The Discovery of a Very Narrow-Line Star Forming Obat a Redshift of 5.66ject

We report on the discovery of a very narrow-line star forming object beyond redshift of 5. Using the prime-focus camera, Suprime-Cam, on the 8.2 m Subaru telescope together with a narrow-passband filter centered at $\lambda_{\rm c}$ = 8150 \AA with passband of $\Delta\lambda$ = 120 \AA, we have obtained a very deep image of the field surrounding the quasar SDSSp J104433.04$-$012502.2 at a redshift of 5.74. Comparing this image with optical broad-band images, we have found an object with a very strong emission line. Our follow-up optical spectroscopy has revealed that this source is at a redshift of $z=5.655\pm0.002$, forming stars at a rate $\sim 13 ~ h_{0.7}^{-2} ~ M_\odot$ yr$^{-1}$. Remarkably, the velocity dispersion of Ly$\alpha$-emitting gas is only 22 km s$^{-1}$. Since a blue half of the Ly$\alpha$ emission could be absorbed by neutral hydrogen gas, perhaps in the system, a modest estimate of the velocity dispersion may be $\gtrsim$ 44 km s$^{-1}$. Together with a linear size of 7.7 $h_{0.7}^{-1}$ kpc, we estimate a lower limit of the dynamical mass of this object to be $\sim 2 \times 10^9 M_\odot$. It is thus suggested that LAE J1044$-$0123 is a star-forming dwarf galaxy (i.e., a subgalactic object or a building block) beyond redshift 5 although we cannot exclude a possibility that most Ly$\alpha$ emission is absorbed by the red damping wing of neutral intergalactic matter.Comment: 6 pages, 2 figures. ApJ Letters, in pres

Pharmacokinetic study of adjuvant gemcitabine therapy for biliary tract cancer following major hepatectomy (KHBO1101)

Background: Biliary tract cancer (BTC) patients who have undergone surgical resection with major hepatectomy cannot tolerate the standard gemcitabine regimen (1, 000 mg/m2 on days 1, 8, and 15 every 4 weeks) due to severe toxicities such as myelosuppression. Our dose-finding study of adjuvant gemcitabine therapy for biliary tract cancer following major hepatectomy determined that the recommended dose is 1, 000 mg/m2 on days 1 and 15 every 4 weeks. Here, we evaluate the pharmacokinetics and pharmacodynamics of gemcitabine in these subjects. Methods: We evaluated BTC patients scheduled to undergo surgical resection with major hepatectomy followed by gemcitabine therapy. A pharmacokinetic evaluation of gemcitabine and its main metabolite, 2′, 2′-difluorodeoxyuridine (dFdU), was conducted at the initial administration of gemcitabine, which was given by intravenous infusion over 30 min at a dose of 800-1, 000 mg/m2. Physical examination and adverse events were monitored for 12 weeks. Results: Thirteen patients were enrolled from August 2011 to January 2013, with 12 ultimately completing the pharmacokinetic study. Eight patients had hilar cholangiocarcinoma, three had intrahepatic cholangiocarcinoma, and one had superficial spreading type cholangiocarcinoma. The median interval from surgery to first administration of gemcitabine was 65.5 days (range, 43-83 days). We observed the following toxicities: neutropenia (n = 11, 91.7%), leukopenia (n = 10, 83.3%), thrombocytopenia (n = 6, 50.0%), and infection (n = 5, 41.7%). Grade 3 or 4 neutropenia was observed in 25% (n = 3) of patients. There were differences in clearance of gemcitabine and dFdU between our subjects and the subjects who had not undergone hepatectomy. Conclusion: Major hepatectomy did not affect the pharmacokinetics of gemcitabine or dFdU. Trial Registration: UMIN-CTR in (JPRN) UMIN000005109

Benefits and limitations of middle bile duct segmental resection for extrahepatic cholangiocarcinoma

Background: Pancreaticoduodenectomy (PD) is a standardized strategy for patients with middle and distal bile duct cancers. The aim of this study was to compare clinicopathological features of bile duct segmental resection (BDR) with PD in patients with extrahepatic cholangiocarcinoma. Methods: Consecutive cases with extrahepatic cholangiocarcinoma who underwent BDR (n = 21) or PD (n = 84) with achievement of R0 or R1 resection in Kobe University Hospital between January 2000 and December 2016 were enrolled in the present study. Results: Patients who underwent PD were significantly younger than those receiving BDR. The frequency of preoperative jaundice, biliary drainage and cholangitis was not significantly different between the two groups. The duration of surgery was longer and there was more intraoperative bleeding in the PD than in the BDR group (553 vs. 421 min, and 770 vs. 402 mL; both PClavien-Dindo IIIa) were observed in the PD group (46% vs. 10%, P<0.01). Postoperative hospital stay was also longer in that group (30 vs. 19 days, P = 0.02). Pathological assessment revealed that tumors were less advanced in the BDR group but the rate of lymph node metastasis was similar in both groups (33% in BDR and 48% in PD, P = 0.24). The rate of R0 resection was significantly higher in the PD group (80% vs. 38%, P<0.01). Adjuvant chemotherapy was more frequently administered to patients in the BDR group (62% vs. 38%, P = 0.04). Although 5-year overall survival rates were similar in both groups (44% for BDR and 51% for PD, P = 0.72), in patients with T1 and T2, the BDR group tended to have poorer prognosis (44% vs. 68% at 5-year, P = 0.09). Conclusions: BDR was comparable in prognosis to PD in middle bile duct cancer. Less invasiveness and lower morbidity of BDR justified this technique for selected patients in a poor general condition