食道扁平上皮癌新規バイオマーカーとしての血中マイクロRNA/isomiR(アイソミア)の検討

広島大学(Hiroshima University)博士(医学)Doctor of Philosophy in Medical Sciencedoctora

Design Automation of Polyomino Set That Self-Assembles into a Desired Shape

The problem of finding the smallest DNA tile set that self-assembles into a desired pattern or shape is a research focus that has been investigated by many researchers. In this paper, we take a polyomino, which is a non-square element composed of several connected square units, as an element of assembly and consider the design problem of the minimal set of polyominoes that self-assembles into a desired shape. We developed a self-assembly simulator of polyominoes based on the agent-based Monte Carlo method, in which the potential energy among the polyominoes is evaluated and the simulation state is updated toward the direction to decrease the total potential. Aggregated polyominoes are represented as an agent, which can move, merge, and split during the simulation. In order to search the minimal set of polyominoes, two-step evaluation strategy is adopted, because of enormous search space including many parameters such as the shape, the size, and the glue types attached to the polyominoes. The feasibility of the proposed method is shown through three examples with different size and complexity

Surgical Resection of Thoracic Esophageal Cancer with Interstitial Lung Disease : A Case Report

Patients with esophageal cancer often have various comorbidities, and these sometimes limit treatment choices. We describe a patient with stage IA esophageal cancer accompanied by interstitial lung disease (ILD). Endoscopic resection and radiotherapy were not appropriate because of clinically diagnosed submucosal invasion and the patient was at high risk of ILD exacerbation. We therefore selected transhiatal esophagectomy without a thoracotomy considering the risk of postoperative respiratory complications, and administered methylprednisolone and sivelestat in the perioperative period for the reduction of surgical stress. To our knowledge, this is the first report of surgical treatment for esophageal cancer with ILD. The patient was discharged without postoperative complications. Transhiatal esophagectomy is an appropriate choice for patients with early-stage esophageal cancer without lymph node metastasis who are at high risk for postoperative respiratory complications. The appropriate selection of treatment is important for patients with esophageal cancer considering the risk of complications

ABCA7 Gene Expression and Genetic Association Study in Schizophrenia

Introduction: Although ATP-binding cassette sub-family A member 7 gene (ABCA7) is known to be associated with Alzheimer’s disease, the relationship between ABCA7 and schizophrenia has been unknown. Methods: Schizophrenia patients (n = 50; 24 males, 62.1 ± 0.50 years old) and age- and sex-matched healthy controls (n = 50) were recruited for the mRNA analysis. Additionally, a case-control study for the rs3764650 genotypes was performed with 1308 samples (control subjects; n = 527, schizophrenia patients; n = 781). All participants were Japanese, unrelated to each other, and living in the same area. Results: The distributions of the rs3764650 genotypes in schizophrenia patients were not different from that of controls. However, the ABCA7 mRNA expression levels in schizophrenia patients were significantly higher than those in controls by a logistic regression analysis. Additionally, the ABCA7 mRNA expression levels in schizophrenia patients were correlated with the rs3764650 genotypes in a dose-dependent manner. Discussion: The ABCA7 mRNA expression levels in peripheral blood with the rs3764650 genotypes may be related to pathological mechanisms in schizophrenia and may be a biological marker for schizophrenia

Real-world clinical outcomes of nivolumab and taxane as a second- or later-line therapy for recurrent or unresectable advanced esophageal squamous cell carcinoma

BackgroundNivolumab is approved in Japan as a second-line treatment for patients with advanced esophageal squamous cell carcinoma (ESCC) resistant to fluoropyrimidine and platinum-based drugs. It is also used in adjuvant and primary postoperative therapies. This study aimed to report real-world data on nivolumab use for esophageal cancer treatment.MethodsIn total, 171 patients with recurrent or unresectable advanced ESCC who received nivolumab (n = 61) or taxane (n = 110) were included. We collected real-world data of patients treated with nivolumab as a second- or later-line therapy and evaluated treatment outcomes and safety.ResultsMedian overall survival was longer and progression-free survival (PFS) was significantly longer (p = 0.0172) in patients who received nivolumab than in patients who received taxane as a second- or later-line therapy. Furthermore, subgroup analysis for second-line treatment only showed the superiority of nivolumab in increasing the PFS rate (p = 0.0056). No serious adverse events were observed.ConclusionsIn real-world practice, nivolumab was safer and more effective than taxane in patients with ESCC with diverse clinical profiles who did not meet trial eligibility criteria, including those with poor Eastern Cooperative Oncology Group performance status, comorbidities, and receiving multiple treatments

Minimally Invasive Surgery for Giant Oesophageal and Gastric Leiomyomas

Herein, we describe a case of a 41-year-old woman with two giant leiomyomas located in the lower thoracic oesophagus and gastric cardia that were treated by minimally invasive thoracoscopic and laparoscopic surgery. We first resected the gastric cardia and laparoscopically prepared a gastric tube, and then we resected the lower thoracic oesophagus and intrathoracically anastomosed the oesophagus and gastric tube using thoracoscopic surgery with the patient in the prone position. Two concurrent giant leiomyomas of the oesophagus and stomach are rare, and the choice of surgical procedure to address the tumour from the mediastinum into the abdominal cavity was particularly challenging. We selected a minimally invasive thoracoscopic approach with the patient in the prone position. This strategy seems effective for resecting these giant tumours in the lower thoracic oesophagus and gastric cardia

Adult Intussusception Due to Endometriosis Arising from the Uterine Tube: Report of a Case

Introduction: Endometriosis is a rare cause of intussusceptions in adults. Although intestinal endometriosis sometimes arises as a consequence of direct involvement of the pelvic organs with endometrial tissue, there is no report that this type of endometriosis causes ileocecal intussusception. Case presentation: Computed tomography assessment of a 40-year-old woman who presented with abdominal pain revealed ileocecal intussusceptions. The patient was managed by endoscopic reduction followed by laparoscopic resection. Adhesion between the right uterine adnexa and caecum was identified during surgery; therefore, combined resection of the uterine adnexa and ileocecum was performed. Pathological findings revealed that endometriosis, arising from the uterine tube and directly involving the cecal wall, had caused the intussusceptions. Conclusion: Although rare, endometriosis should be considered as part of a differential diagnosis of intussusception in adult women who present with abdominal pain. A preoperative diagnosis is sometimes difficult, therefore, surgical resection could be a reasonable strategy to achieve a precise diagnosis