrectomy (DG) followed by Roux-en-Y (R-Y) reconstruction is one of the most worrisome complications, and the course of DGE has not been completely elucidated. This retrospective study aimed to evaluate the frequency of DGE after DG followed by R-Y reconstruction for gastric cancer and identify the risk factors for its development. This study included 266 patients with gastric cancer who underwent DG followed by R-Y reconstruction between 2005 and 2016. We compared clinicopathological characteristics and surgical procedures between the DGE group and non-DGE group. DGE occurred in 24 of the 266 patients. There were no relationships of gender, age, TNM stage, historical grade, surgical approach, extent of lymphadenectomy, preservation of the vagal nerve, and reconstruction route with DGE development. Body mass index (BMI) was higher in DGE patients than in non-DGE patients (P = 0.053). Univariate analysis revealed that a tumor located in the lower third of the stomach (P = 0.005) and isoperistaltic reconstruction (P = 0.043) were significant factors for DGE. Multivariate analysis showed that a tumor located in the lower third of the stomach (P = 0.007), isoperistaltic reconstruction (P = 0.044), and BMI (P = 0.034) were significant predictors of DGE. Our findings suggest that tumor location, the direction of peristalsis for gastrojejunostomy, and BMI are associated with DGE after R-Y reconstruction.
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Affiliation(s)
- Sohei Matsumoto
- From the Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Kohei Wakatsuki
- From the Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Kazuhiro Migita
- From the Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Masahiro Ito
- From the Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Hiroshi Nakade
- From the Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Tomohiro Kunishige
- From the Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Mutsuko Kitano
- From the Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Mitsuhiro Nakatani
- From the Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
| | - Masayuki Sho
- From the Department of Surgery, Nara Medical University School of Medicine, Nara, Japan
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14
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Nakatani M, Migita K, Matsumoto S, Wakatsuki K, Ito M, Nakade H, Kunishige T, Kitano M, Sho M. Prognostic Significance of the Prognostic Nutritional Index in Patients with Recurrent Esophageal Squamous Cell Carcinoma. Nutr Cancer 2018. [DOI: 10.1080/01635581.2018.1445771] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | - Kazuhiro Migita
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Masahiro Ito
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | | | - Mutsuko Kitano
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Kashihara, Nara, Japan
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15
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Migita K, Matsumoto S, Wakatsuki K, Ito M, Kunishige T, Nakade H, Kitano M, Nakatani M, Sho M. The prognostic significance of inflammation-based markers in patients with recurrent gastric cancer. Surg Today 2017; 48:282-291. [PMID: 28836056 DOI: 10.1007/s00595-017-1582-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 08/06/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim of this study was to evaluate the prognostic impact of inflammation-based markers, including the neutrophil-to-lymphocyte ratio (NLR) and prognostic nutritional index (PNI), in patients with recurrent gastric cancer (RGC). METHODS This study reviewed 167 patients with RGC. A receiver operating characteristics (ROC) curve analysis was performed to determine the NLR and PNI cutoff values. The prognostic significance of the NLR and PNI was evaluated by a multivariate analysis. RESULTS The optimal NLR and PNI cutoff values for predicting the 1-year survival after recurrence were 2.2 and 47, respectively. A univariate analysis revealed that the NLR (p < 0.001) and PNI (p < 0.001) were significantly associated with the survival time after recurrence, along with the histology, peritoneal recurrence, carbohydrate antigen 19-9, and chemotherapy for recurrence. In the multivariate analysis, a higher NLR (p < 0.001) and a lower PNI (p = 0.002) were independent predictors of a shorter survival time. Among the patients who underwent chemotherapy, the NLR and PNI were also independent prognostic factors. CONCLUSIONS Inflammation-based markers, including the NLR and PNI, are simple and useful clinical biomarkers that can be used to predict the survival time of patients with RGC.
