[Ascending Colon Cancer with Radical Resection after Stent Reimplantation Due to Colonic Stent Obstruction for Palliation-A Case Report].

Since the insurance coverage of colorectal stents for bowel obstruction due to colorectal cancer in 2012, the use of colorectal stenting for palliation has rapidly spread. We report a case of ascending colon cancer in which a colorectal stent was placed for palliation, but the stent was reimplanted due to obstruction, followed by radical resection. The patient was a 92- year-old woman who was brought to the emergency room at the age of 90 years with repeated vomiting and abdominal pain, and was diagnosed as colorectal cancer ileus caused by ascending colon cancer, and a colorectal stent was inserted.

[A Case of Refractory Lymphorrhea after Laparoscopic Distal Gastrectomy].

An 84-year-old man with gastric cancer, cT2N0M0, cStage Ⅰ underwent laparoscopic distal gastrectomy, D1+dissection, and Roux-en-Y reconstruction. We started enteral nutrition on the second postoperative day, but milky drainage appeared from the drain on the fifth postoperative day. The triglyceride in the ascites was markedly elevated, and it was diagnosed as a lymphorrhea.

[A Case of Two-Stage Operation for Esophageal Cancer with Sarcoidosis].

A 69-year-old man with dysphagia was diagnosed with advanced esophageal cancer by upper gastrointestinal endoscopy. He had undergone pancreatic tail and partial transverse colon resection for pancreatic cancer, and right hilar lymph node biopsy and partial lower lobe resection for the diagnosis of pulmonary sarcoidosis. Contrast-enhanced computed tomography(CT)scan showed no change over time in lymph node enlargement in the mediastinum, so metastasis of esophageal cancer was considered to be negative.

Significance of the effects of chemotherapy on programmed death-ligand 1 expression in triple-negative breast cancer.

Background: Atezolizumab has been approved as an antibody against programmed death-ligand 1 (PD-L1)-positive immune cells in patients with advanced or recurrent triple-negative breast cancer. However, the optimal timing to examine PD-L1 expression remains controversial. We retrospectively researched PD-L1 positivity rates in biopsy, surgical and recurrent specimens from patients with triple-negative breast cancer treated with neoadjuvant chemotherapy.

Capecitabine in Combination with Endocrine Therapy as Maintenance Therapy after Bevacizumab Plus Paclitaxel Induction Therapy for Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer: KBCSG-TR1214.

Optimal treatment strategies for hormone receptor (HR)-positive, HER2-negative advanced and/or metastatic breast cancer (AMBC) remain uncertain. We investigated the clinical usefulness of adding capecitabine to maintenance endocrine therapy after induction chemotherapy and the efficacy of reinduction chemotherapy. Patients who had received bevacizumab-paclitaxel induction therapy and did not have progressive disease (PD) were randomized to maintenance therapy with endocrine therapy alone (group E) or endocrine plus capecitabine (1657 mg/m/day on days 1-21, q4w) (group EC).

[A Case of Colon Cancer with Peritoneal Dissemination and Liver Metastasis That Responded to Comprehensive Treatment by Perioperative Chemotherapy and Cytoreductive Surgery].

A 64-year-old man was referred to our hospital to determine the cause of fecal occult blood. Colonoscopy revealed a type Ⅱtumor located in the ascending colon. Histopathologic analysis of the tumor biopsy specimen revealed moderately differen- tiated, tubular adenocarcinoma with KRAS exon 2(G12V)mutation.

[A Case of Multiple Pancreatic Metastases from Renal Cell Carcinoma Diagnosed Using EUS-FNA].

The patient was a 79-year-old man, who underwent left nephrectomy for left renal cell carcinoma in 2007. In March 2015, he complained ofthirst, polydipsia, and polyuria. A slight elevation ofamylase levels was detected following laboratory testing.

[A Case of Metastatic Colorectal Cancer Refractory to Standard Chemotherapies Treated with TAS-102 with Bevacizumab].

A 51-year-oldwoman with lung, liver, andd istant lymph node metastases from sigmoidcolon cancer was treatedusing TAS-102 with bevacizumab as fourth-line chemotherapy. There was a 35%decrease in the size of target lesions after the first 4 cycles of therapy, and disease control has been maintained for 9 months. The only Grade 3 or worse adverse event experiencedwas neutropenia.

