Objective: This study aimed to investigate the prognosis of patients with intermediate-risk cervical cancer and to evaluate the necessity of adjuvant therapy. Methods: We conducted a retrospective chart review of patients with stage IB–II cervical cancer who underwent type III radical hysterectomy with pelvic lymphadenectomy between 2008 and 2017. In our institution, radical hysterectomy is performed as an open surgery and not as a minimally invasive surgery, and adjuvant therapy is not administered to patients with intermediate-risk cervical cancer. The intermediate-risk group included patients with 2 or more of the following factors: tumor size >4 cm, stromal invasion >1/2, and lymphovascular stromal invasion. Intermediaterisk patients with squamous cell carcinoma were included in the I-SCC group, whereas those with endocervical adenocarcinoma, usual type, or adenosquamous carcinoma were included in the I-Adeno group. Results: There were 34 and 18 patients in the I-SCC and I-Adeno groups, respectively. The 5-year recurrence-free survival (RFS) and overall survival rates in the I-SCC group were 90.5% (95% confidence interval [CI], 85.3–95.7%) and 100% (95% CI, 100%), respectively, whereas those in the I-Adeno group were 54.9% (95% CI, 42.0–67.9%) and 76.1% (95% CI, 63.7–88.4%), respectively. Multivariate analysis revealed that endocervical adenocarcinoma, usual type, or adenosquamous carcinoma, and tumor size >4 cm had worse RFS. Conclusion The I-SCC group had good prognosis without adjuvant therapy; therefore, adjuvant therapy may be omitted in these patients. In contrast, the I-Adeno group had poor prognosis without adjuvant therapy; therefore, adjuvant therapy should be considered in their treatment.

Objective: This study aimed to investigate the prognosis of patients with intermediate-risk cervical cancer and to evaluate the necessity of adjuvant therapy. Methods: We conducted a retrospective chart review of patients with stage IB–II cervical cancer who underwent type III radical hysterectomy with pelvic lymphadenectomy between 2008 and 2017. In our institution, radical hysterectomy is performed as an open surgery and not as a minimally invasive surgery, and adjuvant therapy is not administered to patients with intermediate-risk cervical cancer. The intermediate-risk group included patients with 2 or more of the following factors: tumor size >4 cm, stromal invasion >1/2, and lymphovascular stromal invasion. Intermediaterisk patients with squamous cell carcinoma were included in the I-SCC group, whereas those with endocervical adenocarcinoma, usual type, or adenosquamous carcinoma were included in the I-Adeno group. Results: There were 34 and 18 patients in the I-SCC and I-Adeno groups, respectively. The 5-year recurrence-free survival (RFS) and overall survival rates in the I-SCC group were 90.5% (95% confidence interval [CI], 85.3–95.7%) and 100% (95% CI, 100%), respectively, whereas those in the I-Adeno group were 54.9% (95% CI, 42.0–67.9%) and 76.1% (95% CI, 63.7–88.4%), respectively. Multivariate analysis revealed that endocervical adenocarcinoma, usual type, or adenosquamous carcinoma, and tumor size >4 cm had worse RFS. Conclusion The I-SCC group had good prognosis without adjuvant therapy; therefore, adjuvant therapy may be omitted in these patients. In contrast, the I-Adeno group had poor prognosis without adjuvant therapy; therefore, adjuvant therapy should be considered in their treatment.

BACKGROUND: The canonical Wnt/β-catenin signaling pathway is a fundamental regulatory system involved in various biological events. ICG-001 selectively blocks the interaction of β-catenin with its transcriptional co-activator cyclic AMP response element-binding protein (CBP). Recent studies have provided convincing evidence of the inhibitory effects of ICG-001 on Wnt-driven disease models, such as organ fibrosis, cancer, acute lymphoblastic leukemia, and asthma. However, the effects of ICG-001 in atopic dermatitis (AD) have not been investigated. OBJECTIVE: To investigate whether β-catenin/CBP-dependent signaling was contributed in the pathogenesis of AD and ICG-001 could be a therapeutic agent for AD. METHODS: We examined the effects of ICG-001 in an AD-like murine model generated by repeated topical application of the hapten, oxazolone (Ox). ICG-001 or vehicle alone was injected intraperitoneally every day during the development of AD-like dermatitis arising from once-daily Ox treatment. RESULTS: Ox-induced AD-like dermatitis characterized by increases in transepidermal water loss, epidermal thickness, dermal thickness accompanied by increased myofibroblast and mast cell counts, and serum levels of thymic stromal lymphopoietin and thymus and activation-regulated chemokine, and decreases in stratum corneum hydration, were virtually normalized by the treatment with ICG-001. Elevated serum levels of periostin tended to be downregulated, without statistical significance. CONCLUSION: These results suggest that β-catenin/CBP-dependent signaling might be involved in the pathogenesis of AD and could be a therapeutic target.
Animals ; Asthma ; Chemokine CCL17 ; Cyclic AMP Response Element-Binding Protein ; Cyclic AMP ; Dermatitis ; Dermatitis, Atopic ; Fibrosis ; Mast Cells ; Mice ; Myofibroblasts ; Oxazolone ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Water