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Affiliation(s)
- Kazuhiro Migita
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Masahiro Ito
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Tomohiro Kunishige
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Mutsuko Kitano
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Mitsuhiro Nakatani
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
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Nakatani M, Migita K, Matsumoto S, Wakatsuki K, Ito M, Nakade H, Kunishige T, Kitano M, Kanehiro H. Prognostic significance of the prognostic nutritional index in esophageal cancer patients undergoing neoadjuvant chemotherapy. Dis Esophagus 2017; 30:1-7. [PMID: 28575242 DOI: 10.1093/dote/dox020] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 03/06/2017] [Indexed: 12/11/2022]
Abstract
Nutritional status is one of the most important issues faced by cancer patients. Several studies have shown that a low preoperative nutritional status is associated with a worse prognosis in patients with various types of cancer, including esophageal cancer (EC). Recently, neoadjuvant chemotherapy (NAC) and/or radiotherapy have been accepted as the standard treatment for resectable advanced EC. However, NAC has the potential to deteriorate the nutritional status of a patient. This study aimed to evaluate the prognostic significance of the nutritional status for EC patients who underwent NAC. We retrospectively reviewed 66 squamous cell EC patients who underwent NAC consisting of docetaxel, cisplatin, and 5-fluorouracil followed by subtotal esophagectomy at Nara Medical University Hospital between January 2009 and August 2015. To assess the patients' nutritional status, the prognostic nutritional index (PNI) before commencing NAC and prior to the operation was calculated as 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count in the peripheral blood (per mm3). The cutoff value of the PNI was set at 45. A multivariable analysis was performed to identify prognostic factors for overall survival (OS) and relapse-free survival (RFS). The mean pre-NAC and preoperative PNI were 50.2 ± 5.7 and 48.1 ± 4.7, respectively (P = 0.005). The PNI decreased following NAC in 44 (66.7%) patients. Before initiating NAC, 9 (13.6%) patients had a low PNI, and 12 (18.2%) patients had a low PNI prior to the operation. The pre-NAC PNI and preoperative PNI were significantly associated with the OS (P = 0.013 and P = 0.004, respectively) and RFS (P = 0.036 and P = 0.005, respectively) rates. The multivariable analysis identified the preoperative PNI as an independent prognostic factor for poor OS and RFS, although the pre-NAC PNI was not an independent predictor. Our results suggest that the preoperative PNI is a useful marker for predicting the long-term outcomes of EC patients undergoing NAC and subsequent subtotal esophagectomy. Therefore, patients with a low preoperative nutritional status may be at a higher risk of EC recurrence.
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Affiliation(s)
- M Nakatani
- Department of Surgery, Nara Medical University, Nara, Japan
| | - K Migita
- Department of Surgery, Nara Medical University, Nara, Japan
| | - S Matsumoto
- Department of Surgery, Nara Medical University, Nara, Japan
| | - K Wakatsuki
- Department of Surgery, Nara Medical University, Nara, Japan
| | - M Ito
- Department of Surgery, Nara Medical University, Nara, Japan
| | - H Nakade
- Department of Surgery, Nara Medical University, Nara, Japan
| | - T Kunishige
- Department of Surgery, Nara Medical University, Nara, Japan
| | - M Kitano
- Department of Surgery, Nara Medical University, Nara, Japan
| | - H Kanehiro
- Department of Surgery, Nara Medical University, Nara, Japan
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Ito M, Migita K, Matsumoto S, Wakatsuki K, Tanaka T, Kunishige T, Nakade H, Nakatani M, Nakajima Y. Overexpression of E3 ubiquitin ligase tripartite motif 32 correlates with a poor prognosis in patients with gastric cancer. Oncol Lett 2017; 13:3131-3138. [PMID: 28521418 DOI: 10.3892/ol.2017.5806] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 01/06/2017] [Indexed: 12/24/2022] Open
Abstract
Tripartite motif protein (TRIM) 32 belongs to the TRIM family, which is composed of RING finger, B-box and coiled-coil domains. TRIM32 has been reported to function as an enzyme 3 ubiquitin ligase and is overexpressed in numerous types of cancer. The present study evaluated the clinical significance of TRIM32 expression levels in gastric cancer. The current study also investigated the TRIM32 expression levels in 142 patients with gastric cancer using immunohistochemistry and examined its clinical importance and potential as a prognostic marker. Furthermore, the function of TRIM32 was examined in vitro. High TRIM32 expression levels were detected in gastric cancer tissues. The postoperative overall and relapse-free survival rates were significantly reduced in patients with tumors with high levels of TRIM32 expression compared with those with tumors expressing low levels of TRIM32. Tumors expressing high levels of TRIM32 were associated with an increased risk of postoperative recurrence, particularly hematogenous recurrence. Multivariate analysis identified TRIM32 status as an independent prognostic factor. Furthermore, TRIM32 gene silencing induced apoptosis and inhibited the proliferation of gastric cancer cells in vitro. Therefore, TRIM32 expression levels may be of potential prognostic value in gastric cancer.
