The aim of this retrospective study was to evaluate L-type amino acid transporter 1 (LAT1) expression in colorectal cancer with invasion to the subserosal layer (T3), its relationship with clinicopathological characteristics, and its potential metastatic significance. LAT1 expression was measured by immunohistochemistry in tumors from 65 patients with primary colorectal carcinomas. LAT1 expression was deemed positive when more than 10% of the tumor cells showed distinct membranous immunoreactivity. Positive LAT1 expression was demonstrated in 29.2% (19 of 65) of primary tumors. LAT1 expression showed no significant relationship with clinicopathological characteristics, such as age, gender, tumor location, tumor size, macroscopic/microscopic classification, or lymph node metastasis. However, LAT1 expression showed a positive relationship with liver metastasis (P < 0.05). LAT1 expression in cancer cells may be a good marker for predicting potential metastasis to the liver in colorectal cancer.

View full abstract

Breast cancer is increasing in the elderly. Although elderly breast cancer patients frequently receive less invasive therapy, its appropriateness is debatable. Ki-67 expression is a controversial prognostic factor and predictor of the efficacy of postoperative adjuvant therapy. This study investigated the value of the Ki-67 labeling index (LI) in elderly breast cancer patients, especially with respect to adjuvant therapy. This retrospective study investigated 82 primary breast cancer patients aged ≥ 70 years who underwent surgery between 1995 and 2005. Their clinicopathological findings were reviewed and their Ki-67 LIs were determined. The patients' mean age was 78 years, the mean observation period was 53.8 months, and 60 patients (73.2%) underwent adjuvant therapy. The St. Gallen (2007) risk category and the Ki-67 LI (mean, 15.3%) were both significantly correlated with relapse and prognosis. In the 31 cases with a low Ki-67 LI (< 10%), 1 patient who underwent adjuvant treatment relapsed, but there were no deaths. Among the intermediate- and high-risk patients, Ki-67 was low in 15; 1 patient who underwent adjuvant treatment relapsed, but there were no deaths. For elderly breast cancer patients aged ≥ 70 years categorized low risk by St. Gallen (2007) or with a low Ki-67 LI, the risk of relapse and death appears to be low regardless of adjuvant therapy. Though further investigation is needed to determine a method of measuring the Ki-67 LI and determining a cut-off value, our findings suggest that the Ki-67 LI helps with the selection of adjuvant therapy in elderly patients.

View full abstract

Various markers of bone metabolism are used in the treatment of osteoporosis as they can help assess the condition of bony tissue/bone metabolism and can help predict the likelihood of fractures and bone loss in the near future. We investigated correlations between various bone metabolism markers to ascertain which could be used as a universal marker of bone metabolism and its associated care. Subjects comprised 144 female patients treated for osteoporosis at this facility between January and December 2009, in whom the following bone metabolism markers were measured on the same day: BAP, urine NTX, OC, ucOC, and TRACP-5b. The mean age of the subjects was 71.2 years. All subjects were analyzed as an entire group (total group), and subjects were also divided into 2 groups and analyzed based on whether they were using an osteoporosis drug or not. Subjects currently being treated were included in the treated group (n=113; mean age: 71.9 years). Subjects with no treatment experience were included in the untreated group (n=31; mean age: 68.6 years). In the total group and treated group, significant correlations were revealed between BAP, urine NTX, OC, ucOC, and TRACP-5b. In the untreated group, no correlation was observed between BAP and ucOC, but correlations between BAP, urine NTX, OC, ucOC, and TRACP-5b were observed. ucOC is a marker of bone metabolism, and is also an indicator of the state of vitamin K intake. Based on the correlations with both bone resorption markers and osteoplastic markers found in this study, ucOC was found to be the best universal marker to use in the clinical setting.

View full abstract

Background: Pulmonary vein isolation (PVI) is expected to cure atrial fibrillation (AF) and to improve atrial remodeling. However, the effects of PVI on the right atrial (RA) size have not been fully examined. We studied the effects of PVI on RA size in comparison that with the effects on LA size.
Method: We studied 17 patients with drug-refractory AF (11 paroxysmal, 6 persistent). Two-dimensional echocardiography was performed at baseline and at follow-up to measure and compare RA and LA size.
Results: Despite a short duration of AF in 7 patients after the PVI, all cases were maintained in sinus rhythm during the follow-up. LA and RA size were both reduced after the PVI compared with baseline measurements (LA 25.5 ± 2.9cm² vs. 23.2 ± 3.6cm², P < 0.05, RA 21.2 ± 2.9cm² vs. 18.1 ± 3.0cm², P < 0.01). The reduction ratio was more prominent in RA size (14.9%) than in LA size (8.7%)(P < 0.05).
Conclusion: Atrial size was reduced following PVI for both the LA and RA, although the rate of reduction was more prominent in the RA.

