Multiple glass transitions and higher-order replica symmetry breaking of binary mixtures.

We extend the replica liquid theory in order to describe the multiple glass transitions of binary mixtures with large size disparities, by taking into account the two-step replica symmetry breaking (2RSB). We determine the glass phase diagram of the mixture of large and small particles in the large-dimension limit where the mean-field theory becomes exact. When the size ratio of particles is beyond a critical value, the theory predicts three distinct glass phases; (i) the one-step replica symmetery breaking (1RSB) double glass where both components vitrify simultaneously, (ii) the 1RSB single glass where only large particles are frozen while small particles remain mobile, and (iii) a glass phase called the 2RSB double glass where both components vitrify simultaneously but with an energy landscape topography distinct from the 1RSB double glass.

Clinical usefulness of laparoscopic surgery for clinical stage 0/I cancer in the rectum: a single-center experience in 137 patients.

PURPOSE: Laparoscopic surgery has yet to achieve widespread acceptance for the treatment of rectal cancer because of technical difficulty caused by anatomical features and the lack of sufficient evidence supporting effectiveness. Consequently, the safety and long-term outcomes of laparoscopic surgery for rectal cancer remain to be established in Japan. We evaluated the feasibility, safety, and effectiveness of laparoscopic surgery in patients with up to clinical stage 0/I rectal cancer. MATERIALS AND METHODS: From February 1998 through December 2010, we studied 137 patients with up to clinical stage 0/I rectal cancer treated by laparoscopic surgery. Surgical outcomes, invasiveness, safety, recurrence rates and patterns, and medium-term outcomes were examined. Four patients were converted to open surgery and excluded from analysis. RESULTS: The median follow-up was 64 months (range, 9 to 156 mo), and the rate of conversion to open surgery was 2.8% (4/141). Postoperative complications occurred in 37 patients (27%) and included anastomotic leakage in 10 patients (10/125, 7.9%) and ileus in 10 patients (10/37, 7.3%). The recurrence rate was 6.6%. Lung metastasis and liver metastasis were frequent, but no patient had port-site recurrence. The 5-year disease-free survival rate and the cumulative survival rate were 94.2% and 96.9%, respectively, in patients with stage I disease and 80.2% and 94.7% in those with stage III disease. DISCUSSION: Laparoscopic resection had good surgical outcomes, minimal invasiveness, high safety, and high rates of disease-free survival and overall survival in patients with up to clinical stage 0/I rectal cancer. These results suggest that laparoscopic surgery is a safe and effective procedure for the management of rectal cancer with clinical stage 0/I.

Feasibility and outcomes of surgical therapy in very elderly patients with colorectal cancer.

PURPOSE: Short-term and midterm outcomes of surgery remain unclear in very elderly patients (≥85 y) with colorectal cancer. This study was designed to clarify the safety and therapeutic usefulness of surgery for colorectal cancer in this subgroup of patients. We compared postoperative short-term and midterm outcomes between laparoscopic surgery and open surgery to evaluate the feasibility of laparoscopic surgery in very elderly patients. MATERIALS AND METHODS: The study group comprised 80 patients [38 men (48%) and 42 women (52%)] aged 85 years or older who had colorectal cancer and were treated in our department from 1987 to 2010. The mean age was 87.3±2.3 years, and the median follow-up was 45 months (range, 4 to 252 mo). Sixty-nine patients (86%) were 85 to 89 years old, and 11 (14%) were aged 90 years or older. The American Society of Anesthesiologists' (ASA) risk class was I in 2 patients (2%), II in 44 (55%), and III in 34 (43%). Open surgery was performed in 46 patients (58%), and laparoscopic surgery was performed in 34 patients (42%). RESULTS: The ASA risk class was II or III in 78 patients (98%). Postoperative complications occurred in 21 patients (26%), including ileus in 8 patients (10%), wound infection in 7 (9%), and anastomotic leakage in 3 (4%). As compared with open surgery, laparoscopic surgery had significantly lower intraoperative blood loss (P<0.0001) and a significantly shorter postoperative hospital stay (P=0.0001) but required a significantly longer operation time (P=0.0017). Clinicopathologically, laparoscopic surgery was associated with a significantly smaller tumor size (P=0.0371), significantly fewer dissected lymph nodes (P=0.0181), and significantly fewer patients with stage II or III disease (P=0.0090). Postoperative complications occurred in 14 patients (30%) in the open surgery group and 6 (18%) in the laparoscopic surgery group, but this difference was not significant. As for midterm outcomes, the disease-free survival rate and the overall survival rate were, respectively, 90.9% and 100% in stage I disease, 89.7% and 100% in stage II disease, and 68.4% and 75.9% in stage III disease. CONCLUSIONS: Colorectal surgery was safe, therapeutically useful, and had good short-term and midterm outcomes in very elderly patients with colorectal cancer. As compared with open surgery, laparoscopic surgery was associated with lower intraoperative blood loss and a shorter postoperative hospital stay. These results suggest that laparoscopic surgery is suitable for very elderly patients with colorectal cancer because it is less invasive than open surgery.

Laparoscopic surgery for obese patients with colon cancer: a case-matched control study.

