[Two Cases of Effective Hepatic Arterial Infusion Chemotherapy for Liver Metastases of Colon Cancer Resistant to Systemic Chemotherapy].

A 69-year-old man underwent right hemicolectomy for ascending colon cancer with liver metastases. Postoperative systemic chemotherapy did not reduce the metastases, and therefore, hepatic arterial infusion chemotherapy (HAI) was administered. The metastases decreased in size after 26 rounds of therapy, and the patient underwent resection. He is recurrence-free 63 months after the primary operation. A 57-year-old man underwent Hartmann's operation for sigmoid colon cancer with liver metastases. He underwent hepatic left lobe resection after metastases reduction by systemic chemotherapy. However, multiple liver metastases were detected 2 months later. Because the disease progressed despite the administration of systemic chemotherapy, HAI was utilized instead. The metastases decreased in size remarkably, and resection was performed. The patient is surviving 52 months after the primary operation while being continuously treated with HAI, resection, and systemic chemotherapy for re-recurrence. HAI is a potential alternative treatment for patients with colorectal liver metastases resistant to systemic chemotherapy.

[A case of postoperative recurrent hilar cholangiocarcinoma in the lower bile duct treated with pancreatoduodenectomy].

When surgery is selected to treat postoperative recurrent hilar cholangiocarcinoma in the intrapancreatic bile duct, attention should be paid to the following: 1 ) technical resectability of the lesion, 2) reconstruction, and 3) high risk of complications. Eight cases, including the present case, of pancreatoduodenectomy (PD) for postoperative recurrent hilar cholangiocarcinoma in the intrapancreatic bile duct have been reported thus far. In October 2009, a 73-year-old man noticed that his stools were gray and visited a physician. He was diagnosed with cholangiocarcinoma on close examination and underwent left hepatic and caudate lobectomy in January 2010. After the surgery, he was treated with TS-1 (80 mg) and followed up at the outpatient clinic of our hospital. In July 2013, he was diagnosed with cancer of the lower bile duct and was admitted for surgery. The first and second pathological findings were carcinoma of the bile duct and papillary adenocarcinoma, respectively. The findings from the immunostaining were also inconsistent. The histopathological examination result suggested multicentric recurrence. The surgery was highly invasive, increasing the patient's risk of complications, in addition to the presence of postoperative adhesion. Therefore, surgery may be an important option for cases of localized recurrence but not for multicentric recurrence.

Hyperthermia in the treatment of recurrent abdominal desmoid tumor.

The most suitable management of recurrent abdominal desmoid tumor is still unclear. A case of recurrent huge abdominal desmoid tumor successfully treated by hyperthermia therapy is described. A 63-year-old man was operated upon for desmoid tumor in the retroperitoneum involving pancreas, posterior wall of the stomach and transverse mesocolon in 2007. In 2008, the tumor recurred and could not be resected because of the patient refused the operation. Several therapies using tamoxifen, anastrozole, imatinib mesylate and radiotherapy were all ineffective. The tumor grew bigger and bigger during a treatment period. Finally, hyperthermia treatment was applied to the tumor. The size of the recurrent desmoid tumor reduced 75% by hyperthermia treatment for 46-month. Base on this experience, we recommend hyperthermia as the treatment for patients with recurrent abdominal desmoid tumor that several therapeutic strategies did not achieve a remarkable response.

[A trial using maximum preoperative chemotherapy for metastatic colorectal cancer].

There are chemotherapy methods applied before operation, before and after operation, or after operation for metastatic colorectal cancer. But the correct times and periods, etc., for their administration have not been obvious. We perform maximum preoperative chemotherapy to control micrometastases, and afterwards surgically remove the metastatic lesions[including radiofrequency ablation(RFA)]. Complications after operation and the severity of pathological liver damage etc., were investigated by comparing 14 patients who received maximum preoperative chemotherapy(group A), with 4 patients for whom 6 courses of FOLFOX+bevacizumab(BV)therapy(group B)were planned. ICG15 before liver resection and bleeding during liver resection were not significantly different(p=0. 26 and p=0. 60, respectively). No severe complication after operation was seen and pathological liver damage was minor in both groups. No interference of maximum preoperative chemotherapy with BV to metastatic colorectal cancer was suggested from the point of view of complications after operation and the severity of pathological liver damage. Further investigation with many more patients is necessary.

Fluoride anion-initiated bis-trifluoromethylation of phenyl aromatic carboxylates with (trifluoromethyl)trimethylsilane.

The fluoride anion-initiated reaction of phenyl aromatic carboxylates with (trifluoromethyl)trimethylsilane (Me3SiCF3) that results in the formation of O-silyl-protected 2-aryl-1,1,1,3,3,3-hexafluoroisopropanols is reported. A phenoxide anion, generated during the trifluoromethylation of the phenyl carboxylate, also activates the Me3SiCF3, which permits a catalytic amount of the fluoride anion source to be used. Various functional groups, which can be used for further elaboration, are tolerated in the reaction.

