Navigation-guided fence-post tube technique for resection of a brain tumor: technical note

INTRODUCTION

A new technique using a navigation system to minimize the influence of brain shift and to perform precise resection of brain tumors is demonstrated. To determine the resection plane, one to six tubes were inserted around the tumor under the guidance of a navigation system before dural incision.

RESULTS

This technique termed the "navigation-guided fence-post tube" (NGFP) procedure was used to treat 34 patients with intraaxial brain tumors including gliomas (23 cases), malignant lymphomas (4 cases) and metastatic tumors (7 cases). Tumors were removed totally in 23 cases (67.6%), subtotally (95% or more removal) in 6 cases (17.6%) and partially (less than 95% removal) in 5 cases (14.7%). The cases with subtotal or partial resection contained tumors that were close to or involved the eloquent area, or disseminated lesions. No complications due to tube insertion occurred.

CONCLUSION

NGFP is a useful and safe technique for brain tumor surgery with no influence of brain shift during tumor resection.

Morphological development of multilamellar phospholipid film depending on drying kinetics

The mechanism for the formation of solid-supported phospholipid membranes during a drying process was investigated. Terracelike multilamellar structures were found to develop from a micellar solution with either spinodal decompositionlike process or nucleation growth, depending on the evaporation rate of an organic solvent. In contrast to the well-known kinetics of phase separation, fast drying induces nucleation while slow drying induces spinodal decompositionlike lipid-film formation. The existing models for the interpretation of phase separation are not sufficient to understand this unexpected kinetics. We suggest a schematic model with which this kinetic feature can be interpreted in terms of a self-assembly pathway in a three-component phase diagram for a phospholipid, organic solvent, and water.

The effects of Gosha-jinki-gan on oxaliplatin-related neurotoxicity: A prospective randomized study

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Background: Oxaliplatin is now considered a standard treatment for advanced or unresectable colorectal cancer, but sensory neurotoxicity is its dose-limiting toxicity. The OPTIMOX (stop and go) approach offers a reasonable strategy, but preventive agent is not established. It is reported that Gosha-jinki-gan (a blended herbal medicine) is recently considered as an effective agent for the neurotoxicity of taxanes and for vibration sensation in patients with diabetic neuropathy. Patients and Methods: From 2007, 32 patients treated with modified FOLFOX6 for advanced or unresectable colorectal cancer were randomized. Fifteen patients received oral administration of 7.5 g/day of Gosha-jinki-gan (G group) every days from first course and 17 patients (Control group) did not. Neurotoxicities were evaluated every course according to DEB-NTC (Neurotoxicity Criteria of DEBIOPHARM) and NCI-CTCAE Ver.3.0 using self-check sheet. Results: The median number of cycles of per patient of G group was 14 (range, 4–26), and that of C Group was 9 (range, 1–20). Cumulative dose of oxaliplatin of two groups was 1,190 mg/m2 (G group) and 765 mg/m2 (C Group). Peripheral neurotoxicity evaluated by DEB-NTC in Group G was grade 0 in 0 patients (0%), grade 1 in 11 (73%), grade 2 in 4 (27%) and grade 3 in 0 (0%) and, in C group, respectively, 1 (6%), 6 (35%), 7 (41%), 3 (18%). According to NCI-CTCAE, neurotoxicity was lower in G group than that of C group. Fifteen patients in G group were evaluated by RECIST criteria with a PR rate of 66.7%, SD rate of 20.0% and PD rate of 13.3%. Seventeen patients in C group were evaluated by RECIST criteria with a PR rate of 52.9%, SD rate of 35.3% and disease control rate of 11.8%. Conclusion: Gosha-jinki-gan is effective for preventing oxaliplatin-induced neuropathy in advanced or unresectable colorectal cancer patients.