PURPOSE: This study compared the results of laparoscopic surgery for colon cancer in obese patients with a body-mass index (BMI) of 25 kg/m(2) or higher with those in nonobese patients (BMI <25 kg/m(2)) who were matched for clinicohistopathological factors. METHODS: The oncologic outcomes were compared between 140 patients with a BMI of 25 kg/m(2) or higher (obese group) and 140 patients with a BMI of <25 kg/m(2) (nonobese group) that were matched for sex, tumor location, date of operation, and pTNM stage. RESULTS: The proportion of patients with postoperative complications was significantly higher in the obese group (15 %) than in the nonobese group (6 %). The disease-free survival rate and overall survival rate in patients with stage I or II disease were similar in the obese group (98.6 and 98.8 %, respectively) and the nonobese group (97.8 and 97.8 %, respectively). The disease-free survival rate and overall survival rate in patients with stage III disease also did not differ significantly between the obese group (77.2 and 79.4 %, respectively) and the nonobese group (83.4 and 84.9 %, respectively). CONCLUSIONS: Postoperative complications and long-term oncologic outcomes were similar in obese and nonobese patients who underwent laparoscopic colectomy for colon cancer in this hospital.

Prevention of limb amputation in patients with limbs ulcers by autologous peripheral blood mononuclear cell implantation.

There are many cases of amputation of ischemic limbs of dialysis patients due to diabetes, despite the availability of medicine therapy and vascular by-pass operations. As there is extensive ruin of the vascular bed due to diabetes, vascular regeneration therapy by stem cell implantation is effective. Thirty patients with ischemic limbs due to diabetes (not including type-I) and on dialysis for chronic renal failure (19 cases), diabetes (5 cases), dialysis patients without diabetes (4 cases), and arteriosclerosis obliterans (ASO, 2 cases) were treated by autologous peripheral blood stem cell (PBSC) implantation where imminent amputation was under consideration. Granulocyte Colony Stimulate Factor (G-CSF: 5 microg/kg/day) was administered subcutaneously for 4 days before PBSC collection, that was carried out using a centrifuge (Spectra and/or CS3000) via the vein. The collected PBSC, containing 4.2 x 10(7) of CD 34 positive cells, was divided into units of 0.5-1.0 mL and implanted, without any purification, to the ischemic area of the limbs in about 65 points. In 21 cases, normalization of limb temperature was observed by thermograph, and symptoms also improved. The result of this first attempt of PBSC implantation is that we were able to save 22 ischemic limbs. This is the first large report of the application of regenerative medicine to peripheral ischemic limbs.

Growth of recombinant equine herpesvirus 1 (EHV-1) replaced with passage-induced mutant gene 1 and gene 71 derived from an attenuated EHV-1 in cell cultures and in the lungs of mice.

The relationship of passage-induced mutant genes 1 and 71 of an attenuated equine herpesvirus 1 (EHV-1) with virulence was analysed by constructing nine recombinant EHV-1 viruses by homologous recombination. Gene 1 or/and gene 71 of a virulent EHV-1 strain, HH1, was replaced by a mutant gene 1 or/and 71 of an attenuated HH1 strain, BK343, respectively. The beta-galactosidase gene of Escherichia coli was inserted within the gene 1 or 71 coding sequence of HH1 to inactivate the genes. Virus replications of these recombinant viruses in cell cultures were similar, but release of the gene 71-inactivated virus from infected cells was delayed compared to that of the other viruses. Plaque sizes of the recombinant viruses were similar to those of HH1, but those of BK343 were significantly smaller, indicating an effect of some unknown factor(s) on viral cell-to-cell spread. The growth abilities of the recombinant viruses with a mutant gene 1 or/and 71 in lungs of mice were similar to those of HH1, but those of gene 71-inactivated viruses were reduced to the level of BK343 and the titers were about 100-times lower than those of the other recombinant viruses. These results indicate that the mutant genes 1 and 71 of BK343 might not confer an attenuated nature to EHV-1.

Effect of continuous combined therapy with vitamin K(2) and vitamin D(3) on bone mineral density and coagulofibrinolysis function in postmenopausal women.

OBJECTIVES: To investigate the therapeutic effect of combined use of vitamin K(2) and D(3) on vertebral bone mineral density in postmenopausal women with osteopenia and osteoporosis. SUBJECTS AND METHODS: We enrolled 172 women with vertebral bone mineral density <0.98 g/cm(2) (osteopenia and osteoporosis) as measured by dual-energy X-ray absorptiometry. In this study, we employed the criteria for diagnosis of osteopenia and osteoporosis using dual energy X-ray absorptiometry proposed by the Japan Society of Bone Metabolism in 1996. Subjects were randomized into four groups (each having 43 subjects in vitamin K(2) therapy group, vitamin D(3) therapy group, vitamin K(2) and D(3) combined therapy group, or a control group receiving dietary therapy alone) and treated with respective agents for 2 years, with bone mineral density was measured prior to therapy and after 6, 12, 18, and 24 months of treatment. The bone metabolism markers analyzed were serum type 1 collagen carboxyterminal propeptide (P1CP), serum intact osteocalcin, and urinary pyridinoline. Tests of blood coagulation function consisted of measurement of activated partial thromboplastin time (APTT) and analysis of concentrations of antithrombin III (AT III), fibrinogen, and plasminogen. RESULTS: Combined therapy with vitamin K(2) and D(3) for 24 months markedly increased bone mineral density (4.92 +/- 7.89%), while vitamin K(2) alone increased it only 0.135 +/- 5.44%. The bone markers measured, revealed stimulation of both bone formation and resorption activity. We observed an increase in coagulation and fibrinolytic activity that was within the normal range, suggesting that balance was maintained in the fibrinolysis-coagulation system. CONCLUSIONS: Continuous combination therapy with vitamin K(2) and D(3) may be useful for increasing vertebral bone mass in postmenopausal women. Furthermore, the increase in coagulation function observed during this therapy was within the physiological range, and no adverse reactions were observed.