Search

The INBUILD trial investigated the efficacy and safety of nintedanib versus placebo in patients with progressive fibrosing interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF). We aimed to establish the effects of nintedanib in subgroups based on ILD diagnosis., info:eu-repo/semantics/published

Introduction Dans l’etude SENSCIS, le nintedanib a reduit la progression de la PID-ScS versus placebo, comme le montre un taux de declin de la capacite vitale forcee (CVF) plus faible. Le profil d’evenements indesirables (EI) du nintedanib a ete caracterise principalement par des evenements gastro-intestinaux (GI), dont une perte de poids. L’objectif de l’etude est d’evaluer le declin de la CVF et les EI dans des sous-groupes de perte de poids ≤ 5 % versus > 5 % sur 52 semaines dans l’etude SENSCIS. Patients et methodes Des patients atteints d’une PID-ScS avec un premier symptome hors Raynaud 5 %) sur 52 semaines. Resultats Dans les groupes nintedanib (n = 288) et placebo (n = 288), respectivement 112 (38,9 %) et 43 (14,9 %) patients ont presente une perte de poids > 5 % sur 52 semaines. A l’inclusion, les patients avec une perte de poids > 5 % sur 52 semaines avaient un âge moyen plus eleve (57,0 versus 52,9 ans), une proportion de femmes plus elevee (81,3 % versus 72,9 %) et un IMC moyen (respectivement 26,5 versus 25,7 kg/m2) et une CVF en % de la valeur predite (respectivement 71,0 % versus 73,1 %) similaires versus les patients avec une perte de poids ≤ 5 %. Dans le groupe placebo, le taux annuel moyen (ES) de declin de la CVF etait similaire entre les patients ayant presente une perte de poids ≤ 5 % et > 5 % sur 52 semaines (respectivement −92,7 [14,7] mL/an et −96,4 [34,9] mL/an). Le taux annuel de declin de la CVF estime a ete plus faible chez les patients traites par le nintedanib (−42,8 mL/an) versus placebo (−66,2 mL/an), avec des differences entre groupes chez les patients ayant presente une perte de poids ≤ 5 % et > 5 % de respectivement 49,9 mL/an [IC95 % : 4,2 ; 95,6] et 30,2 mL/an [IC95 % : −50,5 ; 110,9], sans signe d’heterogeneite entre les sous-groupes de perte de poids (p = 0,68 pour l’interaction). Les differences standardisees des valeurs a l’inclusion des variables de confusion potentielles ont ete 5 %), les nausees (respectivement 30,1 % et 33,9 %) et les vomissements (respectivement 19,3 % et 33,3 %). Dans les groupes nintedanib et placebo, des EI entrainant l’arret du medicament a l’etude se sont produits chez respectivement 17,0 % et 8,6 % des patients ayant presente une perte de poids ≤ 5 % et chez respectivement 14,3 % et 9,3 % des patients ayant presente une perte de poids > 5 % sur 52 semaines. Conclusion Dans l’etude SENSCIS conduite chez des patients atteints d’une PID-ScS, une proportion plus elevee de patients traites par le nintedanib versus placebo a presente une perte de poids > 5 % sur 52 semaines. Le taux de declin de la CVF a ete numeriquement plus faible dans le groupe nintedanib versus le groupe placebo a la fois chez les patients avec une perte de poids ≤ 5 % et ceux avec une perte de poids > 5 % sur 52 semaines. Les EI entrainant l’arret du nintedanib n’ont pas ete plus frequents chez les patients avec une perte de poids > 5 % versus ≤ 5 %. Donnees SENSCIS initialement presentees a l’EULAR 2020.

