Photodynamic therapy for submucosal tumor of the central bronchus

A 75-year-old man was referred to our hospital because of the emphysema and tumor of the right intermediate bronchus. Thoracic CT scan and bronchoscopic examination demonstrated a spherical tumor of the right intermediate bronchus covering a normal mucosa. The biopsy specimen obtained from this tumor was histologically diagnosed as“glandular type of adenocarcinoma in the bronchus”. Surgical treatment was not feasible because of poor pulmonary function. Therefore, the patient underwent Photodynamic therapy (PDT) using porfimer sodium (Photofrin) and an excimer dye laser. After 4 months, the tumor disappeared and there has been no recurrence for 3 years 3 months. PDT can affect a submucosal tumor of the central airway, and is safe for patients with poor pulmonary function. Our report recommends that PDT should be applied not only to early lung cancer but also submucosal tumor of the central bronchus

肺癌同所移植モデルマウスの経時的評価における小動物用呼吸同期PET/CTの有用性

Our aim in this study was to clarify the effects of respiratory-gated PET in the evaluation of lung cancer according to the 18F-FDG uptake in an orthotopic transplantation mouse model. We created such a model, and we performed PET/CT. The mice were divided into two groups according to tumor volume: a small-tumor group (20 mm3). We reconstructed the following conditions based on list-mode data: non-gated (3D) images and gated (4D) images, divided based on the respiratory cycle (expiration phase, stable phase, and inspiration phase). We calculated the maximum standardized uptake values (SUVmax) in each phase. We used the % difference [= (4D SUVmax – 3D SUVmax)/3D PET SUVmax × 100 (%)] to evaluate the differences in the 4D SUVmax and 3D SUVmax. The 4D SUVmax values were significantly higher than the 3D SUVmax, regardless of the tumor size. The % difference for the small tumors was greater than that for the large tumors, and it was highest in the stable phase. We conclude that the SUVmax in the stable phase under respiratory-gated PET are the most reliable. The SUVmax observed under non-gated PET are considered to be more frequently underestimated in cases involving small tumors than in those involving large tumors. In the chronologic study evaluating the time course of tumor development, the size of the tumor is small in early stage, and respiratory-gated PET is effective in reducing the underestimation of such tumors caused by respiratory motion

マウスiPS細胞由来の気管支肺胞幹細胞は末梢気道上皮再生を促進する

Background: Bronchioalveolar stem cells (BASCs) located at the bronchioalveolar-duct junction (BADJ) are stem cells residing in alveoli and terminal bronchioles that can self-renew and differentiate into alveolar type (AT)-1 cells, AT-2 cells, club cells, and ciliated cells. Following terminal-bronchiole injury, BASCs increase in number and promote repair. However, whether BASCs can be differentiated from mouse-induced pluripotent stem cells (iPSCs) remains unreported, and the therapeutic potential of such cells is unclear. We therefore sought to differentiate BASCs from iPSCs and examine their potential for use in the treatment of epithelial injury in terminal bronchioles. Methods: BASCs were induced using a modified protocol for differentiating mouse iPSCs into AT-2 cells. Differentiated iPSCs were intratracheally transplanted into naphthalene-treated mice. The engraftment of BASCs into the BADJ and their subsequent ability to promote repair of injury to the airway epithelium were evaluated. Results: Flow cytometric analysis revealed that BASCs represented ~ 7% of the cells obtained. Additionally, ultrastructural analysis of these iPSC-derived BASCs via transmission electron microscopy showed that the cells containing secretory granules harboured microvilli, as well as small and immature lamellar body-like structures. When the differentiated iPSCs were intratracheally transplanted in naphthalene-induced airway epithelium injury, transplanted BASCs were found to be engrafted in the BADJ epithelium and alveolar spaces for 14 days after transplantation and to maintain the BASC phenotype. Notably, repair of the terminal-bronchiole epithelium was markedly promoted after transplantation of the differentiated iPSCs. Conclusions: Mouse iPSCs could be differentiated in vitro into cells that display a similar phenotype to BASCs. Given that the differentiated iPSCs promoted epithelial repair in the mouse model of naphthalene-induced airway epithelium injury, this method may serve as a basis for the development of treatments for terminal-bronchiole/alveolar-region disorders

