[A Review of Six Cases of Neuro Endocrine Carcinoma of the Stomach].

Gastric endocrine carcinoma is a comparatively rare type of gastric cancer, accounting for 0.6% of all gastric cancers. Six cases of gastric endocrine carcinomas that were identified from November 2011 to March 2017 were reviewed. The mean age of the patients was 73.3 years, and 1 patient had StageⅠA cancer, 1 had Stage ⅡB, 2 had Stage ⅢA, and 2 had Stage Ⅳ. Three patients had concomitant conventional adenocarcinoma. Four patients underwent total gastrectomy, 3 of whom showed liver metastases after surgery. The prognosis of gastric endocrine carcinoma is poor because it rapidly metastasizes to the liver and lymph nodes. When unresectable metastatic disease occurs, systemic therapy with cytotoxic chemotherapy can be introduced. Chemotherapy is performed in accordance with that for small cell lung cancer; however, the response rate of chemotherapy is very low, so further studies are needed to improve this treatment.

Global Monitoring of Persistent Organic Pollutants (POPs) Using Seabird Preen Gland Oil.

Situated at high positions on marine food webs, seabirds accumulate high concentrations of persistent organic pollutants (POPs), such as polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethane and its metabolites (DDTs), and hexachlorocyclohexanes (HCHs). Our previous studies proposed the usefulness of seabirds preen gland oil as a nondestructive biomonitoring tool. The present study applied this approach to 154 adult birds of 24 species collected from 11 locations during 2005-2016 to demonstrate the utility of preen gland oil as a tool for global monitoring POPs, i.e., PCBs, DDTs, and HCHs. Concentrations of the POPs were higher in the Northern Hemisphere than in the Southern Hemisphere. In particular, ∑20PCBs and∑DDTs were highly concentrated in European shags (Phalacrocorax aristotelis) and Japanese cormorants (Phalacrocorax capillatus), explainable by a diet of benthic fishes. Higher concentrations of γ-HCH were detected in species from the polar regions, possibly reflecting the recent exposure and global distillation of ∑HCHs. We examined the relationship between age and POP concentrations in preen gland oil from 20 male European shags, aged 3-16 years old. Concentrations and compositions of POPs were not related to age. We also examined sex differences in the POP concentrations from 24 streaked shearwaters (Calonectris leucomelas) and did not detect a sex bias. These results underline the importance of the geographic concentration patterns and the dietary behavior as determinants species-specific POPs concentrations in preen gland oil.

[A Case of Advanced Gastric Cancer Treated with Curative Resection after Preoperative Secondary Chemotherapy with Irinotecan after Primary Chemotherapy with Docetaxel, Cisplatin, and S-1].

A 70-year-old man was diagnosed with advanced gastric cancer based on esophagogastroduodenoscopy(EGD). Abdominal computed tomography(CT)showed swelling of the lymph nodes and invasion to the liver and pancreas. The patient was treated using combined docetaxel, cisplatin, and S-1(DCS)chemotherapy. After 2 courses of treatment, the primary tumor and lymph node metastases continued to grow. The patient was treated using secondary chemotherapy with irinotecan (CPT-11). After 1 course of treatment, the primary tumor and regional lymph nodes reduced in size. We performed curative total gastrectomy with D2 lymph node dissection. There has been no recurrence for 15 months after adjuvant chemotherapy with capecitabine and oxaliplatin(CapeOX). Therefore, CPT-11 therapy is a possible option for the management of advanced gastric cancer after DCS therapy.

The COMET Open-label Phase II Study of Neoadjuvant FOLFOX or XELOX Treatment Combined with Molecular Targeting Monoclonal Antibodies in Patients with Resectable Liver Metastasis of Colorectal Cancer.