Introduction Dans cette etude conduite chez des patients atteints de SSc-PID, le nintedanib a reduit le taux de declin de la capacite vitale forcee (CVF) sur 52 semaines de 44 % vs placebo, avec un profil de securite d’emploi et de tolerance similaire a celui observe chez les patients FPI. Les etudes conduites chez des patients FPI suggerent qu’un IMC plus faible pourrait etre associe a un pronostic plus sombre. L’efficacite et la tolerance du nintedanib a ete evalue par sous-groupes d’IMC a l’inclusion (IMC inc). Methodes Des patients SSc-PID avec un premier symptome hors Raynaud Resultats Les patients avec un IMC inc Fig. 1 ). Le taux annuel de declin de la CVF (mL/an) est presente dans la figure (pas d’heterogeneite de l’effet du nintedanib entre ces sous-groupes). Les evenements indesirables (EI) rapportes chez > 15 % des patients traites par le nintedanib en fonction de l’IMC inc Conclusion L’effet du nintedanib sur la reduction du taux de declin de la CVF chez les patients SSc-PID etait similaire quel que soit l’IMC inc ( NCT02597933 .

BACKGROUND Lung-dominant connective tissue disease (LD-CTD) is a disease concept for interstitial pneumonia; however, it has not been robustly validated. /p study was conducted to elucidate the clinical, radiologic, and histologic features of LD-CTD. METHODS We retrospectively reviewed 44 consecutive patients with serologically defined LD-CTD who underwent surgical lung biopsy. Six were identified as having LD-CTD if they had specific autoantibodies but did not meet the criteria for connective tissue disease. We conducted a multidisciplinary diagnosis and evaluated major histologic patterns according to the current idiopathic interstitial pneumonias (IIPs) classification of 2013. Characteristic histologic features for LD-CTD (eg, prominent plasmacytic infiltration, lymphoid aggregates with germinal centers), high-resolution CT (HRCT) scan patterns, and prognosis were also assessed. METHODS The major histologic patterns were usual interstitial pneumonia (UIP) in 25 patients and nonspecific interstitial pneumonia (NSIP) in 13 patients. Two or more characteristic histologic features for LD-CTD were observed in 15 patients with histologic UIP (h-UIP) and 11 patients with histologic NSIP (h-NSIP). Fifteen patients with h-UIP (60%) showed an inconsistent UIP pattern on HRCT scan multidisciplinary discussion (MDD), 18 patients with h-UIP were labeled as having unclassifiable IIP. The annual change in percent predicted FVC improved significantly in patients with h-NSIP (P = .002), who also had better survival than those with h-UIP (P = .031). In contrast, survival was not associated with HRCT scan pattern (P = .79). CONCLUSIONS The major histologic patterns in LD-CTD were UIP followed by NSIP. Two-thirds of patients had characteristic histologic features for LD-CTD. A majority of patients with h-UIP were considered to have unclassifiable IIP based on MDD. Patients with h-UIP had worse survival than those with h-NSIP. CHEST 2015;148(6):1438-1446

