Water detection in organic solvents using a copolymer membrane immobilised with a fluorescent intramolecular charge transfer-type dye: effects of intramolecular hydrogen bonds.

Numerous fluorescent dye-based optical sensors have been developed to detect water in organic solvents. However, only a few such sensors can detect water in polar solvents such as methanol or dimethyl sulfoxide, and their detection range is generally narrow. Therefore, in this study, a copolymer membrane incorporated with a pyridinium betaine dye (denoted PB1), which exhibited intramolecular charge transfer (ICT) characteristics, was developed to realise simple water detection in organic solvents. The pyridinium betaine structure, comprising intramolecular hydrogen bonds between the oxygen in the maleimide moiety and the hydrogen in the pyridinium, was vital for achieving efficient fluorescence emission. The membrane was prepared by copolymerising PB1 with the N,N-dimethyl acrylamide/acrylamide monomer on a glass plate, and the fluorescence in water-mixed organic solvents was investigated (λabs = 490 nm, λfl = 630 nm). The fluorescence intensity of the dye-immobilised membrane decreased with increasing water content of the organic solvents. The detection ranges in tetrahydrofuran, ethanol, methanol, and dimethyl sulfoxide were approximately <40, <40, <40, and <60 vol% water, respectively. In contrast, membranes based on a quaternary pyridinium dye (without intramolecular hydrogen bonds) did not detect water in methanol and dimethyl sulfoxide, although it was more sensitive than PB1 in the narrow region of low water concentration in THF. Theoretical calculations corroborated the importance of the pyridinium betaine structure in detecting water in organic solvents, with the increase in polarity and the formation of intermolecular hydrogen bonds between PB1 and water found to induce molecular rotation and fluorescence quenching.

A case of massive hemoptysis caused by lung cancer saved by V-V ECMO and hemostasis achieved by radiotherapy.

Massive hemoptysis is one of the fatal complications of lung cancer. There is no established standard treatment method for it, and it often causes sudden suffocation, and some cases may be difficult to save. A 63-year-old man was admitted to the hospital with dyspnea, and developed massive hemoptysis from lung cancer shortly after admission. The tumor had obstructed the right main bronchus and had invaded the right pulmonary artery. Surgery and interventional radiology were judged impossible. The patient was successfully saved by the introduction of Veno-Venous Extra Corporeal Membrane Oxygenation (V-V ECMO), and hemostasis was obtained by radiotherapy. Two months after completion of radiotherapy, he was weaned off the ventilator and discharged on his own. He died of increased peritoneal dissemination and other complications 1 year and 1 month later, but no recurrence of hemoptysis was noted until his death. We experienced a case of massive hemoptysis in which V-V ECMO and radiation therapy succeeded in saving life and stopping bleeding. The use of V-V ECMO by emergency care teams and multimodality therapy, including radiotherapy, were effective for massive hemoptysis from lung cancer.

Drug-induced lung injury in a patient treated with prior atezolizumab and subsequent sotorasib: A case report.

We report a case of drug-induced lung injury treated with prior atezolizumab and subsequent sotorasib. The patient was a 62-year-old woman with lung adenocarcinoma harbouring a KRAS G12C mutation that was resistant to chemotherapy, including immune checkpoint inhibitors. Cough and dyspnea appeared on day 80 after sotorasib was administered as second-line therapy, and chest computed tomography revealed ground glass opacities in all lung lobes. Bronchoalveolar lavage fluid showed an increased total cell count with lymphocyte predominance. The patient was considered to have lung injury caused by prior atezolizumab or sotorasib administration. Withdrawal of sotorasib did not improve symptoms and shadows in both lungs. We administered moderate-dose prednisolone and the lung disorder quickly resolved. Prednisolone tapering was completed in 2 months, followed by several months without relapse. Definitive identification of the responsible drug for the drug-induced lung injury proved challenging in the setting of exposure to multiple potential inciting agents. There is a need for high levels of clinical suspicion for timely evaluation and management.

Long-term follow-up of unresectable adenoid cystic carcinoma of the trachea and bronchus treated with high-dose proton beam therapy: A report of two cases.

Adenoid cystic carcinoma (ACC) of the trachea is a rare disease that is slow growing and has a risk of distant metastasis. The standard treatment for ACC of the trachea is surgery, but this tumor is often unresectable. In definitive radiotherapy using photons for unresectable ACC of the trachea, it is sometimes difficult to deliver a sufficient dose to the target without exceeding the tolerable dose to the surrounding normal tissues. Here, we report two cases of ACC of the trachea that received a high dose (74 Gy [relative biological effectiveness]) of proton beam therapy and achieved long-term survival.

