[Left traumatic diaphragmatic hernia in the postoperative state of lung cancer: report of a case]

We report a case of left traumatic diaphragmatic hernia in the postoperative state of the lung cancer. A 68-year-old man underwent video-assisted partial resection of the left lung for lung cancer. One year after the operation, he experienced an accident of falling from a tree. Chest radiograph and chest computed tomography revealed the stomach herniating into the left thoracic cavity. An emergent operation was performed by the abdominal approach. The stomach was returned into the abdominal cavity, and the hiatus in the central tendon of the left diaphragm was primarily sutured. The postoperative course was uneventful.

Sulfate complexation of element 104, Rf, in H2SO4/HNO3 mixed solution

The cation-exchange behavior of 261Rf (T 1/2= 78 s) produced in the 248Cm(18O, 5n) reaction was studied on a “one-atom-at-a-time” scale in 0.15–0.69 M H2SO4/HNO3 mixed solutions ([H+]=1.0 M) using an automated ion-exchange separation apparatus coupled with the detection system for alpha-spectroscopy (AIDA). It was found that adsorption probabilities ( decrease with an increase of [HSO4 −], showing a successive formation of Rf sulfate complexes. Rf exhibits a weaker complex formation tendency compared to the lighter homologues Zr and Hf. This is in good agreement with theoretical predictions including relativistic effects.

Emergence of raltegravir-resistant HIV-1 in the central nervous system

Integrase inhibitor-resistant HIV-1 was detected in the cerebrospinal fluid, but not in the plasma of a 42-year-old man with HIV encephalopathy treated with a raltegravir (RAL)-containing regimen. Raltegravir resistance may develop in the central nervous system when the virus is already multi-drug resistant because of different penetration into cerebrospinal fluid of individual antiretroviral agents.

MicroRNA profiling of gastric cancer patients from formalin-fixed paraffin-embedded samples

MicroRNA (miRNA) is a small non-coding RNA that targets specific mRNA. Recent progress in the extraction of RNA from formalin-fixed paraffin-embedded (FFPE) tissues has facilitated miRNA profiling using samples stored in laboratories worldwide. In the present study, miRNA profiling of gastric cancer patients is determined using FFPE samples. First, criteria were established for determining evaluable RNA from the FFPE samples. miRNA profiling was then undertaken using miRNA oligo chips with 885 featured genes. The FFPE samples were obtained from 47 gastric cancer patients who underwent operations between 1997 and 2007. Results showed that out of 47 paired samples, 37 pairs (78.8%) were evaluable by our criteria. A total of 30 miRNAs were significantly up-regulated and 11 miRNAs were down-regulated in gastric cancer compared with those in normal gastric tissue. Among these, 14 miRNAs, including miR-21, were identified as prognostic factors of gastric cancer patients. Furthermore, miR-34a was selected as an independent prognostic factor. In conclusion, we identified miRNAs that are associated with the prognosis of gastric cancer patients. miRNA profiling using FFPE samples is a useful and promising method of evaluation for samples stored in laboratories worldwide, and can generate extremely valuable clinical data.

The effect of Assertive Community Treatment in Japan

OBJECTIVE

The aim of this study was to evaluate the effects of the Assertive Community Treatment (ACT) program in a Japanese mental health service setting.

METHOD

This study was a randomized controlled trial. ACT was the intervention condition (n = 59), and the usual hospital-based rehabilitation program was the control condition (n = 59). Outcome indicators include in-patient days, psychiatric symptoms, social functioning, quality of life, and client satisfaction. The follow-up period was 12 months after the intervention.

RESULTS

We found a significant reduction of in-patient days for the ACT group demonstrated by t-test (t = 2.33, P = 0.02). However, the results of ancova did not show significant differences for in-patient days between the two groups (F = 1.85, P = 0.18). The depression score for Brief Psychiatric Rating Scale for the ACT group was significantly lower than the control group at the 12-month follow-up assessment (F = 5.57, P = 0.03). According to the t-test, the ACT group had a higher client satisfaction than the control group (t = 2.08, P = 0.05).

CONCLUSION

We concluded that ACT had a positive influence, as evidenced by a reduction of in-patient days, lower depressive symptoms, and higher client satisfaction.

Abstract 4935: microRNA profiling of esophageal squamous cell carcinoma patients from formalin-fixed paraffin-embedded (FFPE) specimens

Introduction: microRNA (miRNA) are small non-coding RNAs which target specific mRNA. Recent progression of RNA extraction technology from formalin-fixed paraffin-embedded (FFPE) tissues enables us to access miRNA profiling using world wide stored specimens. Here, we present miRNA profiling of esophageal squamous cell carcinoma (ESCC) patients from FFPE specimens.

