[A Case of Long-Term Clinical Complete Response after Chemotherapy for Locally Advanced Rectal Cancer].

With the advancement ofchemotherapy against colorectal cancer, clinical complete responses(cCR)are more frequently observed. We report a case oflocally advanced rectal cancer with maintained long-term cCR after chemotherapy alone. Detailed examinations ofa man in his 60s revealed that he had poorly controlled diabetes mellitus, with elevated serum CEA and CA19-9 levels. Colonoscopy revealed rectal cancer(Rba). Besides the prostate invasion observed in the CT scan, intestinal obstruction was caused by a tumor that required surgical removal. However, the tumor was unresectable due to prostate and pelvic wall metastases; therefore, only sigmoid colostomy was performed. After 6 courses of mFOLFOX6, the tumor shrunk, and prostate invasion reduced as confirmed by the CT scan. Chemotherapy was switched to sLV/5FU2 due to the occurrence of peripheral neuropathy. No tumor was found after 20 courses of treatment, and cCR was achieved after 58 courses ofcontinuous and consecutive treatment. Throughout the treatment, radical resection was proposed to the patient; however, the surgery was not performed because of his lifestyle, ie, heavy smoking, which resulted in poor blood sugar control. The patient appears to be tumor free for 7 years after the initiation of chemotherapy.

[A Case of Transverse Colon Cancer Metastasized to the Spermatic Cord after Resection of Peritoneal Dissemination].

We report a rare case of spermatic cord metastasis from colon cancer. A man in his 50s underwent extended right hemicolectomy for transverse colon cancer followed by resection of a peritoneal recurrence. After receiving adjuvant chemotherapy for 6 months, he became aware of a right inguinal mass. A spermatic cord tumor was noted on computed tomography(CT) and FDG/PET-CT. He underwent radical orchiectomy. The resected tumor was histologically compatible with the colon cancer. Although he received additional chemotherapy, right inguinal recurrence was resected 6 months after orchiectomy. Colon cancer is the second most common origin, after gastric cancer, of metastatic spermatic tumor. As several metastatic routes have been reported, peritoneal seeding is mostly suspected in this case.

[A study of 10 patients with unresectable colorectal cancer who achieved long-term survival].

Appropriate evaluation and countermeasures against adverse events are important for the continuation of long-term chemotherapeutic treatment of patients with unresectable colorectal cancer. We studied 10 patients who were treated for advanced recurrent colorectal cancer at the outpatient chemotherapy unit of our department during the period from 2006 to 2010 and who survived with cancer for at least 3 years. In order to prevent grade 3 neuropathy caused by oxaliplatin (L- OHP), the duration and severity of adverse events were simultaneously assessed using a self-assessment form and a numeric rating scale( NRS) at the unit. In patients with an NRS score above 5 on or after the seventh day of treatment, L- OHP discontinuation was considered. In patients with long-term survival, the duration of FOLFOX or sLV5FU2 chemotherapy was significantly prolonged, and the L-OHP reintroduction rate was also high. Once non-hematological toxicities such as peripheral neuropathy occur, these can undermine the willingness to continue treatment and present considerable obstacles to ongoing therapy. Detailed assessment may prevent or at least reduce the incidence of grade 3 adverse events and thereby contribute to treatment continuation.

Effects of proteoglycan on dextran sulfate sodium-induced experimental colitis in rats.

Proteoglycans (PG) are macromolecules composed of glycosaminoglycan chains covalently attached to a protein core. In this study, we examined the effects of PG on dextran sulfate sodium (DSS)-induced experimental colitis in rats. First, to examine whether PG may ameliorate acute established DSS colitis, PG was administered orally for 5 days to the model animals. We evaluated the effects of PG on the basis of clinical symptoms, hematological analysis, macroscopic observation, and microscopic examination. We then examined whether PG administered orally to rats was detectable in their colonic lumen. After administration of PG, the colonic contents were collected, and the molecular weight of PG in the sample was analyzed by gel filtration high-performance liquid chromatography. Furthermore, we examined whether orally administered PG affected the concentrations of short-chain fatty acids (SCFAs) in the colonic feces. Orally administered PG ameliorated the clinical symptoms of bloody stools and diarrhea, and attenuated the increase in the white blood cell count in rats with established DSS colitis. Histologically, orally administered PG reduced the degree of mucosal erosion and inflammatory cell infiltration into the erosive area induced by DSS. Orally administered PG was detected in rat colon, although its molecular weight was slightly decreased. Orally administered PG significantly increased the concentration of total SCFAs and n-butyrate in rat colonic feces. This is the first study to indicate that exogenous PG ameliorates experimental colitis, suggesting the potential usefulness of PG for clinical treatment of colitis.

Reconstruction of glycosaminoglycan chains in decorin.

The glycosaminoglycan chain of decorin from human spinal ligaments was digested using the hydrolysis of bovine testicular hyaluronidase. As a result, decorin with hexasaccharide, octasaccharide, and decasaccharide including the linkage region, GlcA-Gal-Gal-Xyl, was obtained. The obtained decorin as an acceptor and hyaluronic acid as a donor were incubated with bovine testicular hyaluronidase under the condition of transglycosylation reaction. The transglycosylation reaction product had hexasaccharide to triacontasaccharide. Judging from the analysis of glycosaminoglycan chain in the transglycosylation reaction product, it was confirmed that hyaluronic acid chain as a donor was transferred to the retained glycosaminoglycan chain of decorin as an acceptor. Similarly, it was possible to reconstruct the glycosaminoglycan chain in decorin to chondroitin, chondroitin 4-sulfate or chondroitin 6-sulfate. Therefore, we succeeded in synthesizing an artificial family of decorins.