チョウ カイテン イジョウショウ オ トモナッタ オウコウ ケッチョウガン ニ タイシテ フククウキョウ ホジョカ ケッチョウ セツジョジュツ オ シコウ シタ 1レイ

A ６４-year-old woman with complaint of intermittent abdominal pain for one year was admitted to our hospital. She had been diagnosed as transverse colon cancer by barium enema and colonoscopy at the former hospital. Abdominal enhanced CT showed that the duodenal third portion was not detected at the back of superior mesenteric vessel. She underwent laparoscopic surgery based on a diagnosis of transverse colon cancer with intestinal malrotation. We could perform laparoscopic-assisted transverse colectomy using abdominal enhanced CT which was effective for not only preoprerative diagnosis of accompany of intestinal malrotation but also anatomical anomalies of vessels. The right sided colon which was not fixed to the retroperitoneum in cases with intestinal malrotation could be pulled out easily from the small incision wound. We also considered that colectomy and dissection of its lymph nodes to these cases could be safety performed using by laparoscopy and through small laparotomy

タンカンナイ シュヨウセン オ ミトメ ゲンパツセイ カンナイ タンカンガン トノ カンベツ オ ヨウシタ イジセイ ダイチョウガン カンテンイ ノ 1セツジョレイ

The patient was a 68-year-old man who had undergone right hemicolectomy for ascending colon cancer, and pulmonary resection for lung metastases. After 10 months of operations, abdominal computed tomograms revealed a liver tumor with a biliary tumor thrombus in the segment 5 and a localized dilation of the intrahepatic bile duct. Endoscopic retrograde cholangiopancreatography showed obstruction, 2cm long, of the intrahepatic bile duct （B5） and dilation of the peripheral duct. Cytological examination of extracted bile showed adenocarcinoma. A right hepatic lobectomy was performed under the diagnosis of metastatic liver tumor with tumor development in the intrahepatic bile duct or intrahepatic cholangiocarcinoma. The resected specimen showed massive infiltration of the tumor into intrahepatic bile duct （B5） with forming a tumor thrombus. Histologically, the tumor was moderately differentiated adenocarcinoma, similar to the ascending colon cancer. The final diagnosis was liver metastasis of ascending colon cancer with intrabiliary tumor growth

ガン カガク リョウホウ ニオケル ショウカカン ドクセイ ト ケッセイ Diamine Oxidase DAO カッセイ ニ カンスル ケントウ

There are so many patients with advanced gastric cancer who undergo systemic chemotherapy worldwide. The quality of life（QOL）of patients with gastric cancer who receive chemotherapy is often lowed by various gastrointestinal toxicities during the chemotherapy. Nutrition is also impaired by gastrointestinal toxicities. However, it is difficult to predict their occurrence in advance and further there is no good serum marker for nutrition in the patients treated with chemotherapy. Thus, it is important to objectively evaluate and predict the toxicity of the digestive tract during cancer chemotherapy. Diamine Oxidase（DAO）is an enzyme that is expressed in intestinal epithelial cells. Recently it has been reported that DAO activity may reflect damage or atrophy of the intestinal villi, and therefore it may be a sensitive serum marker for nutritional state. In this study, we measured serum DAO activity of patients with gastric cancer treated with systemic chemotherapy, and investigated the correlation between DAO activity and gastrointestinal toxicities. Six patients with gastric cancer, who were treated by docetaxel+cisplatin+S‐１combination chemotherapy, were enrolled. DAO activity was measured by sensitive colorimetric assay. DAO activities diminished after treatment in４patients with moderate to severe gastrointestinal toxicities. In contrast, they did not change in２patients with no gastrointestinal toxicities. Our results may suggest that DAO activity is a good serum marker for the gastrointestinal toxicities as well as nutrition state in patients who receive systemic chemotherapy. More large scale study is needed to warrant

Concise Total Synthesis of Spirocurcasone

A concise total synthesis of spirocurcasone was accomplished. Key features of the synthesis involved a vinylogous Mukaiyama aldol reaction, a Carroll rearrangement of β-keto allyl ester derivative, an intramolecular aldol condensation, and a spiro ring formation by ring-closing metathesis of the pentaene compound. This synthetic work was complete in nine steps from (<i>S</i>)- or (<i>R</i>)-perillaldehyde without the use of protecting groups. Interestingly, the optical rotation of the synthetic spirocurcasone was different from the reported value of the natural product