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Affiliation(s)
- Masahiro Ito
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Kazuhiro Migita
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Tetsuya Tanaka
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Tomohiro Kunishige
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Mitsuhiro Nakatani
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Yoshiyuki Nakajima
- Department of Surgery, Nara Medical University, Kashihara, Nara 634-8522, Japan
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18
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Migita K, Matsumoto S, Wakatsuki K, Ito M, Kunishige T, Nakade H, Kitano M, Nakatani M, Kanehiro H. A decrease in the prognostic nutritional index is associated with a worse long-term outcome in gastric cancer patients undergoing neoadjuvant chemotherapy. Surg Today 2017; 47:1018-1026. [PMID: 28251372 DOI: 10.1007/s00595-017-1469-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/25/2016] [Indexed: 12/26/2022]
Abstract
PURPOSE The aim of this study was to evaluate the prognostic impact of the prognostic nutritional index (PNI) in gastric cancer patients undergoing neoadjuvant chemotherapy (NAC). METHODS This study reviewed 54 patients with gastric cancer who underwent NAC and a subsequent R0 gastrectomy. The PNI before starting NAC and before gastrectomy were calculated using the following formula: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm3). A multivariate analysis was performed to identify the predictors of overall survival (OS). RESULTS The mean pre-NAC and preoperative PNI were 48.3 ± 5.1 and 48.2 ± 4.7, respectively (p = 0.934). The PNI decreased after NAC in 31 patients (57.4%). The pre-NAC PNI and preoperative PNI were not significantly associated with the OS rate. The 3-year OS rate in patients with the decreased PNI values was significantly lower than that in the patients whose PNI values were either maintained or increased (41 vs. 76.4%, p = 0.003). A multivariate analysis revealed that a decreased PNI value was an independent predictor of a poor OS (p = 0.006). CONCLUSIONS Decreased PNI values were associated with worse long-term outcomes in gastric cancer patients undergoing NAC.
