DOK2 as a Marker of Poor Prognosis of Patients with Gastric Adenocarcinoma After Curative Resection

Background

DOK2 is known as the substrate of chmeric p210bcr/abl oncoprotein characterizing chronic myelogenous leukemia with Philadelphia chromosome. Reduced DOK2 expression was recently reported in lung adenocarcinoma, suggesting that this protein acts as a tumor suppressor in solid tumors. The purpose of this study was to determine the significance of DOK2 in gastric cancer.

Methods

The study subjects were 118 patients who underwent curative surgery for gastric cancer, as well as 7 gastric cancer cell lines. The tissues and cell lines were analyzed for DOK2 gene and protein expressions by histopathology and immunohistochemistry, and also using a microsatellite marker for loss of heterozygosity. Correlation of survival with clinicopathological parameters was investigated by univariate and multivariate analyses.

Results

DOK2 expression was confirmed in the normal gastric mucosa. Considerable differences in the gene expression were noted among the gastric cell lines. Positive DOK2 expression was noted in the noncancerous regions of all pathological specimens, whereas 59 (50.0%) specimens of 118 patients were negatively stained in the tumor. Loss of heterozygosity was observed in 54.5% of DOK2(?) cases. DOK2(?) patients were more likely to develop recurrence than DOK2(+) and showed poorer 5-year overall survival (59.1%) than DOK2(+) (76.4%, P = .0403). Multivariate analysis identified pT (hazard ratio [HR] = 2.748, 95% confidence interval [95% CI] = 1.061–8.927, P = .0361), pN (HR = 2.486, 95% CI = 1.264–4.932, P = .0086), and DOK2(?) (HR = 2.343, 95% CI = 1.211–4.727, P = .0112) as significant and independent determinants of poor survival.

Conclusions

Our data suggest the potential usefulness of DOK2 as a marker of poor prognosis in patients with gastric cancer after curative resection.

     

Intrathoracic irrigation with arbekacin for methicillin-resistant Staphylococcus aureus empyema following lung resection

OBJECTIVES Empyema is a well-known complication following lung resection. In particular, empyema caused by methicillin-resistant Staphylococcus aureus (MRSA) is difficult to treat. Here, we present our experience of MRSA empyema treated with local irrigation using arbekacin. METHODS Six patients consisted of 4 males and 2 females with an average age of 65.7 years. They developed MRSA empyema following lung resection and were treated at our institution between 2007 and 2011. Cases comprised four primary and one metastatic lung cancer, and 1 patient was a living lung transplantation donor. The surgical procedure consisted of four lobectomies, one segmentectomy and one wedge resection. After diagnosis of MRSA empyema, anti-MRSA drugs were administered intravenously in all cases. In addition, arbekacin irrigation at a dose of 100?mg dissolved in saline was performed after irrigation with saline only. RESULTS The average number of postoperative days for the diagnosis of MRSA empyema was 13 (range 4-19). The period of irrigation ranged from 6 to 46 days. Arbekacin irrigation did not induce nephrotoxicity or other complications, and no bacteria resistant to arbekacin was detected in the thoracic cavity. We re-operated on 1 case because he had pulmonary fistula and severe wound infection. At the time of removing the thoracic catheter, MRSA in the pleural effusion disappeared completely in 3 patients. The period until MRSA concentration in the pleural effusion became negative after starting arbekacin irrigation ranged from 4 to 9 days. In the remaining cases, in which MRSA did not disappear, the catheter was removed because of no inflammatory reaction after stopping irrigation and clamping the catheters. All patients were discharged from our institution without thoracic catheterization and no patients had relapsed during the follow-up period ranging from 6 to 44 months. CONCLUSIONS Irrigation of the thoracic cavity with arbekacin proved to be an effective, safe and readily available method for treating MRSA empyema following lung resection.     

Spontaneous regression of hepatocellular carcinoma repeated 3 times with invasion of portal vein and inferior vena cava: report on a rare case

A 65-year-old man suffered from advanced hepatocellular carcinoma in the right lobe of the liver, for which he received no treatment. His serum was positive for hepatitis C antibody. In spite of his poor prognosis, he remained in good clinical condition and at 6-month follow-up the tumor had regressed without specific treatment, as assessed both radiologically and from a decrease of a previously elevated serum tumor marker level (1st regression). The tumor regrew in size, but at 23-month follow-up could no longer be visualized radiologically (2nd regression). A follow-up computed tomography (CT) scan did not show any relapse of hepatocellular carcinoma until March 2005. At that time, a new lesion had developed in the caudate lobe and tumor size had increased to ≥10 cm in diameter, and in June 2006 had invaded the portal vein and inferior vena cava. Afterwards, the tumor lesion gradually decreased again. In June 2007, a CT scan showed a further reduction of tumor size (3rd regression). Here, we report a rare case of spontaneous regression of hepatocellular carcinoma in which spontaneous regression and recurrence were repeated 3 times.     

Ultraselective arterial embolization of vasa recta using 1.7-French microcatheter with small-sized detachable coils in acute colonic hemorrhage after failed endoscopic treatment

OBJECTIVE: The purpose of this article is to document our experiences with ultraselective arterial embolization to manage acute colonic hemorrhage using a 1.7-French microcatheter with small-sized detachable coils and to discuss the feasibility and clinical efficacy of this new technique. CONCLUSION: We achieved technical success in all four patients with the sole use of short-segment embolization of the long branch of the vasa recta. Our findings suggest that this technique is useful for embolization in cases of colonic hemorrhage.     

Isolation and Characterization of an Actin-like Protein from Membranes of Human Red Cells

The existence of an actin-like protein in human red-cell membranes has been confirmed. The protein was extracted from acetone-treated ghosts and purified by (NH₄)₂SO₄ fractionation. The protein undergoes G-F transformation and forms filaments in the presence of O.I. M KCl. The filaments can be 'decorated'by muscle heavy meromyosin. The protein has the same molecular weight as muscle actin and interacts with muscle myosin. All these properties show that the protein closely resembles muscle actin.     

Inhibition of the in vitro formation of irreversibly sickled cells by cepharanthine

S ummary. A method was developed to prepare irreversibly sickled cells (ISC) in vitro under a physiological condition. By exposing sickle red cells to repeated deoxygenation-reoxygenation cycles for 15 h at 37°C, 20–30% of the red cells formed ISC. These cells were separated from biconcave-shaped cells by a gradient density centrifugation. The percentage of the formation of ISC was determined spectrophoto-metrically after cells were haemolysed. Cepharanthine, a bisbenzylisoquinoline alkaloid, was found to inhibit this in vitro formation of irreversibly sickled cells by 50% at 15 μM. This concentration was much lower than that required to inhibit the in vitro sickling.