View full abstract

Although epidemiological evidence has confirmed the role of heavy alcohol consumption as an established risk factor for esophageal, liver, and breast cancers, the molecular mechanisms underlying this effect are not fully understood, particularly with regard to breast cancer. In this study, expression of the retinoic acid early inducible-1 (RAE-1) gene was determined in mice adipocytes. RAE-1 is a ligand of the natural-killer group 2 member D (NKG2D) receptor, which plays a crucial role in tumor immunity. RT-PCR and Western blotting analysis demonstrated that TNF-α treatment induced RAE-1 mRNA and RAE-1 protein expression in adipocytes obtained from differentiated 3T3-F442A cells. Real-time RT-PCR analysis showed that 300 mM ethanol enhanced RAE-1 mRNA expression, which peaked 6 h after administration. In addition, RAE-1 mRNA was detected in visceral adipose tissue obtained from mice. These observations indicate that RAE-1 mRNA is expressed in adipocytes and that its expression is enhanced by TNF-α, which has been shown to be induced in adipose tissue by long-term alcohol consumption. Furthermore, ethanol directly enhanced RAE-1 mRNA expression, suggesting that alcohol consumption enhances RAE-1 expression in adipose tissue and might modify tumor immunity. This finding might provide novel insight into the mechanism of alcohol-associated carcinogenesis.

View full abstract

Recurrence at the site of a stapled anastomosis is generally believed to result from the luminal implantation of viable cancer cells during stapling. We report a 57-year-old woman who underwent radical surgery for sigmoid colon cancer and developed anastomotic recurrence ten months after the initial operation. Her serum carcinoembryonic antigen (CEA) levels were within normal limits during the postoperative follow-up. The patient subsequently underwent a partial colon resection for the anastomotic recurrence. The clinicopathological findings revealed that possible tumor cell implantation caused the recurrence. We encountered a case of anastomotic recurrence due to possible tumor implantation after curative surgery for sigmoid colon cancer. Follow-up colonoscopy was more helpful for the diagnosis of anastomotic recurrence than CEA monitoring.

View full abstract

We report a case of acute rhinosinusitis complicated by epidural abscess. A 33-year-old woman consulted her local otorhinolaryngology clinic complaining of left eye pain and left periorbital swelling. After visiting additional clinics and receiving treatment she did not obtain relief from her symptoms. Thereafter, she was referred to our hospital. Contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) were conducted and it was found that acute rhinosinusitis had caused an epidural abscess in the left frontal tip. The patient was admitted to the hospital and endoscopic sinus surgery (ESS) as well as septoplasty were performed under general anesthesia. A neurosurgeon was consulted regarding the brain lesion and treatment with antibiotics was selected. Intravenous PAPM/BP (panipenem/betamipron) and hydrocortisone sodium succinate were administered postoperatively. On the fifth postoperative day, the patient's condition had improved and the nasal inflammation had almost disappeared. She was discharged from hospital on the tenth postoperative day.

View full abstract

Ischemic colitis is characterized by lesions arising from colonic ischemia. The treatment of choice is surgery, and resection of the affected segment is often life saving. This study presents a case of segmental ischemic colonic stenosis of the splenic flexure. A 70-year-old woman was admitted to our hospital with abdominal pain and distension. Physical examination revealed mild tenderness of the left-upper abdomen but no peritoneal signs. A computed tomography scan demonstrated a thickening of the splenic flexure of the colon with active inflammation. A gastrografin enema revealed a 5-cm-long tight stricture at the left transverse colon, which suggested a subileus. Surgery for segmental ischemic colonic stenosis was performed because the stricture did not respond to treatment. Pathological examination revealed features typical of ischemic colitis, including ulceration and segmental colonic stenosis of the splenic flexure, but revealed no evidence of tumors, lymph node swelling, or vascular disorder.

View full abstract

We report a rare case of adult subpial spinal lipoma at the conus medullaris level. A 61-year-old man presented with lower back pain, numbness in his legs, difficulty walking and a sensation of residual urine. T1- and T2-weighted magnetic resonance imaging showed a well-demarcated hyperintense intradural tumor level with the lower part of the T12 vertebra. Laminectomy at the T12 level and partial removal of the tumor using ultrasonic aspiration were performed. Pathologically, the excised mass was composed of mature adipose tissue with no evidence of inflammatory cell invasion or malignancy. Symptoms other than numbness and hypoesthesia in the left leg were relieved postoperatively. This case report indicated that partial tumor removal and ultrasonic aspiration are useful methods for removing tumors with significant adhesion to the spinal cord.

View full abstract