BACKGROUND: Advantages of neoadjuvant chemotherapy combined with monoclonal antibodies for treating patients with resectable colorectal cancer liver metastasis (CLM) have not been established. The purpose of this study was to evaluate the efficacy and safety of oxaliplatin-based regimen (FOLFOX or XELOX) plus monoclonal antibodies (cetuximab or bevacizumab) treatment in patients with resectable CLM. METHODS: A single-arm, open-label, multicenter, phase II trial was conducted for patients aged ≥ 20 years with resectable and untreated CLM. Patients received preoperative FOLFOX (6 cycles) or XELOX (4 cycles). Cetuximab or bevacizumab was administered to patients with wild-type or mutated KRAS codons 12 and 13, respectively. The primary endpoint was progression-free survival (PFS). RESULTS: Between January 2010 and June 2012, 47 patients were enrolled from 12 institutions. Wild-type or mutant KRAS sequences were examined in 32 and 15 patients, respectively. Twenty-one (45 %) patients experienced Grades 3/4 adverse events, and 55 % of all patients responded to therapy. The sizes of tumors of patients in the wild-type KRAS group were significantly reduced compared with those of the mutant KRAS group. The overall rates of liver resection and postoperative morbidity were 83 and 14 %, respectively, and the median PFS was 15.6 months. The median PFS times of the KRAS wild-type and mutant groups were 22.5 months and 10.5 months, respectively. CONCLUSIONS: Neoadjuvant therapy using FOLFOX/XELOX combined with monoclonal antibodies did not improve PFS, although it was administered safely and had less adverse effects after liver resection.

Combination of the tumor angiogenesis inhibitor bevacizumab and intratumoral oncolytic herpes virus injections as a treatment strategy for human gastric cancers.

BACKGROUND/AIMS: Advanced gastric cancer is difficult to treat due to the frequency of liver metastases and peritoneal dissemination. A combination of two new strategies, including the anti-angiogenesis inhibitor bevacizumab and an oncolytic herpes virus is a promising treatment for advanced cancer. METHODOLOGY: The effects of bevacizumab on oncolytic herpes virus replication and viral cytotoxicity were examined at varying bevacizumab concentrations and viral titers. In addition, the ability of these two new promising anticancer agents to inhibit tumor growth was studied. Histological examinations of CD31 and LacZ were used to assess angiogenesis and virus distribution within the tumor, respectively. RESULTS: Bevacizumab did not affect viral replication or viral cytotoxicity in vitro. The combination of bevacizumab and the oncolytic herpes virus hrR3 significantly reduced tumor growth in vivo in an experimental gastric cancer model. Bevacizumab inhibited angiogenesis caused by local injection of hrR3 and induced virus spread. Bevacizumab increased the distribution of the intratumorally injected oncolytic herpes virus within the tumor. CONCLUSIONS: Combination therapy consisting of bevacizumab and an oncolytic herpes virus is a promising new treatment strategy for gastric cancer.

Piece-by-piece analysis of additives and manufacturing byproducts in plastics ingested by seabirds: Implication for risk of exposure to seabirds.

The risk of marine organisms ingesting plastics has become a growing concern due to hazard chemicals in plastics. To identify compounds to which seabirds potentially have substantial exposure, 194 plastics fragments and pellets ingested by seabirds, i.e., northern fulmars from the Faroe Islands, and laysan albatross and black-footed albatross from Mukojima Island, were analyzed piece by piece. Four kinds of UV stabilizers, 2 brominated flame retardants, and styrene oligomers were detected at detection frequencies of 4.6%, 2.1%, and 2.1%, respectively. Concentrations ranging from not detected (n.d.) - 1700 µg/g were measured for UV stabilizers, n.d. - 1100 µg/g for flame retardants, and n.d. - 3200 µg/g for styrene oligomers. We found that these chemicals could be retained in plastics during drifting and fragmentation in the ocean and transported to seabirds. This type of transport via plastics can be direct pathway that introduces hazardous compounds to marine organisms.

Fournier's gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy.

BACKGROUND: Fournier's gangrene is a necrotizing fasciitis of the genital and perineal region. It may progress, affecting the groin, the thigh, or even the abdominal wall. Despite adequate treatment (debridement and antibiotics), the mortality rate is very high, reaching 20-35%. Fournier's gangrene caused by penetration of a rectal cancer followed by neoadjuvant chemotherapy is very rare. We report this case with a review of the literature. CASE PRESENTATION: A 68-year-old man visited the emergency room due to perineal pain during which he accepted the chemotherapy for locally advanced rectal cancer. Abdominal CT scan showed extensive emphysema in the scrotum and gluteus maximus muscle. We diagnosed as Fournier's gangrene caused by penetration of a rectal cancer. We performed debridement, left orchiectomy, transverse colostomy with double orifices. Post-operative day 30, we performed abdominoperineal resection. We performed CapeOX therapy eight courses as adjuvant chemotherapy. The patient had no recurrence for 1 year and 2 months after the operation. CONCLUSIONS: Going forward, knowledge gained from this case will increase the opportunity to perform neoadjuvant chemotherapy for locally advanced rectal cancer. In medical treatment, we must put the possibility of Fournier's gangrene in mind and treat as soon as possible.