Successful Treatment of Recurrent Gastric Cancer with Chemotherapy for M ore than 6 Years : A Case Report

A 66 year-old male underwent a distal gastrectomy with D2 dissection in April 2003. Pathological findings showed a well-differentiated carcinoma with a depth of m, n2, stage II. Six months later, a computed tomography revealed multiple lymph node swellings in the para-aortic lesion ; we judged this to be a recurrence of the gastric cancer. As treatment, paclitaxel was administered weekly on days 1, 8, and 15, in combination with doxifluridine for 5 days per week, on a 28-day cycle. Following three courses of chemotherapy, the lymph nodes had almost disappeared. This therapy was continued until January 2007. Because of the appearance of a Virchow lymph node, S-1＋ cisplatin was administered. Following administration of the altered chemotherapy regime, a computed tomography displayed a significant reduction in Virchow lymph node swelling. Four years and ten months following the initiation of chemotherapy, the patient displayed jaundice. A computed tomography revealed lymph node swelling in the hepato-duodenal region. Following bile duct drainage, he received four cycles of paclitaxel and doxifluridine therapy. The patient then received S-1 monotherapy for 5 months. He died in February 2010, 6 years and 3 months after the recurrence in the stomach cancer

Regional evaluation of childhood acute lymphoblastic leukemia genetic susceptibility loci among Japanese

Genome-wide association studies (GWAS) performed mostly in populations of European and Hispanic ancestry have confirmed an inherited genetic basis for childhood acute lymphoblastic leukemia (ALL), but these associations are less clear in other races/ethnicities. DNA samples from ALL patients (aged 0–19 years) previously enrolled onto a Tokyo Children’s Cancer Study Group trial were collected during 2013–2015, and underwent single nucleotide polymorphism (SNP) microarray genotyping resulting in 527 B-cell ALL for analysis. Cases and control data for 3, 882 samples from the Nagahama Study Group and Aichi Cancer Center Study were combined, and association analyses across 10 previous GWAS-identified regions were performed after targeted SNP imputation. Linkage disequilibrium (LD) patterns in Japanese and other populations were evaluated using the varLD score based on 1000 Genomes data. Risk associations for ARID5B (rs10821936, OR = 1.84, P = 6 × 10⁻¹⁷) and PIP4K2A (rs7088318, OR = 0.76, P = 2 × 10⁻⁴) directly transferred to Japanese, and the IKZF1 association was detected by an alternate SNP (rs1451367, OR = 1.52, P = 2 × 10⁻⁶). Marked regional LD differences between Japanese and Europeans was observed for most of the remaining loci for which associations did not transfer, including CEBPE, CDKN2A, CDKN2B, and ELK3. This study represents a first step towards characterizing the role of genetic susceptibility in childhood ALL risk in Japanese

腸回転異常症を伴った胃癌の１手術例

症例は86歳の女性. 検診の上部消化管内視鏡検査で噴門から体下部にかけての胃癌と診断され, 手術を施 行した. 開腹すると十二指腸水平脚は後腹膜に固定されておらず, トライツ靭帯を形成していなかった. 腹腔 内で小腸が右側,結腸が左側に偏在していたため腸回転異常症と診断した.Ladd靭帯の形成も認めなかった. 胃全摘術を施行してRoux-en Y 再建を行い, 腸回転異常に対しての手術は行わなかった. 成人で発見される 腸回転異常症は比較的まれであり, 消化管悪性腫瘍の手術の際に偶然発見されることもある. 画像検査の発 達した現在では, 従来の造影検査以外にも診断可能な方法があるため, 詳細な術前画像所見の検討が必要で あった. また, 腸回転異常症に対して術式を付加するかどうかは一定の見解を得ておらず, 個々の腹腔内所見 により検討されるべきと考えられた