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2.
Artigo em Inglês | MEDLINE | ID: mdl-34398301

RESUMO

Chronic inflammation contributes to tumor development by creating a local microenvironment that facilitates neoplastic transformation and potentiates the progression of cancer. Esophageal cancer (EC) is an inflammation-associated malignancy with a poor prognosis. The nature of the switch between chronic inflammation of the esophagus and EC-related immunological changes remains unclear. Here, we examined the dynamic alterations of immune cells at different stages of chronic esophagitis, Barrett's esophagus (BE) and EC using an esophageal spontaneous carcinogenesis rat model. We also investigated the anticancer effects of metformin. To stimulate EC carcinogenesis, chronic gastroduodenal reflux esophagitis via esophagojejunostomy was induced in 120 rats in metformin-treated and non-treated (control) groups. After 40 weeks, BE and EC developed in 96.7% and 63.3% of the control group, and in 66.7% and 23.3% of the metformin-treated group, respectively. Flow cytometric analysis demonstrated that the balance of M1/M2-polarized or phospho-Stat3-positive macrophages, regulatory T, cytotoxic T, natural killer (NK), NK T cells, and Th17 T cells was dynamically changed at each stage of the disease and were resolved by metformin treatment. These findings clarify the immunity in esophageal carcinogenesis and suggest that metformin could suppress this disease by improving the immunosuppressive tumor microenvironment and immune evasion.

3.
Gan To Kagaku Ryoho ; 48(8): 1049-1051, 2021 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-34404074

RESUMO

The rate of aging in Japan has currently exceeded 28.1%. Moreover, it is expected that the rate of aging will continue to increase in the future. Under these circumstances, the opportunities to treat breast cancer in the super-elderly individuals are elevating. Here, we summarized and examined the cases who were 85 years or above in age and diagnosed with breast cancer at our hospital during the last 10 years. There were 29 cases(30 breasts), who were all female, with an average age of 89.6 years. Dementia coexisted in 17 cases, and an enlarged mass was the trigger for the discovery in most cases. For breast cancer in super-elderly females, it is necessary to treat it in the right proportion. Moreover, it is considered that the treatment policy should be decided considering the presence or absence of dementia and comorbidities. Also, the treatment regime should be decided upon full consultation with the surroundings, such as family members and long-term care facilities.


Assuntos
Neoplasias da Mama , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Comorbidade , Feminino , Hospitais , Humanos , Japão/epidemiologia
4.
Gan To Kagaku Ryoho ; 48(7): 955-957, 2021 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-34267035

RESUMO

The case involved a 51-year-old woman who was diagnosed with Stage Ⅰ right breast cancer(cT1, N0, M0). Partial resection of the right breast and sentinel lymph node biopsy were performed. The histological type was found to be Stage Ⅰ triple-negative medullary carcinoma with pT1c, pN0(sn), and M0. A pituitary tumor was diagnosed after discharge. After removal of the pituitary tumor, whole-breast irradiation was performed. Subsequently, chemotherapy was started. Approximately 5 months after surgery, redness and swelling of the right breast were observed. Inflammatory breast cancer recurrence could not be ruled out by imaging, and skin biopsy was performed. No malignant findings were observed, and the symptoms were considered to indicate radiation recall dermatitis caused by chemotherapy. When chemotherapy was discontinued, the redness of the right breast improved.


Assuntos
Neoplasias da Mama , Neoplasias Inflamatórias Mamárias , Radiodermatite , Axila , Neoplasias da Mama/cirurgia , Feminino , Humanos , Neoplasias Inflamatórias Mamárias/diagnóstico , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Radiodermatite/diagnóstico , Radiodermatite/etiologia , Biópsia de Linfonodo Sentinela
5.
J Surg Case Rep ; 2020(10): rjaa296, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33072250

RESUMO

Conventional jejunal reconstruction procedures for large duodenal defects include jejunal serosal patch repair and duodenojejunostomy and have some risks of postoperative complications. The pedicled jejunal flap is used for reconstruction following laryngopharyngectomy, esophagectomy and other gastrointestinal surgeries. We report two cases of successful closure of duodenal defects after partial duodenectomies by pedicled jejunal flap reconstruction. Case 1: A 72-year-old man was diagnosed with gastrointestinal stromal tumor by esophagogastroduodenoscopy (EGD), endoscopic ultrasound-guided fine needle aspiration biopsy and computed tomography (CT). Case 2: A 63-year-old woman was diagnosed with early duodenal cancer using EGD and CT. Partial duodenectomy and pedicled jejunal flap reconstruction were performed in both patients. A part of the jejunum was formed into a pedicled flap to fit the duodenal defect and duodenojejunal anastomosis was performed. The patients did not report any postoperative gastrointestinal symptoms or abnormal findings during follow-up EGD or upper gastrointestinal radiography.

