[Complete Response with Neoadjuvant Chemotherapy and Curative Resection in a Case of Locally Advanced Gastric Cancer That Was Strongly Positive for HER2 with Multiple Liver Metastases].

As a part of community screening, a 64-year-old man underwent gastric fluoroscopy, which revealed abnormalities indicative of a type 3 tumor. Contrast-enhanced abdominal computed tomography showed advanced gastric cancer with multiple regional lymph nodes and liver metastases. Chemotherapy was initiated, and after completion of 2 courses of capecitabine (Cape)and oxaliplatin(OHP)therapy, a distalgastrectomy was performed.

Diagnostic accuracy of diffusion-weighted whole-body imaging with background body signal suppression/T2-weighted image fusion for the detection of abdominal solid cancer.

Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) images show significant contrast for cancer tissues against non-cancerous tissues. Fusion of a DWIBS and a T2-weighted image (DWIBS/T2) can be used to obtain functional, as well as anatomic, information. In the present study, the performance of DWIBS/T2 in the diagnosis of abdominal solid cancer was evaluated.

Diffusion-weighted whole-body imaging with background body signal suppression/T2-weighted image fusion of gastrointestinal cancers.

Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) yields positive results for cancer against the surrounding tissues. The combination of DWIBS and T2-weighted images (DWIBS/T2) in the diagnosis of gastrointestinal tract cancers was retrospectively analyzed in the present study. Patients were subjected to magnetic resonance imaging after cancer was diagnosed through specimens obtained via biopsy or endoscopic mucosal resection.

Combined Secretomics and Transcriptomics Revealed Cancer-Derived GDF15 is Involved in Diffuse-Type Gastric Cancer Progression and Fibroblast Activation.

Gastric cancer is classified into two subtypes, diffuse and intestinal. The diffuse-type gastric cancer (DGC) has poorer prognosis, and the molecular pathology is not yet fully understood. The purpose of this study was to identify functional secreted molecules involved in DGC progression.

An association of elevated levels of alkaline phosphatase and gamma-glutamyl transpeptidase with acute cholangitis.

Background/aims: The early diagnosis of acute cholangitis (AC) is critical for appropriate treatment.

Methodology: Patient records from April 2008 to December 2012 were retrospectively analyzed. Data on white blood cell count and levels of C-reactive protein, total-bilirubin, alkaline phosphatase (ALP), aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transpeptidase (gamma-GTP) were collected from AC patients on the day they underwent endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and treatment.

Reduced hemoglobin and increased C-reactive protein are associated with upper gastrointestinal bleeding.

Aim: To investigate the early upper gastrointestinal endoscopy (endoscopy) significantly reduces mortality resulting from upper gastrointestinal (GI) bleeding.

Methods: Upper GI bleeding was defined as 1a, 1b, 2a, and 2b according to the Forrest classification. The hemoglobin (Hb), and C-reactive protein (CRP) were examined at around the day of endoscopy and 3 mo prior to endoscopy.

US-CT 3D dual imaging by mutual display of the same sections for depicting minor changes in hepatocellular carcinoma.

The purpose of this study was to evaluate the usefulness of ultrasound-computed tomography (US-CT) 3D dual imaging for the detection of small extranodular growths of hepatocellular carcinoma (HCC). The clinical and pathological profiles of 10 patients with single nodular type HCC with extranodular growth (extranodular growth) who underwent a hepatectomy were evaluated using two-dimensional (2D) ultrasonography (US), three-dimensional (3D) US, 3D computed tomography (CT) and 3D US-CT dual images. Raw 3D data was converted to DICOM (Digital Imaging and Communication in Medicine) data using Echo to CT (Toshiba Medical Systems Corp.

Identification of a high molecular weight kininogen fragment as a marker for early gastric cancer by serum proteome analysis.

Background: Serum biomarkers currently available for gastric cancers are not sufficiently sensitive and specific.

Methods: We used matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MS) to generate comparative peptide profiles of serum samples obtained from gastric cancer patients (n = 81) and age- and sex-matched healthy controls (n = 66).

Results: Because of initial screening and further validation, we found that the intensities of a 2209 m/z MS peak were increased in the preoperative sera obtained from gastric cancer patients, and we identified this peak, a 2209 Da peptide, as a high molecular weight (HMW) kininogen fragment.

[Histological complete response in a case of primary squamous cell carcinoma of the stomach treated by chemotherapy with docetaxel and cisplatin plus 5-fluorouracil].

The patient was a 68-year-old man with melena. Endoscopic examination revealed a type 2 advanced tumor in the mid body and an elevated lesion in the upper body of the stomach. Biopsy specimens from both lesions were diagnosed histologically as squamous cell carcinoma.

