Zinc transporter 1 expression in hepatocellular carcinoma correlates with prognosis: A single-center retrospective study.

OBJECTIVES: Zinc is crucial in the pathogenesis of hepatocellular carcinoma; however, no reports have examined its association with clinical parameters and zinc transporter 1 (ZNT1) expression intensity. This study aimed to assess the association between ZNT1 expression and prognosis in patients with hepatocellular carcinoma. METHODS: This retrospective study included 65 patients who underwent surgical hepatocellular carcinoma resection at a single center between January 2011 and June 2015. ZNT1 expression on hepatocellular carcinoma cells from specimens was assessed using immunohistochemistry, and the relationship between its intensity and various clinical indexes was examined with univariate and multivariable analyses and the Mann-Whitney U, Kruskal-Wallis, Bonferroni, and log-rank tests. RESULTS: ZNT1 expression on the hepatocellular carcinoma cell membrane was negative in 31 patients and positive in 34 patients, including nine patients showing strongly positive expression. Patients with and without ZNT1 expression had similar blood zinc concentrations, α-fetoprotein levels, protein induced by vitamin K absence-antagonist-II levels, gross classification, maximal tumor diameters, and background liver disease. The blood zinc concentrations were significantly lower in patients with strongly positive ZNT1 expression (57.0 ± 22.1 µg/dL) than in those with positive ZNT1 expression (71.1 ± 14.2 µg/dL; P = 0.015) or those with no ZNT1 expression (72.9 ± 14.1 µg/dL; P = 0.043). Overall survival was significantly shorter in ZNT1-expressing patients than in non-expressing patients (log-rank test, P = 0.024). Multivariable analysis using the Cox proportional hazards model identified maximal tumor diameter (hazard ratio, 1.018; 95% confidence interval, 1.002-1.034; P = 0.026) and ZNT1 expression status (hazard ratio, 2.082; 95% confidence interval, 1.196-3.621; P = 0.010) as prognostic contributing factors.

[The Surgical Experience for Bulky Serous Cystic Neoplasm of Pancreas].

A 74-year-old femalewas admitted to our hospital dueto thebulky abdominal tumor pointed out by ultrasonography of medical screening. Abdominal CT revealed the tumor, in a diameter 20 cm, replaced the total pancreas and compressed the surrounding organs and portal vein. We diagnosed as a pancreatic serous cystic neoplasm with a possibility of malignancy. The operative findings showed the tumor tightly adhered to stomach, duodenum, liver, transverse colon mesenterium, retroperitoneum and the surrounding main vessels. Total pancreatectomy, cholecystectomy, splenectomy and distal gastrectomy were performed. As a histopathological finding, thetumor surfacewas smooth and theinsidewas sponge-likeappe arancemixe d with microcystic and solid components. No malignant finding was observed. The patient was discharged without major complications on postoperative day 42, and remains alive with no recurrence for 9 months after surgery.

[Radiofrequency Ablation under Computed Tomography during Arterial Portography for Hypovascular Liver Metastases from Advanced Pancreatic Cancer].

A 70's man had been treated with gemcitabine(GEM)and nab-paclitaxel(nabPTX)combination for advanced pancreatic tail cancer with splenic invasion and liver metastases. However, the primary lesion was not controlled, then intensity-modulat- ed radiation therapy(76.5 Gy/17 Fr)was performed for primary lesion. Three grown hypovascular liver metastases were detected by follow-up EOB-MRI and PET-computed tomography(CT)imaging with 18F-FDG. Unfortunately, these lesions were not detected by intravenous injection of contrast media with CT nor ultrasonography. Radiofrequency ablation(RFA) under computed tomography during arterial portography(CTAP)guidance was performed. The patient has been alive for 1 year after RFA with no recurrence. CTAP could be a feasible image guidance for the treatment of hypovascular liver metastases with RFA.

[Evaluation of Artificial Hip Joint with Radiofrequency Heating Issues during MRI Examination: A Comparison between 1.5 T and 3 T].

In magnetic resonance imaging (MRI), when radiofrequency (RF) is irradiated to a subject with metallic implant, it can generate heat by RF irradiation. Recently 3 T MRI scanner has spread widely and imaging for any regions of whole body has been conducted. However specific absorption rate (SAR) of 3 T MRI becomes approximately four times as much as the 1.5 T, which can significantly affect the heat generation of metallic implants. So, we evaluated RF heating of artificial hip joints in different shapes and materials in 1.5 T and 3 T MRI. Three types of artificial hip joints made of stainless alloy, titanium alloy and cobalt chrome alloy were embedded in the human body-equivalent phantom respectively and their temperature change were measured for twenty minutes by 1.5 T and 3 T MRI. The maximum temperature rise was observed at the bottom head in all of three types of artificial hip joints, the rise being 12°C for stainless alloy, 11.9°C for titanium alloy and 6.1°C for cobalt chrome alloy in 1.5 T. The temperature rise depended on SAR and the increase of SAR had a good linear relationship with the temperature rise. It was found from the result that the RF heating of metallic implants can take place in various kinds of material and the increase of SAR has a good linear relationship with the temperature rise. This experience shows that reduction of SAR can decrease temperature of metallic implants.