6.
Am J Case Rep ; 21: e922405, 2020 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-32205837

RESUMO

BACKGROUND Strangulation ileus is caused by external obstruction to the small bowel, which results in ischemia and loss of bowel peristalsis. Low-grade appendiceal mucinous neoplasm (LAMN) is a low-grade adenocarcinoma that arises in the appendix. LAMN is usually asymptomatic but can present with appendiceal rupture and pseudomyxoma peritonei (PMP). This report is of a rare presentation of LAMN with strangulation ileus in a 92-year-old man. CASE REPORT A 92-year-old man was admitted to the emergency room with sudden onset of lower abdominal pain and abdominal distension. Laboratory investigations showed a leukocytosis with a white blood cell (WBC) count of 14.6×10³/µL with 85.5% neutrophils, blood urea nitrogen (BUN) of 26.6 mg/dL, and serum creatinine of 2.6 mg/dL, consistent with acute renal failure. Arterial blood gas analysis showed lactic acidosis (pH of 7.11) with a base excess of -20.8 mmol/L and lactate of 13.7 mmol/L. Abdominal computed tomography (CT) showed ascites and a dilated obstructed closed loop of the distal ileum associated with an external mass (3.9×2.8 cm). An initial diagnosis was of strangulation ileus due to Meckel's diverticulum. Emergency ileocecal resection was performed. Histopathology showed a low-grade mucinous tumor arising from the mucosa of the appendix, consistent with LAMN. At a 13-month follow-up, the patient was well with no tumor recurrence. CONCLUSIONS This report is of a rare case of LAMN that presented as a surgical emergency with strangulation ileus.


Assuntos
Adenocarcinoma Mucinoso/complicações , Neoplasias do Apêndice/complicações , Íleus/etiologia , Divertículo Ileal/etiologia , Adenocarcinoma Mucinoso/cirurgia , Idoso de 80 Anos ou mais , Neoplasias do Apêndice/cirurgia , Serviço Hospitalar de Emergência , Humanos , Íleus/cirurgia , Masculino , Divertículo Ileal/cirurgia , Resultado do Tratamento
7.
J Med Case Rep ; 12(1): 314, 2018 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-30367665

RESUMO

BACKGROUND: Most colorectal cancer liver metastases form nodules within the hepatic parenchyma, and hepatectomy is the only radical treatment for synchronous metastases. There is concern about intrabiliary tumor growth which may affect the surgical margin, resulting in local recurrence after hepatectomy for colorectal cancer liver metastasis; however, there has been no report of the dissemination in the bile duct after hepatectomy. Here, we report an unusual case of biliary dissemination of colorectal cancer that caused recurrent intrabiliary growth after hepatectomy, and discuss the management of intrabiliary metastasis of colorectal cancer. CASE PRESENTATION: A 69-year-old Japanese man underwent treatment for liver dysfunctions 3 years after aortic valve replacement. Computed tomography revealed an enhanced tumor within the hilar bile duct and dilatation of the left hepatic duct, typical of hilar cholangiocarcinoma. Endoscopic retrograde cholangiopancreatography revealed tumor shadow in his bile duct, and the cytology confirmed malignant cells in the bile. We performed extended left hepatectomy with bile duct resection; his postoperative course remained good without acute complications. After 3 months postoperatively, he was readmitted for subacute cholangitis and obstructive jaundice. Immediately, percutaneous transhepatic cholangiography drainage was performed, followed by cholangiography that exhibited intrabiliary tumor growth in the remnant liver. On immunohistochemical examination, tumor cells were positive for cytokeratin 20 and CDX2 but negative for cytokeratin 7. Then, computed tomography revealed an enhanced tumor-like lesion at the descending colon. After 3 months, left hemicolectomy was performed. Meanwhile, the percutaneous transhepatic cholangiography drainage fluid turned bloody, which was considered to be bleeding from a residual bile duct tumor. Accordingly, radiotherapy was initiated to prevent tumor bleeding around the hilar bile duct, but, unfortunately, the effects were short-lived, and cholangitis rebooted after 1 month leading to our patient's death due to septic liver failure. Autopsy revealed a remnant tumor in the bile duct, but no noticeable nodular metastasis was observed, except for a single small metastasis in the lower lobe of the left lung. CONCLUSIONS: The intrabiliary growth of metastatic colorectal cancer mimics cholangiocarcinoma occasionally. To date, as the effect of chemotherapy or radiotherapy remains uncertain, the complete resection of a bile duct tumor is the only method which could result in a better prognosis.