Capillary Leak Syndrome With Pulmonary Edema Preceded by Organizing Pneumonia Caused by Combination Therapy With Nivolumab and Ipilimumab: A Case Report.

Treatment with drugs can cause lung disorders. Immune checkpoint inhibitors are often associated with organizing pneumonia. Capillary leak syndrome is a clinical form of drug-induced lung injury, a rare condition characterized by hemoconcentration, hypoalbuminemia, and hypovolemic shock. There have been no reports of multiple lung injury with immune checkpoint inhibitors, and although capillary leak syndrome alone has been reported in the past, there have been no reports of pulmonary edema as a complication. We report a 68-year-old woman who died of respiratory and circulatory failure owing to pulmonary edema caused by capillary leak syndrome, preceded by organizing pneumonia induced by combination therapy with nivolumab and ipilimumab for postoperative recurrence of lung adenocarcinoma. Residual inflammation and immune abnormalities from previous immune-related pulmonary adverse events may have increased pulmonary capillary permeability, leading to marked pulmonary edema.

A case of COVID-19 with superficial thrombophlebitis caused by an indwelling peripheral venous catheter.

A local hypercoagulable state caused by SARS-CoV-2 and an indwelling peripheral venous catheter can lead to superficial thrombophlebitis. If the venous catheter is no longer needed during treatment for COVID-19 it should be removed promptly.

Posterior mediastinal nodule diagnosed as a tuberculous granuloma infiltrating into the aorta.

Although tuberculous infection rarely results in aortic aneurysm formation or rupture, its precursor lesion has never been identified in cases with tuberculosis. We incidentally encountered a case of a posterior mediastinal nodule with concomitant chest computed tomography (CT) findings of multiple pulmonary micronodular shadows. Since an enlargement of the mediastinal nodule was retrospectively apparent, we considered the lesion as malignant. Enhanced CT showed luminal irregularity in the descending aorta, located adjacent to the nodule, in addition to the disappearance of the fat plane between the lesion and the aorta. We successfully resected the nodule with the aorta under partial cardiopulmonary bypass. Based on the pathological and postoperative bacterial findings, the nodule was diagnosed as a tuberculous granuloma infiltrating into the medial layer of the aorta.

Fluorescence navigation with indocyanine green for identification of intersegmental planes using a photodynamic eye camera.

BACKGROUND: Pulmonary segmentectomy is an important surgical option for complete resection in patients with poor lung function. However, correctly recognizing the intersegmental plane for accurate segmentectomy is sometimes difficult. We therefore developed a novel method that allows the detection of intersegmental planes using an indocyanine green (ICG) fluorescence imaging device, photodynamic eye (PDE) camera, PDE-neo. METHODS: As a prospective study, we performed bronchial ICG-guided segmentectomy using PDE-neo. The patients were placed in a lateral position under general anesthesia, and we performed a combined muscle-sparing minithoracotomy with video assistance. The pulmonary artery, pulmonary vein, and segmental bronchi were separated, and ICG mixed with autologous blood was introduced by spraying through the resected segment bronchi to enable visualization of the intersegmental surface with PDE-neo. This study protocol was approved by the Research Ethics Board of Hamamatsu University School of Medicine, Japan. Written informed consent was obtained from all patients. RESULTS: Overall, 10 lung malignancy patients, including 8 males and 2 females, participated in this study from March 2011 to October 2013. The median age was 69 years (range, 29-76 years). Pathologic diagnoses were 7 adenocarcinomas, 1 adenosquamous carcinoma, 1 carcinoid tumor, and 1 lung metastasis from the parotid gland cancer. The intersegmental planes of 8 cases could be identified by this method using a PDE-neo, whereas those of 2 cases did not show clear demarcations. The reason was that because of severe emphysema, air flowed from the resected segment to the surrounding segments, obliterating the demarcation between the two segmental planes. There were no recurrent cases and only two deaths due to other diseases were observed; and the 5-year cause-specific survival rate was 100%. CONCLUSIONS: Intersegmental planes could be more easily identified using ICG fluorescence imaging during segmentectomy. This method is feasible and effective and has a good long-term prognosis.

Clinicopathological Features in Elderly ALK-rearranged Non-small Cell Lung Cancer Patients.

