Background Anaplastic thyroid carcinoma (ATC) is an aggressive type of thyroid cancer, and its metastasis requires cell motility. Ceramide is involved in a variety of biological processes, including inflammation, cell signaling, cell motility, and induction of apoptosis, however has not previously been reported to inhibit the motility of ATC cells. We evaluated the effect of short chain C₆-ceramide on motility of ATC cells.

Methods Cell motility of 8305C thyroid carcinoma cell line treated with C₆-ceramide was assessed using a transwell migration assay and a pseudopodia formation assay.

Results Treatment with 10 µM C₆-ceramide resulted in significantly fewer migratory cells than control treatment in a transwell migration assay (P < 0.002). In condition medium, 82.6% of C₆-ceramide–treated cells formed lamellipodia. Importantly, treatment with 10 µM C₆-ceramide drastically decreased the number of cells forming lamellipodia by 17.6% (P < 0.01).

Conclusion Our results suggest that treatment with a low concentration of ceramide may prevent metastasis and recurrence of ATC by inhibiting cell motility. Further studies are necessary to investigate the mechanism of inhibition of cell motility by ceramide. Ceramide shows promise as a therapeutic treatment for ATC.

Background We compared short- and long-term clinical outcomes including inflammatory marker levels between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) to define the advantages of RG over LG.

Methods We enrolled 209 patients with gastric cancer who underwent curative distal gastrectomy. We compared short- and long-term clinical outcomes including inflammatory marker levels between RG and LG to define the advantages of RG over LG. C-reactive protein (CRP) levels; the CRP-to-albumin, neutrophil-to-lymphocyte, and platelet-to-lymphocyte ratios; and the prognostic nutritional index were compared as systemic inflammatory markers.

Results RG was associated with a longer operative time. The incidence of postoperative infectious complications of grade II or higher according to the Clavien–Dindo classification was not significantly different between the two groups. Amylase levels in drainage fluid on postoperative days 1 and 3 were significantly lower in the RG group than in the LG group. The incidence of pancreatic fistula in the RG group (4.3%) was lower than that in the LG group (7.5%), albeit without significance. There were no significant differences in inflammatory marker levels either before or after surgery between the two groups. The 3-year overall survival rate did not significantly differ between the RG and LG groups (91.1% vs. 91.1%). Similar results were observed regarding the 3-year disease-specific survival rate (100% vs. 97.1%).

Conclusion RG might be feasible and safe for treating gastric cancer from both surgical and oncological perspectives. The use of robotic assistance is associated with decreased amylase levels in drainage fluid, which may reduce the risk of pancreatic fistula and prevent pancreatic injury.

Background It is important to intervene early and treat children and individuals with behavioral disorders. We conducted a functional assessment-based consultation for teachers of several students with severe behavioral disorders and examined the effects of the consultation.

Methods Eight students with severe behavioral disorders were selected from two special schools for intellectual disabilities in western Japan. An external consultant team conducted a functional assessment-based consultation in cooperation with a team of teachers. Consultations were held once a month, and comprised three to six sessions per student.

Results As a result of the functional assessment, only 8 out of 10 behaviors with some communication function, and 2 with only sensory enhancements were estimated. The Effects of consultations based on functional assessment were presented. It was found that 6 out of 10 target behaviors had obtained high effects. The total score for each behavioral scale showed a statistically significant improvement.

Conclusion Although consultations lasted for only six months and occurred from three to six times for each student, scale scores for problem behavior before and after intervention were improved, overall. Each case report suggested that many factors influence the difference in the effects of consultation among individual students. This study is significant in that it provides a model for the consultation system that operates on a short-term basis, and presents a means for small-scale group consultations for students with intellectual disabilities and autism in cooperation with external specialized institutions in special schools in Japan.

Background The current literature shows that one of the alternative therapies used to control constipation is reflexology. This study was conducted to assess the effect of reflexology on the constipation status of elderly people.

