[Hepatic arterial infusion with subsequent hepatectomy for a sigmoid colon cancer patient with hepatic metastases-a case report]

It is common to use systemic chemotherapy, instead of hepatic arterial infusion (HAI) of 5-fluorouracil (5-FU) or other cytotoxic agents, for unresectable hepatic metastases in colorectal cancer patients. Nevertheless, systemic administration of anticancer agents such as FOLFOX or FOLFIRI is sometimes difficult to continue for infirm patients. A 71-year-old female who had undergone sigmoidectomy for sigmoid colon cancer received HAI for 12 months because of big bilobar hepatic metastases and poor performance status. Thereafter, a two-stage hepatectomy(first, left lobe: second, S7+8 and S5) was performed successfully. She has been alive for 2.5 years after the first operation but with two small lung metastases in the left lobe. Because of bad performance status and her weak social and familial conditions, treatment with standard systemic chemotherapy could not be continued. In such cases, HAI should be performed if the metastases are limited to the liver.

[Triple synchronous primary lung carcinomas in the same lobe; report of a case]

A 78-year-old female was referred to our department due to 3 abnormal shadows in the left lower lobe, that were S6, S8 and S10 by chest computed tomography (CT). Bronchoscopy was performed, but definitive diagnosis was not obtained. The result of surgical biopsy for S10 nodule was squamous cell carcinoma and left lower lobectomy with lymph node dissection was performed. Other 2 lesion were both adenocarcinoma with mixed subtypes. According to the criteria of Warren and Gates, and Martini, these 3 carcinomas were all primary lung cancers.

[A case of the long-term survivor of rectal cancer who suffered from successive metastases to ovarium, peritoneum, liver, bone and para-aortic lymphonode]

A 37-year-old female, who had undergone a low anterior resection for lower rectal cancer, had been received chemotherapy (FOLFOX4, FOLFIRI) for 2 years because of right ovarian metastasis occurred and removed 9 months after the first operation. One month after 2 years of continued chemotherapy, progressive metastases happened to occur successively (rt lunge, left ovarium, liver, para-aortic lymphonode, Virchow lymphonode and bone). Right upper lobe pnemonectomy was performed first, then, peritonectomy, total hysterectomy with left oophorectomy and a partial resection of the small bowel were done. IRIS, as postoperative chemotherapy, performed with hepatic arterial infusion (HAI) of CPT-11 and 5- FU resulted in getting a minimal response for about 10 months. Because of the hepatic arterial thrombosis at 10 months after the previous operation, we could not continue HAI with systemic chemotherapy, that was resulted in the progresion of mutiple metastases, and that the patient died 62 months after the first surgery. Immunohistochemical analyses with MIB-1 stainning of four surgical specimens revealed 80% positive cells in the cancerous tissues.

[A case of transverse colon cancer without a recurrence lesion after five years from resection of hepatic metastasis]

The treatment of hepatic metastasis of colon cancer was in progress by new biochemical agents. Generally, a resection was the first alternative treatment against hepatic metastasis of colon cancer, but new antitumor agents were more effective than conventional antitumor agents. Disappearance of metastasis for colon cancer treated with only antitumor agents was commenced to report. We were experienced a case of transverse colon cancer without a recurrence lesion after five years from the resection of hepatic metastasis. A case was a 77-year-old man. He was operated against transverse colon cancer in February 2003. Pathological stage was ss, n0, Stage II. In April 2004, serum CEA was increased. CT examination was not detected a hepatic metastasis but ultrasound examination and MRI detected the metastasis at S7 lesion in the liver. In July 2004, he was admitted to S-1 and PSK until October 2004. In December 2004, the lesion of hepatic metastasis was reduced and serum CEA was decreased. But in September 2005, the metastatic lesion was re-grown. A resection for hepatic metastasis was executed in November 2005. After the resection for hepatic metastasis, he was admitted to UFT/ UZEL from January 2006 to October 2006. Present time( June 2011), the lesion of recurrence was not detected by several examinations (CT, MRI, Ultrasound etc).

[A case of colon cancer with long-term survival treated by resection of recurrence on the rectum and chemotherapy for lung metastasis]

A 69-year-old male was operated on sigmoidectomy for sigmoid colon cancer (SS, N2, H0, P0, M0, stage IIIb) 7 years ago. Two years later, he was diagnosed for rectal cancer and bilateral lung metastases by TBLB. We performed Mile's operation, and the rectal focus was pathologically diagnosed with a recurrence of sigmoid colon cancer. After surgery, chemotherapy with FOLFOX was started for bilateral lung metastases, resulting in CR during the 22 months. But bilateral lung metastases were exacerbated, and then we administered several other chemotherapies. Five years have passed since chemotherapy started, although the focuses tended to progress. Right now, he has been a chemotherapy outpatient for last 5 years.