AIM: To clarify the clinicopathological features in elderly anaplastic lymphoma kinase (ALK) rearranged non-small cell lung cancer (NSCLC) patients. PATIENTS AND METHODS: A retrospective study was performed in 129 ALK rearranged NSCLC patients diagnosed between April 2008 and March 2019 in fifteen Institutions of the Ibaraki prefecture, Japan. RESULTS: Median age of patients was 63 years. In 59 patients aged 65 and older, the proportions of patients with advanced stage and those treated with ALK-tyrosine kinase inhibitor (TKI) were lower than those younger than 65 years. There was no difference in overall survival (OS) between the two age groups. Among the elderly patients, no difference was observed in OS between the patients aged 65-69 and those aged 70 and older. In 89 patients treated with TKI, no significant differences were observed in the progression-free survival of TKIs and OS between patients aged 65 and older and those younger than 65, respectively. CONCLUSION: Evaluation of ALK gene status and TKI treatment are desirable even for elderly patients.

Serum CEA and CYFRA Levels in ALK-rearranged NSCLC Patients: Correlation With Distant Metastasis.

AIM: To clarify the correlation between serum levels of carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA) and metastasis and survival in anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) patients. PATIENTS AND METHODS: CEA and CYFRA levels in 131 ALK-rearranged NSCLC patients were determined using fluorescence in situ hybridization (FISH), real time-reverse transcription polymerase chain reaction, and immunohistochemistry, using biopsy specimens, cytology specimens, and plasma specimens. Cut-off value of each marker was determined as 10 ng/ml. RESULTS: In logistic regression analysis, higher levels of both markers had a positive relationship with bone metastases, and higher levels of CYFRA was relevant to liver metastases, and multiple-organ metastases. However, these markers were not proven to be poor prognostic factors in Cox's proportional model analysis. CONCLUSION: Elevated serum CEA and CYFRA levels seem to provide useful clinical information about presence of bone and liver metastasis and multiple-organ metastases, although they were not a powerful indicator of prognosis. These two markers may suggest the extension of metastasis and would be helpful in considering treatment options.

A case of ROS1-rearranged lung adenocarcinoma exhibiting pleural effusion caused by crizotinib.

Reports of crizotinib-induced pleural effusion in non-small cell lung cancer (NSCLC) are limited. A 35-year-old Japanese woman was diagnosed with ROS1-rearranged lung adenocarcinoma (primary left lower lobe, cT4N3M1c). Crizotinib was administered as first-line therapy, and the primary and mediastinal hilar lymph node metastases rapidly shrank. On the fourth day of treatment, chest X-ray demonstrated contralateral pleural effusion. On the 41st day of treatment, crizotinib was discontinued because of grade 3 neutropenia. Examination including surgical thoracoscopy did not reveal causative findings, and the continued cessation of drug administration enabled the right pleural effusion to decrease gradually and disappear, suggesting that this event was a side effect of crizotinib. The disease did not progress even though the drug was withdrawn for more than one year. In conclusion, crizotinib was considered to cause pleural effusion as an adverse event in a case of ROS1-rearranged lung adenocarcinoma with a complete response.

Detection of circulating tumor cells in patients with lung cancer using metallic micro-cavity array filter: A pilot study.

We have developed a metallic micro-cavity array filter and an automated detection system for capturing circulating tumor cells (CTCs). In this single institutional pilot study, we assessed the ability of this device to detect CTCs in patients with lung cancer at each stage. Patients diagnosed with lung cancer, undergoing planned surgery for lung cancer, or suspected of having lung cancer were recruited (40 recruited and 2 excluded). Blood samples were obtained from the patients and 3 ml whole blood was applied to the device without any preparation. The captured cells were stained to differentiate the nucleus, and determine cytokeratin and CD45 expression. Subsequently, two operators blinded to clinical information counted the number of CTCs. Sample collection was performed at the time of recruitment, before treatment and ~3 months after initial blood collection. CTC counts at recruitment were 1.4±0.4, 1.8±1.2, 1.3±0.6 and 7.4±5.1 (mean ± SE) in clinical stages I, II, III and IV, respectively. No significant difference was observed among the stages. These data indicated the ability of this device to detect CTCs at early or non-metastatic stages of lung cancer. Further research on a larger scale is needed for a more accurate assessment of the device, and research on the utility of captured cells remains a future challenge.

Coenzyme A and Its Thioester Pools in Obese Zucker and Zucker Diabetic Fatty Rats.

