Experimental study of a novel thermotherapy for hepatocellular carcinoma using a magnesium ferrite complex powder that produces heat under a magnetic field

BACKGROUND/AIMS: The anti-cancerous effect on hepatocellular carcinoma of a newly established form of thermotherapy, which uses an implant heating system, was evaluated. As a new material for application in hyperthermia, the authors developed a powder type Mg-ferrite complex that produces heat under a relatively low-power magnetic field. METHODOLOGY: This material suspended in Lipiodol was injected into tumors on the backs of mice that consisted of human hepatocellular carcinoma cells. Hyperthermia was performed by directing a magnetic charge on tumor-bearing mice that contained the Mg-ferrite complex. The temperature of the tumor was kept at 42-43 degrees C, while the magnetic field power ranged from 50 to 80G. RESULTS: A 10-min hyperthermia treatment was insufficiently effective against tumor growth. Systemic injection of doxorubicin (ADM) before hyperthermia appeared to enhance the anti-cancerous effect, but the difference was little and did not reach a statistically significant level (repeated measure analysis of variance). The anticancerous effect of hyperthermia for 15 minutes, in contrast, was marked. The nodules had almost completely disappeared by the end of the experiment. CONCLUSIONS: In conclusion, it is suggested that hyperthermotherapy using this newly developed Mg-ferrite complex might become an option for low-invasive therapy for advanced hepatocellular carcinoma in humans.     

Rare and Well Done: Endoscopic Control of Colonic Hemorrhage in Severe Ulcerative Colitis

Digestive Diseases and Sciences -     

Four types of Ipsilateral Breast Tumor Recurrence (IBTR) after breast‐conserving surgery: Classification of IBTR based on precise pathological examination

We classified ipsilateral breast tumor recurrences (IBTRs) based on strict pathological rules. Ninety‐six women who were surgically treated for IBTR were included. IBTRs were classified according to their origins and were distinguished based on strict pathological rules: relationship between the IBTR and the primary lumpectomy scar, surgical margin status of the primary cancer, and the presence of in situ lesions of IBTR. The prognosis of these subgroups were compared to that of new primary tumors (NP) in the narrow sense (NPn) that occurred far from the scar. Distant‐disease free survival of IBTR that occurred close to the scar with in situ lesions and a negative surgical margin of the primary cancer (NP occurred close to the scar, NPcs) was similar to that of NPn. In contrast, IBTR that occurred close to the scar without in situ lesions (true recurrence (TR) that arose from residual invasive carcinoma foci, TRinv) had significantly poorer prognosis than NPn. IBTR that occurred close to the scar with in situ lesions and a positive surgical margin of the primary cancer (TR arising from a residual in situ lesion, TRis) had more late recurrences than NPcs. Precise pathological examinations indicated four distinct IBTR subtypes with different characteristics.     

Macular Hole Associated with Vogt-Koyanagi-Harada Disease at the Acute Uveitic Stage

We describe a case with macular hole (MH) associated with Vogt-Koyanagi-Harada (VKH) disease. A 71-year-old Japanese woman presented with visual loss and headaches. The best-corrected visual acuity (BCVA) was 0.02 in the right eye (RE) and 0.1 in the left eye (LE). The patient was diagnosed with VKH based on circumferential choroidal detachments, multiple serous retinal detachments, and optic disc hyperemia. The multiple serous retinal detachments improved with high-dose corticosteroid therapy and gradual tapering. The BCVA was recovered to 1.2/0.7 in the RE/LE. Six weeks after the initial administration of steroid, vitreomacular traction was found by optical coherence tomography in the LE, which progressed to stage 4 MH with the BCVA of 0.2 in the LE. Twenty-three weeks after the initial treatment, vitrectomy was performed with the standard surgical procedures, including inner limiting membrane peeling around the fovea and air tamponade. The MH was closed successfully and the BCVA was 0.4 in the LE 5 weeks after the vitrectomy. This is the first report of a case with MH secondary to the acute uveitic stage of VKH. Successful closure of MH was achieved with the standard surgical intervention for an idiopathic MH. To conclude, at the early stage of VKH, there is a possibility of MH formation due to the rapid progress of vitreous traction following the inflammation, and the surgical procedure could be effective to resolve this secondary disorder.Key Words: Macular hole, Vogt-Koyanagi-Harada disease, Uveitis, Vitrectomy     

Comprehensive genetic characterization of rectal cancer in a large cohort of Japanese patients: differences according to tumor location

Journal of Gastroenterology - In clinical practice, rectal cancer (RC) is classified according to tumor location. However, RC’s genetic characteristics according to tumor location remain...     

Removal of a chronically infected bipolar pacemaker electrode: a successful case report

A chronic infected bipolar pacemaker electrode with a fin tip was successfully removed 7 years and 9 months after its original implantation from a 72-year-old Japanese man, using the Cook pacemaker lead extraction system. The locking stylet could not advance to the lead tip over the positive pole because of firm adhesions. Because the scar tissue between the positive pole and myocardium could not be freed by the inner sheath, it was disrupted by the slanted end of the outer sheath. The firmest adhesion was on the positive pole, not on the fin tip. The complete extraction success rate of bipolar tined or fin leads is worse than for other types of leads. When extracting a bipolar pacemaker lead, dissection of the positive pole from scar tissue should be taken into account in addition to the lead tip. Rotating the slanted end of the outer sheath is a useful technique when dissecting firm adhesions.     

Pulse dispersion due to atrial fibrillation causes arterial thrombosis in a rabbit experimental model

Thrombosis associated with atrial fibrillation (AF) is usually caused by a left atrial (LA) thrombus, but it is not always detected. The present study was based on the hypothesis that abnormalities in peripheral artery are responsible for the ischemic stroke associated with AF. Peripheral arterial coagulability was investigated in a rabbit experimental model in which AF was induced by high-frequency stimulation of the right atrium, creating stenosis of the carotid artery together with endothelial damage. The rabbits were classified into 4 groups: (i) sinus rhythm only (group 1), (ii) sinus rhythm after 6 h of pacing (group 2), (iii) short AF (continuous pacing for 5 min; group 3) and (iv) long AF (continuous pacing for 6 h: group 4). The carotid blood flow developed a typical pattern, called cyclic flow reductions (CFRs), the frequency of which (CFRF) was 18.59+/-2.85 in AF (group 3+4) compared with 14.46+/-2.1 in sinus rhythm (group 1+2) (p<0.0005). Among the groups with AF, correlation analysis showed an association between CFRF and pulse dispersion (p<0.02, r=0.58). This study suggests that the distinctive hemodynamic effects with AF, in particular pulse dispersion, substantively influence thrombus formation on injured vascular endothelium.