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The purpose of this study is twofold: (a) to examine how women adjust their time allocation when they become working mothers; and (b) to assess the effect of their adjustment on their daily emotional experience. Using a methodology based on the Day Reconstruction Method which is designed to reduce systematic bias, seven women responded to a questionnaire during parental leave (T1), within 1 month after returning to work (T2), and 3 months after returning to work (T3). The results revealed that most of the participants tended to utilize the time available to them for sleep and child care by decreasing housework and leisure. They experienced increased pressure in terms of time and felt more or equally energetic or intimate toward their families in both T2 and T3. The other participants, who had less time available for sleep or meals, experienced increased depression or tiredness. [ABSTRACT FROM AUTHOR]

Background: In Japan, esophagectomy with three-field lymphadenectomy is the standard therapy for resectable esophageal cancer. However, its outcome is considered unsatisfactory because the 5-year survival rate is less than 50%. Chemoradiotherapy (CRT) is the standard therapy for unresectable esophageal cancer and could also be considered as an option for resectable esophageal cancer. We retrospectively determined the efficacy and safety of CRT for patients with esophageal cancer., Methods: The study population comprised patients with esophageal cancer who had been treated with CRT between April 2004 and October 2009 in our institute. Acute and late toxicity was assessed with NCI-CTC and RTOG/EORTC late radiation morbidity scoring scheme, respectively. Survival time was calculated using Kaplan-Meier methods., Results: We enrolled 29 consecutive patients and classified them on the basis of clinical staging: stage I, 4 patients; stage II/III, 11 patients; and stage IV, 14 patients. Complete response was achieved in 37.9% and 45.5% of the total study population and the stage II/III group, respectively. The median survival time in these groups was 12.1 months and 15 months, respectively. Grade 3/4 acute toxicities were observed in 62.1% of the patients. Grade 3/4 late toxicities were observed in 12% of the patients. The first failure after CRT was almost locoregional., Conclusion: CRT appears to be an effective therapy for esophageal cancer; however, its outcome is not satisfactory. Therefore, it is necessary to evaluate the role of salvage surgery after CRT and new chemotherapeutic agents.

Primary malignant melanoma of esophagus (PMME) is a rare tumor; therefore, the prognostic factors, predictive factors, and difference in biological behaviors of cutaneous melanoma and primary esophageal squamous cell carcinoma remain uncertain. Although we did not adopt a standard therapeutic strategy, we performed surgical resection, chemotherapy, immunotherapy, and radiotherapy either alone or in combination; all procedures resulted in poor outcomes. A 67-year-old woman presented with a swallowing disorder. An esophagogastroduodenoscopy was performed, leading to diagnosis of PMME. According to the Japanese Classification of Esophageal Cancer, the pathological stage was T1b, ly0, v0, N0, M0, stage I . KIT immunostaining was focally positive. After subtotal esophagectomy, adjuvant chemotherapy was performed, but the malignant melanoma relapsed in the mediastinum and the patient died 10 months after diagnosis. We serially monitored the patient using several new modalities, including PET/CT, metabolites of melanin: 5-S-CD, and circulating tumor cells (CTCs) by reverse transcription-polymerase chain reaction to identify the melanoma-specific gene. To our knowledge, this is the first report of a case in which CTCs in PMME were detected.

The purpose of this study is twofold: (a) to examine how women adjust their time allocation when they become working mothers; and (b) to assess the effect of their adjustment on their daily emotional experience. Using a methodology based on the Day Reconstruction Method which is designed to reduce systematic bias, seven women responded to a questionnaire during parental leave (T1), within 1 month after returning to work (T2), and 3 months after returning to work (T3). The results revealed that most of the participants tended to utilize the time available to them for sleep and child care by decreasing housework and leisure. They experienced increased pressure in terms of time and felt more or equally energetic or intimate toward their families in both T2 and T3. The other participants, who had less time available for sleep or meals, experienced increased depression or tiredness.

In May 2007, a 48-year-old woman was admitted to our hospital for acute intestinal obstruction, and she was subsequently diagnosed with metastatic colorectal cancer in the sigmoid colon. Jejunum-ileum anastomosis and colostomy were performed as palliative surgery because the locally-advanced primary tumor had involved the ileum and other surrounding organs and formed huge mass. After placement of a central venous port, palliative chemotherapy mFOLFOX6 was commenced. In May 2008, mFOLFOX6 was replaced with FOLFIRI because of progression of both the metastasized and the primary tumors. On November 20, 2008, cetuximab was added to FOLFIRI because of the further disease progression. However, on December 24, 2008, the patient presented with sudden-onset dyspnea. Her blood gas analysis revealed severe hypoxemia and metabolic acidosis, and CT scan showed bilateral pulmonary artery embolism. After intensive treatment, the patient was able to walk under the room-air condition. However, on January 19, 2009, she died of pneumonitis. We believe that this is an interesting case with respect to the relationship between pulmonary embolism and malignancy and may hint at a causal relationship between pulmonary embolism and cetuximab, which is currently uncertain. We report this case herein along with a literature review.

A 51-year-old man was found comatose in a decerebrate posture in a cottage. Brain MRI showed diffuse high-signal-intensity areas in the white matter on T 2-weighted and FLAIR images, and diffusion-weighted images showed marked diffuse high intensity areas in the white matter. Initially inflammatory demyelinating diseases were suspected and methylprednisolone pulse therapy was administered. However, no improvement was noted. On close inspection of the cottage, a gas generator was discovered in the poorly ventilated room. He was therefore suspected to have suffered from gas intoxication, including carbon monoxide (CO). Hyperbaric oxygen therapy was administered, but without any improvement. The diffuse white matter lesions and brain edema progressed with time and the patient died of cerebral herniation. Autopsy revealed no inflammatory processes. Most cases with CO intoxication show hyperintense lesions in the globus pallidus on both sides in T 2-weighted images, and some cases show lesions only in the white matter without any involvement of the globus pallidus. The progressive clinical course, diffuse leukoencephalopathy and brain edema may be due to apoptosis of oligodendrocytes. CO intoxication is thus important in the differential diagnosis of diffuse white matter lesions of the cerebrum.