The effects of the herbal medicine Daikenchuto (TJ-100) after esophageal cancer resection, open-label, randomized controlled trial

Background Daikenchuto (TJ-100), a traditional Japanese herbal medicine, is widely used in Japan. Its effects on gastrointestinal motility and microcirculation and its anti-inflammatory effect are known. The purpose of this prospective randomized controlled trial was to investigate the effect of TJ-100 after esophagectomy in esophageal cancer patients. Methods Forty patients for whom subtotal esophageal resection for esophageal cancer was planned at our institute from March 2011 to August 2013 were enrolled and divided into two groups at the point of determination of the operation schedule after informed consent was obtained: a TJ-100 (15 g/day)-treated group (n = 20) and a control group (n = 20). The primary efficacy end-points were maintenance of the nutrition condition and the recovery of gastrointestinal function. The secondary efficacy end-points were the serum C-reactive protein (CRP) level and adrenomedullin level during the postoperative course, the incidence of postoperative complications, and the length of hospital stay after surgery. Results We examined 39 patients because one patient in the TJ-100 group was judged as having unresectable cancer after surgery. The mean age of the TJ-100 group patients was significantly older than that of the control group patients.The rate of body weight decrease at postoperative day 21 was significantly suppressed in the TJ-100 group (3.6% vs. the control group: 7.0%, p = 0.014), but the serum albumin level was not significantly different between the groups. The recovery of gastrointestinal function regarding flatus, defecation, and oral intake showed no significant between-group differences, but postoperative bowel symptoms tended to be rare in the TJ-100 group. There was no significant between-group difference in the length of hospital stay after surgery. The serum CRP level at postoperative day 3 was 4.9 mg/dl in the TJ-100 group and 6.9 mg/dl in the control group, showing a tendency of a suppressed serum CRP level in the TJ-100 group (p = 0.126). The rate of increase in adrenomedullin tended to be high postoperatively, but there was no significant difference between the two groups. Conclusions TJ-100 treatment after esophageal cancer resection has the effects of prompting the recovery of gastrointestinal motility and minimizing body weight loss, and it might suppress the excess inflammatory reaction related to surgery

EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Scientific Opinion on the substantiation of health claims related to the substantiation of health claims related to various microorganisms and changes in bowel function, and digestion and absorption of nutrients (ID 960, 961, 967, 969, 971, 975, 983, 985, 994, 996, 998, 1006, 1014), decreasing potentially pathogenic gastro-intestinal microorganisms (ID 960, 967, 969, 971, 975, 983, 985, 994, 996, 998, 1006, 1014), and stimulation of immunological responses (ID 962, 968, 970, 972, 976, 984, 986, 995, 997, 999, 1007, 1015) (further assessment) pursuant to Article 13(1) of Regulation (EC) No 1924/2006

<p>Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to provide a scientific opinion on health claims pursuant to Article 13 of Regulation (EC) No 1924/2006 in the framework of further assessment related to various microorganisms and changes in bowel function, and digestion and absorption of nutrients, decreasing potentially pathogenic gastro-intestinal microorganisms, and stimulation of immunological responses. The food constituents, <em>Bifidobacterium animalis </em>subsp.<em> lactis</em> THT 010801, <em>Bifidobacterium longum </em>subsp. <em>infantis</em> THT 010201, <em>Bifidobacterium longum </em>subsp.<em> longum</em> THT 010301, <em>Bifidobacterium pseudolongum </em>subsp.<em> pseudolongum</em> THT 010501, <em>Lactobacillus casei</em> THT 030401, <em>Lactobacillus gasseri</em> THT 031301, <em>Lactobacillus helveticus</em> THT 031102, <em>Lactobacillus plantarum</em> THT 030701, <em>Lactobacillus plantarum</em> THT 030707, <em>Lactobacillus reuteri</em> THT 030802, <em>Lactobacillus salivarius</em> THT 031001 and <em>Streptococcus thermophilus</em> THT 070102, are sufficiently characterised. The evidence provided did not establish that the proposed claimed effect, stimulation of immunological responses, is a beneficial physiological effect. The references provided for the health claims related to changes in bowel function and decreasing potentially pathogenic gastro-intestinal microorganisms included studies which assessed the effects of food constituents other than the food constituents which are the subject of the claims and/or investigated health outcomes unrelated to the claimed effects. No human studies which investigated the effects of the food constituents on appropriate measures of the claimed effects were provided. On the basis of the data presented, the Panel concludes that a cause and effect relationship has not been established between the consumption of the food constituents and the claimed effects evaluated in this opinion.</p&gt