Methods This study was randomized clinical trial conducted from at the private nursing home in the Ankara Province. At the nursing home, 60 eligible elderly people were randomly assigned into experimental (n = 30) and control (n = 30) groups. The experimental group received foot reflexology massage for 1 month three times per week for 30 min. Reflexology was initiated from the patient’s right foot. The foot was relaxed primarily by applying effleurage followed by shaking, rotation, and stretching methods. The practice ended by applying solar plexus pressure on both feet. For elderly people in the control group foot surface massage without pressure was applied to simulate the interventions similar to the experimental group. The scale scores before and after reflexology were noted for the experimental group, and those for the control group, which did not receive any reflexology massage, were also determined

Results After the implementation of reflexology, the rate of emptying bowels on alternate days increased in the experimental group as opposed to that in the control group (P < 0.001). In this study, reflexology was found to improve the quality of life of the elderly and decrease the severity of constipation.

Conclusion Foot reflexology massage was found to be effective in relieving the constipation of elderly people. Therefore, reflexology is recommended as part of nursing care to reduce the constipation status of elderly people.

We present a very rare case of a laparoscopically-assisted repair of a small bowel perforation secondary to multiple metastases of undifferentiated pleomorphic sarcoma from the posterior mediastinum. A 46-year-old man presented with middle to upper abdominal pain during chemotherapy for lung metastases from undifferentiated pleomorphic sarcoma. Computed tomography revealed intra-abdominal free air, and emergency laparoscopy was performed. Consequently, a perforation was detected in the jejunum, and partial jejunal resection was performed by mini-laparotomy. Pathological examination demonstrated an ulcerated tumor with perforation and four additional tumors in the resected jejunum. Pathological examination also revealed undifferentiated pleomorphic sarcoma in all five tumors. To our knowledge, our case is the first report of a laparoscopically-assisted repair of a small bowel perforation secondary to metastasis of undifferentiated pleomorphic sarcoma. Although the perforation site was unclear preoperatively, laparoscopic observation readily identified the lesion in this patient. Therefore, minimally invasive surgery could be performed successfully with mini-laparotomy following laparoscopic observation. Laparoscopic techniques for the small intestine are viable options, even in acute and uncommon situations, and small bowel perforation secondary to metastasis should be considered in patients with undifferentiated pleomorphic sarcoma and acute abdomen.

Reconstruction of bone and soft-tissue defects in the forearm is a surgery that often proves unsuccessful. Free fibular osteocutaneous flaps are a useful material for reconstruction that enable simultaneous reconstruction of bone, skin, and soft tissues. However, in free fibular osteocutaneous flaps, the fibula, skin, and vascular pedicle are tightly bound together by the posterior intermuscular septum and the perforators that pass through the septum, giving the disadvantage of a low degree of freedom when setting these structures in place. We take into account the 3-dimensional structure of the free skin flap when selecting which lower leg to use as the donor. We report here the case of a 61-year-old man with defects in the radius, skin, and soft tissues after resection of spindle cell carcinoma of the right forearm, which was reconstructed using a free fibular osteocutaneous flap harvested from the left lower leg. Two years postoperatively, recovery has been uneventful with no complications. Donor-side selection of free fibular osteocutaneous flap is an important factor for safely completing composite radius reconstruction.

Home oxygen therapy (HOT) is an important treatment for patients with chronic respiratory diseases. Recently, telemonitoring of HOT has been become available. In the present study, we examined whether telemonitoring of HOT could improve health-related quality of life (HRQOL). Twelve patients receiving HOT participated in this study. The oxygen flow rates, use of the oxygen concentrator, and the values of percutaneous arterial oxygen saturation measured by each patient with a pulse oximeter were checked using a telemonitoring system for a period of one month. Interventions based on the results obtained were carried out in order to optimize oxygen use in this patient cohort. We evaluated the results of the SF-36 questionnaire before the initiation of telemonitoring and at 3 months after completion of the study. We identified significant improvements in SF-36 sub-scores after completion of this intervention. We conclude that telemonitoring may be a useful method to improve HRQOL.