Therapeutic hypothermia protects neurons after severe brain damage; however, the underlying mechanisms have yet to be fully elucidated. Activated microglia, which appear soon after the primary injury, release cytokines and nitric oxide（NO），known to damage neurons. T cells infiltrate the infarcted brain tissue within days of cerebral ischemia and play essential roles in exacerbating ischemic brain injury by producing inflammatory factors. Then, we examined how therapeutic hypothermia can prevent and brain hyperthermia can exacerbate secondary brain damage and demonstrated that the release of tumor necrosis factor（TNF）-α, interleukin（IL）-10, and NO from microglia, and that of IL-17 and granzyme B（GrB），a serine protease, from several T cell lineages is reduced by hypothermia but augmented by hyperthermia. The pathophysiological significance of these temperature-dependent changes in TNF-α, IL-10, NO, IL-17, and GrB levels in relation to hypothermic neuronal protection and hyperthermic neuronal injury was demonstrated by showing that all these molecules independently induce neuronal cell death in a concentration-dependent manner, in which the kinetics of concentration dependence was found to be proportional to that of the temperature-dependent changes in their production. These findings suggest that a decrease in TNF-α, IL-10, NO, IL-17, and GrB levels during hypothermia contributes to the direct protection of neurons, whereas an increase in their levels during hyperthermia contributes to direct injury of neurons.

We investigated the efficacy and safety of combination therapy of XELOX and Bevaci-zumab in late-stage elderly patients with advanced or recurrent colorectal cancer.

We report the result including a few case presentation. 12 patients who received XELOX and Bevacizumab therapy for 3 cycle or more in our hospital were evaluated.

After first treatment, the response rate in all patients was 50% and the disease control rate was 58.3%（CR：1/12, PR：5/12, NC：1/12, PD：5/12）．But 6 months later, the response rate was decreased to 8.3%. 5 cases were found to be ineffective in first treatment of this regimen, so next another chemotherapy were administered to

them, but 4 of 5 were found to be ineffective and followed best supportive care. On the other hand 1 of 5 was found to be partial response. 7 cases were found to be effective, but 5 of 7 were obliged to be interrupted chemotherapy due to general fatigue or anorexia, and all of 5 were found to be progressive disease in 6 months later of first treatment. In over the age of 80, the response rate was 42.3%（3/7），the desease control rate was 42.3%（3/7）．Bevacizumab and XELOX therapy was effective in elderly patients with advanced or recurrent colorectal cancer. It is very important to manage the side effects for continuity of chemotherapy.

Background：Adenosquamous carcinoma（Adsq）and large cell carcinoma with neuroendocrine morphology（LCCNM）are rare histologic types of primary lung cancer. The metachronous occurrence of these types has not been reported previously in Japan.

Case：A man in 80s had undergone whole larynx enucleation for laryngeal cancer when he was in 60s. Partial lung resection was performed because a nodular shadow was detected in the middle and lower lobes of the right lung on chest computed tomography（CT）before the laryngeal surgery, but the nodules were found to be benign. Seven years later, CT showed a nodular shadow in all lobes of the right lung. On suspicion of metastatic laryngeal cancer, partial lung resection was performed. However, all the nodules were histopathologically diagnosed with LCCNM. Three years thereafter, partial lung resection was performed again because of a nodular shadow in the upper lobe of the right lung on CT. The nodule was histopathologically classified as Adsq. Five years later, a fourth lung operation was performed because of a nodular shadow in the lower lobe of the right lung on CT, which was diagnosed as Adsq.

Conclusion：We report a rare case who got long-term survival by lung operation of metachronous multiple lung cancers with LCCNM and Adsq.

A 72 years old woman was found to have diagnosed by computed tomography（CT）with a tumor in the left lobe of the liver and referred to our hospital. Abdominal ultrasonography showed a 106mm tumor with calcification in the left of the liver. Computed tomography（CT）showed it to be a tumor with ring enhancement. Magnetic resonance imaging（MRI）showed it to have a low signal on T1-weighted and high signal on T2-weighted images. Positron emission tomography（PET）was not remarkable. Abdominal angiography showed no tumor stain but slightly enhanced in the edge and inside of the tumor. We suspected a benign liver tumor, but couldn’t exclude the possibility of a malignant liver tumor. Left hepatic lobectomy was conducted. The histological examination of the liver tumor revealed to be a hepatic sclerosing cavernous hemangioma. We report a case of the rare tumor which was mimicking a malignant liver tumor.