Method: First, we examined and contrasted the levels of cross-linking caused by formalin and degradation of mRNA and miRNA from daily to yearly time frames. Then, we established the criteria of evaluable RNA from FFPE specimens. The miRNA profiling was obtained from 44 ESCC patients who received operations from 1991 to 2009 using 3D-Gene human miRNA chip (Toray) which contains 904 has-miRNAs. The approval number from Toyama University institutional review board was #19-67.

Results: Out of 44 paired samples, 24 pairs (54.5%) were determined evaluable with our criteria. We found that 39 miRNAs (including miR-21, and miR-25) were significantly up-regulated and that 24 miRNAs (including miR-145) were down-regulated in ESCC in comparison to normal esophageal tissue. Of these, miR-15b, miR-200c and miR761 were identified as prognostic factors of ESCC patients. Furthermore, we found 22 miRNAs that have association with the hematogenic recurrence and 9 miRNAs (including miR-103) have association with lymph node metastasis.

Conclusion: We have discovered miRNAs that are associated with prognosis, hematogenic recurrence and lymph node metastasis in ESCC patients. miRNA profiling using FFPE specimens is a useful and promising method of evaluation of world wide stored specimens that accompany many valuable clinical data.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4935. doi:10.1158/1538-7445.AM2011-4935

Abstract 4184: Expression analysis of iPS inductive gene in gastrointestinal cancer by tissue microarray

Background: Recent progress is enabling us to induce iPS cells using somatic differentiated cells. We are now establishing iPS cells from normal gastrointestinal epithelial cells. However, the risks associated with transfection of iPS inductive genes (Sox2, Oct 3/4, klf4 and c-Myc) to somatic differentiated cells has not been well examined. Thus, in order to understand the role of iPS inductive genes in gastrointestinal cancer, we examined the expression of Sox2, Oct3/4, klf4, c-Myc and Nanog by cancer tissue microarray.

Methods: We examined gene expression in 86 esophageal cancers, 50 gastric cancers, 80 colorectal cancers, 37 biliary tract cancers and 34 pancreatic cancers. Immunohistochemical expression levels of 5 genes were evaluated by the combination of their intensity and distribution. The expression level was compared to the clinico-pathological data of the patients.

Results: Klf4 reduction was associated with lymph node metastasis of colorectal cancer which resulted in a poor prognosis for the patients (p=0.02). Klf4 reduction also tended to indicate a poor prognosis in esophageal cancer (P=0.06). Furthermore, Sox2 reduction was an independent prognostic factor in gastric cancer (p=0.03) and a high expression of OCT3/4 tended to indicate a poor prognosis in esophageal cancer (p=0.07). Nanog reduction was associated with poor prognosis in biliary tract and pancreatic cancer(p=0.02). On the other hand, c-Myc did not have any association with clinico-pathological factors of gastrointestinal cancer. Clustering analysis revealed that prognosis of the subgroup of simultaneous positive expressions of iPS inductive genes was better than that of other subgroups in colon cancer, however there was no difference among subtypes in esophageal cancer.

Conclusions: The role of iPS inductive genes may differ in various gastroenterological cancer patients. However, further large-scale analysis is needed to elucidate this issue.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4184. doi:10.1158/1538-7445.AM2011-4184

[Effective chemotherapy with S-1 alone in a patient with lung metastases of breast cancer]

We report a 50-year-old female with pulmonary metastases from breast cancer who responded to S-1. In September 2003, she underwent surgery for breast cancer. Four years 8 months after the operation, lung relapse was detected. After the treatment failure of FEC60 (5-FU 500 mg/m², epirubicin 60 mg/m², cyclophosphamide 500 mg/m²) and taxane antitumor drugs, oral administration of S-1 80 mg/body/day was initiated. At the end of three courses, thoracic CT revealed the disappearance of the lung metastasis. Advanced reactions during the administration period were mild. After 14 courses of S-1 therapy (during 11 months), a complete response was clinically maintained. S-1 showed a good antitumor effect and tolerance, and it might be useful for treating metastatic and recurrent breast cancers.

A High Speed Contact-Type Image Sensor using Amorphous Silicon Alloy Pin Diodes

A new A4-size contact-type image sensor with 8 elements per millimeter (1,728 elements) was developed by using amorphous silicon alloy pin photodiodes as the light receiving elements. The matrix switching method is employed for signal reading. This method can read the signals from all of the 1,728 photodiodes using a 54 (54-channel input) x 32 (32.channel output) matrix switching scheme. It is advantageous in that the required input and output external circuits can be simplified. To prevent signal crosstalk between the diodes in the matrix, amorphous silicon alloy pin diodes, which are made in the same process as the photodiodes for maintaining a low cost, are connected in series to each photodiode in reverse polarity as blocking diodes.

