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.     

Synthesis of Pd–Ru solid-solution nanoparticles by pulsed plasma in liquid method

We have synthesized solid-solution nanoparticles (Pd : Ru = 1 : 3, 1 : 1 and 3 : 1) in an immiscible Pd–Ru system by the pulsed plasma in liquid method using Pd–Ru mixture bulk electrodes. The particle sizes of the floated and sedimented samples were measured to be <10 and <20 nm, respectively, via high-resolution transmission electron microscopy (HR-TEM). The lattice parameters of nanoparticles followed the Vegard''s law, and the energy-dispersive X-ray spectroscopy (EDX) results almost coincided with those obtained for the starting bulk mixtures. The solid-solution structures and local structure were confirmed via HR-TEM, X-ray photoelectron spectroscopy (XPS) and X-ray absorption fine structure spectroscopy (XAFS).

We have synthesized solid-solution nanoparticles (Pd : Ru = 1 : 3, 1 : 1 and 3 : 1) in an immiscible Pd–Ru system by the pulsed plasma in liquid method using Pd–Ru mixture bulk electrodes.     

Surgery for a gastroenteropancreatic neuroendocrine tumor (GEPNET) in multiple endocrine neoplasia type 1

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominantly inherited endocrine tumor syndrome characterized by tumor development in various endocrine organs such as the parathyroid, endocrine pancreas, anterior pituitary and adrenal cortex. The first extensive database for Asian patients with MEN1 was established by the MEN Consortium of Japan. Although the clinical features of Japanese patients with MEN1 are similar to those from Western countries, there are several characteristic differences between them. In particular, gastroenteropancreatic neuroendocrine tumor (GEPNET) is seen in approximately 60 % of patients with MEN1 in Japan. Although its development is the strongest prognostic factor in patients with MEN1, the characteristics of MEN1-associated GEPNET still remain unclear. This is especially true for the differences in clinical features of GEPNET with and without MEN1. Improved long-term survival is obtained by curative surgery for patients with MEN1-associated GEPNET. The current surgical indications are expanding even in patients with hepatic metastases because of the improved surgical outcome. This article reviews the clinical characteristics in these patients with a particular focus on surgery, diagnosis, surgical indications, surgical method, and surgical outcome.     

Dynamic change and influence of osteoporotic back pain with vertebral fracture on related activities and social participation: evaluating reliability and validity of a newly developed outcome measure

The objective of this study was to record the clinical course of osteoporosis over time in Japanese women. We hypothesized that successful control of acute pain associated with osteoporosis will allow better treatment for health-related problems. To confirm this working hypothesis, we developed the Japan Questionnaire for Osteoporotic Pain (JQ22) to measure health status associated with osteoporosis. We examined the validity and reliability of the JQ22 compared with the current gold standard scale for back pain, the Roland Morris questionnaire (RDQ). A total of 125 women who were more than 65 years old, had an acute back pain episode, and had a fragile vertebral fracture confirmed by X-ray and clinical signs, participated in this study. The psychometric analyses for validity and reliability were tested for the JQ22 and the RDQ. The time course up to 6 weeks was observed by investigating both changes in pain characteristics and its influence on related activities and social participation. Cronbach’s alpha coefficient was 0.979 and 0.919 for the JQ22 and RDQ, respectively. The Akaike Information Criterion (AIC) indicated that the JQ22 items were separated into four domains, which were sequentially arranged at the baseline and subsequently changed. This structure reflected osteoporotic back characteristics covering a range from pain to social activities. The JQ22 was shown to be a valid and reliable scale for patient-based measurement of osteoporotic back pain. It also revealed both changes in pain characteristics and the influence of pain on related activities and participation.     