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Affiliation(s)
- Kazuhiro Migita
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Masahiro Ito
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Tomohiro Kunishige
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Mutsuko Kitano
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Mitsuhiro Nakatani
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Hiromichi Kanehiro
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
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Migita K, Matsumoto S, Wakatsuki K, Ito M, Kunishige T, Nakade H, Nakatani M, Kitano M, Nakajima Y. The anatomical location of the pancreas is associated with the incidence of pancreatic fistula after laparoscopic gastrectomy. Surg Endosc 2016; 30:5481-5489. [PMID: 27126620 DOI: 10.1007/s00464-016-4909-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 04/02/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Postoperative pancreatic fistula (POPF) is one of the major complications after laparoscopic gastrectomy (LG). We investigated the impact of the anatomical location of the pancreas, especially in relation to the suprapancreatic lymph nodes, on the incidence of POPF after LG. METHODS We retrospectively reviewed the preoperative computed tomography (CT) images of 246 patients who underwent LG with the suprapancreatic lymph node dissection between November 2008 and November 2015. The length between the levels of the pancreatic body surface and the root of the common hepatic artery (LPC) was measured on a CT image with an axial view. A receiver operating characteristics (ROC) curve analysis was performed to determine the cutoff LPC value. A multivariate analysis was performed to determine the predictive factors for POPF. RESULTS POPF occurred in 11 patients (4.5 %). The median LPC was significantly longer in the patients with POPF than in those without (26 mm vs. 21 mm, p = 0.026). The ROC curve analysis revealed that the optimal cutoff LPC value for predicting POPF was 25 mm. The POPF rate was significantly higher in the long LPC group than in the short LPC group (10 vs. 1.3 %, p = 0.002). A multivariate analysis demonstrated that a long LPC (p = 0.018) and dissection of the lymph nodes along the distal splenic artery (p = 0.042) were independent predictors of POPF. The amylase level in the drainage fluid on postoperative day 1 was significantly higher in the long LPC group than in the short LPC group. CONCLUSIONS The LPC is a simple and reliable predictor of POPF after LG. Surgeons should take the anatomical location of the pancreas into consideration when performing LG with suprapancreatic lymph node dissection.
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Affiliation(s)
- Kazuhiro Migita
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Kohei Wakatsuki
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Masahiro Ito
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Tomohiro Kunishige
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Hiroshi Nakade
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Mitsuhiro Nakatani
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Mutsuko Kitano
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Yoshiyuki Nakajima
- Department of Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
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Nakade H, Matsumoto S, Wakatsuki K, Tanaka T, Migita K, Ito M, Kunishige T, Kitano M, Nakatani M, Nakajima Y. [Long-Term Disease-Free Survival through Postoperative Chemotherapy in a Case of Gastric Cancer with Peritoneal Dissemination]. Gan To Kagaku Ryoho 2015; 42:2055-2057. [PMID: 26805262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An 80-year-old man with type 4 gastric cancer in the mid-gastric region underwent total gastrectomy and D2-No.10 lymph-node dissection (cT4a, N0, M0, cStageⅡB). Several nodules were detected under the left diaphragm, some of which were biopsied. Pathological findings indicated a poorly differentiated adenocarcinoma, pT4a (SE), pN3b, pM1 (P1, CY1), pStage Ⅳ. Systemic chemotherapy was initiated, using a regimen of S-1/docetaxel (DOC). After 6 courses of combination therapy, we switched to S-1 alone, which was continued for 1 year. Eighteen months after the surgery the patient discontinued S-1 treatment and has since survived for 5 years with no obvious cancer recurrence.
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Matsumoto S, Takayama T, Wakatsuki K, Tanaka T, Migita K, Ito M, Nakade H, Kunishige T, Nakajima Y. Preoperative Cardiac Risk Assessment and Surgical Outcomes of Patients with Gastric Cancer. Ann Surg Oncol 2015; 23 Suppl 2:S222-9. [DOI: 10.1245/s10434-015-4464-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Indexed: 01/21/2023]
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Ito M, Takayama T, Matsumoto S, Wakatsuki K, Tanaka T, Migita K, Kunishige T, Nakade H, Nakajima Y. [Treatment of type four gastric cancer in our institution]. Gan To Kagaku Ryoho 2014; 41:2242-2244. [PMID: 25731483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Since 2011, we have performed routine staging laparoscopy on 7 patients presenting with type 4 gastric cancer at our department. After staging laparoscopy, the patients received neoadjuvant chemotherapy with docetaxel, cisplatin, and S-1 (DCS). After the completion of 2 courses of chemotherapy, radical gastrectomy with D2 gastrectomy or greater was performed, followed by postoperative adjuvant chemotherapy with S-1 for 1 year. In the present study, we evaluate the outcomes of the treatment strategies for the type 4 gastric cancer patients treated at our institution. Staging laparoscopy and peritoneal lavage cytology revealed that none of the patients had peritoneal metastasis, while peritoneal cytology detected carcinoma cells in 3 patients. Grade 3 or greater neutropenia developed in 3 patients, and Grade 3 or greater nonhematological toxicity developed in 3 patients after neoadjuvant chemotherapy. The disease control rate was 100% and all patients underwent radical gastrectomy. Of the 3 patients who had positive peritoneal cytology on staging laparoscopy, 2 patients had no peritoneal cancer cells at the time of gastrectomy. Six patients underwent R0 surgery after DCS chemotherapy, and the response rate was 57.1%. The median survival time was 540 days. Four patients experienced peritoneal recurrence, and 1 developed lymph node recurrence. Our therapeutic strategy for type 4 gastric cancer contributed to prolonged survival; however, it is necessary to develop better strategies that can prevent or control the peritoneal recurrence.
