[Three Cases of Resectable Advanced Gastric Cancer Treated with Neoadjuvant Chemotherapy].

Three patients diagnosed with HER2-negative resectable advanced gastric cancer with extensive regional lymph node metastases were treated with neoadjuvant chemotherapy(NAC), followed by gastrectomy with D2lymph node dissection. One patient received four 21-day courses of S-1 plus oxaliplatin(G-SOX), and pathological effect(PE)was Grade 3. Two patients received four 21-day courses of capecitabine plus oxaliplatin(CapeOX), and each PE was Grade 2and Grade 1a, respectively. One patient in poor PE was with recurrent liver and peritoneal metastases. This suggested that for resectable advanced gastric cancer with extensive regional lymph node metastases, NAC by SOX or CapeOX was effective for some patients.

2,3 Butanediol production in an obligate photoautotrophic cyanobacterium in dark conditions via diverse sugar consumption.

Cyanobacteria are under investigation as a means to utilize light energy to directly recycle CO2 into chemical compounds currently derived from petroleum. Any large-scale photosynthetic production scheme must rely on natural sunlight for energy, thereby limiting production time to only lighted hours during the day. Here, an obligate photoautotrophic cyanobacterium was engineered for enhanced production of 2,3-butanediol (23BD) in continuous light, 12h:12h light-dark diurnal, and continuous dark conditions via supplementation with glucose or xylose. This study achieved 23BD production under diurnal conditions comparable to production under continuous light conditions. The maximum 23BD titer was 3.0gL(-1) in 10d. Also achieving chemical production under dark conditions, this work enhances the feasibility of using cyanobacteria as industrial chemical-producing microbes.

[A difficult to treat case of malignant peritoneal mesothelioma with peritoneal metastasis].

A 57-year-old man presented with abdominal discomfort. A computed tomography (CT) scan revealed a tumor, with a maximum diameter of approximately 5 cm, in the transverse mesocolon near the splenic flexure as well as a small nodular shadow suggestive of peritoneal dissemination on the greater omentum. Fluorodeoxyglucose (FDG)-positron emission tomography (PET) showed marked accumulations of FDG at the same sites. Laparoscopic examination revealed an elastic hard tumor, with a maximum diameter of slightly over 5 cm, at the posterior sheath of the transverse mesocolon and a small nodule on the greater omentum with apparent dissemination. Since radical surgery was considered to be difficult to perform, we only resected the disseminated nodule for diagnostic purposes. The final pathological diagnosis was biphasic- type (mixed epithelial and sarcomatoid type) malignant mesothelioma arising from the peritoneum. Approximately 20 days postoperatively, the patient received combination therapy with pemetrexed and cisplatin with a 3-week interval between the courses. Image assessment after completion of the third course revealed enlargement of the tumor mass and worsening of the peritoneal dissemination. Therefore, the treatment was switched to paclitaxel, which has been reported to be effective as a second-line therapy. The drug was scheduled to be administered on days 1, 8, and 15. However, after the first course on day 1, the patient's condition gradually deteriorated and he subsequently died.

Correlated Rattling of Sodium-Chains Suppressing Thermal Conduction in Thermoelectric Stannides.

Tin-based intermetallics with tunnel frameworks containing zigzag Na chains that excite correlated rattling impinging on the framework phonons are attractive as thermoelectric materials owing to their low lattice thermal conductivity. The correlated rattling of Na atoms in the zigzag chains and the origin of the low thermal conductivity is uncovered via experimental and computational analyses. The Na atoms behave as oscillators along the tunnel, resulting in substantial interactions between Na atoms in the chain and between the chain and framework. In these intermetallic compounds, a shorter inter-rattler distance results in lower thermal conductivity, suggesting that phonon scattering by the correlated rattling Na-chains is enhanced. These results provide new insights into the behavior of thermoelectric materials with low thermal conductivity and suggest strategies for the development of such materials that utilize the correlated rattling.

[Case of pancreatic ascites successfully treated with endoscopic pancreatic drainage].

We report a 47-year-old man with abdominal distension without other distinct signs. Massive ascites with any singular lesions was revealed on computed tomography, and the ascites was high-amylase and high-protein. on these findings, pancreatic ascites was suspected and he was first treated with conservative therapy, but it failed. Computed tomography one month from the start of therapy demonstrated a pancreatic cyst, and endoscopic retrograde pancreatography revealed transudation of contrast medium from the cyst. A pancreatic duct stent was placed, and the ascites was smoothly eliminated. Endoscopic pancreatic stenting is considerable treatment for pancreatic ascites.

