Effectiveness of adjuvant intermittent endocrine therapy following neoadjuvant endocrine therapy and external beam radiation therapy in men with locally advanced prostate cancer

PURPOSE: To clarify the optimal duration and methods for adjuvant endocrine therapy after external beam radiation therapy (EBRT) in patients with locally advanced prostate cancer. MATERIALS AND METHODS: Between 2001 and 2003, 215 patients with locally advanced prostate cancer were enrolled in the study. Patients were registered as primary candidates of the study and were treated with 6 months of LHRH agonist, with short-term of antiandrogen treatment for flare-up prevention. Patients with PSA levels below 10 ng/ml after the 6-month endocrine treatment were randomly divided into two arms. Then, a total dose of 72 Gy was given to the prostate. After 14 months of the protocol treatment, patients were treated with continuous androgen ablation (arm 1) or intermittent androgen ablation (arm 2). RESULTS: A total of 188 cases (87%) remained in the protocol. The median PSA level at entry was 25.3 ng/ml. The Gleason score was 2-6 in 32 cases (16%), 7 in 94 cases (48%), and 8-10 in 68 cases (35%). The median PSA level showed a remarkable decrease to 1.1, 0.2, and 0.1 ng/ml, after 6, 8, and 14 months of the protocol treatment, respectively. Of the 157 cases treated with EBRT, 153 cases (97.5%) had no biochemical failure in the mean follow-up of 17.3 months. CONCLUSIONS: The present study may reveal the possibilities of intermittent endocrine therapy after EBRT. However, the follow-up interval is short and little can be said about the results observed so far, exception of acute tolerance and patient acceptance of the protocol.     

Chemical methodology as a source of small-molecule checkpoint inhibitors and heat shock protein 70 (Hsp70) modulators

Unique chemical methodology enables the synthesis of innovative and diverse scaffolds and chemotypes and allows access to previously unexplored "chemical space." Compound collections based on such new synthetic methods can provide small-molecule probes of proteins and/or pathways whose functions are not fully understood. We describe the identification, characterization, and evolution of two such probes. In one example, a pathway-based screen for DNA damage checkpoint inhibitors identified a compound, MARPIN (ATM and ATR pathway inhibitor) that sensitizes p53-deficient cells to DNA-damaging agents. Modification of the small molecule and generation of an immobilized probe were used to selectively bind putative protein target(s) responsible for the observed activity. The second example describes a focused library approach that relied on tandem multicomponent reaction methodologies to afford a series of modulators of the heat shock protein 70 (Hsp70) molecular chaperone. The synthesis of libraries based on the structure of MAL3-101 generated a collection of chemotypes, each modulating Hsp70 function, but exhibiting divergent pharmacological activities. For example, probes that compromise the replication of a disease-associated polyomavirus were identified. These projects highlight the importance of chemical methodology development as a source of small-molecule probes and as a drug discovery starting point.     

Ectopic gastric pancreatic cancer: report of a case

It is very rare for ectopic pancreas to become cancerous. We herein report on a case of ectopic pancreatic cancer developed in the stomach. A neoplastic lesion was detected in the pyloric part in an upper GIS of a 76-year-old female, requiring biopsy, but because it was classified as Group I, it was observed temporarily. Following blood collection after approximately 2 years, the CA19-9 increased from 177.5 to 279.5, so a GIS was again performed. Although the pyloric part of the stomach became more stenosed than before, it was still considered Group I disease based on biopsy findings. When EUS was performed, the tumor appeared as a submucosal tumor, and was thus suspected as GIST. In an abdominal CT, a neoplastic lesion with a clear boundary was observed in the pylorus, as was an enlarged lymph node in the hepatoduodenal ligament. Therefore malignancy could not be ruled out, and a gastrectomy on the pylorus side, lymph node dissection (D2), and cholecystectomy were performed. The tumor was a submucosal tumor covered by a coherent mucosa. According to histopathological findings, it was diagnosed as ectopic pancreatic cancer developed in the ectopic pancreas (Heinrich type II), consisting of acinar tissue and capillary tubes. Thus ectopic pancreas should be considered in the differential diagnosis of gastric submucosal tumors. Regarding surgery for ectopic pancreas, it is considered necessary to establish a treatment policy by making an immediate pathological diagnosis with sufficient consideration of the possibility of malignancy.     

Relationship between age and occlusal force in adults with natural dentition

Odontology - This study aimed to clarify the relationship between age and occlusal force in adults with natural dentition. A total of 385 adults (180 males and 205 females) with natural dentition...     

Influence of two masticating conditions on assessment of movement path stability

PurposeThe purpose of this study was to clarify whether differences in masticating conditions affected masticatory path stabilities of healthy subjects and TMD patients.MethodsTwenty healthy female subjects as the healthy group, and 20 female Temporomandibular Disorders (TMD) patients as the TMD group, were selected. Incisal point movement of during mastication of both masticating condition 1 (mc1; crispy bread chewed until swallowing on the free side) and masticating condition 2 (mc2; softened chewing-gum chewed for 20 s on the habitual side) were recorded by MKG. As for mc1, out of all cycles during mastication only those cycles on the habitual chewing side were analyzed. As for mc2, the ten cycles from the fifth cycle were analyzed. For these analyzed sections, the indicators representing movement path stability were calculated and compared between the two groups.ResultsAs for mc1, though the values of the indicators representing path stability were larger for the TMD group, there were cases where no significant differences were found between the two groups. As for mc2, the values were significantly larger for the TMD group (SDs; P < 0.05, SD/ODs; P < 0.01).ConclusionsFrom these results, it was suggested that the differences in masticating conditions affected the assessment of masticatory path stabilities of healthy subjects and TMD patients and the conditions should be considered for analyzing masticatory movement.     

Evidence of the Sequential Changes of Lung Sounds in COVID-19 Pneumonia Using a Novel Wireless Stethoscope with the Telemedicine System

A 60-year-old woman was admitted to our hospital due to coronavirus disease 2019 (COVID-19) pneumonia with a chief complaint of persistent low-grade fever and dry cough for two weeks. Thoracic computed tomography demonstrated a crazy paving pattern in the bilateral lower lobes. In a COVID-19 ward, we used a novel wireless stethoscope with a telemedicine system and successfully recorded and shared the lung sounds in real-time between the red and green zones. The fine crackles at the posterior right lower lung fields changed from mid-to-late (day 1) to late inspiratory crackles (day 3), which disappeared at day 5 along with an improvement in both the clinical symptoms and thoracic CT findings.