Common EEG spectral power characteristics during meditation in five meditation traditions

Introduction

Different meditation practices reportedly affect brain electric activity.

Objectives

To assess common characteristics in brain electric activity during the state of meditation across different meditation traditions.

Aims

Do meditation traditions share commonalities in EEG spectral power changes from task-free resting to meditation?

Methods

Data from 71 experienced meditators of five meditation traditions were analyzed (13 Tibetan Buddhists, 15 Qigong, 14 Shaja Yoga, 14 Ananda Marga Yoga, and 15 Zen). Power spectral results of multichannel EEG recordings (average reference) during meditation were compared with those during pre- and post-meditation task-free resting. Spectra were averaged across channels (19–58), and subject-wise normalized. Integrated power was computed for the eight independent frequency bands (delta through gamma).

Results

During meditation compared to the average of pre- and post-meditation resting, across the five traditions, there was a significant decrease of power in the alpha-2 band (10.5–12 Hz), and significant increases of power in the beta-3 (21.5–30 Hz) and gamma (35–44 Hz) bands; theta (6.5–8 Hz) band power showed an increase at p = 0.14.

Conclusions

The results indicate that EEG spectral power differences between task-free resting state EEG versus meditation state EEG show communalities that are shared by all five meditation traditions in spite of important differences in meditation techniques.

[A case of recurrent esophageal cancer with tracheal invasion treated by chemo-radiotherapy (CRT) after placement of tracheal stent that maintained complete response (CR) for two years]

Frequently advanced or recurrent esophageal cancer was invasive trachea and often causing hemoptysis, stenosis and dyspnea. Occasionally, these cases were treated by a placement of tracheal stent. The placement effect was quickly and a main symptom of dyspnea was improved dramatically. However, the most of the cases were in poor prognosis with advanced cancer treated by chemo-radiotherapy (CRT). We experienced a case of recurrent esophageal cancer with tracheal invasion treated by placement of tracheal expandable metallic stent (EMS). A case was a 73-year-old man (at first admission). He was performed esophagectomy with tracheotomy against esophageal carcinoma at cervical portion. Eighteen month later, a local recurrence with tracheal invasion was appeared. The tracheal covered stent was inserted at the recurrent site. After stenting, CRT was performed with 5-FU and docetaxel. The effect of CRT was complete response (CR). Hence, a stent was removed from trachea. No recurrence was observed at the site and maintained a CR condition for two years after CRT.

[An elderly colon cancer patient with hepatic, lunge and peritoneal metastases was treated by hepatic arterial infusion and systemic chemotherapy-a case report]

A-75 year-old man, diagnosed as ascending colon cancer with large bowel obstruction, multiple hepatic, lunge metastases and peritoneal dissemination, was treated with neoadjuvant chemotherapy (FOLFOX4: 2 courses) and subsequent ileocecal resection. Postoperative systemic chemotherapy with hepatic arterial infusion (HAI) of 5-FU was performed in the following fashion: FOLFOX4, FOLFIRI with or without bevacizumab or cetuximab was administered every 4 weeks and a weekly HAI twice every 4 weeks. By those treatments, the patient could maintain a 30-month long NC effect and a good performance status.

[The colon cancer patient with multiple hepatic metastases and peritoneal disseminations was treated by hepatic arterial infusion chemotherapy and resection of the metastatic peritoneal dissemination with successive systemic chemotherapy--a case report of the long term survivor]

A 33-year-old man, who underwent ileo-cecal resection and sigmoidectomy for concomitant cecal cancer and sigmoid colon cancer which was diagnosed during the emergent operation for the perforated acute appendicitis, suffered simultaneous multiple hepatic metastases. Postoperative hepatic aerial infusion chemotherapy with 5-FU was done (total dose 63 g), and the metastases were successfully disappeared (CR). Although 16-month passed from the operation, locoregional recurrence at the colorectal anastomosis and peritoneal dissemination were occurred. Aggressive resections of the recurrent sites (anterior resection of the rectum, ileum, ascending colon and other recurrent sites) and successive systemic administration of FOLFOX4(9-course), FOLFIRI (20-course) and capecitabine (15-course) were achieved. The patient survived for 4.5 years after the initial treatment.