Engineering an Obligate Photoautotrophic Cyanobacterium to Utilize Glycerol for Growth and Chemical Production.

Cyanobacteria have attracted much attention as a means to directly recycle carbon dioxide into valuable chemicals that are currently produced from petroleum. However, the titers and productivities achieved are still far below the level required in industry. To make a more industrially applicable production scheme, glycerol, a byproduct of biodiesel production, can be used as an additional carbon source for photomixotrophic chemical production. Glycerol is an ideal candidate due to its availability and low cost. In this study, we found that a heterologous glycerol respiratory pathway enabled Synechococcus elongatus PCC 7942 to utilize extracellular glycerol. The engineered strain produced 761 mg/L of 2,3-butanediol in 48 h with a 290% increase over the control strain under continuous light conditions. Glycerol supplementation also allowed for continuous cell growth and 2,3-butanediol production in diurnal light conditions. These results highlight the potential of glycerol as an additional carbon source for photomixotrophic chemical production in cyanobacteria.

Global metabolic rewiring for improved CO2 fixation and chemical production in cyanobacteria.

Cyanobacteria have attracted much attention as hosts to recycle CO2 into valuable chemicals. Although cyanobacteria have been engineered to produce various compounds, production efficiencies are too low for commercialization. Here we engineer the carbon metabolism of Synechococcus elongatus PCC 7942 to improve glucose utilization, enhance CO2 fixation and increase chemical production. We introduce modifications in glycolytic pathways and the Calvin Benson cycle to increase carbon flux and redirect it towards carbon fixation. The engineered strain efficiently uses both CO2 and glucose, and produces 12.6 g l-1 of 2,3-butanediol with a rate of 1.1 g l-1 d-1 under continuous light conditions. Removal of native regulation enables carbon fixation and 2,3-butanediol production in the absence of light. This represents a significant step towards industrial viability and an excellent example of carbon metabolism plasticity.

[A case of granulocyte-colony stimulating factor producing gastric cancer].

We report a case of granulocyte-colony stimulating factor producing gastric cancer with multiple liver metastases. A 68-year-old woman who complained of epigastralgia visited our hospital. Upper gastrointestinal endoscopic examination revealed a type-2 gastric cancer. The laboratory data at admission indicated leukocytosis (35,900/microl) and a high level of serum granulocyte-colony stimulating factor (61 pg/mg). Granulocyte-colony stimulating factor producing gastric cancer was diagnosed by immunohistochemistry of biopsy specimen. Since we detected multiple liver metastases, chemotherapy was performed. Granulocyte-colony stimulating factor-producing gastric cancer is relatively rare and we summarize previous reports.

Procedural memory in schizophrenia assessed using a mirror reading task.

The preservation of procedural memory in individuals with schizophrenia has been confirmed by methods such as the Tower of Hanoi, pursuit rotor and mirror reading tests. However, the cognitive procedural memory of Japanese subjects with schizophrenia has never been assessed using mirror reading. To better determine the characteristics of cognitive procedural memory in schizophrenia, a Japanese version of the mirror reading task, consisting of cards with words written in Japanese katakana characters in mirror image, was administered to 18 Japanese patients with schizophrenia and 21 normal controls. The results indicated that the patients indeed learned the skill despite exhibiting lower overall performances in reading time than the controls, their scores displaying correlation with the severity of schizophrenic negative symptoms. This suggests that procedural memory for this task is retained in individuals with schizophrenia. It is important for them to use their preserved procedural memory for efficient rehabilitative efforts.

[A case of advanced gastric carcinoma with liver metastasis with no recurrence and long survival by means of surgery and postoperative chemotherapy].

A 69-year-old man was diagnosed with type 2 advanced gastric carcinoma at the antrum of the stomach with liver metastasis (S8) in July 1995. Operative staging was H1P0T2N2 stage IV. Distal partial gastrectomy was performed with combined D2 lymphadenectomy and partial hepatectomy. Fifty-six courses of low-dose chemotherapy with CDDP and 5-FU were administered from the time of surgery to March 1997. Sequentially the administration of UFT (150 mg/day, orally) was continued up to the present. The patient still has had no recurrence 6 years and 3 months after operation. Aggressive treatment combining surgery and long-term postoperative chemotherapy is potentially useful in contributing to long survival in cases of advanced gastric cancer with liver metastasis.

[Examination of second-line therapies following administration of low-dose TS-1+CDDP for highly-advanced gastric cancer].

