Comparison between early gall bladdercancer and advanced gall bladdercancer in terms of clinicopathologic factors: large volume tertiary center experience

Background:Early diagnosis of gallbladder cancer (GBC) which enables to surgical resection is key for improve prognosis. Aim of this study was to investigate clinical features of early GBC patients compare to advanced ones.Methods:We retrospectively reviewed medical records of all pathologically confirmed primary GBC patients between in single tertiary referral center.Results:250 patients (57.3%) were early GBC (stage IandII) and 186 (42.7%) were advanced GBC (stage IIIandIV). Less patients with early GBC had symptom at initial diagnosis (69.2% versus90.8%, p<0.001). Large number of patients with early GBC were diagnosed GBC incidentally after surgical resection which initially suspected benign gallbladder polyp or symptomatic gallbladder stones (71/250, 28.4% versus7/186, 3.8%) (p<0.001). Patients who initially diagnosed gallbladder stone or cholecystitis tended to more advanced than gallbladder polyp.Conclusions:There were no definitive symptoms which can detect early GBCs. Large number of early GBCs were diagnosed incidentally and many of these initially diagnosed with or accompany with benign cholecystic disease. Careful examination should be performed before diagnosis and after treatment, even in patient with vague symptom or benign cholecystic disease without elevated tumor markers.

Suppressive activity of RGX-365 on HMGB1-mediated septic responses

Abstract RGX-365 is the main fraction of black ginseng conmprising protopanaxatriol (PPT)-type rare ginsenosides (ginsenosides Rg4, Rg6, Rh4, Rh1, and Rg2). No studies on the antiseptic activity of RGX-365 have been reported. High mobility group box 1 (HMGB1) is recognized as a late mediator of sepsis, and the inhibition of HMGB1 release and recovery of vascular barrier integrity have emerged as attractive therapeutic strategies for the management of sepsis. In this study, we examined the effects of RGX-365 on HMGB1-mediated septic responses and survival rate in a mouse sepsis model. RGX-365 was administered to the mice after HMGB1 challenge. The antiseptic activity of RGX-365 was assessed based on the production of HMGB1, measurement of permeability, and septic mouse mortality using a cecal ligation and puncture (CLP)-induced sepsis mouse model and HMGB1-activated human umbilical vein endothelial cells (HUVECs). We found that RGX-365 significantly reduced HMGB1 release from LPS- activated HUVECs and CLP-induced release of HMGB1 in mice. RGX-365 also restored HMGB1-mediated vascular disruption and inhibited hyperpermeability in the mice. In addition, treatment with RGX-365 reduced sepsis-related mortality in vivo. Our results suggest that RGX- 365 reduces HMGB1 release and septic mortality in vivo, indicating that it is useful in the treatment of sepsis.