[A case of recurrence gastric cancer patient who was post operated and multi drug chemotherapy was effective for administration of S-1 and docetaxel combination therapy]

Recently, chemotherapy against gastric cancer has been diversified with an appearance of new agents such as S-1, capecitabine, CPT-11, oxaliplatin, paclitaxel and docetaxel. But a prognosis of advanced or recurrent gastric cancer patient, who was failure of first- and second-line chemotherapy, was poor. We reported that a case of recurrence gastric cancer patient who was post operated and multi drug chemotherapy was effective for administration of S-1 and docetaxel combination therapy. A case was a 50-year-old man. He underwent distal gastrectomy and administered of multi anticancer drugs until about eight years after operation. But multi lung and liver and lymph-node metastases were appeared. We administered S-1 and docetaxel combination chemotherapy. After two courses, multi metastatic lesions were reduced in size, and tumor markers were decreased. The same combination therapy was administered for six courses, but metastatic lesions were increased again. At one hundred four months after the operation, he died in the palliative care unit.

[A case of unresectable cardiac gastric cancer patient who maintained a long-term QOL with chemotherapy and detention of metallic stent]

A case was a 66-year-old man. He visited our hospital for dysphagia, abdominal distention and body weight loss. He was underwent gastro-endoscopy and made a diagnosis of the advanced cardiac gastric cancer. The early esophageal and gastric cancer also detected. Furthermore, computed tomography was performed and detected multiple liver and spleen, para-aortic lymph-node metastases and the ascites (suspected for dissemination). We decided that curative resection was impossible. Therefore, we performed an abdominal puncture to remove the ascites and combination chemotherapy with S-1 and docetaxel. The combination therapy was effective. The main tumor and multiple metastatic lesions were reduced. But after six months, a tumor marker was increased. The anticancer drug was changed to S-1 and CDDP. After eight months from the first-line chemotherapy started, the stenosis was appeared at esophago-gastric junction. We performed balloon dilation, and a metallic stent was detention with gastroscopy and radiography at stenotic lesion. He improved swallowing and discharged from hospital. After eleven months from the first-line chemotherapy started, he was died of increased liver metastases and peritonitis carcinomatousa.

[Primary lung cancer that I was preoperative and needed discrimination for and one example of the repetition cancer of the colon]

The patient was a 59-year-old woman. We performed chemotherapy using S-1 after resection of sigmoid carcinoma because the patient was diagnosed with metastatic lung tumor. The mass was regarded as metastases and reduced in size. We performed pulmonary segmentectomy. Frozen section pathological diagnosis revealed that it was primary lung cancer.

[Sternal metastasis of breast cancer; report of a case]

A 51-year-old woman presented with a painful sternal lump. Nine years earlier she had undergone right modified mastectomy for breast cancer, followed by chemotherapy. Computed tomography and bone scintigraphy demonstrated a solitary sternal bone metastasis. The patient was treated by partial sternectomy. Thereafter, the sternal defect was reconstructed with Marlex mesh and rectus abdominis myocutaneous flap. The postoperative course was uneventful. The patient subsequently developed brain metastasis and died within 52 months after sternal resection. The stability of the chest wall was well preserved for the duration of follow-up.

Parasitism by Dermocystidium ranae in a population of Rana esculenta complex in Central Italy and description of Amphibiocystidium n. gen

We report the enigmatic parasite Dermocystidium ranae in a green frog population (Solomeo, Umbria, Italy) of the Rana esculenta complex, consisting of the parental species R. lessonae (L) and hybrid form R. esculenta (E). In this population a rapid 50% decline of the parental form L was observed. Large dermal U-shaped cysts of D. ranae were found primarily on the ventral aspect of infected individuals, with a significantly higher incidence of infection in the parental species compared to the clonal hybrid. In each form, however, there was little pathological change associated with infection, and the cause of the recent declines of R. lessonae at this site remains unknown. In this paper we present the first ultrastructural description of an amphibian Dermocystidium sp. and we review the taxonomy of Dermocystidium, Dermosporidium and Dermomycoides spp. from amphibians. We conclude that Dermosporidium multigranulare Broz & Kulda, 1954 is synonymous with Dermocystidium ranae Guyénot & Naville, 1922 and, due to lack of sufficient differences between genera and significant dissimilarities with fish Dermocystidium spp., the 3 amphibian genera are synonymous. We propose that they should be designated to a new genus, Amphibiocystidium n. gen., and Dermocystidium retained for those species parasitic in fish.

