A Phase II Study of S-1 Monotherapy as a First-line Combination Therapy of S-1 Plus Cisplatin as a Second-line Therapy, and Weekly Paclitaxel Monotherapy as a Third-line Therapy in Patients with Advanced Gastric Carcinoma: A Second Report

Background We have previousy reported on a Phase II study of S-1 monotherapy as a first line, combination therapy of S-1 plus cisplatin as a second line, and weekly paclitaxel monotherapy as a third line therapy in patients with advanced gastric carcinomas. The median survival time (MST) of patients over the whole course of treatment was not previously calculated because 12 out of 19 patients had not yet succumbed. Since then, we have calculated the MST for this study and herein report our findings. Patients and Methods Between 2002 and 2005, 19 patients were enrolled in this study. Chemotherapy consisted of either 60 mg/m 2 of S-1 for 4 weeks at 6-week intervals, a combination of 60 mg/m 2 S-1 for 3 weeks and 60 mg/m 2 cisplatin on day 8 at 5-week intervals, or 60 mg/m 2 paclitaxel at days 1, 8, and 15, at 4-week intervals. The regimens were repeated until the occurrence of unacceptable toxicities, disease progression, or patient noncompliance. The primary end point was the overall survival. Results The median survival time was 774 days. The response rates were 33.3% (3/9), 12.5% (1/8), and 0% (0/4) after the first, second, and third line chemotherapies, respectively. The major adverse hematological toxicity was leukopenia, which reached grades 3–4 in all lines of chemotherapy investigated. In addition, the major adverse non-hematological toxicity was anorexia, which reached grade 3–4 in second line chemotherapy, and no deaths were attributable to the adverse effects of the drugs. Conclusion This sequential therapy was an effective treatment for advanced gastric cancer with acceptable toxic side-effects. We considered this therapy to be effective because of the smooth transition to the next regimen

Primary placement technique of jejunostomy using the entristar™ skin-level gastrostomy tube in patients with esophageal cancer

<p>Abstract</p> <p>Background</p> <p>We developed a skin-level jejunostomy tube (SLJT) procedure for patients undergoing esophagectomy using a skin-level gastrostomy tube (G-tube) (Entristar™; Tyco Healthcare, Mansfield, Mass), in order to improve their nutrition status and quality of life (QOL). We describe the procedure and the adverse effects of SLJT in patients with esophageal cancer (EC).</p> <p>Methods</p> <p>Over a 24-month period (March 2008 to March 2010), there were 16 patients (mean age: 61.8 years; age range: 49-75 years; 15 men, 1 woman) who had Stage II or III EC. Primary jejunostomy was performed under general anesthesia during esophagectomy. The technical success and the immediate and delayed complications of the procedure were recorded.</p> <p>Jejunostomy techniques</p> <p>SLJT placement using the G-tube (20Fr) was performed 20 cm from the Treitz ligament on the side opposing the jejunal mesenterium. The internal retention bolster was exteriorized through an incision in the abdominal wall. A single purse string suture using a 4-0 absorbable suture was performed. The internal retention bolster was then inserted into the jejunal lumen via the small incision. The intestine adjacent to the tube was anchored to the peritoneum using a single stitch.</p> <p>Results</p> <p>The SLJT was successfully inserted in all 16 patients. No early complications were documented. Follow-up for a median of 107 days (range, 26-320 days) revealed leakage to the skin in four patients, including superficial wound infections in two patients. There were no cases of obstruction of the tube or procedure-related death.</p> <p>Conclusions</p> <p>This SLJT placement technique using the G-tube is a safe procedure in patients with EC and allows the creation of a long-term feeding jejunostomy.</p

Features of and Mechanisms Underlying Insulitis In aly/aly Male Mice as an Animal Model of Autoimmune Pancreatitis: Activation of CD11c+, CD4+, and Th2 Cells and Predominant Destruction of β-cells

