Successful Treatment of a Mixed Neuroendocrine-Nonneuroendocrine Neoplasm of the Colon with Metastases to the Thyroid Gland and Liver

Patients with mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) of the colon have poor prognosis. Herein, we report a patient with MiNEN of the colon with metastases to the liver and the thyroid gland, with long-term survival. A 45-year-old man presented with anterior neck swelling. Histopathological examination of the thyroid tumor revealed neuroendocrine carcinoma (NEC), suggesting that a primary NEC in another organ had metastasized to the thyroid gland. Computed tomography to identify a primary NEC revealed two tumors: one in the liver and one in the transverse colon. A biopsy revealed that the histopathology of the liver and colon tumors was NEC and adenocarcinoma, respectively. Thereafter, the patient underwent surgical resection of the colon tumor and was finally diagnosed as colon MiNEN with metastases to the thyroid and liver. The surgical resection of the metastatic liver tumor was performed after several courses of systemic chemotherapy, and the patient survives presently without any recurrence for approximately seven years after the diagnosis. Surgical resection of each metastatic lesion combined with systematic chemotherapy apparently improved the prognosis of MiNEN of the colon with distant metastases

<CLINICAL REPORT>A case of inverted papilloma of the maxillary sinus

A case of inverted papilloma arising in the maxillary sinus is described. The first symptoms were rhinorroea and discomfort of the left infraorbital region. A biopsy obtained by penetration into the maxillary sinus resulted in a diagnosis of chronic sinusitis. However, the surgical specimen showed characteristic inverted epithelial proliferation. Two years after operation by the Caldwell-Luc method, there are no signs of recurrence. The diagnosis and treatment of inverted papilloma are discussed

Microanalysis of Pb isotope ratios of low-Pb glass samples by femtosecond laser ablation-multiple ion counter-ICP-mass spectrometry (fsLA-MIC-ICP-MS)

We report high-resolution in situ Pb isotope analysis (207Pb/206Pb and 208Pb/206Pb ratios) by femtosecond laser ablation-multiple ion counter-inductively coupled plasma-mass spectrometry (fsLA-MIC-ICP-MS) for low-Pb geological reference glasses. Pb isotope analysis was realized using a multiple ion counter (MIC) and a modified inductively coupled plasma (ICP) ion interface to improve the signal-to-noise ratio and instrumental sensitivity, respectively. Use of femtosecond deep-UV (200 nm) laser ablation enhanced the sampling efficiency of the small amount of glass. Pb memory from sample-skimmer cones were subtracted using an on-peak background method. Instrumental mass bias correction and inter-MIC calibration were performed simultaneously using a standard-sample bracketing method. The optimized analytical protocol was applied to various rock reference glasses (BHVO-2G, BCR-2G and GSD-1G from the United States Geological Survey, and the MPI-DING series glasses: KL2-G, StHs6/80-G, ATHO-G, T1-G, and GOR132-G from the Max Plank Institute for Chemistry, Germany) with spatial resolution of ~30-μm diameter and 3-25-μm depth. The accuracy achieved was better than 0.38% compared with reference values, and the reproducibility was better than 1.0% (2SD) for both 207Pb/206Pb and 208Pb/206Pb ratios from the glasses with Pb concentrations of 1.7-19 ppm. We found that proper control of signal intensity is crucial for accurate and precise isotopic ratio measurements by the miniature MIC. Signal intensity higher than 300 kcps results in instantaneous saturation of the MIC and consequent inaccurate isotopic ratio measurements. The optimization of the fsLA-MIC-ICP-MS system allows high-throughput Pb isotopic microanalysis with the precision, accuracy and lateral spatial resolution comparable to those of secondary ion mass spectrometry, indicating the versatility of this method for in-situ microanalysis of Pb isotopes in the geosciences

Golimumab in combination with methotrexate in Japanese patients with active rheumatoid arthritis: results of the GO-FORTH study

Objective: To assess the efficacy and safety of golimumab + methotrexate (MTX) in Japanese patients with active rheumatoid arthritis (RA). Methods: 269 Japanese patients with active RA despite treatment with MTX were randomised (1:1:1) to placebo + MTX (Group 1), golimumab 50 mg + MTX (Group 2) or golimumab 100 mg + MTX (Group 3). Subcutaneous golimumab/placebo was injected every 4 weeks; stable doses of oral MTX (6-8 mg/week) were continued. Patients were allowed to enter early escape (Group 1 added golimumab 50 mg, Group 2 increased golimumab to 100 mg, Group 3 continued golimumab 100 mg) based on swollen/tender joint counts at week 14. The primary study endpoint was achievement of at least 20% improvement in the American College of Rheumatology (ACR20) response criteria at week 14. To control for multiplicity of testing, treatment group comparisons were first made between combined Groups 2 and 3 versus Group 1, followed by comparisons of Group 2 and Group 3 versus Group 1. Results: The proportion of patients with an ACR20 response at week 14 was significantly higher in combined Groups 2 and 3 (73.4%, 127/173) and in each of Group 2 (72.1%, 62/86) and Group 3 (74.7%, 65/87) compared with Group 1 (27.3%, 24/88; p<0.0001 for all comparisons). Golimumab + MTX also elicited a significantly better response than placebo + MTX in other efficacy parameters, including disease activity score (DAS28) response/remission and radiographic assessments. During the 16-week fixed treatment regimen study period, 72.7%, 75.6% and 78.2% of patients had adverse events and 1.1%, 1.2% and 2.3% had serious adverse events in Groups 1, 2 and 3, respectively. Conclusion: In Japanese patients with active RA despite MTX therapy, golimumab + MTX was significantly more effective than MTX monotherapy in reducing RA signs/symptoms and limiting radiographic progression with no unexpected safety concerns