[A successful two-stage treatment with CDDP and CPT-11 for pancreatic neuroendocrine carcinoma with liver metastasis].

A 59-year-old man was diagnosed as having a pancreatic carcinoma with synchronous liver metastasis at initial surgery. After wedge resection of liver tumor for histopathological analysis and gastro-jejunostomy, he was treated with 3 cycles of combined systematic chemotherapy consisting of CDDP and CPT-11, because of histopathological diagnosis confirming a neuroendocrine carcinoma of the pancreas. After chemotherapy, there was no recurrence and the primary tumor was reduced in size.

A randomized phase II trial of adjuvant chemotherapy with uracil/tegafur and gemcitabine versus gemcitabine alone in patients with resected pancreatic cancer.

Background: There have been few randomized studies of adjuvant chemotherapy using gemcitabine (GEM) in patients with resected pancreatic cancer.

Methods: Patients with invasive ductal pancreatic cancer who underwent radical surgery were enrolled and assigned to receive uracil/tegafur (UFT) and GEM together (GU) or GEM alone (G). GEM was administrated at a dosage of 1 g/m(2) intravenously weekly 3 of 4 weeks and UFT at a dosage of 200 mg/day orally continuously.

Annexin II overexpression predicts rapid recurrence after surgery in pancreatic cancer patients undergoing gemcitabine-adjuvant chemotherapy.

Background: Gemcitabine has been shown to exhibit significant clinical activity against pancreatic cancer and has become a first-line chemotherapeutic for this disease in recent years. However, there are still many patients who do not respond to this treatment and it is expected to improve the clinical outcome if we can develop a method to predict the efficacy of gemcitabine before treatment. The purpose of this study was to determine novel factors that make pancreatic cancer resistant to gemcitabine.

Identification of novel immunohistochemical tumor markers for primary hepatocellular carcinoma; clathrin heavy chain and formiminotransferase cyclodeaminase.

Unlabelled: Early diagnosis of hepatocellular carcinoma (HCC) greatly improves its prognosis. However, the distinction between benign and malignant tumors is often difficult, and novel immunohistochemical markers are necessary. Using agarose two-dimensional fluorescence difference gel electrophoresis, we analyzed HCC tissues from 10 patients.

Effect of the herbal medicine Inchin-Ko-To for serum bilirubin in hepatectomized patients.

Background/aims: Persistent hyperbilirubinemia is a symptom of postoperative liver failure after hepatectomy. We examined the effectiveness of a herbal medicine, Inchin-Ko-To (ICKT), on postoperative serum bilirubin levels in patients undergoing liver resection.

Methodology: Patients were divided into two groups.

Treatment with an oral fluoropyrimidine, S-1, plus cisplatin in patients who failed postoperative gemcitabine treatment for pancreatic cancer: a pilot study.

Background: This study set out to evaluate, in patients with gemcitabine-resistant pancreatic cancer, the response rate and toxicity of S-1 plus cisplatin (CDDP).

Methods: Seventeen patients with histologically diagnosed invasive ductal pancreatic cancer were enrolled in this study. All patients had growing recurrent pancreas cancer despite the administration of gemcitabine.

Anterior transhepatic approach for hepatocellular carcinoma located in deep positions of segment VIII.

Liver resection for liver tumors located in deep positions in segment VIII remains a technical challenge. We successfully resected a hepatocellular carcinoma located in deep position in segment VIII and extended into the paracaval portion of the right caudate lobe, using an anterior transhepatic approach. The patient was a 73-year-old man with chronic hepatitis C.

Changes in growth factor and cytokine expression in biliary obstructed rat liver and their relationship with delayed liver regeneration after partial hepatectomy.

Aim: To study the effects of obstructive jaundice on liver regeneration after partial hepatectomy.

Methods: Hepatocyte growth factor (HGF), its receptor, c-Met, vascular endothelial growth factor (VEGF) and transforming growth factor-beta1 (TGF-beta1) mRNA expression in both liver tissue and isolated liver cells were investigated after biliary obstruction (BO) by quantitative reverse-transcription polymerase chain reaction (RT-PCR) using a LightCycler. Immunohistochemical staining for desmin and alpha-smooth muscle actin (alpha-SMA) was also studied.

Vascular endothelial growth factor and angiopoietins regulate sinusoidal regeneration and remodeling after partial hepatectomy in rats.

Aim: To study the regulatory mechanisms of sinusoidal regeneration after partial hepatectomy.

