Radiotherapy-induced supratentorial primitive neuroectodermal tumour in a 17-year-old female: a case report and review of the literature

We report a case of a 17-year-old female who presented with a CNS primitive neuroectodermal tumour 12 years after cranial radiotherapy for relapsed childhood acute lymphoblastic leukaemia. In this article, we discuss the association of these rare tumours with previous craniospinal irradiation and review the pertinent literature.     

Surgical repair of a giant atrial septal aneurysm with patent foramen ovale

Atrial septal aneurysm (ASA) is a rare occurrence. Many studies have established a correlation between ASA and both ischemic stroke of unidentified cause and cardiac embolism. We describe the case of a 59-year-old woman who had a giant ASA with patent foramen ovale. The aneurysm was successfully removed. Although the detailed mechanism involved in the degeneration of the atrial septum is unclear, we recommend that such damage be surgically repaired to reduce the risk of cerebral embolism or heart failure in symptomatic patients. Surgery is recommended for larger ASA.     

Molecular oncology of lung cancer

Progress in genetic engineering has made it possible to elucidate the molecular biological abnormalities in lung cancer. Mutations in KRAS and P53 genes, loss of specific alleles, and DNA methylation of the tumor suppressor genes were the major abnormalities investigated between 1980 and the 2000s. In 2004, mutations in the epidermal growth factor receptor (EGFR) gene that cause oncogene addiction were discovered in non-small-cell lung cancers (NSCLCs), especially in adenocarcinomas. Because they are strongly associated with sensitivity to EGFR-tyrosine kinase inhibitors (EGFR-TKIs), a great deal of knowledge has been acquired in regard to both EGFR and other genes in the EGFR family and their downstream genes. Moreover, in 2007 the existence of the echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) fusion gene was discovered in NSCLC; and the same as EGFR-TKIs, ALK inhibitors are being found to be highly effective in lung cancers that have this translocation. These discoveries graphically illustrate that molecular biological findings are directly linked to the development of clinical oncology and to improving the survival rates of lung cancer patients. Here, we review the remarkable progress in molecular biological knowledge acquired thus far in regard to lung cancer, especially NSCLC, and the future possibilities.     

The role of neoadjuvant and adjuvant treatment for adenocarcinoma of the upper gastrointestinal tract

Both locally advanced adenocarcinoma of the stomach and gastro-esophageal junction are associated with poor prognosis due to the lack of effective treatment. Recently multimodal treatment consisting of neoadjuvant chemotherapy in combination with radiotherapy is reported to improve survival when compared to surgery alone. Neoadjuvant therapy in these locally advanced tumors allows for early tumor responses and the extent of tumor regression that can be achieved is considered a significant prognostic factor. This, in turn, increases the resectability of these tumors. Also due to the high frequency of lymph node metastasis, patients with locally advanced adenocarcinoma should undergo a D2 lymphadenectomy. Postoperative chemoradiation and perioperative chemotherapy have been studied in gastric adenocarcinomas and showed a survival benefit. However, the surgical techniques used in these trials are no longer considered to be standard by today''s surgical practice. In addition, there are no standard recommendations for adjuvant chemotherapy or chemoradiation after R0 resection and adequate lymph node dissection.     

Does the multidimensional grading system (BODE) correspond to differences in health status of patients with COPD?

Study objectives

To verify whether and to what extent the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index correlates with a disease-specific index of health status in patients with COPD.

Design

Cross-sectional study.

Setting

University-affiliated hospital.

Patients

One hundred patients with stable COPD recruited from the outpatient clinic of a single institution.

Measurements

The BODE index was calculated for each patient using variables obtained within 2 weeks of enrollment. At enrollment, all patients completed the St George’s Respiratory Questionnaire (SGRQ). The Kruskal-Wallis test was used to compare health status scores with clinical and functional categories of COPD. The Spearman correlation coefficient (r) was calculated to assess the association between health status scores and clinical or functional variables.

Results

Categorizing the BODE scores into 4 quartiles, we found that higher BODE quartiles were associated with higher (worse) SGRQ scores. The differences among the BODE quartiles in health status indexes were significant for total SGRQ as well as all 3 of the SGRQ sub-scales. In all sections of the SGRQ, scores were moderately to strongly associated with the BODE quartiles (r = 0.27–0.46). In contrast, the association between the SGRQ total, impacts, activity and Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages were weaker (r = 0.27–0.28). There was no significant association between SGRQ symptoms and GOLD stages.

Conclusions

The BODE scoring system corresponds to important differences in health status of patients with COPD. This grading system is better correlated to the health status indexes of the SGRQ than the GOLD staging criteria.     

Discrimination of four soybean dwarf virus strains by dot-blot hybridization with specific probes

Soybean dwarf virus (SbDV) is divided into four strains (YS, YP, DS, and DP) on the basis of host symptoms in infected soybean plants and on aphid vector specificity. To detect and discriminate each strain of SbDV by dot-blot hybridization, probes Y, D, S, and P were prepared. Probes Y and D, covering most of the 3'-noncoding region of the viral genome containing the sequence of small subgenomic RNA, could discriminate strains in accord with the host symptoms. Probes S and P were derived from the 5'-half of open reading frame 5 encoding the N-terminal half of the readthrough domain which is closely related to the aphid vector specificity of each strain. Thus, the four SbDV strains could be discriminated by the combination of these probes. This method, based on a procedure specific to the SbDV sequence, is a good alternative for routine examination of infected plants in soybean breeding programs for evaluation of resistance to SbDV and for assessment of the distribution of each strain in epidemiological studies.     

Prognostic impact of cancer stem cell-related markers in non-small cell lung cancer patients treated with induction chemoradiotherapy

The expression of several cancer stem cell (CSC)-related markers has been confirmed in non-small cell lung cancer (NSCLC). The aim of this study was to clarify the clinical role of CSC-related markers in patients with NSCLC undergoing induction chemoradiotherapy (CRT). Fifty patients with clinically diagnosed N2 or N3 NSCLC who underwent induction CRT with docetaxel and cisplatin concurrently with thoracic radiation followed by surgery were examined in this study. The expressions of CSC related markers (CD133, ALDH1, ABCG2, and Bmi-1) were examined using immunohistochemical staining in surgically resected specimens. Among the 50 patients, 20 patients had no residual tumor cells in the resected specimen when examined pathologically; CSC-related marker expressions and their correlation to survival were evaluated in the other 30 patients. After a median follow-up period of 72 months, the 5-year overall survival rate of the patients with CD133-positive or ALDH1-positive specimens was significantly worse than that of the patients with both CD133-negative and ALDH1-negative expressions (44.9% vs. 90.0%, respectively; P = 0.042). In a multivariate analysis, CD133 and ALDH1 negativity (P = 0.047) and cN2-3 single station metastasis (P = 0.03) were significant independent prognostic factors for prolonged survival. The expressions of CSC-related markers after CRT were significantly correlated with a poor prognosis in patients with NSCLC. The development of therapeutic strategies including adjuvant therapy that take CSC-related marker positivity into consideration is likely to be a key factor in further improvements of the prognosis of patients undergoing trimodality therapy.