Genetic association of the functional CDHR3 genotype with early-onset adult asthma in Japanese populations

BackgroundRecent studies have demonstrated that a coding SNP (rs6967330, Cys529→Tyr) in cadherin-related family member 3 (CDHR3), which was previously associated with wheezing illness and hospitalizations in infancy, could support efficient human rhinovirus C (RV-C) entry and replication. Here, we sought to examine the genetic contribution of this variant to the development of adult asthma.MethodsWe performed a candidate gene case–control association study of 2 independent Japanese populations (a total of 3366 adults). The odds ratios (ORs) for association of the A allele at rs6967330 with adult asthma were calculated according to age at onset of asthma. In addition, the effect of the CDHR3 genotype on the development of specific asthma phenotypes was examined.ResultsThe A allele was associated with asthma (OR = 1.56; Mantel–Haenszel p = 0.0040) when the analysis was limited to patients with early-onset adult asthma. In addition, when the analysis was limited to atopic individuals, a stronger association of the CDHR3 variant with early-onset asthma was found, and interaction of the CDHR3 genotype with atopy was demonstrated. Finally, a significant association of this variant was specifically found with a phenotype of asthma characterized by atopy, early-onset, and lower lung function.ConclusionsOur study supports the concept that the CDHR3 variant is an important susceptibility factor for severe adult asthma in individuals who develop the disease in early life. The interaction between the CDHR3 variant and atopy indicates that genetic predisposition to early respiratory viral infection is combined with atopy in promoting asthma

Association analyses of eQTLs of the TYRO3 gene and allergic diseases in Japanese populations

BackgroundTYRO3 is a member of the TAM (TYRO3, AXL, MERTK) receptor tyrosine kinase family and functions to limit type 2 immune responses implicated in allergic sensitization. Recent studies have shown that multiple intronic variants of TYRO3 were associated with asthma, implying that genetic variation could contribute to errant immune activation. We therefore hypothesized that expression quantitative trait loci (eQTLs) of the TYRO3 gene influence the development of allergic diseases (including asthma and allergic rhinitis) in Japanese populations.MethodsWe performed a candidate gene case–control association study of 8 eQTLs of TYRO3 on atopy, asthma, and allergic rhinitis using 1168 unrelated Japanese adults who had GWAS genotyping. We then examined the genetic impact of rs2297377 (TYRO3) on atopy and allergic rhinitis in 2 other independent Japanese populations.ResultsA meta-analysis of 3 Japanese populations (a total of 2403 Japanese adults) revealed that rs2297377 was associated with atopy and allergic rhinitis (OR = 1.29 and 1.31; P = 0.00041 and 0.0010, respectively). The risk allele at rs2297377 correlated with decreased expression of TYRO3 mRNA. The gene–gene interaction between HLA-DPB1 and TYRO3 was not significant with regard to sensitization. The estimated proportion of atopy and allergic rhinitis cases attributable to the risk genotype was 14% and 16%, respectively.ConclusionsOur study identified TYRO3 as an important susceptibility gene to atopy and allergic rhinitis in Japanese

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This is a clinico-statistical study of 97 inpatients with maxillary antrum-related lesions with exception of traumas and malignant tumors in this hospital during the past 10 years. In this study, special emphasis was placed on the diagnosis and treatment in primary dental or medical facilities prior to our surgery. The results were as follows : 1) Most of the 97 cases were postoperative maxillary cysts (44 cases : 46%) or odontogenic maxillary sinusitis (34 cases : 35%). 2) 74 cases (76%) of the 97 were referred from the other dental or medical clinics to the hospital. 3) The average periods of the treatment till the patients with postoperative maxillary cysts visited to our hospital were 48 days and for odontogenic sinusitis it was 89 days, respectively. 4) The treatments for these two lesions before consultation with us were mostly antibiotic therapy and/or root canal treatment. 5) These results suggest the necessity of tight affiliation between primary medical facilities and secondary or tertiary medical facilities in investigation of maxillary antrum-related lesions too