Regulatory T cells induce a suppressive immune milieu and promote lymph node metastasis in intrahepatic cholangiocarcinoma.

BACKGROUND: Emerging evidence indicates that immunogenicity plays an important role in intrahepatic cholangiocarcinoma (ICC). Herein, we systematically evaluated the clinical relevance of immunogenicity in ICC. METHODS: Highly immunogenic ICCs identified in the public dataset and the Cancer Immunome Atlas (TCIA) were assessed to determine the prognostic impact of immunogenicity in ICC and key components after curative resection. We also investigated the clinical relevance of the immune milieu in ICC. RESULTS: Using the Gene Expression Omnibus dataset 89749 and TCIA, we identified CD8+/forkhead box P3 (FoxP3)+ tumour-infiltrating lymphocytes (TILs), T-cell immunoglobulin and mucin domain 3 (TIM-3) and human leukocyte antigen-A (HLA-A) in highly immunogenic ICCs. Immunohistochemical analysis of the in-house cohort showed that intratumoral FoxP3+ TILs correlated with CD8+ TILs (P = 0.045, Fisher's exact test) and that high FoxP3+/CD8+ ratio (FCR) was an important marker for poor survival (P < 0.001, log-rank test). Furthermore, the FCR was higher in tumour-free lymph nodes in ICCs with lymph node metastases than in those without lymph node metastases (P = 0.003, Mann-Whitney U test). CONCLUSIONS: FCR should be considered an important biomarker that represents the immune environment of ICC based on its potentially important role in tumour progression, especially lymph node metastasis.

Power scalable 30-W mid-infrared fluoride fiber amplifier.

A fluoride-fiber-based master oscillator power amplifier (MOPA) for 30-W class continuous-wave (cw) operation at 2.8-µm wavelength has been demonstrated. To overcome the low durability of ZBLAN fibers, various novel technologies for using fluoride glass with a ZBLAN-fiber-based side-pump combiner have been adopted in the system. A maximum cw output power of 33 W and stable operation under 23-W output have been demonstrated. We suggest that such fiber MOPA systems will open up advanced fluoride fiber technology for next-generation high-power mid-IR lasers.

Optimization of laser emission at 2.8 µm by Er:Lu2O3 ceramics.

We have demonstrated the continuous-wave operation of a highly efficient 2.8 µm Er-doped Lu2O3 ceramic laser at room temperature. An Er:Lu2O3 ceramic with a doping concentration of 11 at.% afforded a slope efficiency of 29% and an output power of 2.3 W with pumping at 10 W. To our knowledge, these are the highest slope efficiency and output power obtained to date for an Er:Lu2O3 ceramic laser at 2.8 µm. In addition, we prepared ceramics with various doping concentrations and determined their emission cross sections by fluorescence lifetime measurements and emission spectroscopy.

Plane-by-plane femtosecond laser inscription of first-order fiber Bragg gratings in fluoride glass fiber for in situ monitoring of lasing evolution.

We report the femtosecond laser inscription of fiber Bragg gratings (FBGs) in an Er-doped fluoride glass fiber used for lasing at a mid-infrared wavelength of 2.8 µm. The lasing evolution is discussed in terms of the FBG reflectivity, wavelength transition to the Bragg wavelength, and output power of the mid-infrared fiber laser. A first-order and short (2.5-mm-long) Bragg grating showed a reflectivity of 97%, because of a laser-induced index modulation of 1.1 × 10-3. This modulation was sufficient to saturate this system's output power. The laser oscillator is designed to lase in the atmospheric window of 2799-2800 nm slope. Further, this oscillator's efficiency is as high as 29.1% for the launched pump power over the range of 0.4-4.6 W and at a lasing wavelength of 2799.7 nm. This oscillator also exhibited a FWHM bandwidth of 0.12 nm.

[A Case of Goblet Cell Carcinoid of the Appendix Treated by Laparoscopic Ileocecal Resection after Diagnosis by Colonoscopic Examination for Positive Occult Blood].

