Adiponectin suppresses tumorigenesis in Apc mice

Recent reports have shown that adiponectin has a suppressive effect on various types of malignancy. In order to clarify the role of adiponectin in colorectal carcinogenesis, we examined the effect of exogenous administration of adiponectin on intestinal polyp formation in C57BL/6 J-Apc^Min/+ mice, which possess a point mutation in the Apc gene. And we found that adiponectin treatment significantly decreased the number of adenomatous polyps, especially polyps larger than 2 mm in diameter, in the small intestine. Two major receptors for adiponectin, AdipoR1 and AdipoR2, were expressed in adenomatous polyps, and their expression levels were not altered by adiponectin injection. In conclusion, adiponectin suppresses the growth of intestinal adenomas in the Apc^Min/+ mice. Increasing the adiponectin level may be a new strategy for the prevention of colorectal cancer at an early step of carcinogenesis.     

A case of colon cancer with multiple liver metastases effectively treated with hepatic arterial infusion followed by systemic chemotherapy

A 63-year-old female was diagnosed as descending colon cancer with severe liver dysfunction caused by multiple liver metastases. Her performance status (PS) was 3 because of liver dysfunction and high fever. Initially, hepatic arterial infusion (HAI) chemotherapy was started to reduce the size of metastatic tumors and to prevent a liver failure. After 10 courses of HAI chemotherapy, she recovered from liver dysfunction, and CapeOX plus bevacizumab regimen was started. A partial response of metastatic liver tumors was observed after 8 cycles of this regimen and metastatic lung tumors were disappeared. The patient was alive after 12 months with PS 0 and CapeOX was continued.     

Radiation-induced glioblastoma occurring 35 years after radiation therapy for medulloblastoma: case report

A 41-year-old man was admitted in June 2007 with a 1-month history of headache and cerebellar ataxia. At the age of 5 years, in May 1971, he had presented with headache, vomiting, and gait disturbance. Cerebral angiographical study demonstrated vascular shift caused by a mass lesion in the cerebellar vermis. He had immediately undergone partial removal. Histological diagnosis was medulloblastoma (MB). Postoperatively he received a total of 40 Gy radiation to the whole brain and 30.5 Gy to the spine without chemotherapy. He was again seen 35 years later with a radiation-induced glioblastoma (GB) that arose in the region of the original MB. The tumor was surgically removed, and he received radiotherapy and chemotherapy with ACNU, procarbazine, and vincristine. Postoperative irradiation reduced the size of the second tumor.     

Gastrointestinal stromal tumor presenting with prominent calcification

We present a rare case of a gastrointestinal stromal tumor (GIST) in the stomach with prominent calcification at presentation. A 61-year-old woman visited our hospital because of epigastric discomfort. A spherical calcified lesion with a diameter of about 30 mm was incidentally shown in the left upper quadrant on an abdominal X-ray. Computed tomography demonstrated that the tumor was growing from the upper gastric body, with calcification in the peripheral ring area. A laparoscopic partial gastrectomy was performed, and the resected specimen revealed a well-circumscribed tumor with exophytic growth from the gastric muscularis propria. Microscopic examination revealed spindle-shaped tumor cells with calcification and hemorrhage. Additionally, positive immunoreactivity of the tumor to KIT and CD34 and a low mitotic index resulted in the diagnosis of very low risk GIST. There are a few case reports of heavily calcified GIST, although solitary or punctate calcification of primary GIST has been reported in several case series. Dystrophic calcification of necrotic or degenerative tissue is the supposed cause of primary calcified GISTs. In contrast, appearance of calcification after administration of imatinib mesylate, which may be one indicator of disease response, is possibly caused by a different mechanism.     

Concentration of acute phase factors in vitreous fluid in diabetic macular edema

Purpose

Diabetic retinal maculopathy is associated with acute and chronic local inflammation. We measured the concentrations of acute phase factors in vitreous fluid of patients with diabetic macular edema (DME) and examined their relations to visual acuity and central retinal thickness (CRT) both before and after vitrectomy.

Study design

Retrospective.

Methods

Vitreous fluid was collected during vitreoretinal surgery from 19 patients with DME and 12 control subjects with epiretinal membrane. The concentrations of acute phase factors (α2-macroglobulin, haptoglobin, C-reactive protein, serum amyloid P and A, procalcitonin, ferritin, tissue plasminogen activator, fibrinogen) and vascular endothelial growth factor (VEGF) were measured with multiplex assays. CRT of macular edema was measured by optical coherence tomography (OCT).

Results

The levels of serum amyloid P, procalcitonin, ferritin, and fibrinogen in vitreous fluid were increased in DME patients compared with control subjects. The levels of procalcitonin and fibrinogen in DME patients were inversely correlated with visual acuity both before and 3 months after vitrectomy but not 6 months postsurgery. The concentrations of these four factors were not correlated with either CRT or the vitreous levels of VEGF in DME patients.

Conclusion

Acute phase factors may contribute to local inflammation in DME and may therefore influence disease progression.

     

Social impacts of the work loss in cancer survivors

Background

As cancer frequently occurs during the most productive years of life, our purpose was to estimate the cost of work loss of cancer survivors and develop interventions to minimize the loss.

Methods

We estimated the cost of the work loss from all cancers resulting from patients’ inpatient, outpatient, and non-treatment days. This was calculated with a new method, the product of the “employment rate coefficient × productivity coefficient,” making use of data published by the Japanese Ministries.

Results

The estimate of work loss on treatment days for all cancers was $1820.21 million in men and $939.38 million in women. In terms of disease classification, lung cancer was the largest cause in men, whereas breast cancer was the largest in women. On non-treatment days, the work losses because of gastric, colon, and lung cancers were large in men, while breast cancer was the largest in women and in total. The estimated loss for all cancers was $3685.506 million in men and $2502.565 million in women, when the product was assumed 0.5.

Conclusions

In Japan, breast cancer was considered the leading cause for cost of work loss, and the most influential cause when the product of the “employment rate coefficient × productivity coefficient” for breast cancer was assumed the same as the product for all other types of cancers. It is necessary to establish support systems for working cancer survivors.

     

Hepatosplenic Hodgkin lymphoma without lymphadenopathy following reversible methotrexate-associated lymphoproliferative disorder

Lymphoproliferative disorders (LPDs) occur more frequently in rheumatoid arthritis (RA) patients treated with immunosuppressive agents than in the non-RA population. However, the various forms of disease progression have not yet been elucidated in detail. We encountered a case of Epstein–Barr virus (EBV)-positive atypical polymorphous LPD in the cervical and intraabdominal lymph nodes with hepatosplenomegaly in an 88-year-old female with RA who had taken infliximab and methotrexate (MTX) for six years. Although spontaneous remission occurred following the withdrawal of infliximab and MTX, reversible LPD evolved into hepatosplenic Hodgkin lymphoma without lymphadenopathy presenting as a cholestatic febrile illness. Our findings suggest that the recurrent lesions of MTX-associated LPDs may not always coincide with the primary lesion and may present unexplained findings based on various extranodal diseases.     

TAFRO syndrome: 2 cases and review of the literature

Recently, more than ten cases of thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly (TAFRO) syndrome or Castleman–Kojima disease exhibiting such symptoms as thrombocytopenia, anasarca, fever, reticulin fibrosis and organomegaly have been reported in Japan. We have found two cases of TAFRO syndrome and have reviewed another eighteen previously reported cases. Histological findings of the lymph nodes and levels of interleukin 6 (IL-6) and vascular endothelial growth factor in both serum/plasma and effusions are important characteristics for diagnosing this syndrome.