Background:In the SENSCIS trial, nintedanib reduced the progression of SSc-ILD vs placebo, as shown by a lower rate of decline in forced vital capacity (FVC). The adverse event (AE) profile of nintedanib was characterised mainly by gastrointestinal (GI) events, including weight loss.Objectives:Assess FVC decline and AEs in subgroups by weight loss ≤5% vs >5% over 52 weeks in the SENSCIS trial.Methods:Patients with SSc-ILD with first non-Raynaud symptom 5%) over 52 weeks.Results:In the nintedanib (n=288) and placebo (n=288) groups, respectively, 112 (38.9%) and 43 (14.9%) patients had weight loss >5% over 52 weeks. At baseline, patients with weight loss >5% over 52 weeks had a higher mean age (57.0 vs 52.9 years), greater proportion of females (81.3% vs 72.9%), and similar mean BMI (26.5 vs 25.7 kg/m2, respectively) and FVC % predicted (71.0% vs 73.1%, respectively) vs patients with weight loss ≤5%. In the placebo group, the mean (SE) annual rate of decline in FVC was similar between patients who had weight loss ≤5% and >5% over 52 weeks (-92.7 [14.7] mL/year and -96.4 [34.9] mL/year, respectively). The estimated annual rate of decline in FVC was lower in patients treated with nintedanib than placebo, with between-group differences in patients who had weight loss ≤5% and >5% of 49.9 mL/year [95% CI 4.2, 95.6]) and 30.2 mL/year [95% CI -50.5, 110.9]), respectively, with no evidence of heterogeneity between subgroups by weight loss (p=0.68 for interaction). Standardised differences in baseline values of potential confounders were 5%, respectively), nausea (30.1% and 33.9%, respectively) and vomiting (19.3% and 33.3%, respectively). In the nintedanib and placebo groups, respectively, AEs leading to discontinuation of study drug occurred in 17.0% and 8.6% of patients with weight loss ≤5%, and 14.3% and 9.3% of patients with weight loss >5% over 52 weeks.Conclusion:In the SENSCIS trial in patients with SSc-ILD, a greater proportion of patients treated with nintedanib than placebo had weight loss >5% over 52 weeks. The rate of decline in FVC was numerically lower in the nintedanib group than in the placebo group both in patients with weight loss ≤5% and >5% over 52 weeks. AEs leading to discontinuation of nintedanib were not more frequent in patients with weight loss >5% vs ≤5%.References:Disclosure of Interests: :Alain LESCOAT: None declared, Stéphane Jouneau Grant/research support from: AIRB, Boehringer Ingelheim, LVL Medical, Novartis, Roche, Bellorophon Therapeutics, Biogen, Fibrogen, Galecto Biotech, Gilead Sciences, Pharm-Olam, Pliant Therapeutics, Savara Pharmaceuticals/Serendex Pharmaceuticals, Consultant of: Actelion, AIRB, AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Chiesi, Genzyme, GlazoSmithKline, LVL Medical, Mundipharma, Novartis, Pfizer, Roche, Sanofi, Bruno Crestani Grant/research support from: AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Novartis, Roche, Sanofi, Consultant of: AstraZeneca, Bristol-Myers Squibb, Boehringer Ingelheim, Roche, Sanofi, Speakers bureau: AstraZeneca, Boehringer Ingelheim, Roche, Sanofi, Gabriela Riemekasten Consultant of: Cell Trend GmbH, Janssen, Actelion, Boehringer Ingelheim, Speakers bureau: Actelion, Novartis, Janssen, Roche, GlaxoSmithKline, Boehringer Ingelheim, Pfizer, Yasuhiro Kondoh Consultant of: Boehringer Ingelheim, Asahi Kasei Pharma, Janssen, Shionogi, Speakers bureau: Boehringer Ingelheim, Asahi Kasei Pharma, Janssen, Eisai, KYORIN, Mitsubishi Tanabe Pharma, Novartis, Shionogi, Vanessa Smith Grant/research support from: The affiliated company received grants from Research Foundation - Flanders (FWO), Belgian Fund for Scientific Research in Rheumatic diseases (FWRO), Boehringer Ingelheim Pharma GmbH & Co and Janssen-Cilag NV, Consultant of: Boehringer-Ingelheim Pharma GmbH & Co, Speakers bureau: Actelion Pharmaceuticals Ltd, Boehringer-Ingelheim Pharma GmbH & Co and UCB Biopharma Sprl, Nina Patel Grant/research support from: Boehringer Ingelheim, Consultant of: Boehringer Ingelheim, Speakers bureau: Genentech, John Huggins Consultant of: I was a site PI for the SENSCIS trial for Boehringer Ingelheim, Christian Stock Employee of: Employee of Boehringer Ingelheim, Martina Gahlemann Employee of: Employee of Boehringer Ingelheim, Margarida Alves Employee of: Employee of Boehringer Ingelheim, Christopher Denton Grant/research support from: GlaxoSmithKline, CSL Behring, and Inventiva, Consultant of: Medscape, Roche-Genentech, Actelion, GlaxoSmithKline, Sanofi Aventis, Inventiva, CSL Behring, Boehringer Ingelheim, Corbus Pharmaceuticals, Acceleron, Curzion and Bayer

