[Successful R0 Resection of Hilar Cholangiocarcinoma Invading the Inferior Vena Cava through Left Trisegmentectomy with Combined Resection of the Portal Vein and Inferior Vena Cava after Gemcitabine/Cisplatin Combination Chemotherapy-A Case Report].

A 65-year-old woman was admitted to our institution with sonography results indicating a caudate lobe mass. CT showed a large low-density mass in the caudate lobe, extensively involving the inferior vena cava and main portal vein. Moderately differentiated adenocarcinoma was found on transcutaneous biopsy.

Metastatic primary pulmonary leiomyosarcoma to the pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration.

A 77-year-old female patient consulted our hospital for an abnormal shadow observed on chest X-ray. Computed tomography revealed the shadow of a mass in the right lower lung lobe and two shadows of masses in the pancreatic head and body. F-fluorodeoxyglucose-positron emission tomography showed an intense uptake only in the fields corresponding to these three masses.

-associated cholangitis associated with Lemmel syndrome.

is an unusual human pathogen. Gastroenteritis is the most frequently reported manifestation of infection and extraintestinal infection including cholangitis has rarely been reported. The overall mortality rate for bacteremia is, however, reported to be up to 50% (Janda and Abbott, 1993).

Progression-Free and Overall Survival of Patients With ALK Rearrangement-Positive Non-Small Cell Lung Cancer Treated Sequentially With Crizotinib and Alectinib.

Introduction: Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) show marked therapeutic efficacy in patients with non-small cell lung cancer (NSCLC) harboring the echinoderm microtubule-associated protein-like 4-ALK fusion gene. The effect on overall survival (OS) of sequential treatment with the first- and second-generation ALK-TKIs crizotinib and alectinib, respectively, has remained unknown. We have examined the clinical outcome of such sequential treatment in a retrospective analysis of patients with ALK-rearranged NSCLC.

Afatinib is especially effective against non-small cell lung cancer carrying an EGFR exon 19 deletion.

Background: A recent pooled analysis of the LUX-LUNG3 and LUX-LUNG6 trials suggested that afatinib (an irreversible epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI)) is especially effective against non-small cell lung cancer (NSCLC) carrying an EGFR exon 19 deletion.

Materials And Methods: Stable viral transfectant HEK293 cell lines carrying an exon 19 deletion (HEK293/19 del) or exon 21 L858R mutation (HEK293/ L858R)) were created and their drug sensitivities to AG1478 (a reversible EGFR-TKI) and afatinib were examined using an MTT assay. Western blot analyses were performed to estimate the phosphorylation of EGFR.

Chronic nicotine exposure mediates resistance to EGFR-TKI in EGFR-mutated lung cancer via an EGFR signal.

Background: Some of patients with non-small cell lung cancer (NSCLC) harboring somatic activating mutations of the epidermal growth factor receptor gene (EGFR mutations) show poor responses to EGFR-tyrosine kinase inhibitors (EGFR-TKIs) treatment. Cigarette smoking is the strongest documented risk factor for the development of lung cancer. Nicotine, while not carcinogenic by itself, has been shown to induce proliferation, angiogenesis, and the epithelial-mesenchymal transition; these effects might be associated with EGFR-TKI resistance.

Inhibition of β-Catenin enhances the anticancer effect of irreversible EGFR-TKI in EGFR-mutated non-small-cell lung cancer with a T790M mutation.

Introduction: Patients with non-small-cell lung cancer (NSCLC) with somatic activating mutations of the epidermal growth factor receptor gene (EGFR mutations) generally respond to EGFR tyrosine kinase inhibitors (EGFR-TKIs). β-Catenin is a key component of the Wnt/β-Catenin signal and is an important oncogene that is involved in the pathogenesis and progression of malignant tumors, especially cancer stem cells.

Methods And Results: We found that EGFR-mutated NSCLC cell lines exhibited a high expression level of β-Catenin, compared with cell lines with the wild-type EGFR gene, and XAV939 (a β-Catenin inhibitor) enhanced the sensitivities to EGFR-TKI in EGFR-mutated NSCLC cell lines.

Tolerability of nintedanib (BIBF 1120) in combination with docetaxel: a phase 1 study in Japanese patients with previously treated non-small-cell lung cancer.

Background: This phase I, open-label study evaluated the safety/tolerability and maximum tolerated dose of second-line nintedanib combined with docetaxel in Japanese patients with advanced non-small-cell lung cancer.

Methods: Eligible patients received docetaxel 60 or 75 mg/m(2) (day 1) plus nintedanib 100, 150, or 200 mg twice daily (bid; days 2-21) in 21-day cycles. Standard 3 + 3 dose escalations were performed separately in patient cohorts with a body surface area (BSA) of less than 1.

Clinical utility of erlotinib for the treatment of non-small-cell lung cancer in Japanese patients: current evidence.

Gefitinib, an epidermal growth factor tyrosine kinase inhibitor (EGFR-TKI), has been approved in Japan for the treatment of patients with advanced non-small-cell lung cancer (NSCLC) based on Phase II clinical trials since 2002. Erlotinib, another EGFR-TKI, was also approved a few years thereafter. In 2004, activating mutations in the EGFR gene were discovered to be a predictive biomarker for EGFR-TKI treatment, and gefitinib, which is not effective for patients with EGFR wild-type NSCLC, has since been used only in patients with EGFR-mutated NSCLC.