Atrial natriuretic peptide (ANP) system in frog skin

In this study the ultrastructure of Rana esculenta skin is described. Cytochemical methods were used to localize guanylate cyclase in the presence of atrial natriuretic peptide and immunocytochemical methods showed the presence of the atrial natriuretic peptide in various levels of skin. The peptide is mainly found in the epithelium and in the lymph sacs of the tela subcutanea. Its receptors are located in the same zones and are indicated by guanylate cyclase activity. We demonstrate that frog skin is a target organ for atrial natriuretic peptide and propose that, at this level, the peptide carries out an important osmoregulatory role.

Ultrastructural analysis and cytochemical localization of atrial natriuretic peptide-stimulated guanylate cyclase in internal gills of Bufo bufo tadpoles

In this study on the internal gills of the larvae of Bufo bufo we examined the ultrastructural features and, using cytochemical methods, showed the localization of guanylate cyclase in the presence of atrial natriuretic peptide. The gill apparatus consists of a series of arches each with a dorsal part or gill rakers with filtering and glandular functions. In the epithelium, cells were found that contain granular secretions similar to those atrial natriuretic factor-immunoreactive granules of larval Bufo arenarum gill rakers. The ventral portion of the gill arches is made up of gill tufts with a respiratory function. The cytochemical localization of the guanylate cyclase in the presence of exogenous atrial natriuretic peptide demonstrates that the internal gills of the larvae are an important target organ for the peptide and therefore, it is proposed that, at this level, the atrial natriuretic peptide carries out an important osmoregulatory role.

Morphological and ultrastructural study of carpal organ in adult female wild swine

The carpal organ of adult female wild swine is a sweat-type gland which secretes an odorous substance. The gland consists of 5-7 lobes, each made up of lobules with convoluted glandular tubules. The gland secretion is transported in large excretory canals which empty from 5 to 7 clearly visible pores. An ultrastructural examination showed that the glandular tubules are made up of single-layered epithelium with different types of cells. One type, with rather electron-dense cytoplasm, is secretory cells full of granular material which empties into the tubule lumen. A second cell type has a glycogen-rich, transparent cytoplasm. Its role appears to be secreting a watery, electrolyte-containing liquid. In the intermediate zone of the tubules, there is a third type of cell with transparent cytoplasm. Its ultrastructural characteristics seem to indicate that its function is to reabsorb the excess watery component. In the wall of the glandular tubules, outside the epithelium, there are myoepithelial cells which facilitate the movement of the secretions toward the collector canal.

Ultracytochemical localization of guanylate cyclase after stimulation with natriuretic peptides in frog choroid plexus

The ultracytochemical localization of particulate guanylate cyclase (GC) has been studied in Rana esculenta choroid plexus after activation with rat atrial natriuretic peptide (ANP), porcine brain natriuretic peptide (BNP) and porcine C-type natriuretic peptide (CNP). This study shows that the three peptides are activators of GC in the choroid plexus as demonstrated by the presence of reaction products at the level of the epithelium and sinusoids. In the apical zone of the epithelial cells predominantly BNP seems to activate GC, while ANP and CNP activate GC mainly at the level of the lateral surfaces. Moreover, ANP stimulates the enzyme along the basal membrane of the epithelial cells as well as the membranes of the endothelium of the sinusoids. In the presence of CNP, enzyme stimulation can also be found at the level of the endocellular membranes. These results confirm that the choroid plexus is an organ with receptors for the natriuretic peptides which are involved in the processes of osmoregulation and the control of cerebrospinal fluid production.

Cytochemical localization of adenylate cyclase in the limb buds of Bufo bufo

The importance of cyclic nucleotides in the regulation of the processes of differentiation and embryonic development is known. The possible role that cyclic adenosine monophosphate (cAMP) plays during the development of the posterior limb of Bufo bufo is studied by the cytochemical localization of adenylate cyclase (AC), an enzyme that catalyzes the synthesis of the cyclic nucleotide. The method is based on the reaction between the enzyme AC and its specific substrate AMP-PNP (5'-adenylylimidodiphosphate) in the presence of lead. The lead precipitates that form as secondary reaction products are evidence of enzymatic activity. Reaction products are present only at the epithelial level in the limb bud; initially, such products are visible only at the base of the bud, particularly on the epithelial fascia located at the boundary with the body. During successive elongation and toe formation, AC activity is only present on the cells of the proximal portion of each new segment. Enzymatic activity is never present in correspondence to the ectodermal apical crest. cAMP is probably not involved in the processes of cellular proliferation but, rather, in the processes of inducing differentiation of the internal mesenchymal cells.

