Solitary mandibular metastasis as an initial manifestation of hepatocellular carcinoma.

Oral metastases from hepatocellular carcinoma are very rare. We encountered a case of hepatocellular carcinoma with a solitary metastasis to the mandible as an initial manifestation. The patient was a 76-year-old man who was admitted for left mandibular swelling. A biopsy specimen of mandible was suspected to be a metastatic tumor. The histological findings, abdominal computed tomography, bone scintigraphy, and F-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) revealed it to be a solitary metastasis from hepatocellular carcinoma. As a result, he was diagnosed to have liver cirrhosis due to a hepatitis C virus infection and hepatocellular carcinoma with a solitary metastasis to the mandible. The primary lesion was treated with transcatheter arterial embolization (TAE), and the metastasis to the mandible was surgically resected. The patient survived for 9 months after treatment without recurrence

Interferon-α and Interleukin-12 Are Induced Differentially by Toll-like Receptor 7 Ligands in Human Blood Dendritic Cell Subsets

Dendritic cells (DCs) play a crucial role in the immune responses against infections by sensing microbial invasion through toll-like receptors (TLRs). In humans, two distinct DC subsets, CD11c− plasmacytoid DCs (PDCs) and CD11c+ myeloid DCs (MDCs), have been identified and can respond to different TLR ligands, depending on the differential expression of cognate TLRs. In this study, we have examined the effect of TLR-7 ligands on human DC subsets. Both subsets expressed TLR-7 and could respond to TLR-7 ligands, which enhanced the survival of the subsets and upregulated the surface expression of costimulatory molecules such as CD40, CD80, and CD86. However, the cytokine induction pattern was distinct in that PDCs and MDCs produced interferon (IFN)-α and interleukin (IL)-12, respectively. In response to TLR-7 ligands, the Th1 cell supporting ability of both DC subsets was enhanced, depending on the cytokines the respective subsets produced. This study demonstrates that TLR-7 exerts its biological effect in a DC subset-specific manner

Structural Study of Amorphous Cu-Zr Alloys(Physics)

Detailed analyses of X-ray scattering intensities of amorphous Cu-Zr alloys with four different compositions were carried out, and three partial structures required to characterize the binary alloys were estimated. These results were discussed by using the dense random packing of hard spheres (DRPHS) model. In addition, thermal instability of amorphous structure was examined at the incipient stage of crystallization, and it was found that a gradual crystallization from an amorphous to a single f. c. c. structure (α_0=3.601 A) takes place at 300℃

A Case of pulmonary tumor thrombotic microangiopathy improved by the treatment with prednisolone

Pulmonary tumor thrombotic microangiopath(PTTM)presents with severe manifestations and rapid progression and is difficult to diagnose ante mortem. We report a case of gastric adenocarcinoma diagnosed with PTTM before death. Chest XR and CT showed ground-glass shadows in the bilateral lung fields,gastric adenocarcinoma was demonstrated by gastrointestinal fiber scopy and biopsy,and poorly differentiated　carcinoma　cells　were　detected　in　the　pulmonary　arterial　blood　by　pulmonary　wedge aspiration　cytology　on　cardiac　catheterization. After　diagnosis　of　PTTM,prednisolone　therapy　of　30 mg/day　was started. Dyspnea　and　hypoxemia　were　improved　on　the　next　day　of　administration　of prednisolone. Although　PTTM　is　rare,it should be considered the differential diagnosis of pulmonary hypertension and progressive respiratory failure with diffuse ground-glass shadow on chest radiographies. Furthermore,administration of prednisolone should be considered one of the treatment for the dyspnea by PTTM

Clinical impact of postprogression survival for overall survival in elderly patients (aged 75 years or older) with advanced nonsmall cell lung cancer

Introduction: The effects of first-line single-agent chemotherapy on overall survival (OS) might be confounded by subsequent treatments in elderly patients with nonsmall cell lung cancer (NSCLC). We, therefore, aimed to evaluate whether progression-free survival (PFS), postprogression survival (PPS), or tumor response might be a valid surrogate endpoint for OS in this patient population. Patients and Methods: We retrospectively reviewed the clinical data of 58 elderly patients with advanced NSCLC, who received first-line single-agent cytotoxic chemotherapy at our institution between October 2003 and November 2013. The relationships of PFS, PPS, and tumor response with OS were individually analyzed. Results: The study cohort included 46 men and 12 women with a median age of 79 years (range: 75-87 years). There were 30 adenocarcinomas, 22 squamous cell carcinomas, and 6 other histologic types with 1 stage IIIA, 9 IIIB, and 48 IV cases. The performance status (PS) scores were 0, 1, and 2 in 18, 35, and 5 patients, respectively. The median PFS and OS were 2.8 and 5.4 months, respectively. Our analyses revealed a strong correlation of PPS and PFS with OS, whereas that between tumor shrinkage and OS was weak. Tumor stage and PS after initial treatment were significantly associated with PPS. Individual analysis indicated that PPS might serve as a surrogate for OS in elderly patients with advanced NSCLC receiving first-line single-agent chemotherapy. Conclusion: Our findings suggested that the disease course after progression following first-line single-agent chemotherapy might influence the OS of elderly patients with advanced NSCLC