Diabetes mellitus (DM) is observed in patients with autoimmune pancreatitis (AIP). The development of DM in AIP is believed to be due to blood flow obstruction of the endocrine gland that accompanies pancreatitis, as well as injury to the islets caused by inflammation. The latter is called insulitis and the detailed mechanisms underlying its development are not yet clear. The aim of the present study was to elucidate the mechanisms involved in the development of insulitis in AIP using aly mice as an animal model of AIP: results in aly/aly male mice, as the AIP group, were compared with those inaly/+ male mice as a control group. Mice in both groups were killed between 16 and 48 weeks of age, and pancreatitis and insulitis were evaluated histologically. Inflammatory and endocrine cells were evaluated by immunofluorescence staining with anti-CD4, anti-CD8, anti-CD11b, and anti-CD11c antibodies, as well as immunohistochemical analyses using insulin and glucagon antibodies. Plasma levels and the pancreatic content of interferon (IFN)-γ (as a Th1-secreted cytokine) and interleukin (IL)-4 (as a Th2-secreted cytokine) were determined. Pancreatitis was seen in aly/aly mice from 16 weeks of age and it developed gradually thereafter. Insulitis also developed gradually and was seen in mice after 24 weeks of age in association with a decrease in the number of islets. CD11c+ cells and CD4+ T cells were seen to infiltrate into the islets. Although the number of β-cells decreased with time, the number of α-cells was maintained until mice were 48 weeks of age. IFN-γ content peaked in mice at 16 weeks of age and declined rapidly from 20 weeks. There were two peaks in IL-4 content, one at 16 weeks and the other at 32 weeks, suggesting an association between IL-4 content and advanced insulitis after 32 weeks. In conclusion, the results suggest that insulitis in AIP is induced predominantly by the infiltration of CD11c+ cells and CD4+ T cells into the islets, and progression is facilitated by the imbalance of the activation of Th2 rather than Th1. Furthermore, insulitis in AIP predominantly involves β-cells rather than α-cells

Imaging of elemental distribution in the small area of biological samples- micro-PIXE analysis

Abstract Particle Induced X-ray Emission(PIXE)analysis is one of the analytical methods for elements. PIXE has high sensitivity, multi-elemental and non-destructive characteristics and the advantage of micro-beam scanning ability on the sample surface. In 1999, micro-beam scanning PIXE system was installed at the National Institute of Radiological Sciences (NIRS). The system allowed multi elemental mapping on 2mm x 2mm areas of small samples such as fish scales, small fish eyes, pollen etc. with a special resolution of about 1mu m with accelerated proton micro-beams produced by an electrostatic accelerator, Tandetron (Model 4117MC, High Voltage Engineering Europe Co.) and a micro-beam scanning system (Model OM2000, Oxford Micro Beams, Ltd.). Fine ring structure of a fish scale was observed with P and Ca maps. Pollen was examined to ability of the system to draw elemental distribution maps of singles cell. The distribution of elements in a thin section of Medaka eye was investigated in connection with Scanning Transmission Ion Microscopy (STIM)

Introduction of PIXE anallysis system in National Institute of Radiological Sciences

An electrostatic accelerator, Tandetron (Model 4117MC, High Voltage Engineering Europe Co.) was installed in National Institute of Radiological Sciences (NIRS) for PIXE (Particle Induced X-ray Emission) analysis in 1999. The accelerating voltage is 0.4 to 1.7MV, and the maximum beam current is 5microA at 3.4MeV. This system has three beam ports for different types of PIXE analysis, conventional, micro-beam and in-air. Normal PIXE line has two types of X-ray detecting device, Si (Li) and CdZnTe detectors detectable for elements from Na (Z=11) to U (Z=92). Fifteen samples can semi automatically be measured at one time with the optical beam size from 0.5 to 2.0 mm at 100 nA of the beam current. A quadruple triplet magnet (Model OM2000, Oxford Micro beams, Ltd.) attached to the other beam port produces a proton micro-beam of the square shape less than 1micron x 1micron. Micro-beam scanning PIXE analysis is carried out with this beam at 50pA current and scanning area up to 2.0mm square. The in-air PIXE analysis is performed using the third beam port.In this paper, we introduce micro-PIXE scanning system showing the ability to draw elemental maps in a spatial resolution of about 1 &micro;m with analyses of fish scale, fish otolith, crocus pollen and micro organisms. Fine ring structure of a fish scale was observed using elemental mapping with proton micro-beam scanning. Pollen was analyzed as one example of single cell to demonstrate the elemental distribution. Fish scale and otolith seem to be a kind of time recorder like tree rings. And the elemental composition reflects the living condition. Therefore, fish scale and otolith are possible to be used as a biological indicator.3rd International Symposium on Nuclear Analytical Chemistry (NAC-III

Introduction of micro-PIXE analysis system in NIRS

The 7 th International Conference on Nuclear Analytical Methods in the Life Scienc