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Clinical usefulness of mtTFA expression as a predictive marker in colorectal cancer patients treated with FOLFOX

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Background: We previously reported that mitochondrial transcription factor A (mtTFA; also designated Tfam) preferentially recognizes cisplatin-damaged DNA via physical interaction with p53 and is upregulated by the treatment with cisplatin and 5-FU (Yoshida et al, Cancer Res. 2003). The aim of this study was to evaluate whether expression of mtTFA predicts clinical outcome in patients with metastatic colorectal cancer treated with modified FOLFOX6 (mFOLFOX6). Methods: From January 2006 to April 2008, 59 patients who had metastatic lesions from colorectal cancer treated with mFOLFOX6 at the Osaka Rosai Hospital were included in this study. They consisted of 25 women (42.4%) and 34 men (57.6%), with a median age of 62 years (29–84). Patients were treated with oxaliplatin 85mg/m2 plus leucovorin 200mg/m2 as a 2-h infusion at day 1, followed by 5-FU bolus 400mg/m2 and 46-h continuous infusion of 2400 mg/m2. Treatment was repeated in 2-week intervals for at least 4 cycles. The expressions of mtTFA and p53 of resected primary tumors were examined by immunohistochemistry. Results: Among 59 patients, one complete response and 32 partial responses were observed (response rate, 55.9%) . The positive rates was 44.1% (26/59; CR 1, PR 7, SD/PD 18) for mtTFA and 59.3% (35/59; CR 1, PR 19, SD/PD 15) for p53, respectively. Strong expression of mtTFA was detected in 8 of 33 CR/PR (24.2%) and in 18 of 26 SD/PD (69.2%), indicating that the expression of mtTFA correlated significantly with response to chemotherapy (P<0.01). On the other hand, there was no significant correlation between response to chemotherapy and p53 expression (P=0.82). mtTFA expression was significantly associated with overall survival (P=0.036) and progression free survival (P=0.037). Multivariate analysis revealed that mtTFA expression significantly impacted on OS (Hazard ratio 2.10, P=0.036). Conclusions: Immunohistochemical study of mtTFA may be useful in prediction of the clinical outcome of metastatic colorectal cancer patients treated with FOLFOX.

No significant financial relationships to disclose.

Myr-Ric-8A enhances G(alpha15)-mediated Ca2+ response of vertebrate olfactory receptors

The determination of ligand specificities of odorant receptors will contribute to the understanding of how odorants are discriminated by the olfactory system. To date, the ways in which some olfactory receptors (ORs) pair with their cognate ligands has been studied using a Ca(2+) imaging technique. This approach has been used to investigate orphan G protein-coupled receptors expressed in heterologous cells; however, most attempts to functionally express ORs on the cell surface of heterologous cells have failed. Recently, receptor-transporting protein 1 and Ric-8B have been identified as proteins involved in targeting receptors to the cell membrane and amplifying receptor signals, and thus, they are able to facilitate cellular responses via ORs in a heterologous cell system. Here, we describe a technique in which we employed a myristoylation sequence-conjugated mutant of Ric-8A (Myr-Ric-8A) as a signal amplifier and show Myr-Ric-8A greatly enhances G(alpha15)-mediated Ca(2+) responses of ORs in HEK293 cells. Coexpression of Myr-Ric-8A enabled us to deorphanize a mouse OR and to determine its molecular receptive range. Our results suggest that Myr-Ric-8A should be helpful in functional characterization of ORs in heterologous cells using Ca(2+) imaging.

Wave emission from heterogeneities opens a way to controlling chaos in the heart

The effectiveness of chaos control in large systems increases with the number of control sites. We find that electric field induced wave emission from heterogeneities (WEH) in the heart gives a unique opportunity to have as many control sites as needed. The number of pacing sites grows with the amplitude of the electric field. We demonstrate that WEH has important advantages over methods used in clinics, and opens a new way to manipulate vortices in experiments, and potentially to radically improve the clinical methods of chaos control in the heart.

Changes in survival during the past two decades for breast cancer at the Kyoto University Hospital

AIMS

To report the changes in survival over 20 years of 775 breast cancer women operated between 1982 and 2003 at the Kyoto University Hospital in Japan, reflecting changes in clinical practice over that period.