[Evaluation of Pre-Therapeutic Ki-67 as a Predictive Marker for Histological Response to Neoadjuvant Therapy in Breast Cancer].

There is controversy as to whether the proliferative marker Ki-67 is useful as a predictive marker for response to neoadjuvant therapy in breast cancer. We evaluated Ki-67 levels in pre-therapeutic breast cancer core biopsies from 52 breast cancer patients. These patients underwent anthracycline and taxane-based chemotherapy (n=48) or endocrine therapy (n=4) followed by surgery between March 2010 and February 2015. Expression of estrogen receptor (ER), progesterone receptor (PgR), HER2, and Ki-67 were examined by immunohistochemistry in the core-needle biopsy specimens. Ki-67 levels were categorized into 3 groups: low (<20%), intermediate (20-50%), and high (≥50%). Pathological response rates were 29%, 15%, and 48% in the low, intermediate, and high-risk groups, respectively. In univariate analysis, pre-therapeutic high levels of Ki-67, as well as negative ER status were significantly associated with the responder group (p<0.05). However, neither Ki- 67 nor ER status were significantly associated with a response in multivariate analysis. Ki-67 appears to be a promising parameter for histological response to neoadjuvant therapy in breast cancer.

[Investigation of radio frequency heating of dental implants made of titanium in 1.5 tesla and 3.0 tesla magnetic resonance procedure: measurement of the temperature by using tissue-equivalent phantom].

Titanium (Ti) implants are increasingly being used for dental parts. There is no problem with the attraction of a static magnetic field for Ti in magnetic resonance imaging (MRI), since Ti is paramagnetic. However, there is a risk of radio frequency (RF) heat generation within Ti. 3.0 T-MRI scanners are becoming increasingly common. The specific absorption rate (SAR) of 3.0 T-MRI is quadruple that of SAR compared with 1.5 T-MRI due to its being proportional to the square of the strength of a static magnetic field. The effect of heat generation in 3.0 T-MRI can thus be greater than in 1.5 T-MRI. So, using 1.5 T and 3.0 T-MRI scanners, we measured the temperature of several Ti implants using the same scanning parameters during MRI scanning. Our measurements showed the rise in temperature of the Ti implants to be a maximum of 0.4 degrees C. In this study, however, Ti in a human mouth was not directly measured, so we need to attempt to perform MRI carefully on patients with Ti implants.

[Investigation of radiofrequency heating for a closed conducting loop formed in a part of the patient's body in 1.5 Tesla magnetic resonance (MR) imaging and 3.0 Tesla MR imaging-measurement of temperature by use of human body-equivalent phantom].

Thermal injuries have been sometimes reported due to a closed conducting loop formed in a part of the patient's body during magnetic resonance imaging (MRI). In recent years, 3.0 T-MRI scanner has been widely used. However, it is considered that the specific absorption rate (SAR) of 3.0 T-MRI can affect the heat of the loop because its own SAR becomes approximately 4 times as much as that of the1.5 T-MRI scanner. With this, the change in temperature was measured with human body-equivalent loop phantom in both 1.5 T-MRI and 3.0 T-MRI. In the two scanners, the temperature during 20 min of scanning time was measured with three types of sequences such as field echo (FE), spin echo (SE), and turbo SE (TSE) set up with the same scanning condition. It was found from the result that rise in temperature depended on SAR of the scanning condition irrespective of static magnetic field intensity and any pulse sequences. Furthermore, the increase of SAR and rise in temperature were not only in proportion to each other but also were indicated to have good correlation. However, even low SAR can occasionally induce serious thermal injuries. It was found from result that we had to attempt not to form a closed conducting loop with in a part of the patient's body during MRI.

[Local control of advanced breast cancer with mohs'paste].

We report two cases of primary advanced breast cancer that was locally controlled by using Mohs'paste. CASE 1: A 70- year-old woman was suffering massive exudates and offensive smell from her right giant breast tumor. Histopathological examination showed an invasive ductal carcinoma. However, she didn't have distant metastases. The patient received chemotherapy and the breast tumor has been fixed using Mohs'paste, and dissected. The giant tumor became flat and dry, so we could perform a radical operation. Then, she had contra-lateral axillary lymph node metastases. We performed a resection of left axillary lymph node and radiation therapy. After two years, we have not found a new lesion. CASE 2: A 54-year- old woman with right local advanced breast cancer discharged massive exudates and oozed blood. Histopathologically, she had an invasive ductal carcinoma. Moreover, she had lung and contra-lateral axillary lymph node metastases. She received chemotherapy and the breast tumor has been fixed using Mohs'paste, and dissected. The bleeding and exudates stopped almost completely, and the breast tumor became flat and dry. Both patients had experienced a mild pain, but their QOL improved remarkably. It is suggested that the patient with local advanced breast cancer may be controlled by using Mohs' paste.

