Treatment outcomes of sialendoscopy for submandibular gland sialolithiasis: The minor axis of the sialolith is a regulative factor for the removal of sialoliths in the hilum of the submandibular gland using sialendoscopy alone

Objective

To assess the general guidelines for the removal of sialoliths for submandibular gland sialolithiasis using sialendoscopy alone.

Prophylactic effect of neoadjuvant chemotherapy in gastric cancer patients with postoperative complications

Background

The occurrence of postoperative complications may have a significant negative impact on the prognosis of patients with gastrointestinal cancers. The inflammatory response releases systemic cytokines, which may induce residual cancer cell growth. Recently, neoadjuvant chemotherapy (NAC) was found to improve the prognosis of advanced gastric cancer (GC). We hypothesize that when postoperative complications occur after gastrectomy, NAC treatment of micrometastases can prevent residual cancer cell growth.

Methods

This study included 101 patients who underwent curative resection after NAC for GC from 2005 to 2015. Clinical data, including intraoperative parameters, were collected retrospectively. Overall survival (OS) and relapse-free survival (RFS) were compared between the patients with complications and those without complications.

Results

Of the 101 patients, 35 (34.7%) had grade 2 or higher complications. Among those with complications, the 3- and 5-year OS rates were 63.5 and 58.2% and the 3- and 5-year RFS rates 41.7 and 41.7%, respectively. Among those without complications, the 3- and 5-year OS rates were 65.9 and 56.3% and the 3- and 5-year RFS rates 51.1 and 43.9%, respectively. There was no significant difference in prognosis between the patients with complications and those without complications.

Conclusion

Our study is the first to demonstrate the potential of NAC to abolish the poor prognosis induced by postoperative complications after curative resection for GC.

     

Abiraterone Followed by Enzalutamide Versus Enzalutamide Followed by Abiraterone in Chemotherapy-naive Patients With Metastatic Castration-resistant Prostate Cancer

Background

Abiraterone (AA) and enzalutamide (ENZA) are increasingly being used in chemotherapy-naive patients with metastatic castration-resistant prostate cancer owing to efficacy and favorable toxicity. However, the order in which they should be administered has not been determined.

WT1 peptide‐based immunotherapy for advanced thymic epithelial malignancies

Thymic epithelial tumors are rare malignancies, and no optimal therapeutic regimen has been defined for patients with advanced disease. Patients with advanced thymic epithelial tumors, which were resistant or intolerable to prior therapies, were eligible for this study. Patients received 9 mer‐WT1‐derived peptide emulsified with Montanide ISA51 adjuvant via intradermal administration once a week as a monotherapy. After the 3‐month‐protocol treatment, the treatment was continued mostly at intervals of 2–4 weeks until disease progression or intolerable adverse events occurred. Of the 15 patients enrolled, 11 had thymic carcinoma (TC) and 4 had invasive thymoma (IT). Median period from diagnosis to the start of treatment was 13.3 and 65.5 months for TC and IT, respectively. No patients achieved a complete or partial response. Of the 8 evaluable TC patients, 6 (75.0%) had stable disease (SD) and 2 had progressive disease (PD). Of the 4 evaluable IT patients, 3 (75.0%) had SD and 1 (25.0%) had PD. Median period of monotherapy treatment was 133 and 683 days in TC and IT patients, respectively. No severe adverse events occurred during the 3‐month‐protocol treatment. As adverse events in long responders, thymoma‐related autoimmune complications, pure red cell aplasia and myasthenia gravis occurred in two IT patients. Cerebellar hemorrhage developed in a TC patient complicated with Von Willebrand disease. Induction of WT1‐specific immune responses was observed in the majority of the patients. WT1 peptide vaccine immunotherapy may have antitumor potential against thymic malignancies.     

Hypercoagulable state and disseminated intravascular coagulation following an effective chemotherapy in tumor-bearing rats

OBJECTIVE: To detect the changes in blood coagulation system and clarify the related mechanisms of chemotherapy-induced disseminated intravascular coagulation. METHODS: Changes in blood coagulation system and immunohistochemistry for fibrinogen were investigated in six groups of rats designed for different purposes. RESULTS: Decreased platelet count, prolonged prothrombin time and active partial thromboplastin time, elevated fibrinogen level, and decreased antithrombin were observed in the rats receiving a newly developed chemotherapy (NDC group), in which mitomycin C was administered intravenously together with angiotensin. Accumulation of fibrinogen and microthrombi in the blood vessels of multiple organs were also found in the NDC group by immunohistochemistry and histopathological examination. CONCLUSIONS: Rapid reduction of tumor mass induced by an effective chemotherapy could cause hypercoagulable state and disseminated intravascular coagulation.     

