Elimination of esophageal multiple precancerous lesions by chemotherapy: potential chemoprevention of metachronous multiple cancer development after curative treatment

Background

Dysplastic squamous epithelium is a precancerous lesion for squamous cell carcinoma. It is often present in the esophagus and head and neck region, and can be visualized as a Lugol-voiding lesion (LVL) by iodine chromoendoscopy. However, effective treatment for such dysplastic epithelia has not yet been developed.

Methods

Between March 2008 and July 2011, 40 consecutive patients with advanced esophageal squamous cell carcinoma were treated by two cycles of neoadjuvant chemotherapy (NAC) (5-fluorouracil, 800?mg/m², d 1?C5; cisplatin, 80?mg/m², d 1: q 21?days) at Kyoto University Hospital, and received iodine chromoendoscopy both before and after NAC. Iodine chromoendoscopy findings were divided into 4 groups: group?A, absence of LVLs; group?B, several (??10/one endoscopic view) small (??5?mm) LVLs; group?C, many (??10/one endoscopic view) small (??5?mm) LVLs; group?D, numerous irregular-shaped multiform LVLs. Group?C and D are defined as multiple LVLs. Endoscopic changes of LVLs before and after NAC were investigated retrospectively.

Results

Before NAC, 6, 12, 9, and 13 cases were classified in group?A, B, C, and D, respectively. All cases in group?A before NAC remained in group?A after NAC. Multiple LVLs (group?C and D) were significantly improved in 17 of 22 patients (77.3?%), while several small LVLs (group?B) were improved in only 4 of 12 cases (33.3?%) (p?=?0.025 by Fisher??s exact test).

Conclusions

Multiple dysplastic lesions tended to improve by chemotherapy. In contrast, there was little change in the mucosa with fewer dysplastic lesions after chemotherapy. These data show that chemotherapy has the potential to eliminate precancerous lesions.     

Introduction of the targeted alpha therapy (with Radium-223) into clinical practice in Japan: learnings and implementation

Annals of Nuclear Medicine - Radium-223 dichloride (Ra-223) is the first targeted alpha therapy approved for the treatment of patients with castration-resistant prostate cancer (CRPC) with bone...     

Anti‐Müllerian hormone as a marker of ovarian reserve: What have we learned,and what should we know?

Ovarian reserve reflects the quality and quantity of available oocytes. This reserve has become indispensable for the better understanding of reproductive potential. Measurement of the serum anti‐Müllerian hormone (AMH) level allows quantitative evaluation of ovarian reserve. It has been applied to a wide range of clinical conditions, and it is well established that the measurement of serum AMH levels is more useful than qualitative evaluation based on the menstrual cycle. AMH levels are monitored during infertility treatments; in patients undergoing medically assisted reproductive technology; and in the diagnosis of ovarian failure, polycystic ovarian syndrome, and granulosa cell tumor. It is also useful in the evaluation of iatrogenic ovarian damage. Population‐based studies have indicated a potential role for serum AMH in the planning of reproductive health management. While AMH is currently the best measure of ovarian reserve, its predictive value for future live births remains controversial. Furthermore, there is a serious practical issue in the interpretation of test results, as currently available assay kits use different assay ranges and coefficients of variation due to the absence of an international reference standard. The pros and cons of the serum AMH level as a definitive measure of ovarian reserve merits further review in order to guide future research.     

Reproducibility of corrected QT interval in pediatric genotyped long QT syndrome

Reproducibility of corrected QT interval (QTc), especially QTc after exercise, has not been thoroughly investigated. We reviewed charts of pediatric patients who underwent treadmill‐exercise stress testing without medication multiple times within 1 year. In patients with long‐QT syndrome (LQTS; n = 22), the discrepancy in QTc between two treadmill exercise stress tests using Fridericia's formula was 14 ± 12 ms at rest, 13 ± 12 ms 4 min after exercise, with a maximum of 14 ± 12 ms after exercise. There was no statistically significant difference in QTc between the two tests. Intraclass correlation coefficients (ICC) were 0.84, 0.85, and 0.85, respectively. In controls (n = 13), the discrepancy in QTc was 18 ± 12 ms at rest, 14 ± 7 ms 4 min after exercise, with a maximum of 14 ± 9 ms after exercise. There was no significant difference in QTc between the two tests. ICC were 0.78, 0.80, and 0.80, respectively. QTc calculated using Bazett's formula also showed high reproducibility. Reproducibility of QTc in children is high at rest and after exercise.     