Intramural location and size of arterial calcification are associated with stenosis at carotid bifurcation.

Purpose: The purpose of this study was to investigate the association between internal carotid artery (ICA) stenosis and intramural location and size of calcification at the ICA origins and the origins of the cervical arteries proximal to the ICA.

Method: A total of 1139 ICAs were evaluated stenosis and calcification on the multi-detector row CT angiography. The intramural location was categorized into none, outside and inside location.

Calcification at orifices of aortic arch branches is a reliable and significant marker of stenosis at carotid bifurcation and intracranial arteries.

Purpose: Simple rating scale for calcification in the cervical arteries and the aortic arch on multi-detector computed tomography angiography (MDCTA) was evaluated its reliability and validity. Additionally, we investigated where is the most representative location for evaluating the calcification risk of carotid bifurcation stenosis and atherosclerotic infarction in the overall cervical arteries covering from the aortic arch to the carotid bifurcation.

Method: The aortic arch and cervical arteries among 518 patients (292 men, 226 women) were evaluated the extent of calcification using a 4-point grading scale for MDCTA.

[A case of miliary tuberculosis complicated by a tuberculous aneurysm of the thoracic aorta].

An 85-year-old woman was admitted to our hospital with the chief complaint of fever. Antibiotics were not effective and a chest computed tomography scan revealed a diffuse micronodular shadow and thoracic aortic aneurysm. Subsequently, a bronchoscopy sputum culture was positive for Mycobacterium tuberculosis.

[A case of Churg-Strauss syndrome with short duration from the onset of asthma to diagnosis of vasculitis].

A 68-year-old woman was hospitalized because of bronchial asthma and a high myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) level. She had suffered from rhinitis from one year before hospitalization, body weight loss from three months before, and asthma from one month before. On admission, she complained of dyspnea and body weight loss of over 6 kg.

Direct silicone intubation using Nunchaku-style tube (NST-DSI) to treat lacrimal passage obstruction.

Purpose: To confirm the usefulness of direct silicone intubation using a Nunchaku-style tube (NST-DSI) for the treatment of lacrimal passage obstruction.

Methods: Included in this retrospective study were 54 cases (45 patients) of adult-onset lacrimal passage obstruction on which NST-DSI was performed. The cases were subdivided into two groups: 29 cases of common canalicular obstruction (the canalicular obstruction group) and 25 cases of nasolacrimal duct obstruction (the duct obstruction group).

Pancreatic injuries in rats with fecal peritonitis: protective effect of a new synthetic protease inhibitor, sepinostat mesilate (FUT-187).

To evaluate the effects of sepsis on the exocrine pancreas, we studied (1) serum amylase levels, pancreatic water and trypsin content; (2) pancreatic histological changes; (3) pancreatic subcellular distribution of lysosomal enzyme in the acinar cells; and (4) protective effects of a new synthetic protease inhibitor, FUT-187 against the pancreatic injuries in sepsis of rats induced by cecal ligation and puncture. Elevated serum amylase levels, increased pancreatic water and trypsin content, were observed in rats with fecal peritonitis induced by cecal ligation and puncture. Subcellular redistribution of lysosomal enzyme, cathepsin B, activity from the lysosomal fraction to the zymogen fraction was also observed.

Protective effects of prophylaxis with a protease inhibitor and a free radical scavenger against a temporary ischemia model of pancreatitis.

Objective: To evaluate the protective effects of combined prophylaxis with 4-sulfamoylphenyl, 4-guanidinobenzoate methanesulfonate (E3123), potent new protease inhibitor, and superoxide dismutase (SOD), a free radical scavenger, against the multifactor-related pancreatic injuries that occur in acute pancreatitis.

Design: Controlled experimental study in rats with pancreatitis induced by a temporary ischemic model of pancreaticobiliary-duct (PBD) obstruction.

Setting: A university-affiliated hospital.

Gastric subcellular organelle fragility and impaired gastric energy charge levels in rats with caerulein-induced acute pancreatitis: protective effect of anti-ulcer agent, teprenone.

When rats were given a supramaximal dose of caerulein (infused intravenously at 5 micrograms/kg.h for 4 h) they developed acute pancreatitis characterized by significantly raised amylase levels in the blood. In this model of acute pancreatitis, reduced gastric adenylate energy charge levels were observed, and the leakage of the lysosomal enzyme, cathepsin B, from gastric lysosomes and of the mitochondrial enzyme, malate dehydrogenase, from gastric mitochondria were both significantly accelerated compared with the control group.

Experimental quantitative evaluation of transvascular removal of unnecessary substances in brain edema fluid.

We developed a model by which the transvascular removal of unnecessary substances in brain edema fluid could be measured quantitatively and chronologically. Brain stab wounds were produced in Wistar rats by insertion of paired microdialysis probes in the unilateral caudatoputamen. Homovanillic acid (HVA) was administered by microdialysis from one probe, and the HVA clearance was measured by HPLC analysis of perfusate from the other probe.

[Ruptured dissecting aneurysm of the vertebral artery missed by initial angiography; case report].

Dissecting aneurysm of the intracranial arteries is a well known clinical entity, and its angiographic findings are also well recognized. We encountered a case with dissecting aneurysm of the vertebral artery presented with subarachnoid hemorrhage (SAH). The initial angiography was normal but repeated angiography demonstrated a dissecting aneurysm.