The Glasgow Prognostic Score (GPS) is an inflammation-based cumulative prognostic score calculated from C-reactive protein (CRP) and albumin levels. The aim of the present study was to assess the value of the GPS as a prognostic tool in advanced esophageal cancer patients undergoing radiation therapy. The medical records of 90 patients with advanced esophageal cancer who had been treated with radiation therapy were reviewed retrospectively. Patients with both elevated CRP (>1.0 mg/dL) and hypoalbuminemia (<3.5 g/dL) were assigned a GPS of 2 ; patients who presented with one of these biochemical abnormalities were assigned a GPS of 1 ; and patients with normal CRP and albumin levels were assigned a score of 0. The median survival time in patients with a GPS of 0, 1, and 2 was 640, 394, and 222 days, respectively. A GPS of 2 was associated with shorter overall survival (OS). Multivariate analyses were used to evaluate factors affecting OS and revealed that a GPS of 2 (hazard ratio [HR] 1.897, 95% confidence interval [CI] 1.032.3.484, P=0.0391) was an independent prognostic factor for shorter OS. Eastern Cooperative Oncology Group performance status (ECOG-PS) was not a significant independent predictor of survival (HR 1.694, 95% CI 0.726-3.955, P=0.2229). These findings suggest that the GPS predicts OS in advanced esophageal cancer patients undergoing radiation therapy.

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Purpose : This study investigated the influence of non-colloidal iron delivered in a trace element preparation on hepcidin-25 induction when given in total parenteral nutrition administered with different doses as total calories.
Method : Serum hepcidin-25 was determined after administration of a total parenteral nutrition and trace element preparation in growing rats for 3 days at 3 doses : 300 kcal/kg/day with the necessary total calories ; 200 kcal/kg/day with two thirds of the necessary calorie intake ; and, 150 kcal/kg/day with half of the necessary calorie as total calories. Control rats received a trace element preparation without iron.
Results : At doses designed to control the total calorie administration, the hepcidin-25 levels were high value irrespective of iron in the preparation, resulted in induction of hepcidin-25. In contrast, at doses not suitable for controlling the total calorie administration, the serum hepcidin-25 values were low and there was no induction of hepcidin-25 even in the presence of non-colloidal iron.
Discussion : The above findings suggested an intimate relationship between the total calorie dose of a total parenteral nutrition preparation given in the growing period and serum hepcidin-25 levels. Moreover, in cases where the total calorie dose is controlled and the necessity for ion is low, further hepidin-25 induction would be possible when non-colloidal iron is administered.

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  Myelomeningocele is the most common form of neural tube defect. Prenatal surgical repair has been performed for the past 15 years throughout the world. This procedure, however, merely ensures the prevention of further neural tissue damage in utero; it does not repair prior tissue injury. Although cell sheet technology has been successfully used for the regeneration of diverse organs or tissues including the heart, cornea, esophagus, and cartilage, this procedure has not yet been employed for fetal tissue repair before birth. We report the outcome of the first trial of cell sheets for fetal myelomeningocele using rat animal models. Experimentally, we employed the L6 myoblast cell line derived from rat skeletal muscle tissue for cell sheet engineering. Retinoic acid was injected into the myelomeningocele in fetal rats (pregnant SD rats on embryonic day 10). Subsequently, cell sheets were transplanted to the myelomeningocele lesion at embryonic day 21 by fetal exposure via maternal laparotomy and hysterotomy. Tissue specimens for microscopic study were collected 4 hours after the cell sheet transplantation. H.E staining studies histologically showed the cell sheet attached to the target spinal cord area; viable cell sheet components were recognized as early as 4 hours after transplantation. We are planning to evaluate this fetal procedure in terms of the stimulation of cellular growth and enhancement of neural cell regeneration over a longer period of time. Based on these early results, we expect that the cell sheet technology could clinically improve the outcome of prenatal myelomeningocele care.

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[in Japanese]

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[in Japanese]

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