Speech comprehension assessed by electroencephalography: a new method using m-sequence modulation

Electroencephalograms (EEGs) were recorded from eight Japanese speakers while they listened to Japanese and Spanish sentences (approximately 51s each). The sentences were modulated in amplitude by a binary m-sequence and played forward or backward. A circular cross-correlation function was computed between the EEG signals and the m-sequence and averaged across subjects. Independent component analysis of the averaged function revealed a component source response which was obtained only for the comprehensible Japanese and not for the incomprehensible sentences. The present study has thus shown that a 1-min long EEG signal is sufficient for the assessment of speech comprehension.     

Clarification of the pathogenesis and development of clinical examination for allergic diseases

The incidence of allergic diseases has dramatically increased in recent decades in Japan; therefore, it is important to establish ways to diagnose allergic patients based on their pathogenesis and to treat them. Allergic diseases are complicated and diverse disorders in which various cells and mediators are involved; however, it is widely accepted that they are Th2-type inflammations triggered by the invasion of allergens. It is known that either IL-4 or IL-13, particularly the latter, has an important role in the pathogenesis of bronchial asthma among Th-2 type cytokines; however, it is unclear how IL-4 or IL-13 causes asthmatic phenotypes. We have been trying to address this question by using microarray analysis. We have recently found that periostin, identified as an IL-4/IL-13-inducible gene by microarray analysis, is a novel component of subepithelial fibrosis of bronchial asthma. This finding is important to demonstrate the significance of IL-4 and/or IL-13 as a therapeutic target to inhibit fibrosis in bronchial asthma. Furthermore, it is also important to establish a way to diagnose allergic patients in which IL-4 or IL-13 is dominantly involved, and to apply the developing IL-4/IL-13 inhibitors to these patients. In this article, we show how we are addressing this issue.     

Formaldehyde concentrations in the breathing zone of medical students during gross anatomy laboratory in Toho University

Cadavers for gross anatomy laboratories are conventionally embalmed by formaldehyde (FA) solution in most medical schools. Thus, medical students and instructors are exposed to FA vapors emitted from cadavers during dissection. As a basic survey for the improvement of the dissection environment, we examined FA concentration in the gross anatomy laboratory during the 2006 academic year at the Faculty of Medicine of Toho University. Air samples were taken from 20 cm above a cadaver as breathing zone, and above a desk between cadavers as indoor FA concentration. FA concentrations in the breathing zone were ranged from 0.24 to 3.04 (mean 1.71) ppm during systematic anatomy, and from 0.72 to 1.60 (mean 1.16) ppm during neuroanatomy, and indoor FA concentration ranged from 048 to 1.11 (mean 0.76) ppm and from 0.21 to 0.23 (mean 0.22) ppm, respectively. These results showed that medical students and instructors are exposed to higher concentrations of FA than allowed by the guidelines of the Japan Ministry of Health, Labor and Welfare, and suggested the need to reduce FA levels in the gross anatomy laboratory.     

Survey on changes in subjective symptoms,onset/trigger factors,allergic diseases,and chemical exposures in the past decade of Japanese patients with multiple chemical sensitivity

Background

Recently, with rapid changes in the Japanese lifestyle, the clinical condition of patients with multiple chemical sensitivity (MCS) may also have undergone change. Thus, we conducted a new survey for subjective symptoms, ongoing chemical exposures, the prevalence of allergic diseases, and presumed onset/trigger factors in patients with MCS and compared results with those of an old survey from ten years ago.

Metabolism of fatty acids and bile acids in plasma is associated with overactive bladder in males: potential biomarkers and targets for novel treatments in a metabolomics analysis

International Urology and Nephrology - The present study was conducted to identify metabolites using a metabolomics approach and investigate the relationship between these metabolites and urgency...     

Comparison of visual field defect progression in secondary Glaucoma due to anterior uveitis caused by three types of herpes viruses

Graefe's Archive for Clinical and Experimental Ophthalmology - To clarify the prevalence of secondary glaucoma (SG) and its speed of progression in patients with herpes simplex virus...