[A case of sigmoid colon cancer that spread to the urinary bladder via the ureter].

A 69-year-old male was admitted to the hospital with the chief complaint of left hydronephrosis and diagnosed. A year ago, he underwent sidmoidectomy to cure sigmoid colon cancer diagnosed as stage IV. Ultrasonography (US) and computed tomography (CT) detected the compression of the ureter at its middle left due to the enlargement of the left iliac lymph node and hydronephrosis and hydroureter at the proximal to the compressed part. Then, a ureteral tumor was suspected and urinary cytology was class V. Cystoscopy detected a papillary tumor projecting from the left ureteral orifice. Because the histopathological manifestation by transurethral resection of bladder tumor and that by the sidmoidectomy were consistent, it was considered that sigmoid colon cancer spread to the urinary bladder via the left ureter. There have been only 4 reported cases of adenocarcinoma that multiplied in the ureter, and this is the fifth case report.

[Study of temperature rise in RF irradiation during MR imaging: measurement of local temperature using a loop phantom].

Cases have been reported of a local rise in temperature at the patient's skin and of burns occurring during MR imaging. To verify this phenomenon, we created a phantom from agarose, saline, and preservative, and measured the increase in local temperature. In addition, phantoms of limbs of the human body shaped such that a closed loop was formed were also used. The temperature of the phantom was measured for 50 minutes in each state, i.e., where a closed loop was formed and where the loop was incomplete. Moreover, the radio frequency (RF) and gradient fields were set as respectively independent states, and the temperature of the phantom was measured. Results of the experiment showed that temperature changed from approximately 6 degrees to 11.5 degrees in the closed loop part of the phantom, whereas there was no significant change when the loop was incomplete. In addition, with exposure to RF, a significant rise in temperature occurred where the loop was closed, whereas there was no significant increase in temperature in gradient fields. This experiment demonstrated that the increase in temperature as a result of RF irradiation occurred in the closed part of the loop phantom. Consequently, a loop formed in the human body may be subject to burns in the area of contact.

[A case of urachal xanthogranuloma suspected to be a urachal tumor].

A 47-year-old female consulted our hospital with the chief complaints of lower abdominal pain and fever. There was a palpable mass in the lower abdomen. The patient had undergone oophorectomy by lower abdominal median incision. Ultrasonography, computed tomography, and magnetic resonance imaging (MRI) demonstrated a cystic mass above the bladder dome extending to the umbilicus, which was strongly suspected to be a urachal tumor. Enhanced T1 weighted MRI showed a mass enhanced by contrast media. Partial cystectomy with urachal resection was performed by lower abdominal median incision. The histological diagnosis was xanthogranuloma. This is the thirteenth case report of xanthogranuloma of the urachus in the Japanese literature.

Disposition kinetics of taxanes after intraperitoneal administration in rats and influence of surfactant vehicles.

Rats were intraperitoneally administered 40 mg x kg(-1) of paclitaxel or docetaxel dissolved in various drug solutions. The drug solutions were prepared using 20 mL of saline, adding 4.2% Cremophor EL (crEL) for paclitaxel (TXL), and 1.5% Polysorbate-80 (PS-80) (TXT), 7.5% PS-80 (TXT+PS-80) or 4.2% crEL (TXT+crEL) for docetaxel. The apparent first-order absorption rate constant from the peritoneal cavity (k(a)) of TXL was about one-twentieth of that of TXT. The ratio of the area under the concentration-time curve of drug in plasma over that in ascites for TXL was about one-third of that of TXT. The values of the above ratio and the k(a) of TXT+PS-80 and TXT+crEL were similar to those of TXL. After intraperitoneal administration, the values of the blood-to-plasma concentration ratio in the four groups were similar and independent of time. In the in-vitro study, PS-80 and crEL caused similar, concentration-dependent decreases of drug permeation into red blood cells after a 15-min incubation of rat blood with 10 microg x mL(-1) of TXL. We demonstrated that the disposition kinetics of taxanes after intraperitoneal administration to rats was strongly influenced, in a concentration-dependent manner, by the surfactant vehicle used, crEL or PS-80.

[Sarcomatoid carcinoma of the urinary bladder: a case report].

A 63-year-old man was admitted to our hospital for a bladder tumor. Drip infusion pyelography, computerized tomography (CT) and magnetic resonance imaging suggested the presence of a large invasive tumor in the right wall of the bladder. Histopathological findings by transurethral resection of bladder tumor showed the presence of sarcomatous and carcinomatous elements. Immunohistochemical examination showed that the sarcomatous component did not stain for S-100 protein or for smooth muscle actin but it stained for epithelial markers. Under the diagnosis of sarcomatoid carcinoma, we performed a total cystectomy and ileal conduit without chemotherapy or radiation. A follow-up CT taken at four months postoperatively showed no evidence of recurrence.