Correction to: Association of initial prednisolone dose with remission,relapse, and infectious complications in adult‑onset minimal change disease

Clinical and Experimental Nephrology - In the original publication, the author has found few errors. The corrections are given below.     

Gene therapy for breast cancer

Not only the local treatments like surgery and radiation but also the systemic treatments like chemotherapy and hormone therapy are rather effective on both primary and metastatic breast cancer patients. Nevertheless, the curativity and survival of this disease have been not satisfied yet. The difficulties of the treatment seems the emergence of drug-resistant cells and the low immunity of the host. Gene therapy offers a potentially useful approach for the treatment of breast cancer. The approaches of gene therapy for breast cancer that are now undergoing as clinical protocols in USA can be divided into three strategies: (1) approaches that alter the metabolic or signaling pathways within the breast cancer cell; (2) approaches designed to enhance the immune response to the tumor cells(immuno gene therapy); and (3) approaches that use the drug-resistant gene with chemotherapy. According to the new biology of breast cancer by Fisher, the systemic treatments are more important. Immuno-therapy seems especially promising in this field. Moreover, the immuno gene therapy is hopeful that could overcome the difficulties like heterogeneity and low immunogenicity of breast cancer cell.     

Appendicitis caused by caecal carcinoma: report of a case

Appendicitis can rarely occur in association with carcinoma of the caecum, particularly in elderly patients. We report a case of acute appendicitis provoked by an adenocarcinoma of the caecum which obstructs the lumen of the appendix in a 58-year-old man. The patient underwent an ileocaecal resection with lymph node dissection. The difficulties of identifying a small tumor at laparotomy and the implication for optimal treatment are emphasized.     

Large acinar cell carcinoma of the pancreas in a patient with elevated serum AFP level

A pancreatic carcinoma, associated with elevated serum alpha-fetoprotein level, was resected from a 67-year-old man. The tumor was strongly suggested to be an acinar cell carcinoma of the pancreas, based on the histological findings of the resected specimen. The tumor measured 12 × 10 × 9 cm, and the cut surface was soft, whitish-yellow, focally necrotic, and hemorrhagic. Under a light microscope, the tumor cells were not arranged in a tubular and trabecular pattern, but rather, showed a tendency toward an acinar structure. Immunohistochemically, α 1-antitrypsin- and α 1-antichymotrypsin-positive reactions were diffusely positive in most of the tumor cells, while staining for chromogranin, neuron-specific enolase, Grimelius, glucagon, insulin, and alpha-fetoprotein was negative in the tumor cells. We report a large acinar cell carcinoma (associated with elevated serum alpha-fetoprotein level), which had been misdiagnosed as hepatocellular carcinoma preoperatively. Received for publication on May 9, 1998; accepted on Sept. 20, 1999     

Resectable carcinoma of the pancreatic head developing 7 years and 4 months after distal pancreatectomy for carcinoma of the pancreatic tail

A 67-year-old woman was referred with an abnormal finding on an abdominal echogram but presented with no symptoms; a pancreatic tail tumor was detected by ultrasonography. Biochemical examinations showed slight elevation of serum carcinoembryonic antigen level. The lesion was resected by tail and body pancreatectomy and her postoperative course was uneventful. Seven years and 4 months after the initial operation, however, her serum level of carbohydrate antigen 19-9 was found to be elevated, and a recurrence of pancreatic cancer was suspected. Examinations revealed a mass in the head of the remnant pancreas. The lesion was radically resected by total remnant pancreatectomy. Histological examinations showed that the initial tumor was a well differentiated tubular adenocarcinoma, while the second tumor was characterized as a moderately differentiated tubular adenocarcinoma. The surgical margins of the distal pancreatectomy specimen were free of atypical cells. Therefore, the position of the second lesion diminished the likelihood that it had developed by intrapancreatic metastasis. This suggests that the second carcinoma in the head of the pancreas may have been a second primary lesion. Received for publication on June 1, 1999; accepted on Sept. 20, 1999     

Video-Assisted Thoracic Surgery Lobectomy for Extralobar Pulmonary Sequestration in a Child: Report of a Case

Pulmonary sequestration in infants and children is conventionally treated by resecting the sequestered lung parenchyma (sequestrectomy) or by performing lobectomy through a standard thoracotomy. We performed lobectomy by video-assisted thoracic surgery, using an original tracheal tube that we designed, in a 6-year-old boy with extralobar pulmonary sequestration and bronchiectasis in the left lower lobe.     

Curve models for comparative phase III trials: heterogeneity of the population

Equations were calculated to describe survival on disease-free survival (DFS) curves related to control or adjuvant-therapy-treated patients. They allowed us to differentiate three different segments or populations in the survival curve on a semi-log scale describing high-risk, intermediate-risk and low-risk groups. The percentage of patients and the annual mortality in each risk group could be calculated from the coefficients of the equation. As an example, the DFS curves of the premenopausal breast cancer patients of the Milan group were composed of three segments in the control group and of two segments in the CMF-treated group.     

New survival curve model for comparison of adjuvant therapy of malignant diseases

Two mathematical models were presented to approximate the various survival curves for malignant diseases. The models individualized several segments in the survival curve. Also, the hazard function of the curve and the confidence intervals of the curve could be calculated. First, we studied the survival-after-relapse curve for adjuvant therapy of malignant melanoma. The curve for chemoimmunotherapy had three segments and the curve for immunotherapy, two segments. The immunotherapy showed its effect in the early period of treatment. Second, the disease-free survival curves for adjuvant therapies of breast cancer were compared; Oncofrance trial: a combination of AVCF was superior to a combination of CMF in all the periods of the therapy; Lacour's trial: Poly A-Poly U was more effective than the control in the middle and late period; Bonadonna's trial: CMF was superior to the control in the early period. Third, the survival curves for adjuvant therapy of stomach cancer; immunotherapy versus non-immunotherapy were analysed. Comparison of the confidence intervals of each curve clarified that no significant difference could be found between them. Thus, these analyses showed the effectiveness of the compared adjuvant treatments.