Feeding behavior is closely related to hypothalamic malonyl-CoA level in the brain and diet-induced obesity affects total CoA pools in liver. Herein, we performed a comprehensive analysis of the CoA pools formed in thirteen tissues of Zucker and Zucker diabetic fatty (ZDF) rats. Hypothalamic malonyl-CoA levels in obese rats remained low and were almost the same as those of lean rats, despite obese rats having much higher content of leptin, insulin, and glucose in their sera. Regardless of the fa-genotypes, larger total CoA pools were formed in the livers of ZDF rats and the size of hepatic total CoA pools in Zucker rats showed almost one tenth of the size of ZDF rats. The decreased total CoA pool sizes in Zucker rats was observed in the brown adipose tissues, while ZDF-fatty rats possessed 6% of total CoA pool in the lean rats in response to fa deficiency. This substantially lower CoA content in the obese rats would be disadvantageous to non-shivering thermogenesis. Thus, comparing the intracellular CoA behaviors between Zucker and ZDF rats, as well as the lean and fatty rats of each strain would help to elucidate features of obesity and type 2 diabetes in combination with result (s) of differential gene expression analysis and/or comparative genomics.

Food deprivation changes chemotaxis behavior in Caenorhabditis elegans.

Exploring for food is important in food-deprived condition. Chemotaxis is one of the important behaviors to search food. Although chemotactic strategies in C. elegans have been well investigated: the pirouette and the weathervane strategies, the change of the chemotactic strategy by food deprivation is largely unclear. Here, we show the change of chemotactic strategy by food deprivation, especially for isoamyl alcohol. To compare chemotaxis under different food-deprivation period, we showed that worms change their chemotactic behaviors by food deprivation. The worms with 1-h food-deprivation change the weathervane strategy. On the other hand, 6-h food deprived animals change the pirouette strategy. These results demonstrate that worms change chemotactic strategy different way depend on period of food deprivation.

Solitary pulmonary metastasis from a gingival cancer of 36 years ago: A case report.

INTRODUCTION: Unlike a squamous cell carcinoma (SqCC), an adenoid cystic carcinoma (ACC) is an uncommon histology of all head and neck cancers. The clinical significance of a pulmonary metastasectomy differs greatly between these two types of cancers. A solitary pulmonary nodule in a patient with a history of both these different malignancies is a diagnostic and therapeutic challenge. PRESENTATION OF CASE: An 81-year-old woman presented with a right lung nodule detected by chest computed tomography (CT) one year after a tongue SqCC surgery. She had a remote history of gingival cancer 36 years prior, which was not assessed in detail during the initial work up. We suspected that the nodule was a primary lung cancer and she underwent a right basal segmentectomy. Histology revealed an ACC, which was proven to be a metastasis from the gingival cancer. DISCUSSION: An ACC is an uncommon type of cancer arises mainly in the salivary glands. It is characterized by a long-term behavior and the histology of ACC is a favorable prognostic factor. With its favorable histology and disease free interval of over 30 years, a better outcome would be expected than that of a primary lung tumor or a metastasis from the tongue SqCC. Furthermore, we could have made a differential diagnosis of a metastatic ACC before the surgery with more careful research for a previous history of a gingival cancer. CONCLUSION: Our case emphasized that a precise history taking of any malignancy, even if that of more than 30 years prior, is crucial.

[Outcomes of an Independent Clinical Study to Compare Branded and Generic Formulations of Sustained-Release Oxycodone].

To evaluate the potential for the adoption of a generic formulation of sustained-release oxycodone(Oxycodone SR Capsules), an independent clinical study was planned to accurately evaluate the efficacy and safety during a 9-day period. After a 3-day pretreatment period, the generic formulation was administered to patients with progressive cancer, who had been treated with a branded formulation(OxyContin®Tablets)of the drug for 5 days at the same dose. This was followed by a 1- day observation period. Drug administration to 3 patients with pulmonary cancer achieved the primary(dose, pain level, and adverse drug reactions)and secondary(rescue dose frequency and quality of life)endpoints, as well as safety goals. The merits of adopting a different dosage form were also noted. Independent data collection using an appropriate evaluation method consequently promoted the understanding of generic opioids in the clinical setting.

Clinicopathological significance of caveolin-1 expression by cancer-associated fibroblasts in lung adenocarcinoma.