Background: AE-IPF is a deadly complication of IPF, for which no international guidelines exist, resulting in global variability in prevention, diagnosis and treatment strategies. Methods: Pulmonologists with ILD expertise were invited to participate in a survey designed by an international expert panel. Results: 469 pulmonologists responded (66 countries, 64% experts). Significant geographical variability in approach to managing AE-IPF was found (figure). Common preventive measures include antifibrotics and antacids. Diagnostic differences are most pronounced regarding use of KL-6 and viral testing, while HRCT, BNP and d-dimer are broadly used. High dose steroids are widely administered (92%), but use of immunosuppressant and other strategies is highly variable (fig). Very few (4%) responders never use immunosuppression. Antifibrotics are initiated during AE-IPF by 66%. Invasive ventilation or ECMO are mainly used as a bridge to transplantation. Most physicians educate patients comprehensively on the severity of AE-IPF (82%) and consider palliative care (63%). Conclusion: International approaches to the prevention, diagnosis and treatment of AE-IPF are diverse. Global international guidelines and trials to evaluate these approaches are needed.

Epidemiologic data suggest that there are ethnic differences between Japanese and other populations with regard to the important clinical aspects of interstitial lung disease (ILD), such as the cause of death and prognostic factors in patients with idiopathic pulmonary fibrosis (IPF). Acute exacerbation (AE) of IPF may be more common in Japan than in the rest of the world, although this suggestion remains controversial. Moreover, AE of ILD induced by gefitinib may also be more common in Japan, indicating that Japanese patients have a genetic vulnerability or susceptibility to AE. Recent large-scale studies are starting to reveal ethnic differences in the genetics of ILD, including the prevalence of the genetic polymorphisms associated with the clinical course of ILD. We anticipate that ongoing and upcoming research regarding ethnic differences will continue to provide valuable insights into the pathogenesis and management of ILD.

Summary Progressive fibrotic interstitial lung diseases (ILDs) are characterised by major reductions in quality of life and survival and have similarities to certain malignancies. However, palliative care expertise is conspicuously inaccessible to many patients with ILD. Unmet patient and caregiver needs include effective pharmacological and psychosocial interventions to improve quality of life throughout the disease course, sensitive advanced care planning, and timely patient-centred end-of-life care. The incorrect perception that palliative care is synonymous with end-of-life care, with no role earlier in the course of ILD, has created a culture of neglect. Interventions that aim to improve life expectancy are often prioritised without rigorous assessment of the individual's health and psychosocial needs, thereby inadvertently reducing quality of life. As in malignant disorders, radical interventions to slow disease progression and palliative measures to improve quality of life should both be prioritised. Efficient patient-centred models of palliative care must be validated, taking into account religious and cultural differences, as well as variability of resources. Effective implementation of palliative care for ILD will require multidisciplinary participation from clinicians, specialist nurses, psychologists, social workers, and, in some countries, non-governmental faith and community-based organisations with access to palliative care expertise.

Acute exacerbation of idiopathic pulmonary fibrosis has been defined as an acute, clinically significant, respiratory deterioration of unidentifiable cause. The objective of this international working group report on acute exacerbation of idiopathic pulmonary fibrosis was to provide a comprehensive update on the topic. A literature review was conducted to identify all relevant English text publications and abstracts. Evidence-based updates on the epidemiology, etiology, risk factors, prognosis, and management of acute exacerbations of idiopathic pulmonary fibrosis are provided. Finally, to better reflect the current state of knowledge and improve the feasibility of future research into its etiology and treatment, the working group proposes a new conceptual framework for acute respiratory deterioration in idiopathic pulmonary fibrosis and a revised definition and diagnostic criteria for acute exacerbation of idiopathic pulmonary fibrosis.

