Significant survival improvement of patients with recurrent breast cancer in the periods 2001-2008 vs. 1992-2000.

Background: It is unclear whether individualized treatments based on biological factors have improved the prognosis of recurrent breast cancer. The purpose of this study is to evaluate the survival improvement of patients with recurrent breast cancer after the introduction of third generation aromatase inhibitors (AIs) and trastuzumab.

Methods: A total of 407 patients who received first diagnosis of recurrent breast cancer and treatment at National Kyushu Cancer Center between 1992 and 2008 were retrospectively evaluated.

Real-time 3-dimensional virtual reality navigation system with open MRI for breast-conserving surgery.

Background: The aim of this study was to report on the early experiences using a real-time 3-dimensional (3D) virtual reality navigation system with open MRI for breast-conserving surgery.

Study Design: We developed a real-time 3D virtual reality navigation system with open MRI, and evaluated the mismatch between the navigation system and real distance using a 3D phantom. Two patients with nonpalpable MRI-detected breast tumors underwent breast-conserving surgery under the guidance of the navigation system.

A case of HER-2-positive advanced inflammatory breast cancer with invasive micropapillary component showing a clinically complete response to concurrent trastuzumab and paclitaxel treatment.

We report a case of HER-2-positive advanced inflammatory breast cancer with invasive micropapillary component showing a complete response to trastuzumab and paclitaxel treatment. A 37-year-old woman was referred to our hospital for right breast swelling with broad skin redness and right axillary tumor. Ipsilateral infraclavicular and contralateral axillary lymph nodes swelling were also recognized.

Gold nanoparticle-based colorimetric assay for cancer diagnosis.

A novel gold nanoparticle (GNP)-based colorimetric assay was developed for cancer diagnosis. This system is based on the noncrosslinking aggregation mechanism with a cationic protein kinase C (PKC) alpha-specific peptide substrate, which is used as a coagulant of citrate-coated GNP with anionic surface charges. The phosphorylation of peptide substrates by PKCalpha suppressed GNP aggregation, resulting in a red color, but in the case of non-phosphorylation, the color of the GNP solution changed from red to blue, indicating particle aggregation.

Low incidence of methylation of the promoter region of the FANCF gene in Japanese primary breast cancer.

Purpose: The link between BRCA1 dysfunction and basal-like breast cancer or triple-negative breast cancer (TNBC) has been suggested; however, the associations of other factors involved in the Fanconi anemia (FA)/BRCA pathway with the pathogenesis of basal-like breast cancer remain unidentified. FANCF protein is a component of the FA core complex. The methylation of CpG islands in the FANCF gene plays an important role in occurrence of ovarian cancer and also is an important regulator of cisplatin sensitivity of ovarian cancer.

Clinical characteristics of small cell carcinoma of the breast.

Primary small cell carcinoma of the breast is a rare tumor of which less than 40 cases have been reported in the literature. Because of its rarity, its biological and clinical characteristics are still not fully understood and, to date, no standard therapy has been developed. Here, we present a case and a review of the literature regarding this cancer, focusing on clinicopathological findings and treatment.

Unusual endoscopic findings of CMV esophagitis after liver transplantation.

Cytomegalovirus infections are associated with a high mortality rate after liver transplantation, but they are treated successfully by administration of the combination of ganciclovir plus intravenous immunoglobulin. We herein describe cytomegalovirus esophagitis in a patient having gastrointestinal symptoms such as dysphagia, retrosternal pain and epigastralgia after liver transplantation was detected by performing the surveillance of endoscopy. At first, the findings of endoscopy that were segmental erosive areas but no ulcerative areas on the esophageal lumen were unusual in this case of cytomegalovirus infections, but cytomegalovirus esophagitis was confirmed by cytomegalovirus immunohistochemical stain using biopsies.

Involvement of Rho-kinase in cold ischemia-reperfusion injury after liver transplantation in rats.

Background: Reperfusion of ischemic tissues is known to cause the generation of reactive oxygen species (ROS) with resultant tissue damage. However, the sources of ROS in reperfused tissues are not fully characterized. We hypothesized that the small GTPase Rho and its target effector Rho-kinase/ROK/ROCK are involved in the oxidative burst in reperfused tissue with resultant reperfusion injury.

The impact of splenectomy or splenic artery ligation on the outcome of a living donor adult liver transplantation using a left lobe graft.

Background/aims: The aim of this study was to clarify the impact of splenectomy or splenic artery ligation on the outcome in living donor adult liver transplantation (LDALT) using a left lobe graft.

Methodology: Forty-eight LDALT cases using a left lobe graft were enrolled in this study. The patients were classified into two groups: Group A (n=40), in which neither a splenectomy nor a splenic artery ligation was performed, and Group B (n=8), in which a splenectomy (n=6) or a splenic artery ligation (n=2) was performed.

Use of steatotic graft in living-donor liver transplantation.

Background: The degree of fatty infiltration in hepatic grafts is known to be an important risk factor for primary graft nonfunction in cadaveric liver transplantation. However, the effect of hepatic steatosis in living-donor liver transplantation (LDLT) has not yet been well defined. In this study, we evaluated the impact that the degree of hepatic graft steatosis has on the outcome of LDLT.

Hepatocyte growth factor and transforming growth factor beta1 contribute to regeneration of small-for-size liver graft immediately after transplantation.

