[A Case of Liver Metastasis of Gastric Cancer Successfully Treated with SOX plus Nivolumab]

An 82-year-old, male. He visited his local doctor with a chief complaint of dyspnea on exertion. Anemia was noted, and upper gastrointestinal endoscopy was performed, which revealed an ulcerative lesion in the gastric antrum. A biopsy revealed Group 5, tub2, and HER2 negative, with PD-L1≥5%. cT3N1H1(M1 HEP), cStage ⅣB was diagnosed based on CT scan showing enlarged #8 lymph node and a single liver metastasis in the 2 cm range in S6 of the liver. The patient was deemed unresectable and was started on SOX plus nivolumab therapy. On day 11 after initiation, the patient had Grade 3 diarrhea by CTCAE v5.0, and S-1 was withdrawn for 3 days, but was administered for 2 courses. CT and MRI after chemotherapy showed shrinkage of both the primary tumor and liver metastases; R0 resection was deemed possible, and pyloric gastrectomy, D2 lymph node dissection, and partial hepatic S6 resection were performed. The histological evaluation of response to treatment was Grade 1b, and the patient was in ypStage ⅠA. The patient has been alive without recurrence for 6 months postoperatively while receiving S-1 monotherapy on an outpatient basis.

[A Case of Stage Ⅳc dMMR Transverse Colon Cancer with Complete Response to Combination Therapy with Immune Checkpoint Inhibitor in Stage ⅣB Lung Adenocarcinoma]

The patient is a 72-year-old man. He was diagnosed as a duplication of left upper lobe lung adenocarcinoma cStage ⅣB and transverse colon cancer cStage Ⅳc. Because he had symptoms of atelectasis and esophageal stricture due to the progression of lung cancer, we decided to precede immunochemotherapy(CBDCA plus PEM plus pembrolizumab)for lung cancer. After the start of treatment, both lung and colorectal cancer were shrinking, but after the 3 courses of treatment, he developed intestinal obstruction due to transverse colon cancer. Because generalized peritonitis due to perforation of the colon by endoscopic stenting for the obstruction and then emergency surgery was performed. The resected transverse colon lesion was diagnosed as pathologically complete response. Lung cancer was also diagnosed as clinically complete response. Since his ADL decreased postoperatively, he is under observation without reintroduction of immunochemotherapy. Fourteen months have passed since the last administration, and no progression has been observed in either lung nor colon cancers. Pembrolizumab is considered to be successful in the patient with dMMR colorectal cancer lacking MLH1 and PMS2.

[A Curatively Resected Case of Recto-Sigmoidal Cancer with Massive Bladder Invasion after Multimodal Therapy Including Chemotherapy]

A 68-year-old male patient was referred to our hospital because of unfit to treat his recto-sigmoidal cancer massively invaded to bladder at the former hospital. During drug administration to treat heart failure, we could perform a transverse colostomy and initiated mFOLFOX plus Pmab. During chemotherapy, he improved malnutrition. After 7 courses, CT scan showed a marked reduction in tumor diameter, which was PR. Since his nutritional and heart status were improved, he underwent a high anterior resection with partial bladder resection. Pathological findings showed that a few cancer cells were remained at bladder and bowel wall. He was diagnosed as Stage Ⅱc. His postoperative course was almost uneventful. No symptom of recurrence has been observed at 9 months after surgery without adjuvant chemotherapy.

Photon emissions from rice cells elicited by N-acetylchitooligosaccharide are generated through phospholipid signaling in close association with the production of reactive oxygen species

Biophotons are ultraweak light emissions from biochemical reactions in a living body. They increase in suspension-cultured rice (Oryza sativa L.) cells when elicited by N-acetylchitooligosaccharide. Biochemical analyses were undertaken to investigate the relationship between disease response and biophotons in order to clarify the emission mechanism of biophotons caused by this elicitor. Photon emissions induced by N-acetylchitohexaose were suppressed when cells were pretreated with the reactive oxygen species (ROS)-generating inhibitors: pyrocatechol-3,5-disulfonic acid disodium salt (Tiron); diphenylene iodonium (DPI); and salicylhydroxamic acid (SHAM). Conversely, exogenously applied ROS (superoxide and hydrogen peroxide) were able to induce photon emissions. The effects of protein phosphorylation (K-252a) and the Ca(2+) signaling inhibitors, ethylene glycol-bis(beta-aminoethylether)-N,N,N',N'-tetraacetic acid (EGTA) and LaCl(3), caused photon emissions to decrease. It is clear that photon emissions from rice cells elicited by N-acetylchitohexaose are closely associated with the ROS-generating system, and are regulated by Ca(2+) signaling and protein phosphorylation. Exogenously applied phosphatidic acid (PA), the second messenger in the signal transduction of disease response, raised photon emissions in rice cells. Comparisons of photon emissions from PA and N-acetylchitohexaose regarding time courses, spectral compositions, and the inhibition ratios of several inhibitors, as well as a loss- and gain-of-function assay using the protein synthesis inhibitor cycloheximide (CHX) and PA, showed the possibility that photon emissions from rice cells elicited by N-acetylchitooligosaccharide were generated through PA, an intermediate of phospholipid signaling.

Action potential shortening and negative inotropic effects of a novel potassium channel opener, NIP-121, as compared with cromakalim in guinea pig ventricular myocardium

The potencies of NIP-121, a new potassium channel opener, to shorten action potential duration and to decrease the contractile force was examined using isolated guinea pig right ventricular free wall and papillary muscle preparations, respectively; and they were compared with those of cromakalim. NIP-121 was about 10 times more potent than cromakalim with respect to both effects. This potency ratio in cardiac muscle was about the same as that observed in rat aorta and portal vein. These cardiac effects of both agents were antagonized by glibenclamide.