Assuntos
Neoplasias dos Ductos Biliares/patologia , Ductos Biliares/patologia , Colangiocarcinoma/patologia , Neoplasias do Colo/patologia , Hepatectomia , Neoplasias Hepáticas/secundário , Fígado/patologia , Idoso , Neoplasias dos Ductos Biliares/cirurgia , Neoplasias do Colo/cirurgia , Evolução Fatal , Humanos , Neoplasias Hepáticas/cirurgia , Masculino , Recidiva Local de Neoplasia , Tomografia Computadorizada por Raios X
8.
Am J Case Rep ; 19: 133-136, 2018 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-29402880

RESUMO

BACKGROUND Primary small bowel cancer is a rare malignancy; the common histopathological types are carcinoid and adenocarcinoma. Inflammatory bowel diseases and familial adenomatous polyposis are known risk factors for small bowel cancer. Additionally, cases of surgery-induced small bowel adenocarcinoma are sometimes reported after ileostomy. CASE REPORT A 84-year-old woman, who had undergone ileotransversostomy for intestinal obstruction due to postoperative adhesion following appendectomy at the age of 31 years, was referred to our hospital for further examination after experiencing abdominal pain in the right lower quadrant for 2 weeks. Laboratory data showed elevated serum levels of carcinoembryonic antigen (CEA, 102.9 ng/ml) and carbohydrate antigen 19-9 (CA19-9, 104 U/ml). Enhanced computed tomography (CT) revealed a 10-cm mass in the terminal ileum and a distention of the ileum and colon in the blind loop, with retention of feces. The patient was suspected of having ileal cancer by preoperative examination; therefore, right hemicolectomy with en bloc resection was performed. The tumor was histopathologically diagnosed as a well-differentiated and mucinous adenocarcinoma of the ileum. At over 12 months after surgery, tumor recurrence had not been observed. CONCLUSIONS Difficulties in diagnosis can cause delays in treatment and lead to poor prognosis, mainly because tumors in the small bowel rarely cause clinical symptoms. Adenocarcinoma of the ileum should be considered in postoperative patients with ileotransversostomy.


Assuntos
Adenocarcinoma/diagnóstico , Neoplasias do Íleo/diagnóstico , Ileostomia , Adenocarcinoma/cirurgia , Idoso de 80 Anos ou mais , Apendicectomia/efeitos adversos , Feminino , Humanos , Neoplasias do Íleo/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Fatores de Tempo
9.
Rev Sci Instrum ; 87(8): 085005, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27587151

RESUMO

We have developed a Si-based microelectromechanical systems sensor with high sensitivity for specific low-frequency vibration-sensing and energy-harvesting applications. The low-frequency vibration sensor contains a disk proof mass attached to two or three lead zirconate titanate (PZT) S-shape spring flexures. To obtain a faster and less expensive prototype, the design and optimization of the sensor structure are studied via finite-element method analysis. To validate the sensor structure to detect low-frequency vibration, the effects of geometrical dimensions, including the width and diameter of the S-shape spring of the proof mass, were analyzed and measured. The functional features, including the mechanical property and electrical performance of the vibration sensor, were evaluated. The results demonstrated that a very low resonant frequency of <11 Hz and a reasonably high voltage output of 7.5 mV at acceleration of >0.2g can be typically achieved. Given a low-frequency vibration sensor with ideal performance and mass fabrication, many advanced civilian and industrial applications can be possibly realized.

10.
Opt Express ; 23(23): 29449-56, 2015 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-26698428

RESUMO

We propose and demonstrate that vertically curved waveguides (VCWs) enable vertical coupling between silicon wire waveguides and optical fibers with low wavelength dependence and polarization dependence for wide telecommunication wavelength band light. To bend these VCWs, we implanted silicon ions into silicon wire cantilevers from the vertical direction. The internal stress distribution that was induced by ion implantation drove the bending force, and we achieved vertical bending of the waveguides, with curvature radii ranging from 3 to 25 µm. At a radius of curvature of 6 µm, we obtained a coupling loss of 3 dB using a lens fiber.

11.
Opt Express ; 23(16): 21287-95, 2015 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-26367977

RESUMO

We experimentally demonstrate low-loss and polarization-insensitive fiber-to-chip coupling spot-size converters (SSCs) comprised of a three dimensionally tapered Si wire waveguide, a SiON secondary waveguide, and a SiO(2) spacer inserted between them. Fabricated SSCs with the SiO(2) spacer exhibit fiber-to-chip coupling loss of 1.5 dB/facet for both the quasi-TE and TM modes and a small wavelength dependence in the C- and L-band regions. The SiON secondary waveguide is present only around the SSC region, which significantly suppresses the influence of the well-known N-H absorption of plasma-deposited SiON at around 1510 nm.

