Induction chemotherapy and hepatic artery embolization followed by extended resection for locally advanced gallbladder cancer: a case report.

BACKGROUND: Surgical resection plays a critical role in the curative therapy of patients with gallbladder cancer. However, extended resection for locally advanced gallbladder cancer is a controversial procedure because of the high operative morbidity, mortality, and poor prognosis after surgery, without consensus of its suitability. Several reports have described preoperative treatment modalities to reduce the risk of mortality and morbidity and improve the curability of surgery for locally advanced GBCA. However, only a few well-designed studies have verified the benefits of these preoperative strategies. CASE PRESENTATION: A 62-year-old male patient presented to our department with a gallbladder tumor detected on abdominal ultrasound during an annual medical checkup. Multi-phase enhanced CT revealed a gallbladder tumor with a maximum diameter of 34 mm, invading the right hepatic artery, pancreatic head, hepatic flexure of the colon, and first portion of the duodenum. We diagnosed gallbladder carcinoma as cT4 cN0 cM0 cStage IVA in the Union for International Cancer Control (UICC) classification 8th edition. After administration of 12 cycles of gemcitabine and cisplatin plus S-1 regimen, tumor shrinkage was observed on computed tomography, and elevated serum CA19-9 levels were reduced to normal limits. After preoperative hepatic artery embolization, we performed gallbladder bed resection with pancreaticoduodenectomy (minor hepatopancreatoduodenectomy) and combined resection of the right hepatic artery and hepatic flexure of the colon. Histological examination revealed no evidence of lymph node metastasis (ypT4 ypN0 ycM0 yp Stage IVA in the 8th edition of the UICC). The proximal bile duct and dissected margins were negative. CONCLUSIONS: The combination of induction chemotherapy and preoperative hepatic artery embolization, followed by minor hepatopancreatoduodenectomy and combined resection of the involved arteries and partial colon, could be a feasible treatment strategy for patients with locally advanced gallbladder cancer invading neighboring organs.

Cold crystallization and photo-induced thermal behavior of alkyl-derivatized diarylethene molecules.

The thermal behavior of alkylated diarylethene molecules (2,3-bis(2,4,5-trimethyl-3-thienyl)-N-alkylmaleimides; DAE-Cn) was investigated. DAE-C1 and DAE-C2 exhibited cold crystallization, which is a heat-storage phenomenon. In addition, DAE-Cn showed photoisomerization; the open-ring isomer O-DAE-Cn was formed by visible light irradiation and transformed to the closed-ring isomer C-DAE-Cn by UV light irradiation. X-ray diffraction and optical microscopy analyses revealed that O-DAE-Cn exhibited cold crystallization and C-DAE-Cn showed poor crystallinity. UV irradiation (365 nm) inhibited cold crystallization, and visible light irradiation (525 nm) triggered cold crystallization, suggesting that heat storage by the cold crystallization of DAE-Cn can be photo-controlled.

PEGylation of Co-Zn Ferrite Nanoparticles for Theranostics.

Multi-element ferrite nanoparticles (NPs) were synthesized as heat agents for use in magnetic hyperthermia treatments, specifically, Co0.8Zn0.2Fe2O4 NPs coating with polyethylene glycol. The crystal structures of these particles were examined by X-ray diffraction. Particle diameters were controlled to be approximately 10 nm by controlling the annealing temperature and time. The modification of polyethylene glycol (PEG) on the particles was confirmed by mass spectrometry and Fourier-transform infrared spectrometry. The heat dissipation characteristics of the particles were investigated by measuring AC magnetic susceptibility and temperature increase in AC magnetic fields. A peak in the imaginary part of AC magnetic susceptibility χ″ appeared, depending on the frequency. The value of χ″ was found to contribute to the effective heat dissipation according to the Neel relaxation system. The temperature increase of the particles was measured in AC magnetic fields of 64-146 Oe, with an observed temperature increase of ~10 K. Finally, to test the applications of these particles in theranostics, in vitro experiments using human breast cancer cells were conducted.

The impact of anti-HLA antibodies on unrelated cord blood transplantations.

The majority of cord blood transplantations (CBTs) have human leukocyte antigen (HLA) disparities. We investigated the impact that patients' pretransplantation anti-HLA antibodies have on the outcome of CBTs. Testing for anti-HLA antibody and its specificity was performed retrospectively at the Japanese Red Cross Tokyo Blood Center with sensitive solid-phase antibody detection assays. Among 386 CBTs, which were first myeloablative stem cell transplantations for malignancies and used a single unit of cord blood, 89 tested positive. Among the antibody-positive group, the cord blood did not have the corresponding HLA type for the antibody in 69 cases (ab-positive), while 20 cases had specificity against the cord blood HLA (positive-vs-CB). Cumulative incidence of neutrophil recovery 60 days after transplantation was 83% (95% confidence interval [CI], 79%-87%) for the antibody-negative group (ab-negative), 73% (95% CI, 61%-82%) for ab-positive, but only 32% (95% CI, 13%-53%) for the positive-vs-CB (P < .0001, Gray test). With multivariate analysis, the ab-positive showed significantly lower neutrophil recovery than the ab-negative (relative risk [RR] = 0.69, 95% CI, 0.49-0.96, p = .027). The positive-vs-CB had significantly lower neutrophil recovery (RR = 0.23, 95% CI, 0.09-0.56, P = .001) and platelet recovery (RR = 0.31, 95% CI, 0.12-0.81, P = .017) than the ab-negative. Patients' pretransplantation anti-HLA antibodies should be tested and considered in the selection of cord blood.