A Highly Advanced Gastric Cancer Maintaining a Clinical Complete Response after Chemoradiotherapy Comprising S-1 and Cisplatin

We report a patient with highly advanced gastric carcinoma who was treated successfully with chemoradiotherapy (CRT) comprising S-1 and cisplatin. The patient was a 71-year-old male who was diagnosed with advanced gastric carcinoma by esophagogastroduodenoscopy (EGD) by medical examination. EGD demonstrated type 3 advanced gastric carcinoma in the posterior wall of the upper gastric body. An abdominal computed tomography (CT) scan showed that the gastric wall was thickened due to gastric primary tumor, and large lymph nodes (LNs) including the lesser curvature LN, anterosuperior LN along the common hepatic artery and some para-aortic LNs were detected. The patient was diagnosed with stage IV advanced gastric carcinoma according to the Japanese classification of gastric carcinoma (cT4a, cN3, cM1 [para-aortic LN], cStage IV). Preoperative CRT was carried out in an attempt to downstage the disease. Remarkable reduction of the primary tumor and metastatic LNs was observed after initial CRT, and radiological examination determined that a partial response had been achieved. Adverse effects included grade 2 anorexia and grade 3 ALP elevation (919 U/ml). No grade 4 or more severe adverse event was observed. After CRT, although we recommended curative surgery, the patient refused surgical treatment and opted for conservative treatment. Thus, we continued S-1 oral administration for 1 year. Five months after beginning CRT, upper endoscopy showed that the tumor had maintained regression and scar formation, in which no cancer cells were detected by endoscopic biopsy. The patient is doing well and has maintained a clinical complete response for more than 42 months without curative surgery. CRT could be considered as an option for treatment of patients with locally advanced gastric carcinoma diagnosed as unresectable, or for those who refuse surgical treatment

コキュウ コンナン オ ケイキ ニ ハッケンサレ シュウガクテキ チリョウ ニヨリ カンカイ シタ シンコウ セイソウ ガン ノ 1レイ

A 30-year-old man was referred to our hospital for examination and treatment of dyspnea.Clinical examination revealed multiple lung tumor masses with marked elevation -HCG and -fetoprotein. CT showed not only multiple lung tumors but also retroperitoneal tumor mass. Apercutaneous needle biopsy of lung tumor was performed and pathological findings suggestedchoriocarcinoma. Although testicular swelling was not detected, ultrasonography revealed a righttesticular mass lesion. Therefore we diagnosed multiple lung metastases from right testicularcancer with retroperitoneal lymph node metastasis. The induction chemotherapy with bleomycin,etoposide, cisplatin（BEP） for 3 cycles was performed. Subsequently second line chemotherapywith paclitaxel, ifosfamide, nedaplatin（TIN）for 8 cycles followed. After the tumor markers werenormalized, resection of residual lung metastases by video-assisted thoracic surgery（VATS）andright high orchiectomy were performed. Histologically no viable cells were detected. One cyclechemotherapy with TIN was given after first surgery. Secondly, retroperitoneal lymph nodedissection was performed, and pathologically the small amount of viable cancer was detected in theresected specimen. Then post operative chemotherapy with TIN for 2 cycles were performed.The patient is alive without any recurrence 3 years after combined modality therapy

Characterization of the dnaK Multigene Family in the Cyanobacterium Synechococcus sp. Strain PCC7942

The cyanobacterium Synechococcus sp. strain PCC7942 has three dnaK homologues (dnaK1, dnaK2, and dnaK3), and a gene disruption experiment was carried out for each dnaK gene by inserting an antibiotic resistance marker. Our findings revealed that DnaK1 was not essential for normal growth, whereas DnaK2 and DnaK3 were essential. We also examined the effect of heat shock on the levels of these three DnaK and GroEL proteins and found a varied response to heat shock, with levels depending on each protein. The DnaK2 and GroEL proteins exhibited a typical heat shock response, that is, their synthesis increased upon temperature upshift. In contrast, the synthesis of DnaK1 and DnaK3 did not respond to heat shock; in fact, the level of DnaK1 protein decreased. We also analyzed the effect of overproduction of each DnaK protein in Escherichia coli cells using an inducible expression system. Overproduction of DnaK1 or DnaK2 resulted in defects in cell septation and formation of cell filaments. On the other hand, overproduction of DnaK3 did not result in filamentous cells; rather a swollen and twisted cell morphology was observed. When expressed in an E. coli dnaK756 mutant, dnaK2 could suppress the growth deficiency at the nonpermissive temperature, while dnaK1 and dnaK3 could not suppress this phenotype. On the contrary, overproduction of DnaK1 or DnaK3 resulted in growth inhibition at the permissive temperature. These results suggest that different types of Hsp70 in the same cellular compartment have specific functions in the cell