[Docetaxel and Ramucirumab Combination Chemotherapy after Nivolumab Treatment for Pretreated Pulmonary Squamous Cell Carcinoma-A Successful Case].

For immune checkpoint inhibitor(ICI)-pretreated patients, docetaxel and ramucirumab(DTX plus RAM)combination therapy can be more effective than no treatment. Herein, we present the case of a patient who had been treated with ICIs and was thereafter successfully treated with DTX plus RAM. A 62-year-old man with primary pulmonary squamous cell carcinoma( PDL-1 tumor proportion score<1%)at clinical stage ⅠA2(cT1bN0M0)was treated as follows: 1)right upper lobectomy ND2a-2(pT1bN0M0, stage ⅠA2); 2)surgery for a solitary pleural metastasis 20 months later; 3)cisplatin plus vinorelbine for multiple pleural metastases as a first-line treatment 24 months after the initial surgery; and 4)nivolumab as a second-line treatment. However, progressive disease and an adverse event occurred after 5 courses of nivolumab, and DTX plus RAM were introduced as a third-line treatment. A complete response to 12 courses of combination therapy(41 months after surgery/29 months after recurrence)was determined. Unfortunately, the DTX plus RAM regimen had to be withdrawn because the patient developed drug-induced acute pneumonitis. The patient has been in remission since drug discontinuation and is receiving steroid and home-oxygen therapy.

Software for correcting the dynamic error of force transducers.

Software which corrects the dynamic error of force transducers in impact force measurements using their own output signal has been developed. The software corrects the output waveform of the transducers using the output waveform itself, estimates its uncertainty and displays the results. In the experiment, the dynamic error of three transducers of the same model are evaluated using the Levitation Mass Method (LMM), in which the impact forces applied to the transducers are accurately determined as the inertial force of the moving part of the aerostatic linear bearing. The parameters for correcting the dynamic error are determined from the results of one set of impact measurements of one transducer. Then, the validity of the obtained parameters is evaluated using the results of the other sets of measurements of all the three transducers. The uncertainties in the uncorrected force and those in the corrected force are also estimated. If manufacturers determine the correction parameters for each model using the proposed method, and provide the software with the parameters corresponding to each model, then users can obtain the waveform corrected against dynamic error and its uncertainty. The present status and the future prospects of the developed software are discussed in this paper.

Liver Cirrhosis and Hepatocellular Carcinoma Diagnosed from Chylothorax: A Case Report.

A 71-year-old man visited our hospital with dyspnea and left pleural effusion. Left pleural effusion was diagnosed as chylothorax by thoracentesis. He had no history of trauma or surgery, and there were no findings of malignant lymphoma or thrombosis. Furthermore, he was diagnosed with liver cirrhosis and hepatocellular carcinoma by computed tomography and hematological examinations, and the chylothorax was considered to be caused by liver cirrhosis. We report a review of the literature with this case since it is relatively rare for cirrhosis and hepatocellular carcinoma diagnosed from chylothorax.

Clinical analysis of longstanding subacute myelo-optico-neuropathy: sequelae of clioquinol at 32 years after its ban.

One thousand and thirty-one longstanding patients with subacute myelo-optico-neuropathy (SMON; 275 males, 756 females; mean age +/- S.D., 72.9 +/- 9.6 years; age at onset 37.6 +/- 9.8 years; duration of illness 35.3 +/- 4.0 years) were examined in 2002, 32 years after banning of clioquinol. At onset, 66.7% of patients were unable to walk, and 4.7% complete blindness. At present time, about 41% of patients were still difficult to walk independently, including 15.8% of completely loss of locomotion. One point six percent of patients were in complete blindness and 5.8% had severe visual impairment. The majority (95.6 - 97.7%) of patients exhibited sensory disturbances including superficial and vibratory sensations and dysesthesia. Dysautonomia was observed as leg hypothermia in 79.8%, urinary incontinence in 60.7%, and bowel disturbance in 95.3%. As complication, high incidence was revealed with cataract (56.2%), hypertension (40.2%), vertebral disease (35.5%), and limb articular disease (31.5%). These results indicate the serious sequelae of clioquinol intoxication, SMON.

[Analysis of SMON at 30 years after its outbreak ending: special reference to those patients with blindness].

We analysed the present state of those SMON patients with severely disturbed visual acuity. In medical screening of SMON Research Group at 1999, 52 out of 1,083 patients and 549 out of 1128 had their histories of complete blindness and complete loss of locomotion ability at the onset of SMON, respectively. Eighty one out of 1,149 patients showed severe visual impairment, including 22 with complete blindness. The number of patients with complete loss of locomotion and that of gait with cane/assistance were 59 and 443, respectively. Then, a large number of SMON patients have been still suffering from sequelae of clioquinol intoxication. Those patients groups with blindness and severe visual acuity yet showed after 30 years more severe disorders in locomotive activity, muscle strength and spasticity of lower extremities, degree of dysesthesia as well as vibratory sensory deficit, and ADL score. Those patients with complete or near complete blindness were profoundly handicapped so that the ratio of patients with a life-long institutionalization was high compared to the groups with less severe visual disturbance. Thus, it seems necessary to make a more extensive and meticulous supports for those SMON patients with blindness as they are in need of more finance and care providers.

[Crow-Fukase syndrome (POEMS syndrome)].

In 1971, the author reported an autopsy case of a 48-year-old Japanese man with polyneuropathy, skin hyperpigmentation, diabetes mellitus, and monoclonal gammopathy. Previously, a total of 2 cases of solitary myeloma accompanied by polyneuropathy and endocrinological disorders have been reported by Fukase et al in 1968 and by Shimomori and Kusumoto in 1970 in Japan. The author's case is the first reported non-myeloma case where polyneuropathy associated with dermatoendocrionological changes and dysglobulinemia was observed. In 1956, Crow reported the British case of a 54-year-old man with osteosclerotic myeloma, polyneuropathy, edema, skin hyperpigmentation, clubbed fingers, white nails, and lymphadenopathy. The term Crow-Fukase syndrome was first used in 1984 in a study performed by Nakanishi et al that involved 102 Japanese patients. In 1986, Bardwick et al suggested the acronym POEMS-i.e., polyneuropathy (P), organomegaly (O), endocrinopathy (E), M-protein (M), and skin changes (S)-that represents the most constant and important features of this syndrome. In this paper, the author has described 3 cases that have been reported earlier by the author and has reviewed important Japanese and international literature related to this syndrome. Recent studies have revealed that the signs and symptoms of patients with this syndrome dramatically recover on using recently developed therapies for myeloma, such as autologous peripheral blood stem cell transplantation and thalidomide therapy.