The prognosis in idiopathic pulmonary fibrosis (IPF) is poor. No therapy has been shown to prolong survival. The objective of this study was to examine the prognostic significance of dyspnoea in daily living at baseline in IPF using a simple assessment tool. 93 consecutive patients with IPF, who had undergone evaluation at diagnosis, were included. The level of dyspnoea was assessed using the modified Medical Research Council (MRC) scale. The relationship between data at baseline and survival was examined. A univariate Cox proportional-hazard model showed that forced vital capacity % predicted (hazard ratio (HR) 0.965, 95% CI 0.948-0.982; p

In this paper, we demonstrated the use of a photodiode (PD) packaging technique that employs a catadioptric system. This optical system consisted of two components: a BK7 ball lens with a diameter of 1.5 mm that was soldered with glass on a hermetic cap and a plastic-molded offset parabolic mirror with a radius of 550 mu m and an offset of 550 mu m. The offset parabolic mirror was mounted above a surface-illuminated InGaAs pin PD with a detective area of diameter 20 mum. When an incident pencil of rays were passed through the ball lens and then perpendicularly reflected by the mirror and impinged upon the PD, compact planar assembling became possible for numerous electrical parts on a can-type header for minimizing parasitic impedance due to wire bonds. The optical system provided a high coupling efficiency of 98% between a single-mode fiber and the PD.

An in situ measurement scheme for generating supply-noise maps, which can be conducted while running applications in product-level LSIs, was developed. The design of the on-chip voltage sampling probe is based on a simple ring oscillator, which converts local supply difference between VDD and VSS to oscillation-frequency deviation. High measurement accuracy is achieved by off-chip digital signal processing and calibration. This scheme was used to successfully measure 69-mV local supply noise with 5-ns time resolution in a 3G-cellular-phone processor. It will thus help in designing power-supply networks and in visually verifying the quality of a power supply

The authors have recently developed a finely crystallized smooth surface diamond coating. Using this coating, the anti-sticking property of cutting tools was significantly improved in comparison to conventional rough surface diamond coatings. However, small crystal apices still remained. When aluminum alloy is cut by the tools with this coating, small amount of aluminum alloy still sticks in the valleys in between the apices of diamond crystals and causes friction loss. To solve this problem, we tried to apply DLC (Diamond like carbon) coating over CVD diamond coatings on cutting tools. DLC coating has very smooth surface and shows excellent performance in solid lubrication. But it does not have enough durability in the case being in contact with highly abrasive materials. On the other hand, the fine crystal diamond coating produced by the authors has great durability against highly abrasive materials. By putting them together, both the excellent lubrication performance and durability of coating were compatibly achieved. These new combinations of coatings lead to a better anti-sticking property of cutting tools for aluminum alloy and successfully increased the tool endurance.

The thermochemical two-step water splitting was examined on ZrO 2 -supported Co(II)-ferrites below 1400 °C, for purpose of converting solar high-temperature heat to clean hydrogen energy as storage and transport of solar energy. The ferrite on the ZrO 2 -support was thermally decomposed to the reduced phase of wustite at 1400 °C under an inert atmosphere. The reduced phase was reoxidized with steam on the ZrO 2 -support to generate hydrogen below 1000 °C in a separate step. The ZrO 2 -supporting alleviated the high-temperature sintering of iron oxide. As the results, the ZrO 2 -supported ferrite realized a greater reactivity and a better repeatability of the cyclic water splitting than the conventional unsupported ferrites. The Co x Fe 3− x O 4 /ZrO 2 with the x value of around 0.4–0.7 was found to be the promising working material for the two-step water splitting when thermally reduced at 1400 °C under an inert atmosphere.