A79 -year-old woman underwent colonoscopic examination for positive occult blood. Aneoplastic lesion was seen in the orifice of the vermiform appendix. She was referred to our hospital and underwent colonoscopic examination again. The biopsy revealed poorly differentiated adenocarcinoma or mixed adenoneuroendocrine carcinoma(MANEC), and she was diagnosed with carcinoma of the appendix. She was treated by laparoscopic ileocecal resection with lymph node dissection (D3). Histopathological examination revealed goblet cell carcinoid(GCC)of the appendix with serosal invasion. No metastasis was detected in the dissected lymph nodes. This patient has been followed-up for 6 months after surgery and no recurrences have been detected.

[A Case of Intussusception Caused by Colon Cancer in A 25-Year-Old Woman].

A 25-year-old woman presented to our hospital with left flank pain and diarrhea. Contrast-enhanced abdominal computed tomography(CT)showed a target sign in the descending colon. She was diagnosed with intussusception of the colon. Colonoscopy revealed a tumor at the splenic flexure. We performed surgery and found an invaginated transverse colon at the splenic flexure. Reduction was unsuccessful with Hutchinson's maneuver, and we performed partial resection of the invaginated colon. Histopathological diagnosis was adenocarcinoma, tub1, SM2. Adult intussusception is uncommon, especially in young adults. It is usually caused by a polyp or tumor. We report a case of intussusception caused by colon cancer in a young female patient, and review the literature.

[A Case of Long-Term Survival with Multidisciplinary Therapy for a Patient with Multiple Metastases from Rectal Cancer].

Combined modality therapy is sufficient to treat advanced rectal cancer with multiple metastases. Her, we report a case of long-term survival in a patient with multiple metastases from rectal cancer. A5 8-year-old man had previously undergone low anterior resection for advanced rectal cancer. Multiple liver and lung metastases were identified prior to operation; therefore, we initiated chemotherapy(FOLFOX). Partial resection of metastatic lesions and radiofrequency ablation(RFA)were also administered, but newly developed liver, lung, and adrenal gland metastases were identified. We changed the chemotherapy regimen and administered topical therapies(partial resection, RFA, hepatic arterial infusion chemotherapy, radiotherapy)for each chemotherapy-refractory metastatic lesion. Although the patient is in a tumor-bearing state, he is still alive 10 years after his first operation. This combined modality therapy is an option for patients with chemotherapy-refractory metastases from rectal cancer.

Near-infrared light-boosted antimicrobial activity of minocycline/hyaluronan/carbon nanohorn composite toward peri-implantitis treatments.

Dental implant therapy is a reliable treatment for replacing missing teeth. However, as dental implants become more widely used, peri-implantitis increasingly has become a severe complication, making successful treatment more difficult. As a result, the development of effective drug delivery systems (DDSs) and treatments for peri-implantitis are urgently needed. Carbon nanohorns (CNHs) are carbon nanomaterials that have shown promise for use in DDSs and have photothermal effects. The present study exploited the unique properties of CNHs to develop a phototherapy employing a near-infrared (NIR) photoresponsive composite of minocycline, hyaluronan, and CNH (MC/HA/CNH) for peri-implantitis treatments. MC/HA/CNH demonstrated antibacterial effects that were potentiated by NIR-light irradiation, a property that was mediated by photothermal-mediated drug release from HA/CNH. These antibacterial effects persisted even following 48 h of dialysis, a promising indication for the clinical use of this material. We propose that the treatment of peri-implantitis using NIR and MC/HA/CNH, in combination with surgical procedures, might be employed to target relatively deep affected areas in a timely and efficacious manner. We envision that this innovative approach will pave the way for future developments in implant therapy.

An antibacterial conjugate of carbon nanohorns for NIR-light mediated peri-implantitis treatment.

This study developed a novel antibacterial conjugate based on carbon nanohorns for peri-implantisis, an inflammatory disease around dental implants, which may result in failing implants by bone loss around them. The conjugate demonstrates much better photodurability than commonly used indocyanine green and a significant antibacterial effect under NIR illumination.