Acute pulmonary embolism (PE), usually secondary to deep venous thrombosis (DVT), is a serious disease which may cause sudden death. An inferior vena cava filter (IVCF) is placed in certain circumstances to prevent recurrence of PE. However, some complications of IVCF have been reported and the indications of IVCF should be reviewed. We encounted a case of IVCF migration which required surgical removal through right intercostal thoracotomy. The patient was a 53-year-old woman. She had undergone the placement of IVCF for DVT followed by anticoagulant therapy. Eight days after, CT revealed IVCF migrated above renal veins. As percutaneous extraction was attempted unsuccessfully, the direct approach to remove IVCF between the hepatic vein and renal vein was indicated. Through the right side thoracotomy at the seventh intercostal space with the division of costal arch, the inferior vena cava (IVC) was exposed near the right atrium. The diaphragm was longitudinally divided straight to IVC and the liver was retraced anteriorly after the careful dissection of the venous plexus on the back of the liver. IVCF could be palpated and just below the branch of the caudate rami and above the right renal vein. After systemic heparinization, IVC and branches were clamped simply and IVC was incised longitudinally. The proximal tip of the IVCF dug into the intima and the distal hook penetrated the vein. IVCF was carefully removed and incision and penetration of IVC were repaired. Her postoperative course was unremarkable, and the patient was discharged without any complications.

Rotational acetabular osteotomy (RAO) is a well-established surgical procedure for patients with acetabular dysplasia, and excellent long-term results have been reported. However, RAO is technically demanding and precise execution of this procedure requires experience with this surgery. The usefulness of computer navigation in RAO includes its ability to perform three-dimensional (3D) preoperative planning, enable safe osteotomy even with a poor visual field, reduce exposure to radiation from intraoperative fluoroscopy, and display the tip position of the chisel in real time, which is educationally useful as it allows staff other than the operator to follow the progress of the surgery. In our results comparing 23 hips that underwent RAO with navigation and 23 hips operated on without navigation, no significant difference in radiological assessment was observed. However, no perioperative complications were observed in the navigation group whereas one case of transient femoral nerve palsy was observed in non-navigation group. A more accurate and safer RAO can be performed using 3D preoperative planning and intraoperative assistance with a computed tomography-based navigation system.
Acetabulum/diagnostic imaging/*surgery ; Adult ; Female ; Hip Dislocation/diagnostic imaging/*surgery ; Humans ; Imaging, Three-Dimensional ; Male ; Osteotomy/*methods ; Surgery, Computer-Assisted/*methods ; Tomography, X-Ray Computed ; Young Adult

Purpose：We evaluated that the current state from which a palliative care unit receives emergency admission of cancer patients at home. Methods：We retrospectively investigated the medical records of 393 cancer patients who hospitalized in our unit between January 2013 and December 2014. The patients were shared with a group of two, schedule admission (schedule group) and emergency admission (emergency group), and it was compared with a result on discharge and with a hospitalization period. We investigated admission process, the date and time of admission, and reason for admission in emergency group. Results：The number of patients was 224 of schedule group and 169 of emergency group. The mortality rates were 81% in schedule group and 78% in emergency group (not significant). An emergency group for an average of 24.3 days was shorter for 9 days than schedule groups in a hospitalization period of dead leaving patients (p<0.05). In emergency group, admission process included 128 completed-interviews with the hospitalization, 11 incompleted-interviews before admission and 30 first visits, and 129 patients (76％) admitted within the weekday daytime. Many patients had a complaint of severe pain, appetite loss and oral absorption difficulty, and so much. Conclusions：An emergency group admitted the various processes and the much symptom. There were a lot of cases of early hospital death, but also admitted return at home, and our unit played the role of emergency admission.