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Nakade H, Jordan BJ, Srivastava S, Xu H, Yu X, Pollier MA, Cooke G, Rotello VM. Molecular recognition-induced liquid crystals from complementary diaminopyridine and flavin dyads. Supramol Chem 2010. [DOI: 10.1080/10610278.2010.506540] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hiroshi Nakade
- a Department of Chemistry , University of Massachusetts , 710 North Pleasant Street, Amherst , MA , 01003 , USA
| | - Brian J. Jordan
- a Department of Chemistry , University of Massachusetts , 710 North Pleasant Street, Amherst , MA , 01003 , USA
| | - Sudhanshu Srivastava
- a Department of Chemistry , University of Massachusetts , 710 North Pleasant Street, Amherst , MA , 01003 , USA
| | - Hao Xu
- a Department of Chemistry , University of Massachusetts , 710 North Pleasant Street, Amherst , MA , 01003 , USA
| | - Xi Yu
- a Department of Chemistry , University of Massachusetts , 710 North Pleasant Street, Amherst , MA , 01003 , USA
| | - Michael A. Pollier
- a Department of Chemistry , University of Massachusetts , 710 North Pleasant Street, Amherst , MA , 01003 , USA
| | - Graeme Cooke
- b Department of Chemistry , WestCHEM, University of Glasgow , Joseph Black Building, Glasgow , G12 8QQ , UK
| | - Vincent M. Rotello
- a Department of Chemistry , University of Massachusetts , 710 North Pleasant Street, Amherst , MA , 01003 , USA
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Kakuchi R, Nagata S, Sakai R, Otsuka I, Nakade H, Satoh T, Kakuchi T. Size-Specific, Colorimetric Detection of Counteranions by Using Helical Poly(phenylacetylene) Conjugated to L-Leucine Groups through Urea Acceptors. Chemistry 2008; 14:10259-66. [DOI: 10.1002/chem.200801235] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Otsuka I, Hongo T, Nakade H, Narumi A, Sakai R, Satoh T, Kaga H, Kakuchi T. Chiroptical and Lectin Recognition Properties of Glycoconjugated Poly(phenylacetylene)s Featuring Variable Saccharide Functionalities. Macromolecules 2007. [DOI: 10.1021/ma7020776] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Narumi A, Sakai R, Ishido S, Sone M, Satoh T, Kaga H, Nakade H, Kakuchi T. Enantiomer-Selective Radical Polymerization of Bis(4-vinylbenzoate)s with Chiral Atom Transfer Radical Polymerization Initiating Systems. Macromolecules 2007. [DOI: 10.1021/ma071162j] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Atsushi Narumi
- Division of Biotechnology and Macromolecular Chemistry, Graduate School of Engineering, Hokkaido University, Sapporo, 060-8628, Japan and National Institute of Advanced Industrial Science and Technology (AIST), Sapporo, 062-8517, Japan
| | - Ryosuke Sakai
- Division of Biotechnology and Macromolecular Chemistry, Graduate School of Engineering, Hokkaido University, Sapporo, 060-8628, Japan and National Institute of Advanced Industrial Science and Technology (AIST), Sapporo, 062-8517, Japan
| | - So Ishido
- Division of Biotechnology and Macromolecular Chemistry, Graduate School of Engineering, Hokkaido University, Sapporo, 060-8628, Japan and National Institute of Advanced Industrial Science and Technology (AIST), Sapporo, 062-8517, Japan
| | - Masako Sone
- Division of Biotechnology and Macromolecular Chemistry, Graduate School of Engineering, Hokkaido University, Sapporo, 060-8628, Japan and National Institute of Advanced Industrial Science and Technology (AIST), Sapporo, 062-8517, Japan