[Quality of life in patients with advanced ovarian cancer who underwent cytoreductive surgery followed by chemotherapy]

The aim of this study was to determine the influence of cytoreductive surgery followed by chemotherapy on quality of life (QOL) in patients with advanced ovarian cancer. A total of 33 patients, who underwent the treatment after telling the truth and gave us the information on QOL 11 to 42 months after the discharge, were entered into the present study. Survival and length of hospital stay were calculated. QOL including emotional and physical well-being were assessed with a structure questionnaire which gives 110 points as full marks. The estimated 5-year survival rate was 49.6%. The mean survival time and length of hospital stay were 1,257 and 382 days, respectively. The mean QOL score was estimated to be 93.2. THe scores for both sociality and mentality showed a tendency to increase after completion of the treatment. Thirty-two of 33 cases (97.0%) obtained a good response for telling the truth. Alopecia and emesis due to chemotherapy were serious problems for patients. The present study showed that telling the truth was useful for well-informed consent and the QOL of patients with advanced ovarian cancer was not disturbed by cytoreductive surgery or chemotherapy.

Biochemical and cytochemical analyses of BNP-stimulated guanylate cyclase in frog choroid plexus

This study shows that in the choroid plexus of Rana esculenta particulate guanylate cyclase (GC) is appreciably stimulated by porcine brain natriuretic peptide (BNP). Ultracytochemical tests for GC show that BNP notably increases the enzymatic reaction product along the apical surfaces of the epithelial cells. It can therefore be hypothesized that the apical zone of the epithelial cells possess receptors which have a particular affinity for BNP produced in the central nervous system and dumped into the cerebrospinal fluid. These results, together with those of a previous study [32], confirm that the choroid plexus is an organ which has receptors for the natriuretic peptides which are involved in the processes of osmoregulation and the control of cerebrospinal fluid production.

Response of guanylate cyclase to atrial natriuretic factor in epithelial cells of the frog choroid plexus

This study shows that the choroid plexus of Rana esculenta contains a guanylate cyclase particulate (GCp), similar to that identified in Mammalia, that is quite sensitive to the atrial natriuretic factor (ANF). The cytochemical tests for GCp show that ANF increases the enzymatic reaction products. Deposits are observed on the apical portion, at the basal level and along the lateral edges of the epithelial cells, with the exclusion of some intercalary epithelial cells with reaction-lacking microvilli. In particular, ANF seems to intensely stimulate the GCp activity along the lateral membranes of the epithelial cells delimiting enlarged intercellular spaces, which are probably dilated for the transport of water and solutes. These data confirm the osmoregulatory role of the hormone and its control of cephalorachidian liquid composition.

Ultrastructural and cytochemical analysis for adenyl cyclase in frog choroid plexus

An ultrastructural and cytochemical analysis of the anterior choroid plexus in adult Rana esculenta was undertaken. The epithelial cells are implicated in the production of cephalorachidian liquid by transporting metabolites from the blood and by synthesizing and secreting activity. The epithelial cells are also capable of re-absorbing catabolites from the cephalorachidian liquid. The presence of adenylate cyclase, along the basal and lateral membranes in some epithelial cells and along the apical membranes of others, leads us to hypothesize that the epithelium of the plexus is made up of two cell types, one type with a secretory function and another type with an absorption function.

Ultrastructure of the paraphysis in Bufo bufo larvae

A study of the ultrastructure and function of the paraphysis in Bufo bufo larvae was carried out. The structure is a tubular-ramified gland made up of numerous tubules with monolayered epithelial walls surrounded by connective tissue and sinusoids. The epithelial cells secrete glycoprotein to contribute to production of the cephalorachidian fluid. The role of the paraphysis in the transport of fluids and electrolytes from the blood to the cephalorachidian fluid in regulation of ionic and osmotic homeostasis is discussed.

Activity trends of adenylate and guanylate cyclases and cAMP and cGMP levels during the first embryonic stages of Bufo bufo

1. During the first stages of embryonic development of Bufo bufo, the levels of cAMP and cGMP showed interesting opposite trends analogous to the trends of their respective enzymes. 2. In the late segmentation, the high increase of guanylate cyclase specific activity and the corresponding rise of embryonic level of cGMP, could indicate the involvement of this nucleotide in cellular proliferation. 3. During the following stage of the gastrulation, the increase of adenylate cyclase specific activity, coupled to the loss of guanylate cyclase specific activity, could suggest the importance of cAMP in the phenomena of differentiation induction. 4. Furthermore, the cytochemical investigation of adenylate and guanylate cyclase localization seems to confirm the prominent role of cAMP during the differentiation phases.