Since 'radical lobectomy' was reported by Cahan in 1960, the standard surgical care for lung cancer has been lobectomy, in which units of the lobe are excised with their specific regional hilar and ...mediastinal lymphatics. However, pulmonary function-preserving limited resection for lung cancer has gradually become more prevalent in the late 20th century. In 1995, Ginsberg et al. conducted a randomized controlled trial in which limited resection (segmentectomy and wide-wedge resection) and lobectomy for stage I lung cancer were compared and reported that limited resection should not be applied to healthy patients with clinical stage IA lung cancer. The detection of small-sized and early-stage lung cancers has improved with advancement in diagnostic technology. Ground-glass opacity of lung nodules, as recognized on thin-slice computed tomography, has also been widely recognized as being correlated with less-invasive pathological findings of alveolar epithelial cell replacement of cancer cells. The Lung Cancer Surgical Study Group of the Japan Clinical Oncology Group conducted a cohort study of early peripheral lung cancer and investigated the validity thin-slice computed tomography criteria to diagnose non-invasive lung adenocarcinoma for the preoperative prediction of pathological non-invasive cancer. Following this observational study, the on-going JCOG0802/WJOG4607L, JCOG0804/WJOG4507L and JCOG1211 trials were initiated to confirm the validity of limited resection for stage I lung cancer patients stratified according to preoperative thin-slice computed tomography findings; these trials will clarify whether limited resection for lung cancer is not function-preserving but also only curative surgery.
Introduction
Lobectomy has been the standard surgery for even stage I lung cancer since the validity of limited resection for stage I lung cancer was denied by the randomized study reported in 1995. ...The aim of this non-randomized confirmatory going on since September 2013 is to confirm the efficacy of a segmentectomy for clinical T1N0 lung cancer with dominant ground glass opacity based on thin-slice computed tomography.
Method
A total of 390 patients from 42 Japanese institutions are recruited within 4 years. The primary endpoint of this study is a 5-year relapse-free survival in all of the patients who undergo a segmentectomy for a lung nodule. The secondary endpoints are overall survival, annual relapse-free survival, disease-free survival, proportion of local relapse, postoperative pulmonary function, proportion of segmentectomy completion, proportion of R0 resection completion by segmentectomy, adverse events, and serious adverse events. This trial has been registered at the UMIN Clinical Trials Registry as UMIN000011819 (
http://www.umin.ac.jp/ctr/
).
Results
Patient’s accrual has been already finished in November, 2015 and the primary analysis will be performed in 2021.
Conclusion
This study is one of the pivotal trial of lung segmentectomy for early lung cancer. The result will provide a clear evidence for our daily clinics and will be possible contribution to preserving pulmonary function for lung cancer patients.
A 56-year-woman was admitted to the hospital with an abnormal shadow in the left lower lung field on chest X-ray film. The findings on chest CT examination suggested a pulmonary arteriovenous ...fistula. Left pulmonary arteriogram showed a large fistula (60 mm) with feeding vessels of 8 mm in diameter in the left lower lobe. It seemed to be impossible to perform embolization because of the size of fistula and its feeding vessels. Right pulmonary arteriogram at the same time revealed a small fistula of 10 mm in diameter in the right lower lobe, which was treated by embolization. The fistula of the left lung was resected on thoracotomy.
Life-threatening complications can occur unexpectedly during general anesthesia in operations for acute progressive superior vena caval syndrome. We describe a temporary extracorporeal axillofemoral ...venous bypass procedure to reduce the high venous pressure in the upper part of the body before induction of general anesthesia. The bypass supports the operation for superior vena caval syndrome without life-threatening accidents. No serious complications related to the procedure have been observed.
A 59-year-old man with squamous cell carcinoma of the lung was treated with left pneumonectomy and aortic wall resection. The invaded wall of the descending thoracic aorta was partially resected and ...repaired with a Dacron patch. He is in good condition 9 months after surgery. In this operation a heparinized tube was used satisfactorily for temporary bypass while the aorta was clamped.
We have recently encountered a case of primary carcinoma of the jejunum associated with intussusception and cerebral metastasis. A 55-year-old man was admitted to our hospital, with a chief complaint ...of hypochondralgy. Although barium studies failed to demonstrate abnormal findings, whole body CT scan revealed mass shadow in the tail of the pancreas with elevation of serum CA19-9 levels, and primary tumor of the pancreas was suspected. The patient developed ileus soon after admission, and urgent surgery showed polipoid tumor associated with intussusception in the jejunum about 100cm distal from the ligament of Treitz. The resectedtumor was histologically diagnosed as pooly differentiated adenocarcinoma of jejunum and tumor metastasis in the regional lymphnodes and the tail of the pancreas. In the postoperative period, the patient complained of the headache, and tumor shadow was pointed out on the CT scan of the head. Craniotomy was performed, but the patient died of the cancer two months later. Primary carcinoma of the small intestine is an infrequently encountered tumor that is difficult to diagnose preoperatively. The tumor is rarely associated with intussusception or cerebral metastasis. These characteristic features are reviewed and discussed.