To achieve superior signal-to-noise ratio and response at the same time, amorphous silicon alloy pin diodes are optimized to satisfy both a high photo-to-dark ratio and a high rectification ratio. The image sensor can operate at up to 2 MHz signal reading clock, maintaining a signal-to-noise ratio of over 24 dB under 0. 1–1x sec exposure.

A comparison of two-dimensional techniques for converting magnetocardiogram maps into effective current source distributions

The aim of this study was to develop a method for converting the pseudo two-dimensional current given by a current-arrow map (CAM) into the physical current. The physical current distribution is obtained by the optimal solution in a least mean square sense with Tikhonov regularization (LMSTR). In the current dipole simulation, the current pattern differences (ΔJ) between the results of the CAM and the LMSTR with several regularization parameters (α = 10(-1)-10(-15)) are calculated. In magnetocardiographic (MCG) analysis, the depth (z(d)) of a reconstruction plane is chosen by using the coordinates of the sinus node, which is estimated from MCG signals at the early p-wave. The ΔJs at p-wave peaks, QRS-complex peaks, and T-wave peaks of MCG signals for healthy subjects are calculated. Furthermore, correlation coefficients and regression lines are also calculated from the current values of the CAM and the LMSTR during p-waves, QRS-complex, and T-waves of MCG signals. In the simulation, the ΔJs (α ≈ 10(-10)) had a minimal value. The ΔJs (α = 10(-10)) at p-wave peaks, QRS-complex peaks, and T-wave peaks of MCG signals for healthy subjects also had minimal value. The correlation coefficients of the current values given by the CAM and the LMSTR (α = 10(-10)) were greater than 0.9. Furthermore, slopes (y) of the regression lines are correlated with the depth (z(d)) (r = -0.93). Consequently, the CAM value can be transformed into the LMSTR current value by multiplying it by the slope (y) obtained from the depth (z(d)). In conclusion, the result given by the CAM can be converted into an effective physical current distribution by using the depth (z(d)).

[An elderly advanced breast cancer with a good response to anastrozole]

The patient was an 86-year-old woman. In December 2005, she became aware of a tumor in her right breast at the nipple, gradually increasing in size and bleeding, and visited our department in April 2006. Roughly 3.5 cm in size, the tumor had a prominent large skin surface, bled profusely, and a dark red-colored was found at the E area of the right breast. Ultrasonography and mammography revealed that the tumor had invaded the skin and pectoralis major muscle (T4b). Core needle biopsy examination indicated invasive breast cancer (pap-tub), ER(+), PgR(+), HER2(3+). Chest CT scan and bone scintigraphy revealed swollen changes at the right axillary lymph nodes and osteoblastic changes in the 7th thoracic vertebra. We started anastrozole 1mg/day treatment. Tumor blood loss after one month was confirmed. After six months, the primary tumor size was reduced to 2 cm and the axillary lymph nodes disappeared. Administration continued about three years, and the tumor showed only the scar-like changes, and was unclear from ultrasonography (cPR). We report the long-term effect of aromatase inhibitor for elderly breast cancer patients without operation.

Increase in ouabain-sensitive K+-ATPase activity in hepatocellular carcinoma by overexpression of Na+, K+-ATPase alpha 3-isoform

Na(+),K(+)-ATPase is a housekeeping pump in virtually all animal cells. Recently, cardiac glycosides that inhibit Na(+),K(+)-ATPase have been reported to be candidate for novel anticancer drug. Here, we investigated clinical significance of Na(+),K(+)-ATPase alpha1-isoform (alpha 1NaK), alpha2-isoform (alpha 2NaK) and alpha 3-isoform (alpha 3NaK) in hepatocellular carcinoma (HCC). Interestingly, the expression levels of alpha 3NaK protein in HCC tissues were significantly higher than those in the accompanying non-tumor tissues, whereas no significant increases in expression of alpha 1NaK and alpha 2NaK proteins were observed in HCC compared to non-tumor tissues. The ouabain (10 microM)-sensitive K(+)-ATPase activities (Na(+),K(+)-ATPase activities) in the membrane fraction from HCC tissue were significantly higher than those from non-tumor tissues. The Na(+),K(+)-ATPase activity was positively and significantly correlated with the expression level of alpha 3NaK. Apparent affinity for Na(+) in the Na(+),K(+)-ATPase activity in HCC tissues was significantly lower than that in non-tumor tissues, consistent with an elevated expression of alpha 3NaK relative to alpha 1NaK. Our results suggest that overexpression of alpha 3NaK increases the Na(+),K(+)-ATPase activity of HCC cells.