RESULTS

Survival curves have significantly improved between the periods 1982-1989 and 1990-2003. The 5- and 10-year survival rates between these periods were 80.3% and 85.1%, and 67.5% and 75.0%, respectively. Moreover, there was a difference in overall survival curves of patients of stages II and III, of 35-54 ages, or of positive estrogen receptor (ER) status between these periods.

CONCLUSION

The present study presented the recent advance of the survival rates might be due to the rational development of breast cancer treatment, and suggested the possibility that the patients of stages II and III, of 35-54 ages, or of positive ER status were received benefits by these treatments.

Marked differences in volume phase transitions between gel and single molecule in DNA

Volume phase transitions of a DNA gel and a single giant DNA chain caused by spermidine(3+) (SPD(3+)) were investigated. The change in volume for the single DNA (VV(0) approximately 10(-5)) was four orders of magnitude greater than that for the DNA gel ( approximately 10(-1)), while the critical SPD(3+) concentration for the gel (1.8 mM) was one order of magnitude greater than that of the single DNA (0.12-0.25 mM) at the same pH 6.86. We tried to describe mean-field theories with virial expansion, which is valid for the coil-globule transition of a single polymer chain, for the volume phase transitions to explain the reason why such marked differences appeared. Considering the degree of the ordering of Kuhn segments arising from the gel network structure together with the chain length of cross-linked polymer chains, the volume phase transitions were described and then the significant differences were reproduced quantitatively. We concluded that the network structure plays a significant role in the volume phase transition of the gel.

Development of a novel information technology (IT) system using the electronic medical record (EMR) in daily clinical practice

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Background: The information generated in daily practices is critical to assure safety and efficacy of therapeutic interventions. Clinical investigators are faced with enormous amounts of data and a greater need to organize it in a meaningful and coherent manner than ever before. Computerization could offer many advantages that clinical data systematically accumulated in the course of routine medical care can provide researchers with the clues to resolve many medical questions. Methods: We developed a novel clinical database system, named CyberOncology, integrated in EMR of Kyoto University Hospital. It contained summarized treatment history, national cancer registry and consecutive clinical database. All adverse events according CTCAE ver.3, response to the treatment based on RECIST criteria and survival data were collected. The medical staffs have routinely used the CyberOncology since its starting on October 2003. The CyberOncology directly collected all data concerning oncology management of inpatient and outpatient care from EMR, and simultaneously analyzed clinical outcomes. Results: For three years since October 2003, consecutive 1,516 new cancer patients including 590 GI, 435 lung, 234 breast cancer, and 140 lymphoma with 19,767 chemotherapeutic administrations were registered in the CyberOncology. Main benefits are improvement of the quality of patient care and safety, practice standardization, and the quickness and the reliability of collecting the data. Moreover, it had the capability to serve a cross-sectional approach of cancer and drug-orientated analysis. For example, this system can easily provided with a review of clinical practice in a real time manner. Conclusions: The CyberOncology form integrated EMR successfully meets requirements of electronic case report. It has been useful in monitoring outcomes of care, effectiveness, efficiency and adherence to clinical trial.

No significant financial relationships to disclose.

CT and MRI findings of intraosseous schwannoma of the mandible: a case report

We report the radiographical findings of a rare case of intraosseous schwannoma of the mandible. The tumour that presented as a unilocular, well-defined, radiolucent lesion on plain radiography was located in the molar region. On CT, the tumour was a well-demarcated mass with no periosteal reaction and no destruction of the bone cortex. Destructive changes in the cortical wall of the mandibular canal by the tumour were observed on CT, but no evidence of dilatation and shift in the inferior mandibular canal was seen. MR imaging revealed that the mandibular canal was encased by the tumour as a solid mass without cystic parts. The signal intensity of the tumour was non-specific on MRI. Characteristics of intraosseous schwannoma in the mandible are the encasement of the canal by a well-demarcated tumour without periosteal reaction and the destruction of mandibular bone cortex. The destructive change of the inferior mandibular canal can be observed on CT and MRI. However, a biopsy is necessary to make the final diagnosis because of the non-specificity of the findings.