Kawasaki disease: basic and pathological findings

Kawasaki disease (KD) is considered to be a kind of systemic vasculitis syndrome. It most frequently affects infants and young children and primarily invades medium-sized muscular arteries, including the coronary arteries. The etiology of KD is unknown, but epidemiological data suggest involvement of infectious agents, such as bacteria and viruses, in the onset of KD. In addition, host genetics underlie the disease’s pathogenesis. Histologically, coronary arteritis begins 6–8 days after KD onset, and inflammation of all layers of the artery rapidly ensues. The inflammation spreads completely around the artery, resulting in severe damage to structural components. Then, the artery begins to dilate. KD arteritis is characterized by inflammation consisting of marked accumulation of monocytes/macrophages. Aberrant activation of monocytes/macrophages is thought to be involved in the formation of vascular lesions. Inflammatory-cell infiltration persists until about the 25th day of the disease, after which the inflammatory cells gradually decrease in number. Lesions in all arteries are relatively synchronous, as they evolve from acute to chronic injury. If a giant aneurysm remains or vessel recanalization occurs after thrombotic occlusion of an aneurysm, remodeling of the vascular structure, sometimes including even reocclusion, continues even in the remote stage.     

A case of mesenteric cystic lymphangioma in an adult which caused duodenal stenosis after resection

INTRODUCTIONWe present a rare case of mesenteric lymphangioma in a middle-aged female.PRESENTATION OF CASEA 56-year-old female was admitted to the hospital with upper abdominal pain. Abdominal computed tomography revealed a multicystic mass surrounding the mesentery. We made the decision to resect the mass, suspecting that was a mesenteric lymphangioma based on additional imaging studies. The tumor adhered strongly to parts of the duodenum and the upper jejunum. In order to preserve the jejunum, we dissected its serosa away from the tumor. Approximately 1 week after surgery the patient experienced a constriction of the third portion of the duodenum. Her symptoms were improved with conservative therapy, and she was discharged from the hospital 62 days after surgery.DISCUSSIONLymphangioma originating from the mesentery may have cause adhesions due to exfoliated tumor cells; it is necessary to be concerned about postoperative obstruction.CONCLUSIONThe preoperative diagnosis of lymphangioma is based on various imaging modalities.     

Capillary filling analysis by digital subtraction angiography for vertebro-basilar insufficiency

Abstract

Vertebro-basilar insufficiency (VBI) is a vague clinical entity including several symptoms such as faintnessdizziness, vertigo. Millikan and Siekert reported a ‘syndrome of intermittent insufficiency of basilar arterial system'1. But vascular abnormalities responsible for such symptoms are often hardly diagnosed by conventional angiography, because vertebro-basilar artery systems have many kinds of anomalous congenital origins2. Conventional angiography gives us arterial informations such as stenosis, occlusion and malformationsbut it often fails to reveal capillary perfusions because of its relatively poor density resolution. Digital subtraction angiography (DSA) is considered to have improved density resolutioni, and it may enable us to detect vascular perfusions more sensitively in the capillary phase. In this study, we evaluated the usefulness of the capillary filling analysis in digital subtraction angiography for diagnosis of VBI.     

Ultrafast-charging and long cycle-life anode materials of TiO2-bronze/nitrogen-doped graphene nanocomposites for high-performance lithium-ion batteries

Emerging technologies demand a new generation of lithium-ion batteries that are high in power density, fast-charging, safe to use, and have long cycle lives. This work reports charging rates and specific capacities of TiO₂(B)/N-doped graphene (TNG) composites. The TNG composites were prepared by the hydrothermal method in various reaction times (3, 6, 9, 12, and 24 h), while the N-doped graphene was synthesized using the modified Hummer''s method followed by a heat-treatment process. The different morphologies of TiO₂ dispersed on the N-doped graphene sheet were confirmed as anatase-nanoparticles (3, 6 h), TiO₂(B)-nanotubes (9 h), and TiO₂(B)-nanorods (12, 24 h) by XRD, TEM, and EELS. In electrochemical studies, the best battery performance was obtained with the nanorods TiO₂(B)/N-doped graphene (TNG-24h) electrode, with a relatively high specific capacity of 500 mA h g⁻¹ at 1C (539.5 mA g⁻¹). In long-term cycling, excellent stability was observed. The capacity retention of 150 mA h g⁻¹ was observed after 7000 cycles, at an ultrahigh current of 50C (27.0 A g⁻¹). The synthesized composites have the potential for fast-charging and have high stability, showing potential as an anode material in advanced power batteries for next-generation applications.

The TiO₂-bronze/nitrogen-doped graphene nanocomposites have the potential for fast-charging and have high stability, showing potential as an anode material in advanced power batteries for next-generation applications.