Sixteen patients with highly-advanced gastric cancer were administered low-dose TS-1 and CDDP as a first-line treatment, followed by either paclitaxel or CPT-11/CDDP as a second-line treatment. The results of the 2 second-line treatments are reported herein. Overall response rate for the first-line treatment was 55.6%. For the second-line treatments, responses were noted in both the paclitaxel group and the CPT-11/CDDP group. Overall MST was 16.3 months and 1-year survival was 60%. The paclitaxel group, however, showed significantly better prognoses than the CPT-11/CDDP group. Adverse reactions to the first-line treatment were grade 3 leukopenia in 1 patient, with no other reactions over grade 2 observed. No adverse reaction greater than grade 2 was noted during administration of the second-line treatments. These results appear to present ample data that a first-line treatment of low-dose TS-1/CDDP followed by a second-line treatment of paclitaxel at 1/week in the outpatient setting yields improved prognoses and minimal adverse reactions.

[A case of vulval extramammary Paget's disease associated with pancreatic cancer that was successfully treated with chemotherapy].

We report the case of an 84-year-old woman with vulval extramammary Paget's disease associated with pancreatic cancer who was successfully treated. At first, biweekly low-dose FP (cisplatin 10 mg/body, 5-fluorouracil 250 mg/body) was administered by intravenous infusion. Next, we attempted a regimen of gemcitabine (1,000 mg/body) was administered weekly by intravenous infusion. As a result, the size of the pruritic lesion of the vulva was reduced more than 50%, and the serum level of CA19-9 decreased clearly. These treatments would be a valid option in certain cases of pancreas cancer and extramammary Paget's disease.

Successful surgical treatment of an infrarenal abdominal pseudoaneurysm caused by tuberculosis: report of a case.

A 76-year-old man was admitted to our hospital for investigation of an apparent abdominal aortic aneurysm detected during treatment for epididymitis. A chest X-ray showed miliary shadows in the bilateral lung fields strongly suggestive of tuberculosis. The diameter of the aneurysm increased, and examinations showed impending rupture of a pseudoaneurysm. However, a definitive disease pathogenesis was not obtained before surgery. We performed a subemergency operation, which revealed an infrarenal abdominal pseudoaneurysm caused by tuberculosis. The pseudoaneurysm appeared to have resulted from direct extension of tuberculous lymphadenitis to the aortic wall, which ruptured. We review 24 other cases of tuberculous aortic aneurysms surgically treated in Japan before 2004.

Atomic force microscopic observation of mechanically traumatized erythrocytes.

Erythrocytes are damaged or stimulated mechanically by artificial organs assisting in circulation. For several decades, a large number of research studies have been conducted to investigate the traumatizing phenomena due to nonphysiological flow conditions. These phenomena are thought to be the physical interaction between the cell membrane and the various fluidic conditions. To elucidate or evaluate the phenomena, however, chemical components emerging into the circulating solution, such as liberated hemoglobin or lactic dehydrogenase (LDH), have been measured as a main parameter. Naturally, the physical reaction caused on the membrane itself cannot be detailed by these parameters because they are the secondary products resulting from the mechanical membrane rupture. The aim of this study is to understand the traumatizing mechanism directly from a microbiological viewpoint. As a first step, we visualized the surface of sheep erythrocytes loaded with shear stress and measured erythrocyte surface roughness by atomic force microscopy (AFM) on a nanometer scale (10(-9) m). The constant shear rate was set at 1,800 (1/s), and the exposure time was set at 0.5, 1, and 2 h. We also measured the liberated hemoglobin concentration. As a result, it was found that the fine structure on the cell surface was changed drastically by the stress. It was also found that the surface roughness value increased with the exposure time, and correlated to the hemoglobin concentration. The visualization and the measurement of surface roughness of traumatized erythrocytes by AFM were thought to offer a new parameter for both hemolytic and subhemolytic studies.

Reconstruction of bilateral branch pulmonary artery stenosis caused by Takayasu's aortitis.

A 63 year-old female presented with dyspnea on exertion. Her chest X-ray showed cardiomegaly, and right ventricular overload and tricuspid regurgitation were detected. Her pulmonary ventilation and blood flow scintigraphy findings were suspicious of pulmonary vascular disease; the diagnosis was pulmonary hypertension and bilateral branch pulmonary artery stenosis. After the inflammation settled, the stenotic bilateral branch pulmonary artery was reconstructed with a prosthetic vessel and the pulmonary pressure normalized immediately. A resected specimen revealed that the stenotic changes were from Takayasu's disease. The patient's postoperative course was uneventful, and pulmonary ventilation and blood scintigraphy returned to an almost normal range. At follow-up 5 years and 6 months after the operation, there was no evidence of pulmonary artery disease (eg, stenosis and/or ischemia) or of any change in the central vessels of the retina, the so-called Takayasu's retinopathy.