[A Resected Case of Acinar Cell Carcinoma Diagnosed by Endoscopic Ultrasound Guided Fine-Needle Aspiration Prior to Surgical Treatment].

Acinar cell carcinoma (ACC) of the pancreas is an extremely rare tumor type, accounting for approximately 1% of all pancreatic neoplasm. Here, we report a rare case of ACC of the pancreas diagnosed on the basis of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) findings prior to surgical treatment. A 73-years-old woman was being followed-up for chronic hepatitis C at our institution.

[Analysis of Pancreaticoduodenectomy for Elderly Patients Aged 75 Years or Older].

The feasibility of pancreaticoduodenectomy (PD) for elderly patients is controversial. Of 51 patients with pancreatic or bile duct tumor who underwent PD (except portal vein resection), the surgical results of 27 elderly patients aged 75 years or older (elderly group) we retrospectively evaluated and compared with those of 24 patients younger than 75 years (younger group). Although ASA-PS was significantly higher in the elderly group, we did not observe any significant difference in other background characteristics, complications, or length of hospital stay between the two groups.

[A Case of Extrahepatic Hepatocellular Cancer Discovered during Gynecological Laparoscopic Surgery].

Recently, laparoscopic surgery has become increasingly popular because of its lesser invasiveness, including smaller incisions, and fewer post-operative complications. It is also possible to observe the abdominal cavity by laparoscopy. We report a hepatocellular carcinoma arising in an accessory liver lobe detected during gynecological laparoscopic surgery.

[Analysis of portal vein resection during pancreaticoduodenectomy in patients with pancreatic cancer].

The feasibility of portal vein resection (PVR) during pancreaticoduodenectomy (PD) for cancer of the pancreatic head is controversial. We retrospectively evaluate the surgical results and prognosis of 26 patients with pancreatic cancer who received PD with PVR (PVR group, n=14) or without PVR (non-PVR group, n=12). The operation time was significantly greater in the PVR group, with a mean time of 13.

[A case of partial hepatectomy and gastrectomy for hepatocellular carcinoma with direct invasion to the stomach].

An 81-year-old man treated with chronic hepatitis C virus (HCV)-related hepatitis and hepatocellular carcinoma (HCC) was diagnosed in 2010 with HCC recurrence (subclass S2) on computed tomography (CT). He refused surgery and was followed up without treatment. In 2012, he was admitted to our hospital because of hematemesis.

[A case of long-term survival in rectal cancer with late lung and kidney metastases treated with combined multimodality therapy].

A 59-year-old man was diagnosed with rectal cancer and a low anterior resection was performed. Bilateral lung metastases appeared 4 years and 4 months after the primary surgery. The lung metastases were resected and FOLFOX6 neoadjuvant chemotherapy was administered.

Phase II Study of Neoadjuvant Anthracycline-Based Regimens Combined With Nanoparticle Albumin-Bound Paclitaxel and Trastuzumab for Human Epidermal Growth Factor Receptor 2-Positive Operable Breast Cancer.

Unlabelled: We treated patients with operable human epidermal growth factor receptor 2-positive breast cancer with neoadjuvant anthracycline regimens followed by nanoparticle albumin-bound paclitaxel plus trastuzumab. Of the 44 patients, 49% achieved a pathologic complete response (pCR). The pCR rate was 36% and 71% in the patients with estrogen receptor-positive and -negative cancer, respectively.

[Two cases of human epidermal growth factor receptor 2-positive advanced gastric cancer successfully treated with S-1, cisplatin, and trastuzumab combination therapy followed by curative resection].

We report 2 cases of human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer successfully treated with a combination therapy of S-1, cisplatin( CDDP), and trastuzumab followed by curative resection. Case 1 involved a 62-year-old man with type 3 HER2-positive gastric cancer spanning the antrum of the stomach to the duodenal bulb and directly invading the pancreatic head( cT4b[ Panc] N3H0P0M0, Stage IIIC). We diagnosed it as an unresectable cancer, and selected S-1, CDDP, and trastuzumab for combination chemotherapy.

[A case of partial pancreatectomy for recurrent metastatic renal cell carcinoma in the remnant pancreas after subtotal stomach-preserving pancreaticoduodenectomy].