PURPOSE: Caveolin is an essential constituent of caveolae and has many biological functions. Expression of caveolin-1 in cancer cells was reported to be a prognostic marker in several types of cancers, the prognostic significance of its expression in cancer-associated fibroblasts (CAFs) has not been investigated. This study aimed to evaluate the clinicopathological significance of expression by CAFs in lung adenocarcinoma. METHODS: We examined caveolin-1 expression in both CAFs and cancer cells in stage I invasive lung adenocarcinoma (n = 412) and analyzed the relationship between the expression and clinicopathological factors. RESULTS: Caveolin-1 expression by CAFs and cancer cells was observed in 12.1% and 7.8% of adenocarcinomas, respectively. Tumors with caveolin-1-positive CAFs had vascular and pleural invasion significantly more frequently than those with caveolin-1-negative CAF (p < 0.05). This was also the cases with tumors with caveolin-1-positive cancer cells (p < 0.01). Caveolin-1 expression by CAFs and that by cancer cells were significant predictors of shorter recurrence-free survival (p < 0.001). Caveolin-1 expression by CAFs and cancer cells was found in 25% and 30% of solid predominant subtype, respectively, but only 9.2% and 2.7% of non-solid predominant subtype, respectively. The frequency of cases with caveolin-1-positive CAFs or cancer cells was significantly higher in the solid predominant subtype than in non-solid predominant subtype (p < 0.001). CONCLUSIONS: Our current results highlight the prognostic importance of caveolin-1 expression by CAFs in stage I lung adenocarcinoma and provide new insights into the biological significance of caveolin-1 in the tumor microenvironment, especially in microenvironment of solid predominant adenocarcinoma.

Application of Hectorite-Coated Silica Gel Particles as a Packing Material for Chromatographic Resolution.

A new type of clay column particles was prepared, in which a hectorite layer (∼0.1 µm thickness) covered uniformly the surface of amorphous silica particles with an average radius of 5 µm (ref. Okada et al., The Journal of Physical Chemistry C, 116, 21864-21869 (2012)). The hectorite layer was fully ion-exchanged with Δ-[Ru(phen)3](2+) (phen = 1,10-phenanthroline) ions by being immersed in a methanol solution of Δ-[Ru(phen)3](ClO4)2 (1 mM). The modified silica gel particles thus prepared were packed into a stainless steel tube (4 mm (i.d.) × 25 cm) as a high-performance liquid chromatography column. Optical resolution was achieved when the racemic mixtures of several metal complexes or organic molecules were eluted with methanol. In the case of tris(acetylacetonato)ruthenium(III) ([Ru(acac)3]), for example, the Λ- and Δ-enantiomers gave an elution volume of 2.6 and 3.0 mL, respectively, with the separation factor of 1.2. The total elution volume (5 mL) was nearly one-tenth for the previously reported column of the same size (RU-1 (Shiseido Co., Ltd.)) packed with the spray-dried particles of synthetic hectorite (average radius 5 µm) ion-exchanged by the same Ru(II) complexes.

[Refractory methicillin-resistant Staphylococcus aureus empyema invasion from a cervical abscess: report of a case].

The patient was a 68-year-old male. At the previous hospital, continuous hemodiafiltration (CHDF)was performed through internal jugular vein for diabetic nephropathy. Long term catheterisation caused the abscess of the sternoclavicular joint, which induced methicillin-resistant Staphylococcus aureus( MRSA) empyema. Endoscopic thoracic debridement was performed for the empyema, however inadequate drainage for the abscess. Thereafter, the patient transferred to our hospital. We performed adequate drainage for the abscess under general anesthesia at 5 days after hospitalization, and then open decortication for empyema at 26 days. The patient recovered well after operation and was discharged from the hospital at 46 days. This was a successful case of surgical treatment for refractory MRSA empyema, which controls all focus of infection.

D2-40-positive lymphatic vessel invasion is not a poor prognostic factor in stage I lung adenocarcinoma.

The present study investigates whether lymphatic vessel invasion (LVI) detected by D2-40 staining is a prognostic factor for stage I adenocarcinoma of the lung. We retrospectively reviewed 124 patients who underwent complete resection for stage I adenocarcinoma of the lung from January 1983 to June 2003. LVI was microscopically evaluated using D2-40 immunostaining. The median follow-up was 71 months. The LVI positive rate was 37%. The 5-year cancer-specific survival rates of the D2-40 positive LVI and negative groups were 88.8% and 84.3%, respectively (P = 0.630). The stage I lung adenocarcinoma patients who were determined to be LVI positive based on D2-40 immunostaining did not have a significantly poorer prognosis than the LVI negative cases. Thus, lymphatic microinvasion may not be a prognostic indicator in early lung cancer, although advanced LVI does appear to correlate with survival. It is therefore unnecessary to use D2-40 immunostaining to diagnose LVI in practical settings, and Hematoxylin-Eosin and Elastica van Gieson staining should continue to be used to predict the prognosis of patients with stage I lung adenocarcinoma.