Methods: We investigated the expression of angiopoietin (Ang)-1, Ang-2, Tie-2, and vascular endothelial growth factor (VEGF) in regenerating liver tissue by quantitative reverse-transcription polymerase chain reaction (RT-PCR) using a LightCycler (Roche Diagnostics) and also immunohistochemical staining after 70% hepatectomy in rats. In the next step, we isolated liver cells (hepatocytes, sinusoidal endothelial cell (SEC), Kupffer cell, and hepatic stellate cells (HSC)) from regenerating liver tissue by in situ collagenase perfusion and counterflow elutriation, to determine potential cellular sources of these angiogenic factors after hepatectomy.

Extended cold preservation of the graft liver enhances neutrophil-mediated pulmonary injury after liver transplantation.

Background/aims: The precise mechanisms of pulmonary injury after liver transplantation, especially those associated with cold ischemia time, are not yet clear.

Methodology: We histologically evaluated the number of accumulated polymorphonuclear neutrophils (PMNs) in lungs, and pulmonary injury after liver transplantation with varying periods of cold ischemia (1, 6 and 24h in University of Wisconsin solution at 4 degrees C). Pulmonary expression of cytokine-induced neutrophil chemoattractant (CINC) and macrophage inflammatory protein-2 (MIP-2) mRNA were investigated by quantitative reverse-transcription polymerase chain reaction.

Decreased cell-mediated immune status in colorectal cancer patients with hepatic metastasis.

Background/aims: Depression of cell-mediated immunity frequently accompanies solid tumor malignancy, and appears to be worsened as the disease progresses. In this study, we investigated cell-mediated immune status in colorectal cancer patients.

Methodology: Interleukin-2 (IL-2) productivity by phytohemagglutinin (PHA)-stimulated non-adherent peripheral blood mononuclear cells (PBMC), and prostaglandin E2 (PGE2) productivity by LPS-stimulated adherent PBMC were investigated in colorectal cancer patients with hepatic metastasis (n=20) and without hepatic metastasis (n=20), and in non-malignant disease controls (n=20).

Long-term survival after extended surgical resection of intrahepatic cholangiocarcinoma with extensive lymph node metastasis.

We present a case of long-term survival in a patient that involved intrahepatic cholangiocarcinoma that metastasized to the paraaortic lymph nodes. A 62-year-old man underwent extended left hepatic lobectomy with caudate lobe resection, extrahepatic bile duct resection, portal vein resection and reconstruction, and middle hepatic vein resection and reconstruction with lymph node dissection for a liver tumor that was located in the caudate lobe. Histological examination of the resected specimen revealed moderately differentiated adenocarcinoma compatible with cholangiocarcinoma, and lymph node metastases were found in the area of the hepatoduodenal ligament and the paraaortic region.

[Hilar cholangiocarcinoma].

Surgical resection has been reported to be only hope for cure for the patients with hilar cholangiocarcinoma. Therefore, first of all, radical surgical resection should be considered to be a therapeutic option for hilar cholangiocarcinoma as much as possible. In preoperative staging for hilar cholangiocarcinoma, various extensive patterns of cancer such as the involvements of bile duct, portal vein, hepatic artery and lymph node etc, should be evaluated in each patient.

Should the inferior vena cava be reconstructed after resection for malignant tumors?

Background: Caval replacement after circumferential resection of the inferior vena cava remains controversial. The aim of the current study is to determine whether or not inferior vena cava replacement should be performed.

Methods: We reviewed 36 cases undergoing resection of the inferior vena cava concomitant with resection of malignant neoplasms.

Successful treatment for ampullary submucosal bleeding-induced pancreatitis: a rare sequla of hereditary hemorrhagic telangiectasia.

Hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease) is clinically characterized by the triad of mucocutaneous telangiectasia, recurrent epistaxis, and a familial history. We describe a 68-year-old woman with hereditary hemorrhagic telangiectasia undergoing transduodenal papillectomy for ampullary submucosal bleeding-induced pancreatitis. When she was 63 years old, she presented with abdominal pain due to acute pancreatitis, and from the age of 68, frequency of the symptom increased a couple of times a month.

Simple way to improve accuracy in diagnosis of quadrant inflammatory disease: how to avoid adverse laparotomy by using plain CT.

Background/aims: It has been reported that contrast computed tomography (CT) provides a rapid and accurate diagnosis of acute appendicitis, and could potentially prevent adverse appendectomy. In the present study, we evaluated the diagnostic value of precontrast CT combined with that of serum C reactive protein (CRP) concentration for right lower quadrant inflammatory diseases.

Methodology: One hundred consecutive patients who had rebound tenderness and muscular rigidity or guarding on right lower quadrant underwent an emergency abdominal CT without contrast medium and laboratory tests.