12.
Opt Express ; 23(14): 18602-10, 2015 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-26191918

RESUMO

This paper presents optimized design and measurement results for a low-loss broadband vertical interlayer transition (VIT) device located between lower and upper Si nano-photonic waveguides. The device comprises the lower c-Si taper, the upper a-Si:H taper, and a wide and thin SiON secondary core with a 0.6-µm-thick SiO2 interlayer. The device structure facilitates the low loss VIT, giving insertion losses of 0.87 and 0.79 dB for quasi-TE and TM modes, respectively, at 1550 nm. Also, the evanescent coupling nature of the VIT device renders it wavelength- and polarization-insensitive, leading to loss variation of within 0.5 dB in the C-band.

13.
Opt Express ; 22(4): 4779-88, 2014 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-24663796

RESUMO

We demonstrate a submicrometer-scale hydrogenated amorphous silicon (a-Si:H) waveguide with a record low propagation loss of 0.60 ± 0.02 dB/cm because of the very low infrared optical absorption of our low defect a-Si:H film, the optimized waveguide structure and the fabrication process. The waveguide has a core with a thickness of 440 nm and a width of 780 nm that underlies a 100-nm-thick ridge structure, and is fabricated by low-cost i-line stepper photolithography and with low-temperature processing at less than 350°C, making it compatible with the backend process of complementary metal oxide semiconductor (CMOS) fabrication.

14.
Gan To Kagaku Ryoho ; 40(1): 67-9, 2013 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-23306920

RESUMO

We report having treated patients with metastatic colorectal cancer with panitumumab in our department. Ten patients were treated. The mean age was 65. 7 years-old with 7 males and 3 females. Seven patients were treated with only panitumumab, and three patients were treated with panitumumab and another drug. The median number of infusions was 8 times. In the 9 cases that could be evaluated, the disease control rate was 66. 6%. Skin toxicity was observed in all patients. A low serum magnesium value of grade 3 was observed in one patient. We consider that treatment with panitumumab for patients with metastatic colorectal cancer was a safe option.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Idoso , Neoplasias Colorretais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Panitumumabe
15.
Opt Lett ; 37(8): 1382-4, 2012 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-22513693

RESUMO

Ultra-fast carrier decay, recently discovered in a hydrogenated amorphous silicon waveguide, can be exploited for pattern-effect-free all-optical signal processing based on optical Kerr nonlinearity. In this study, we utilized a 10 Gbit/s RZ-OOK data stream as a pump for degenerate four-wave mixing in a low-loss hydrogenated amorphous silicon waveguide. The propagation loss of the waveguide used was 1.0±0.2 dB/cm at 1550 nm. Unlike crystalline silicon waveguides, no noticeable difference was observed in the BER characteristics between the cases of PRBS 2(7)-1 and 2(31)-1.

16.
Materials (Basel) ; 5(5): 985-1004, 2012 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-28817020

RESUMO

This paper reviews the direct bonding technique focusing on the waveguide optical isolator application. A surface activated direct bonding technique is a powerful tool to realize a tight contact between dissimilar materials. This technique has the potential advantage that dissimilar materials are bonded at low temperature, which enables one to avoid the issue associated with the difference in thermal expansion. Using this technique, a magneto-optic garnet is successfully bonded on silicon, III-V compound semiconductors and LiNbO3. As an application of this technique, waveguide optical isolators are investigated including an interferometric waveguide optical isolator and a semileaky waveguide optical isolator. The interferometric waveguide optical isolator that uses nonreciprocal phase shift is applicable to a variety of waveguide platforms. The low refractive index of buried oxide layer in a silicon-on-insulator (SOI) waveguide enhances the magneto-optic phase shift, which contributes to the size reduction of the isolator. A semileaky waveguide optical isolator has the advantage of large fabrication-tolerance as well as a wide operation wavelength range.

17.
Opt Express ; 17(14): 11267-73, 2009 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-19582039

RESUMO

A TE-TM mode converter is proposed in a single trench GaInAsP/InP waveguide, which is fabricated by a single masking and etching process. Use of single-trench structure makes the design and the fabrication much simpler. The design of single-trench mode converter is described together with its fabrication in this article. We investigated the dependence of conversion efficiency on the waveguide width, trench depth, and trench position. Also, the wavelength dependence of mode conversion efficiency was calculated in a wavelength range between 1.5 microm to 1.58 microm. 95% TE-TM mode conversion was measured at a wavelength of 1.55 microm in a fabricated device with a 210-microm half-beat length.

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