BACKGROUNDHigh-grade chondrosarcoma, which has a high incidence of local recurrence and pulmonary metastasis despite surgical resection, is associated with poor prognosis. Therefore, new and ...effective adjuvant therapies are urgently required for this disease. Gamma-aminobutyric acid (GABA), which acts as a neurotrophic factor during nervous system development, is related to the proliferation and migration of certain cancer cells. The GABAergic system, which is composed of GABA, the GABA-synthesizing enzyme glutamic acid decarboxylase (GAD), and GABA receptors, has an important function in nerve growth and development of neural crest. Therefore, the GABAergic system may play important functional roles in the proliferation of chondrosarcoma cells, which are derived from neural crest cells. We examined the anti-tumor effects of the GABAergic system on a chondrosarcoma cell line.METHODSWe evaluated the underlying mechanisms of the anti-tumor effects of the GABAergic system, such as the involvement of different signaling pathways, apoptosis, and cell cycle arrest, in the high-grade chondrosarcoma cell line OUMS-27. In addition, we performed whole-cell patch-clamp recordings for Ca2+ currents and evaluated the changes in intracellular Ca2+ concentration via Ca2+ channels, which are related to the GABAB receptor in high-grade chondrosarcoma cells.RESULTSThe GABAB receptor antagonist CGP had anti-tumor effects on high-grade chondrosarcoma cells in a dose-dependent manner. The activities of caspase 3 and caspase 9 were significantly elevated in CGP-treated cells compared to in untreated cells. The activity of caspase 8 did not differ significantly between untreated cells and CGP-treated cells. However, caspase 8 tended to be up-regulated in CGP-treated cells. The GABAB receptor antagonist exhibited anti-tumor effects at the G1/S cell cycle checkpoint and induced apoptosis via dual inhibition of the PI3/Akt/mTOR and MAPK signaling pathways. Furthermore, the changes in intracellular Ca2+ via GABAB receptor-related Ca2+ channels inhibited the proliferation of high-grade chondrosarcoma cells by inducing and modulating apoptotic pathways.CONCLUSIONSThe GABAB receptor antagonist may improve the prognosis of high-grade chondrosarcoma by exerting anti-tumor effects via different signaling pathways, apoptosis, cell cycle arrest, and Ca2+ channels in high-grade chondrosarcoma cells.
Surface functionalized mesoporous silicates, MCM-41s, having 3-(2-pyridylmethylideneimino)propyl group (PI-MCM-41) or 3-(2-quinolylmethylideneimino)propyl group (QI-MCM-41) were prepared via Schiff ...base reaction, and the adsorption behavior of metal ions onto the modified MCM-41s was investigated. The function groups on the modified MCM-41 surface were confirmed by Fourier transform infrared spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS), and elemental analysis. The metal ions examined, Co2+, Ni2+, Cu2+, Zn2+, Cd2+, and Pb2+, were quantitatively adsorbed on the PI-MCM-41 and QI-MCM-41, except for Mn2+. In the complexation with these metal ions, it was suggested that imine-N and heterocyclic-N atoms act as donor atoms. In addition, it was considered that the hydrophobicity derived from the organo-functional groups modified on MCM-41 contributed to improving the adsorption ability.
Mutations in TBL1X, a component of the nuclear receptor co-repressor (N-CoR) and silencing mediator of retinoic acid and thyroid hormone receptor co-repressor complexes, have recently been implicated ...in isolated central hypothyroidism (CeH). However, the mechanisms by which TBL1X mutations affect negative feedback regulation in the hypothalamus-pituitary-thyroid axis remain unclear. N-CoR was previously reported to paradoxically enhance the ligand-independent stimulation of TRH and TSHβ gene promoters by thyroid hormone receptors (TR) in cell culture systems. We herein investigated whether TBL1X affects the unliganded TR-mediated stimulation of the promoter activities of genes negatively regulated by T3 in cooperation with N-CoR. In a hypothalamic neuronal cell line, the unliganded TR-mediated stimulation of the TRH gene promoter was significantly enhanced by co-transfected TBL1X, and the co-transfection of TBL1X with N-CoR further enhanced promoter activity. In contrast, the knockdown of endogenous Tbl1x using short interfering RNA significantly attenuated the N-CoR-mediated enhancement of promoter activity in the presence of unliganded TR. The co-transfection of N365Y or Y458C, TBL1X mutants identified in CeH patients, showed impaired co-activation with N-CoR for the ligand-independent stimulation of the TRH promoter by TR. In the absence of T3, similar or impaired enhancement of the TSHβ gene promoter by the wild type or TBL1X mutants, respectively, was observed in the presence of co-transfected TR and N-CoR in CV-1 cells. These results suggest that TBL1X is needed for the full activation of TRH and TSHβ gene promoters by unliganded TR. Mutations in TBL1X may cause CeH due to the impaired up-regulation of TRH and/or TSHβ gene transcription despite low T3 levels.
No primary scandium (Sc) ore exists on the earth and therefore securing a stable supply of Sc is required. The authors reported previously that a hexane solution containing 0.1 mol dm-3 of ...O,O-bis(2-ethylhexyl) hydrogen thiophosphate (MSP-8®) could extract Sc(III) quantitatively from an aqueous solution containing 1.0 mol dm-3 of zirconyl (ZrO(II)) and 0.10 mol dm-3 of tripotassium citrate as a masking reagent. The present study was carried out in order to establish the liquid-liquid extraction separation of Sc from a simulated waste water produced in the zirconium (Zr) refinery by using MSP-8 as the extractant.
PDF
