Objectives: Zinc, vitamin B₁₂ (VB₁₂) and folate have important roles in haematopoiesis. We assessed deficiencies in zinc, VB₁₂ and folate levels in patients with primary haematological malignancy before the administration of cancer chemotherapy.

Methods: We retrospectively reviewed serum levels of zinc, VB₁₂ and folate in 37 patients with haematological malignancy.

Results: Of the 37 study patients, 27 had been diagnosed with malignant lymphoma, 8 with leukaemia and 2 with multiple myeloma. The percentages of patients with sufficient, low and deficient levels of zinc were 18.9%, 59.5% and 21.6%, respectively. VB₁₂ levels were sufficient for more than 80.0% of patients. The percentages of patients with sufficient, low and deficient levels of folate were 51.4%, 43.2% and 5.4%, respectively.

Conclusions: Zinc and folate levels tended to be deficient in patients with haematological malignancy.

Determining the correspondence between points on the area–distance curve derived from acoustic rhinometry and the anatomical landmarks in the nasal and nasopharyngeal airway is important for the clinical evaluation of obstructive sleep apnea in children. In this study, area–distance curves derived from acoustic rhinometry (SER-2000; Rhino Metrics Co., Ltd., Denmark) were measured in a life-size, artificial, soft-silicon, upper-airway model of a healthy 5-year-old child (Koken Co., Ltd., Japan). We created obstacles in both the nasal cavity and nasopharynx with clay, simulating various grades of adenoid hypertorophy. On the area–distance curve, the anterior portion of the inferior turbinate corresponded to the region between the second notch and third peak, the posterior end of the nasal septum corresponded to the third peak, and the adenoid corresponded to the region from immediately after the third peak to 8 mm posterior to the fourth notch. The measured adenoidal volume matched the actual volume of the simulated adenoid; however, the measured airway volume of the nasopharynx according to acoustic rhinometry was far greater than the actual volume of the model. We conclude that the landmarks identified on the area–distance curve and the changes in adenoid volume measured with acoustic rhinometry have potential clinical application. However, acoustic rhinometry measurements of nasopharynx airway volume could be improved.

Objective: This study was performed to investigate risk factors affecting the onset of adverse reaction to metal debris (ARMD) after metal-on-metal total hip arthroplasty (THA).

Methods: Of the patients who underwent metal-on-metal THA as a primary surgery from January 2007 to August 2011, we included 48 patients in whom the serum metal ion concentrations were measured postoperatively. For these patients, we examined the relationship of the serum cobalt ion concentration with sex, age, Japanese Orthopaedic Association (JOA) hip score as a preoperative clinical evaluation parameter, body mass index (BMI), femoral head diameter, cup abduction angle, height of cup positioning, and magnetic resonance imaging (MRI) findings.

Results: No correlation was observed between the serum cobalt ion concentration and age, sex, preoperative JOA hip score, femoral head diameter, cup abduction angle, height of the cup, or MRI findings. Patients with a BMI of >23 kg/m² had significantly higher serum cobalt ion concentrations.

Conclusions: We found that a BMI of >23 kg/m² is a risk factor for a high serum cobalt ion concentration. We believe that postoperative periodic measurement of the serum cobalt ion concentration in such patients will help to accurately diagnose ARMD and determine treatment strategies.

Objectives: Neoadjuvant chemotherapy is a widely-accepted potential treatment for locally-advanced gastric carcinoma. Laparoscopic gastrectomy is performed for advanced gastric carcinoma because it is minimally invasive, which could lead to accessibility to combined chemotherapies. We evaluated the feasibility of performing laparoscopic gastrectomy in patients with or without neoadjuvant chemotherapy.

Methods: We performed a retrospective cohort study that was conducted from 2005–2013. We assessed 49 and 35 patients with clinical stage III disease who underwent laparoscopic gastrectomy with and without neoadjuvant chemotherapy, respectively, using a two-cycle regimen of S-1 plus cisplatin. We evaluated patients’ background data, efficacy and adverse events of chemotherapy, and perioperative factors, including the postoperative complication rate, reoperation rate, and length of hospital stay.

Results: Adverse events of grade 3 or higher during neoadjuvant chemotherapy were observed in five (10.2%) patients. The response and disease control rates were 61.2% and 93.9%, respectively. There were no significant differences in the postoperative complication rate, reoperation rate, and length of hospital stay between the groups. There were no conversions to laparotomy and no in-hospital deaths. Multivariate analyses showed that total gastrectomy was the only significant independent risk factor for determining postoperative complications, and neoadjuvant chemotherapy was not a risk factor.

Conclusions: Our protocol of laparoscopic gastrectomy for locally-advanced gastric carcinoma following neoadjuvant chemotherapy resulted in a considerable response to the chemotherapy and sufficient feasibility in the selected patients. Our strategy is a promising therapeutic option for patients with locally-advanced gastric carcinoma.

Background: Cell-free and concentrated ascites reinfusion therapy (CART) was approved by the National Insurance Scheme in 1981 in Japan and has since been used as a treatment modality for refractory ascites. Two filtration methods may be used for CART: the internal and external pressure filtration methods. However, the precise characteristics of each method are unknown.

Methods: Ascitic fluid will be obtained by puncture from patients with refractory cancerous ascites. The quantity of fluid obtained from each patient will be divided in half, and each half will be processed using either the internal or external pressure filtration method. The primary endpoint will be the time required for the transmembrane pressure to reach 500 mmHg. The secondary endpoints will be serial changes in the weight of the ascitic and filtered fluid, serial changes in the pressure at the inlet and outlet of the filter, measurement of the components of the ascitic and filtered fluid, and observation of the filter by visual inspection and light and electron microscopy.

Conclusion: This trial may clarify the characteristics of the two filtration methods.

Trial registration: UMIN000025382.