Abstract 1752: Prognostic significance of Aquaporin(AQP) expression in gastric and colorectal cancer

Introduction :

Aquaporins (AQPs) are a membrane proteins involved in water transport and have been found to be expressed in several cancers. We have already reported that AQP 5 expression is associated with differentiation for gastric cancer (J Physiol Science 2009). However, the role of AQP family expression has not been well evaluated yet. In this study, we examined the expression of AQP 1, 4, 5 and 8 in gastric cancer and colorectal cancer, and compared them with the clinico-pathological characteristics of the patients.

Method :

The expression of AQP1, 4, 5, and 8 was comprehensively examined by tissue microarray (TMA1150) that has been established in our hospital. The specimens of gastric cancer and colorectal cancer were obtained from the patients who receive an operation between 1993 to 2004. Clinico-pathological data were obtained from the patients’ medical records. After careful examination of two independent pathologists, the results were scored according to the intensity and the distribution. Finally, AQP expressions were compared to the clinical pathologic finding of the patients.

Result :

In stomach cancer, positivity of AQP1, 4, 5, and 8 expressions were 40.7% (22/54), 43.2% (19/44), 97.6% (41/42) and 18.2% (8/44) respectively. AQP4 positive patients have a significant better prognosis than that of negative patients (p=0.004) and low expression of AQP4 tended to relate to poorly differentiated adenocarcinoma (p=0.07). However there was no significant difference between the prognosis, histological type, disease stage (TNM classification) and AQP1, 5, and 8 expressions.

With regard to colorectal cancer, positivity of AQP1, 4, 5, and 8 expressions were 27.4% (20/73), 45.9% (34/74), 98.4% (61/62), and 76.4% (55/72) respectively. AQP4 positive patients tended to have a favorable prognosis (p=0.12), on the other hand AQP1 positive group tended to have a worse prognosis (p=0.06). There was the other relationship between low expression of AQP4 and N factor (p=0.04).

Conclusion :

AQP 1 and 4 expression have some roles in the progression of gastric cancer and colorectal cancer, however the role of AQP 5 and 8 are still unknown. Our findings suggested that AQP 1 and 4 may be a molecular target of gastric cancer and colorectal cancer.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1752.

General rules for recording endoscopic findings of esophagogastric varices (2nd edition)

General rules for recording endoscopic findings of esophageal varices were initially proposed in 1980 and revised in 1991. These rules have widely been used in Japan and other countries. Recently, portal hypertensive gastropathy has been recognized as a distinct histological and functional entity. Endoscopic ultrasonography can clearly depict vascular structures around the esophageal wall in patients with portal hypertension. Owing to progress in medicine, we have updated and slightly modified the former rules. The revised rules are simpler and more straightforward than the former rules and include newly recognized findings of portal hypertensive gastropathy and a new classification for endoscopic ultrasonographic findings.

[Percutaneous transthoracic needle biopsies under a guide of real-time three image computed tomography]

PURPOSES

Experiences of percutaneous transthoracic needle biopsies under a guide of a real time 3 image display computed tomography (3 image CT) is reported.

MATERIALS AND METHODS

Twenty seven biopsies from 23 patients were performed. For 3 image CT, Somatom was used. This equipment can render 3 pictures of serial slices on a screen simultaneously and have X-ray exploration-reduction system for both the patients (35% reduction) and operator's hands (72% reduction).

RESULTS

The median size of the masses was 1.7 (0.5-6.3) cm; the median distance from the pleura to the mass was 0.66 (0-6.5) cm; and the median time to perform biopsies was 12 minutes. We had only 3 failed cases to obtain biopsied specimen (11%).

COMPLICATIONS

Needle biopsy of the lung lesion under a guide of a 3 sectional CT is a safe and timesaving method with a high success rate to obtain biopsied tissues even for small lesions or difficult lesion.

General rules for recording endoscopic findings of esophagogastric varices (2nd edition)

General rules for recording endoscopic findings of esophageal varices were initially proposed in 1980 and revised in 1991. These rules have widely been used in Japan and other countries. Recently, portal hypertensive gastropathy has been recognized as a distinct histological and functional entity. Endoscopic ultrasonography can clearly depict vascular structures around the esophageal wall in patients with portal hypertension. Owing to progress in medicine, we have updated and slightly modified the former rules. The revised rules are simpler and more straightforward than the former rules and include newly recognized findings of portal hypertensive gastropathy and a new classification for endoscopic ultrasonographic findings.