We report a case in which recurrent pancreatic metastasis of renal cell carcinoma( RCC) in the remnant pancreas was resected 6 years after subtotal stomach-preserving pancreaticoduodenectomy (SSPPD). A 74-year-old man underwent right nephrectomy for RCC in 1991, left partial nephrectomy for left renal RCC metastasis in 1996, and SSPPD for pancreatic RCC metastasis in 2007. In November 2012, he was referred to our hospital with a tumor in the remnant pancreas, as seen on abdominal computed tomography (CT).

[Bypass surgery or stent placement for biliary obstruction in patients with unresectable pancreatic cancer].

The therapeutic strategy for biliary obstruction in patients with unresectable pancreatic cancer is controversial. We compared complications and prognosis between 2 groups: the B group, 8 patients who were diagnosed as having inoperable pancreatic cancer at laparotomy and underwent bypass surgery, and the S group, 7 patients who underwent endoscopic stent placement for biliary obstruction due to clinically unresectable pancreatic cancer. Although 1 patient developed cholangitis and surgical site infection in the B group, there was no difference in the duration of hospital stay between the 2 groups.

Rapid on-site cytologic examination of 1500 breast lesions using the modified Shorr's stain.

Background: Rapid on-site evaluation (ROSE) cytology enables sample quality assessment in the procedure room and facilitates the process of examination. While its use for mammary lesions in one-stop breast clinics has been reported, its usefulness as a cytologic diagnostic tool has not been fully explored.

Methods: A total of 1500 examinations of core-needle biopsy imprint/fine-needle aspiration cytology were performed for outpatients with breast lesions.

[A case of sigmoid colon cancer with Virchow's lymph node metastasis successfully treated with chemotherapy].

We report the case of a 71-year-old woman suffering from advanced sigmoid colon cancer with Virchow's and para- aortic lymph node metastasis. Sigmoidectomy was performed for sigmoid colon cancer in January 2008, and pathological analysis revealed that it was Stage II(pT3, pN0, pM0, Cur A). The patient received capecitabine regimen as adjuvant chemotherapy from February 2008 to July 2008.

Ultrasound-guided infraclavicular axillary vein puncture is effective to avoid pinch-off syndrome: a long-term follow-up study.

Purpose: Pinch-off syndrome (POS) is a serious complication encountered during the long-term management of totally implantable access ports (TIAPs). The aim of this study was to examine the effect of ultrasound-guided infraclavicular axillary vein puncture to avoid POS in patients with long-term use of a TIAP.

Methods: This was a retrospective review of 207 consecutive TIAPs: one hundred devices implanted using an anatomical landmark technique were used as historical controls (Landmark group), while 107 devices were implanted using an ultrasound (US)-guided puncture method (US group).

Cosmetic evaluation following volume replacement using lateral tissue flap in breast-conserving surgery.

Background: We examined the effectiveness of volume replacement using a lateral tissue flap (LTF) in breast-conserving surgery for a good cosmetic outcome.

Methods: We analyzed the results of 130 patients with breast cancer who underwent breast-conserving surgery with replacement using an LTF from 2006 to 2010 with cosmetic evaluations performed according to the criteria of the Japanese Breast Cancer Society. We examined scores with regard to the following possible contributing factors: partial resection (Bp) or quadrantectomy (Bq), diameter of the specimen, body mass index (BMI), axillary lymphadenectomy, postoperative irradiation, and position of the tumor.

Expression and function of the inducible costimulator ligand B7-H2 in human airway smooth muscle cells.

Background: B7-H2 is a ligand for the inducible costimulator (ICOS). The aim of this study was to examine the expression and function of B7-H2 in human airway smooth muscle (ASM) cells and compare them with those of CD40 or OX40 ligand (OX40L).

Methods: Expression of B7-H2, CD40 and OX40L in ASM cells and their respective counterparts in T cells was analyzed by RT-PCR or flow cytometry.

Ligation of Toll-like receptor 3 differentially regulates M2 and M3 muscarinic receptor expression and function in human airway smooth muscle cells.

Background: Viral infection causes asthma exacerbations and airway hyperreactivity. Toll-like receptor 3 (TLR3) recognizes double-stranded RNA (dsRNA) of viral or synthetic origin in a fashion different from protein kinase R (PKR). The aim of this study was to examine the expression and function of TLR3 in human airway smooth muscle (ASM) cells.