The balance of VEGF-C and VEGFR-3 mRNA is a predictor of lymph node metastasis in non-small cell lung cancer

A positive association between vascular endothelial growth factor-C (VEGF-C) expression and lymph node metastasis has been reported in several cancers. However, the relationship of VEGF-C and lymph node metastasis in some cancers, including non-small cell lung cancer (NSCLC), is controversial. We evaluated the VEGF-C and vascular endothelial growth factor receptor-3 (VEGFR-3) expression in NSCLC samples from patients who had undergone surgery between 1998 and 2002 using real-time quantitative RT–PCR and immunohistochemical staining. We failed to find a positive association between VEGF-C and VEGFR-3 mRNA expression and lymph node metastasis in NSCLC. An immunohistological study demonstrated that VEGF-C was expressed not only in cancer cells, but also in macrophages in NSCLC, and that VEGFR-3 was expressed in cancer cells, macrophages, type II pneumocytes and lymph vessels. The VEGF-C/VEGFR-3 ratio of the node-positive group was significantly higher than that of the node-negative group. Immunohistochemical staining showed that VEGFR-3 was mainly expressed in cancer cells. The immunoreactivity of VEGF-C and VEGFR-3 was roughly correlated to the mRNA levels of VEGF-C and VEGFR-3 in real-time PCR. VEGF-C mRNA alone has no positive association with lymph node metastasis in NSCLC. The VEGF-C/VEGFR-3 ratio was positively associated with lymph node metastasis in NSCLC. This suggests that VEGF-C promotes lymph node metastasis while being influenced by the strength of the VEGF-C autocrine loop, and the VEGF-C/VEGFR-3 ratio can be a useful predictor of lymph node metastasis in NSCLC

ケッカクセイ キョウマクエン ノ シンダン ニオケル キョクショ マスイカ キョウコウキョウ ノ ユウヨウセイ ニ カンスル ケントウ

局所麻酔下胸腔鏡が施行され,胸膜生検検体にて乾酪性肉芽腫を認め,結核性胸膜炎と診断された症例の臨床的検討を行った.対象は,1999 年12 月から2011 年1 月までに局所麻酔下胸腔鏡により病理学的に診断された結核性胸膜炎32例.男性25例,女性7例.平均年齢62.8歳( 24〜89歳).右側胸水が14例,左側胸水が16 例,両側胸水が2 例.胸水リンパ球比率の平均は90.9%,胸水ADA の平均は69.1 IU/l であった.胸水のTb-PCR( tuberculosis-polymerase chain reaction) は全例で陰性,胸水抗酸菌培養は1例のみ陽性で,陽性率は極めて低値であった.胸腔鏡所見では,壁側胸膜のびまん性の白色小結節病変が最も多く19例( 59.4%)で認められ,胸膜肥厚や癒着,血管増生などの非特異的な所見も高率に認めた.胸膜生検検体の結核菌培養陽性率は約40%であった.結節病変を認めた例では,結節病変を認めなかった例と比較してより年齢が若く,発症から検査までの日数が有意に短かった.結核性胸膜炎の診断は,胸水穿刺だけでは診断効率が低く,局所麻酔下胸腔鏡を行うことにより診断効率は大きく向上し,内科医が施行できる安全性の高い極めて有用性の高い検査法といえる.We reviewed our patients with tuberculous pleurisy underwentmedical thoracoscopy. From December 1999 toJanuary 2011, 32 patients were diagnosed as having tuberculouspleurisy by pleural biopsy pathologically. The typicalthoracoscopic findings of tuberculous pleurisy such as diffusesmall white nodules on the parietal pleura were seen in23 cases (71.9 %). Non-specific pleural findings such asthickness on the pleura or adhesion were seen in 9 cases(22.2 %). In all these patients, pathological diagnoses of tuberculouspleurisy were made by pleural biopsies. Sincemedical thoracoscopy is useful for the diagnosis of tuberculouspleurisy, it is recommended as a diagnostic procedurefor cases with pleural effusion