THE ROLE OF ENDOTHELIAL CELLS IN THE PATHOGENESIS OF ATHEROSCLEROSIS

Using mainly rabbits and rats investigations on the endothelial permeability of the aorta, on relation between thrombus formation and endothelial damage, and on tissue culture of the endothelial cells of the rabbit aorta have been carried out.
The permeability of endothelial layer of rabbit aorta Increased by cholesterol-feeding. This seems to be derived from morphological and functional disorder of the endothelial cells. As a hemodynamic effect of blood flow, increased permeability of the endothelium of rat aorta was also found in experimental renal hypertension.
Accumulation of blood-plasma components (edema) was seen in the subendothellal area in cholesterol-fed rabbit aorta and in hypertensive rat aorta. Long-standing subendothellal edema is considered to be the cause of fibrous intlmal thickening (Grade I lesion/Nakashlma).
Endothelial defect of the aorta due to various damages is related to thrombus formation, and this seems to be accelerated by cholesterol feeding.
Morphological differences between normal endothelium and that of atherosclerotic lesion in human and in rabbit aortas can be seen.
Tissue culture of the endothelium was performed in vivo and in vitro, and some discussions were made on the characteristics of cultured endothelial cells.     

IFN-gamma-producing human T cells directly induce osteoclastogenesis from human monocytes via the expression of RANKL

The current study explored our hypothesis that IFN-gamma-producing human T cells inhibit human osteoclast formation. Activated T cells derived from human PBMC were divided into IFN-gamma-producing T cells (IFN-gamma(+) T cells) and IFN-gamma-non-producing T cells (IFN-gamma(-) T cells). IFN-gamma(+) T cells were cultured with human monocytes in the presence of macrophage-CSF alone. The concentration of soluble receptor activator of NF-kappaB ligand (RANKL) and IFN-gamma, and the amount of membrane type RANKL expressed on T cells, were measured by ELISA. In the patients with early rheumatoid arthritis (RA) treated with non-steroidal anti-inflammatory drugs alone, CD4+ T cells expressing both IFN-gamma and RANKL were detected by flow cytometry. Surprisingly, IFN-gamma(+) T cells, but not IFN-gamma(-) T cells, induced osteoclastogenesis from monocytes, which was completely inhibited by adding osteoprotegerin and increased by adding anti-IFN-gamma antibodies. The levels of both soluble and membrane type RANKL were elevated in IFN-gamma(+) T cells. The ratio of CD4+ T cells expressing both IFN-gamma and RANKL in total CD4+ T cells from PBMC was elevated in RA patients. Contrary to our hypothesis, IFN-gamma(+) human T cells induced osteoclastogenesis through the expression of RANKL, suggesting that Th1 cells play a direct role in bone resorption in Th1 dominant diseases such as RA.     

Inhibition of autologous mixed lymphocyte reaction by monoclonal antibodies specific for the beta chain of HLA-DR antigens

Recent studies using rabbit antisera to the separated HLA-DR alpha and beta subunits have suggested that alpha chain-specific, but not beta chain-specific, antisera inhibit T cell proliferative responses in primary and secondary human autologous mixed lymphocyte reaction (AMLR). In the present study, with the aid of sequential co-precipitation assays and Western blotting methods, a monoclonal rat alloantibody 1E4, specific for the beta chain of rat class II molecules carrying an Ia determinant Ba-2.7, was characterized to recognize a monomorphic determinant located on the beta chain of DR antigens. This antibody and a murine monoclonal antibody HU-4, also specific for the beta chain of DR antigens, strongly inhibited both primary and secondary AMLR through a mechanism distinct from an antibody-dependent cell-mediated cytotoxicity reaction. These results indicate that the inhibition of AMLR is not a unique feature of DR alpha-specific antibodies.     

Irreducible dislocation of the knee with interposition of the patella

Traumatic dislocation of the knee is uncommon, and the knee dislocation can usually be reduced satisfactory by closed methods. We report a case of the irreducible dislocation of the knee with interposition of the patella.