Long-term survival after an aggressive surgical resection and chemotherapy for stage IV pulmonary giant cell carcinoma

BACKGROUND: Pulmonary giant cell carcinoma is one of the rare histological subtypes with pleomorphic, sarcomatoid or sarcomatous elements. The prognosis of patients with this tumor tends to be poor, because surgery, irradiation and chemotherapy are not usually effective. CASE PRESENTATION: We herein report a patient with pulmonary giant cell carcinoma with stage IV disease in whom aggressive multi-modality therapy resulted in a long-term survival. A 51-year-old male underwent an emergent operation with a partial resection of small intestinal metastases due to bleeding from the tumor. The patient also underwent a left pneumonectomy due to hemothorax as a result of the rapid growth of the primary tumor. Thereafter, two different regimens of chemotherapy and a partial resection for other site of small intestinal metastases and a splenectomy for splenic metastases were performed. The patient is presently doing well without any evidence of recurrence for 3 years after the initial operation. CONCLUSION: This is a first report of a rare case with stage IV pulmonary giant cell carcinoma who has survived long-term after undergoing aggressive surgical treatment and chemotherapy

Asymmetry in indegree and outdegree distributions of gene regulatory networks arising from dynamical robustness

Although outdegree distributions of gene regulatory networks have scale-free characteristics similar to other biological networks, indegree distributions have single-scale characteristics with significantly lower variance than that of outdegree distributions. In this study, we mathematically explain that such asymmetric characteristics arise from dynamical robustness, which is the property of maintaining an equilibrium state of gene expressions against inevitable perturbations to the networks, such as gene dysfunction and mutation of promoters. We reveal that the expression of a single gene is robust to a perturbation for a large number of inputs and a small number of outputs. Applying these results to the networks, we also show that an equilibrium state of the networks is robust if the variance of the indegree distribution is low (i.e., single-scale characteristics) and that of the outdegree distribution is high (i.e., scale-free characteristics). These asymmetric characteristics are conserved across a wide range of species, from bacteria to humans

Malignant schwannoma of the upper mediastinum originating from the vagus nerve

BACKGROUND: Malignant schwannoma of the upper mediastinum originating from the vagus nerve is extremely rare. CASE PRESENTATION: A 46-year-old female was admitted for a left cervical mass which was associated with both hoarseness and Horner's syndrome. Chest computed tomography showed a mass extending from the left upper mediastinum to the left supraclavicular area. A fine needle aspiration cytological examination suggested primary lung cancer stage IIIB large cell carcinoma. After administering induction chemo-radiotherapy, a complete surgical resection was performed. The tumor was found to involve both the left vagus nerve and the left sympathetic nerve. Histological examination of the resected specimen revealed the tumor to be malignant schwannoma. CONCLUSION: Despite incorrect preoperative diagnosis, the multimodality treatment administered in this case, including induction chemo-radiotherapy and surgery, proved to be effective

Axial anomaly with the overlap-Dirac operator in arbitrary dimensions

We evaluate for arbitrary even dimensions the classical continuum limit of the lattice axial anomaly defined by the overlap-Dirac operator. Our calculational scheme is simple and systematic. In particular, a powerful topological argument is utilized to determine the value of a lattice integral involved in the calculation. When the Dirac operator is free of species doubling, the classical continuum limit of the axial anomaly in various dimensions is combined into a form of the Chern character, as expected.Comment: 9 pages, uses JHEP.cls and amsfonts.sty, the final version to appear in JHE

Mohawk promotes the maintenance and regeneration of the outer annulus fibrosus of intervertebral discs.

The main pathogenesis of intervertebral disc (IVD) herniation involves disruption of the annulus fibrosus (AF) caused by ageing or excessive mechanical stress and the resulting prolapse of the nucleus pulposus. Owing to the avascular nature of the IVD and lack of understanding the mechanisms that maintain the IVD, current therapies do not lead to tissue regeneration. Here we show that homeobox protein Mohawk (Mkx) is a key transcription factor that regulates AF development, maintenance and regeneration. Mkx is mainly expressed in the outer AF (OAF) of humans and mice. In Mkx(-/-) mice, the OAF displays a deficiency of multiple tendon/ligament-related genes, a smaller OAF collagen fibril diameter and a more rapid progression of IVD degeneration compared with the wild type. Mesenchymal stem cells overexpressing Mkx promote functional AF regeneration in a mouse AF defect model, with abundant collagen fibril formation. Our results indicate a therapeutic strategy for AF regeneration

Tegafur-Uracil Plus Gemcitabine Combination Chemotherapy in Patients with Advanced Non-small Cell Lung Cancer Previously Treated with Platinum

BackgroundAn open-label, single-arm prospective study was conducted to evaluate the efficacy and toxicity of the combination of gemcitabine and tegafur-uracil (UFT) in patients with advanced nonsmall-cell lung cancer (NSCLC) after the failure of previous platinum-containing regimens.Patients and MethodsPatients with advanced NSCLC received 200 mg/m2 of UFT twice daily from day 1 through 14 plus 900 mg/m2 of gemcitabine per day via intravenous injection on days 8 and 15. This regimen was repeated every 3 or 4 weeks.ResultsA total of 40 patients were enrolled. Eleven patients (28%; 95% confidence interval [CI], 15–44%) achieved a partial response. The median progression-free survival, median overall survival, and 1-year survival rate were 4.0 months (95% CI, 3.3–6.7 months), 12.6 months (95% CI, 7.0–22.3 months), and 51% (95% CI, 33–66%), respectively. The most common grade 3 or 4 toxicity was neutropenia (38%; 95% CI, 23–54%) and the rate of grade 3 or 4 nonhematologic toxicity remained at less than 5%. A multivariate Cox model showed that adenocarcinoma, nonsmoking history, and good performance status predicted better survival.ConclusionsCombination chemotherapy with UFT and gemcitabine showed a promising effectiveness and acceptable toxicity for patients with platinum-resistant NSCLC