Purpose: To investigate the indications for use of the Japanese version of the Liverpool Care Pathway (LCP), we evaluated the conditions of patients using and those not using the LCP. Methods: We retrospectively investigated the medical records of 71 LCP patients and 60 non－LCP patients who died in our palliative care unit between March and December 2013. Results: There was no significant difference in patients’ background between the LCP and non－LCP groups. For patients in the non－LCP group, sudden changes in condition were significantly more frequent and deep continuous sedation was used significantly less than in the LCP group. In the LCP group, the average duration on the LCP was 4.0 days, and the beginning criterion was met by three－point or more of all the patients. The initial assessment was achieved except for one case. In the non－LCP group, reasons for not using the LCP were a sudden change in condition (35 patients), a rapid change in medical condition (14), and a risk of falling (4). Conclusions: The LCP met the beginning criterion and was started at suitable time in the LCP group. The LCP is not useful for all patients; it cannot be used for a patient with sudden or rapid changes in condition, or at a risk of falling.

Among 62 patients who underwent hybrid arch TEVAR, which is a combination of supra-aortic bypass and TEVAR to treat arch aneurysm, 5 patients encountered postoperative cerebral infarction. In 2 patients, whose thoracic aorta were extremely shaggy, cerebral infarction were multiple and fatal. Other 3 patients, whose aorta were not shaggy, developed visual disturbance after TEVAR and minor cerebral infarction were detected in the area of vertebral artery. To prevent cerebral infarction after hybrid arch TEVAR, the blood flow from the left subclavian to vertebral artery is considered to be significant.

BACKGROUNDEstrogen receptor alpha (ER alpha) is the most important endocrine therapy responsiveness predictor for women with breast cancer. The accuracy of the prediction of the response to endocrine therapy was thought to be affected by involving the estrogen receptor coregulatory proteins and cross-talk between ER and other growth factor-signaling networks. Nuclear corepressor 1 (NCOR1) is one of the ER a transcription repressor. The objective of the study is to investigate the expression of NCOR1 at the protein level and pursue its predictive value for breast cancer endocrine therapy.

METHODSIn the present study, the level of expression of NCOR1 protein has been assessed by immunohistochemistry in 104 cases of invasive carcinoma of the breast. Associations between NCOR1 protein expression and different clinicopathological factors and survival were sought.

RESULTSIt was found that NCOR1 was expressed at significantly higher levels in responsive patients treated with endocrine therapy as first-line treatment on relapse. Responsive patients also had a significantly longer post-relapse survival and overall survival. No NCOR1 expression difference was found between patient by age, tumor size, lymph node status, different histological grade groups and human epidermal growth factor receptor 2 (HER2) status. Multivariate analysis showed that NCOR1 is an independent prognostic factor for over-all survival.

CONCLUSIONSIn breast cancer, NCOR1 protein expression level predicts response to endocrine therapy as first-line treatment for breast cancer patients on relapse and NCOR1 protein level assay may increase the accuracy in the endocrine treatment determination and, therefore, improving the patients survival.

Antineoplastic Agents, Hormonal ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; Estrogen Receptor alpha ; metabolism ; Female ; Gene Expression Regulation ; Humans ; Immunohistochemistry ; Middle Aged ; Nuclear Receptor Co-Repressor 1 ; metabolism ; Receptor, ErbB-2 ; metabolism ; Receptors, Progesterone ; metabolism ; Tamoxifen ; therapeutic use

We report six cases with honton disease successfully treated with a combination of goshuyuto extract and ryokeijutsukanto extract. Five of the cases were diagnosed as panic disorder, and the remaining case as generalized anxiety disorder. All six cases complained of palpitation, nausea, dizziness, headache and anxiety attacks. We diagnosed them as a hontonto (Zhouhou fang) indication. Their various complaints disappeared after combination therapy with those extracts. Furthermore, efficacy of the combination therapy was proven to be equal to hontonto. These cases suggest that the combination therapy with goshuyuto extract and ryokeijutsukanto extract is useful in place of hontonto.