| | - Toshifumi Satoh
- Division of Biotechnology and Macromolecular Chemistry, Graduate School of Engineering, Hokkaido University, Sapporo, 060-8628, Japan and National Institute of Advanced Industrial Science and Technology (AIST), Sapporo, 062-8517, Japan
| | - Harumi Kaga
- Division of Biotechnology and Macromolecular Chemistry, Graduate School of Engineering, Hokkaido University, Sapporo, 060-8628, Japan and National Institute of Advanced Industrial Science and Technology (AIST), Sapporo, 062-8517, Japan
| | - Hiroshi Nakade
- Division of Biotechnology and Macromolecular Chemistry, Graduate School of Engineering, Hokkaido University, Sapporo, 060-8628, Japan and National Institute of Advanced Industrial Science and Technology (AIST), Sapporo, 062-8517, Japan
| | - Toyoji Kakuchi
- Division of Biotechnology and Macromolecular Chemistry, Graduate School of Engineering, Hokkaido University, Sapporo, 060-8628, Japan and National Institute of Advanced Industrial Science and Technology (AIST), Sapporo, 062-8517, Japan
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Nakade H, Jordan BJ, Xu H, Han G, Srivastava S, Arvizo RR, Cooke G, Rotello VM. Chiral Translation and Cooperative Self-Assembly of Discrete Helical Structures Using Molecular Recognition Dyads. J Am Chem Soc 2006; 128:14924-9. [PMID: 17105303 DOI: 10.1021/ja064554z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Complementary diaminopyridine (DAP) and flavin derivatives self-assemble into discrete helically stacked tetrads in hydrocarbon solvents. The self-assembled structure was demonstrated through induced circular dichroism using DAPs with chiral side-chains and flavin with achiral side-chains. Flavin derivatives with chiral side-chains were synthesized; cooperativity in the self-assembly was established through circular dichroism (CD) profiles and melting curves. It was found that placing stereocenters in both recognition units resulted in a strong bisignated profile and enhancement of complex stability, indicative of cooperative self-assembly.
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Affiliation(s)
- Hiroshi Nakade
- Department of Chemistry, University of Massachusetts, 710 North Pleasant Street, Amherst, MA 01003, USA
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Hong R, Fernández JM, Nakade H, Arvizo R, Emrick T, Rotello VM. In situ observation of place exchange reactions of gold nanoparticles. Correlation of monolayer structure and stability. Chem Commun (Camb) 2006:2347-9. [PMID: 16733575 DOI: 10.1039/b603988j] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Place exchange reactions were studied using dye displacement: subtle changes in ligand structure greatly affected both the rate of displacement and the stability of the monolayer.
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Affiliation(s)
- Rui Hong
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003, USA
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Abstract
The regular arrangement of complementary diaminopyridine-thymine (DAP-THY) on alternating copolymers permits cooperative binding events and the effective formation of well-controlled micrometre-scale aggregates.