Although the ability of the liver to regenerate to a predetermined size after resection made adult-to-adult living donor liver transplantation (LDLT) possible, there is little information regarding the growth regulatory mechanism for a small-for-size graft. Forty-one cases of LDLT were divided into two groups by graft volume to standard liver volume ratio (GV/SLV); small graft group (Group S, GV/SLV<40%, n=16) and non-small graft group (Group NS, GV/SLV>40%, n=25). The regeneration rate (GV at 1 week/harvested GV) and serum levels of hepatocyte growth factor (HGF), transforming growth factor-alpha (TGF-alpha) and transforming growth factor-beta1 (TGF-beta1) were compared between two groups.

Gore-Tex jump graft for portal vein thrombosis following living donor liver transplantation.

Portal vein thrombosis is a rare surgical complication following liver transplantation, which remains a cause of graft loss and death. We describe here the treatment of portal vein thrombosis following living donor liver transplantation using an extended left lobe graft. The patient was treated with a Gore-Tex vascular jump graft extra-anatomically interposed between the recipient superior mesenteric vein and the donor umbilical vein.

Accurate preoperative estimation of liver-graft volumetry using three-dimensional computed tomography.

Background: The aim of this study was to clarify the value of three-dimensional computed-tomography (3D-CT) volumetry for size matching in living-donor liver transplantation (LDLT).

Methods: 3D-CT volumetry was applied to 25 donors who underwent hepatectomy for a living relative needing an orthotopic liver transplantation. Fifteen patients underwent extended left lobectomy, one patient an extended left lateral lobectomy, and nine patients right lobectomy.

Outcome analysis in adult-to-adult living donor liver transplantation using the left lobe.

Graft size problems remain the greatest limiting factor for expansion of living donor liver transplantation (LDLT) to the adult population. The result of adult-to-adult LDLT using the left lobe with special reference to graft size has not been fully evaluated to date. In this study, we evaluated the outcome of adult-to-adult LDLT using the left lobe and also analyze the impact of using small-for-size grafts on outcome.

Feasibility of duct-to-duct biliary reconstruction in left-lobe adult-living-donor liver transplantation.

A Roux-en-Y choledochojejunostomy (CDJ) has been the sole method of choice for the reconstruction of the bile duct in living-donor liver transplantation (LDLT) using left-lobe grafts. In this study, we evaluated the feasibility of duct-to-duct (DD) biliary reconstruction in adult-to-adult LDLT using left-lobe grafts. Between October 1996 and October 2001, 46 adult-to-adult LDLTs using the left lobe were performed at our institution.

Beneficial effect of MCI-186 on hepatic warm ischemia-reperfusion in the rat.

Despite growing evidence that reactive oxygen species are responsible for deleterious effects of ischemia-reperfusion (I/R) injury of the liver, there exists, until now, no reliable antioxidant therapeutics applicable in the clinical setting. We investigated the effects of free radical scavenger, 3-methyl-1-phenyl-2-pyrazolin-5-one (MCI-186), using an isolated liver perfusion model to elucidate its possible therapeutic effects on hepatic warm I/R injury. Isolated livers from Wistar rats were reperfused for 120 min with an oxygenated Krebs-Henseleit bicarbonate buffer after 1 hr of warm ischemia.

Characteristics of liver grafts in living-donor adult liver transplantation: comparison between right- and left-lobe grafts.

Hypothesis: Few studies have investigated the results of research focused on living-donor adult liver transplantation. Different characteristics between right- and left-lobe grafts have not yet been clarified in living-donor adult liver transplantation. Left-lobe graft remains an important option, even in adult recipients.

Hepatic artery reconstruction and biliary stricture formation after living donor adult liver transplantation using the left lobe.

Biliary complications, including bile leak, biliary stricture, and cholangitis, are seen in 15% to 29% of all cases after living related liver transplantation. We investigate risk factors and discuss the management of biliary complications after living related liver transplantation in adults using left-lobe grafts. We studied 37 adult patients who underwent living related liver transplantation using left-lobe grafts.

Auxiliary partial orthotopic liver transplantation from living donors.

Auxiliary liver transplantation was originally started in Western countries in the form of heterotopic auxiliary liver transplantation for end-stage liver disease. It thereafter developed into the form of auxiliary partial orthotopic liver transplantation for acute liver failure. In Japan, where living-donor liver transplantation is the main mode of liver transplantation, auxiliary partial orthotopic liver transplantation was initially used for patients with metabolic liver diseases and has since developed into an effective solution for small-for-size living donor grafts.

Perioperative management and complications in donors related to living-donor liver transplantation.

Background: Living-donor liver transplantation has become a legitimate alternative to cadaveric liver transplantation. However, information on the perioperative management of donors is still scarce.

Methods: Between October 1996 and May 2001, 52 consecutive living-donor liver transplantations have been performed at the authors' institution.

Liver transplantation for hepatocellular carcinoma.

The surgical management for hepatocellular carcinoma (HCC) is multiplicity. In Japan, liver resection has generally been considered to be the only curative treatment for HCC. The resectability of a tumor in cirrhotic patients, however, is limited by the diminished functional reserve of the cirrhotic liver and the attendant risk for intraoperative bleeding and postoperative liver failure.