Nickel-catalyzed reductive defunctionalization of esters in the absence of an external reductant: activation of C-O bonds.

The nickel-catalyzed reductive cleavage of esters in the absence of an external reductant, which involves the cleavage of an inert acyl C-O bond in O-alkyl esters is reported. Various groups, such as N-containing heterocycles, esters, amides, and even arene rings can function as a directing group.

Significance of neoadjuvant chemoradiotherapy for borderline resectable pancreatic head cancer: Pathological local invasion and microvessel invasion analysis.

Borderline resectable pancreatic head cancer (BR-PHC) has low resectability due to vascular invasion. Although the clinical effects of neoadjuvant chemoradiotherapy (NAC-RT) for BR-PHC have been examined, few studies have reported its pathological aspects. The present study retrospectively investigated the effect of NAC-RT on the histological features of BR-PHC. A total of 29 patients with BR-PHC who underwent NAC-RT, and 55 controls with resectable PHC, who underwent pancreaticoduodenectomy at the Kurume University Hospital. Tumor staging, lymphovascular invasion (LVI), and microvessel invasion (MVI) were evaluated. The median tumor size in the NAC-RT group was 2.0 cm, and it was smaller than that of the control group (P=0.006). The rates of lymph node metastasis, LVI, and MVI were significantly lower in the NAC-RT group (P<0.001, 0.002, and 0.015, respectively). Overall survival in the NAC-RT group was comparable to that in the control group, although patients with BR-PHC generally had a poorer prognosis than those with resectable PHC. Patients in the NAC-RT group without portal vein invasion (PVI) had a significantly better prognosis than those with PVI in the control group (P=0.002). NAC-RT may be beneficial for patients with BR-PHC by inhibiting local invasion and metastasis as prognosis following resection could be equivalent to that of patients with conventional ductal adenocarcinoma.

Dynamic fracture of tantalum under extreme tensile stress.

The understanding of fracture phenomena of a material at extremely high strain rates is a key issue for a wide variety of scientific research ranging from applied science and technological developments to fundamental science such as laser-matter interaction and geology. Despite its interest, its study relies on a fine multiscale description, in between the atomic scale and macroscopic processes, so far only achievable by large-scale atomic simulations. Direct ultrafast real-time monitoring of dynamic fracture (spallation) at the atomic lattice scale with picosecond time resolution was beyond the reach of experimental techniques. We show that the coupling between a high-power optical laser pump pulse and a femtosecond x-ray probe pulse generated by an x-ray free electron laser allows detection of the lattice dynamics in a tantalum foil at an ultrahigh strain rate of [Formula: see text] ~2 × 108 to 3.5 × 108 s-1. A maximal density drop of 8 to 10%, associated with the onset of spallation at a spall strength of ~17 GPa, was directly measured using x-ray diffraction. The experimental results of density evolution agree well with large-scale atomistic simulations of shock wave propagation and fracture of the sample. Our experimental technique opens a new pathway to the investigation of ultrahigh strain-rate phenomena in materials at the atomic scale, including high-speed crack dynamics and stress-induced solid-solid phase transitions.

Neoplastic spindle cells are an independent prognostic factor in pancreatic cancer.

OBJECTIVE: Several reports showed that neoplastic spindle cells (NSCs) may be strongly involved in the invasion, metastasis, and poor prognosis, as well as in epithelial-mesenchymal transition (EMT). It has not yet been investigated that NSCs relate to the recurrence and prognosis in various cancers. Furthermore, NSCs participate in EMT in pancreatic cancer (PC) too. We clinicopathologically investigated the association between NSCs and the recurrence, prognosis, and EMT in PC. METHODS: We studied 68 PC patients. Cancer cells with a spindle or oval shape that do not exhibit luminal structures were defined as NSCs. We graded NSCs regarding to an area of NSCs at hematoxylin and eosin stain (NSC grade) and examined the participation in NSCs and EMT by immunohistostaining of snail antibody and E-cadherin antibody. RESULTS: In multivariate analysis, NSC grade was an independent risk factor for disease-free survival and overall survival. This was independent of TNM stage and histological grade. Neoplastic spindle cells were related to EMT pattern in immunohistostaining significantly. CONCLUSIONS: Neoplastic spindle cell grade significantly related to the recurrence and prognosis of PC. The NSC grade assessment can be not only performed inexpensively and conveniently, but also used to guide future individualized therapeutic approaches. Furthermore, NSCs were found to relate to EMT profoundly.

Development of a pumping laser system for x-ray laser research.

A two-beam chirped-pulse-amplification Nd:glass laser system dedicated to x-ray laser research is described. Each beam provides an output energy of 20 J with a typical pulse duration of 1.3 ps. A prepulse of variable duration is generated by use of a novel, to our knowledge, optical system. A reflection optical system, comprised of an off-axis parabolic mirror and a spherical mirror, produces a line focus with 6-mm length and 165-microm width without chromatic aberration. By use of this pumping laser system, the nickel-like silver x-ray laser at a wavelength of 13.9 nm has been demonstrated.