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Affiliation(s)
- Hiroshi Nakade
- Department of Chemistry, University of Massachusetts, Amherst, MA, USA
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Abstract
alpha-Helices are important structural elements in proteins. To provide a scaffold for the facial recognition of peptides, we have explored the interaction of cationic mixed monolayer protected clusters (MMPCs) with a tetra-aspartate peptide in water. In these studies, substantial enhancement of peptide helicity was observed upon addition of the MMPC. Significantly, this stabilization increased with time, demonstrating templation of the monolayer to the peptide helix.
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Affiliation(s)
- Ayush Verma
- Department of Chemistry, University of Massachusetts, Amherst, MA 01003, USA
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Uzun O, Sanyal A, Nakade H, Thibault RJ, Rotello VM. Recognition-Induced Transformation of Microspheres into Vesicles: Morphology and Size Control. J Am Chem Soc 2004; 126:14773-7. [PMID: 15535702 DOI: 10.1021/ja047643p] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Polystyrene functionalized with diamidopyridine (DAP) recognition units self-assembles in nonpolar media to form thermally reversible micrometer-scale spherical aggregates. The size and the thermal stability of these microspheres can be controlled by the molecular weight of the polymer. The addition of thymine-functionalized polymer to these self-assembled microspheres converted them into vesicular aggregates with a controlled size. The morphology change was reversible: the addition of DAP-functionalized polymer converted the vesicles back to microspheres.
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Affiliation(s)
- Oktay Uzun
- Department of Chemistry, University of Massachusetts, Amherst, MA 01003, USA
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Shenhar R, Sanyal A, Uzun O, Nakade H, Rotello VM. Integration of Recognition Elements with Macromolecular Scaffolds: Effects on Polymer Self-Assembly in the Solid State. Macromolecules 2004. [DOI: 10.1021/ma0495590] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Roy Shenhar
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003
| | - Amitav Sanyal
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003
| | - Oktay Uzun
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003
| | - Hiroshi Nakade
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003
| | - Vincent M. Rotello
- Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003
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Affiliation(s)
- Kanad Das
- Department of Chemistry and Department of Polymer Science and Engineering, University of Massachusetts, Amherst, Massachusetts 01003
| | - Hiroshi Nakade
- Department of Chemistry and Department of Polymer Science and Engineering, University of Massachusetts, Amherst, Massachusetts 01003
| | - Jacques Penelle
- Department of Chemistry and Department of Polymer Science and Engineering, University of Massachusetts, Amherst, Massachusetts 01003
| | - Vincent M. Rotello
- Department of Chemistry and Department of Polymer Science and Engineering, University of Massachusetts, Amherst, Massachusetts 01003
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Carroll JB, Waddon AJ, Nakade H, Rotello VM. “Plug and Play” Polymers. Thermal and X-ray Characterizations of Noncovalently Grafted Polyhedral Oligomeric Silsesquioxane (POSS)−Polystyrene Nanocomposites. Macromolecules 2003. [DOI: 10.1021/ma034652u] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Joseph B. Carroll
- Department of Chemistry and Department of Polymer Science and Engineering, University of Massachusetts, Amherst, Massachusetts 01003
| | - Alan J. Waddon
- Department of Chemistry and Department of Polymer Science and Engineering, University of Massachusetts, Amherst, Massachusetts 01003
| | - Hiroshi Nakade
- Department of Chemistry and Department of Polymer Science and Engineering, University of Massachusetts, Amherst, Massachusetts 01003
| | - Vincent M. Rotello
- Department of Chemistry and Department of Polymer Science and Engineering, University of Massachusetts, Amherst, Massachusetts 01003
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Nakade H, Obata M, Tsuji M, Narumi A, Satoh T, Yokota K, Kakuchi T. Chirality Induction in Cyclopolymerization XVI. Synthesis of Optically Active Poly(methyl acrylate-co-dimethyl fumarate) by Radical Cyclopolymerization of Asymmetrical Nonconjugated Diene Having Chiral Pentanediol. Polym J 2001. [DOI: 10.1295/polymj.33.946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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