Existing mechanical relays have reliability-related issues including unstable contact resistance and limited cycle life. These problems are caused by mechanical fatigue and wearing of the contact surfaces. In the liquid metal micro switch (LiMMS), we employ a liquid-liquid contact to address these issues. The switching operation is achieved by forming a gap in the liquid metal using gas expansion. Our prototype has a microchannel on a glass substrate to hold a tiny amount of mercury, 0.15 mm in width and 0.1 mm in height, and TaN thin-film heaters on a ceramic substrate to expand the operating gas by heating. The substrates are bonded together and the total size of the device is 5/spl times/5/spl times/1.4 mm. We successfully demonstrated 70-m/spl Omega/ on-resistance, 1 ms-switching speed, the ability to handle up to 1 A of dc current and over 1/spl times/10/sup 8/ cycle operation. LiMMS also has good RF performance, better than 1 dB insertion loss, and better than 20 dB isolation up to 18 GHz.

The present study compared the efficacy of cyclophosphamide combined with low-dose prednisolone in the treatment of idiopathic pulmonary fibrosis (IPF) with efficacy in idiopathic fibrosing nonspecific interstitial pneumonia fibrosing (NSIP). A total of 27 patients with IPF and 12 patients with fibrosing NSIP were included in this study. All patients had undergone surgical lung biopsy. The diagnoses were made based on clinical, radiological and pathological findings. All patients were treated with intermittent pulse therapy with methylprednisolone for 4 weeks, followed by cyclophosphamide with low-dose prednisolone. According to pulmonary function tests, four of 27 patients with IPF had improved, 22 remained unchanged, and one had worsened at the completion of pulse therapy. After 1 yr of combination therapy, four of 27 patients had improved, 14 remained unchanged, and nine had worsened. After pulse therapy, four of 12 patients with fibrosing NSIP had improved, and eight remained unchanged. After 1 yr of combination therapy, eight of 12 patients had improved, four remained unchanged, and none had worsened. Median survival of IPF patients was 4.1 yrs, which is significantly worse than that of fibrosing NSIP patients. In conclusion, patients with fibrosing nonspecific interstitial pneumonia had a more favourable response to combination therapy and a better survival than those with idiopathic pulmonary fibrosis.

Composite materials of catalytically activated porous ceramics with molten salts were proposed for use in solar thermochemical reforming processes of methane as catalyst with high-temperature thermal storage. The high heat capacity and large latent heat (heat of solidification) of the composite molten salt at high temperatures are expected to circumvent the rapid temperature change of the catalyst bed under fluctuation of insolation. The composite catalysts of Ni-activated porous ceramics (mm-sized alumina or zirconia balls) with an alkali-metal chloride or carbonate (NaCl or Na2CO3) were prepared and examined for the activity and stability for CO2 reforming of methane.

Mental retardation (MR) occurs in 2–3% of the general population, and more than half of MR patients are categorised as idiopathic—that is, the cause is unknown.1,2 Patients with idiopathic MR are presumed to be affected with certain genetic disorders or undetectable chromosomal abnormalities. MR may also be caused by environmental factors independently or by their interaction with genetic factors. Subtelomeric rearrangements comprise about half of segmental aneusomies,3 and are one of the major causes of MR.4,5 A recent review showed that subtelomeric rearrangements were detected in 131 (5.1%) of 2585 children with MR.1,4–6 Conventional cytogenetic analysis can detect many, but not all, rearrangements, depending on its powers of resolution.4 Other methods, such as fluorescent in situ hybridisation (FISH) using a complete set of subtelomeric probes, multicolour FISH (M-FISH), comparative genomic hybridisation (CGH), spectrum karyotyping, multiple amplifiable probe hybridisation, primed in situ labelling, and genotyping have been designed to detect subtelomeric rearrangements, but none of them is ideal in terms of sensitivity and/or efficiency.4,6 Microarray based CGH is a promising, high throughput method of detecting subtelomeric rearrangements.4 Veltman et al recently reported a microarray CGH system using crude bacterial/plasmid derived artificial chromosome (BAC/PAC) DNA for the analysis of subtelomeric aberrations, and suggested that degenerate oligonucleotide primed (DOP)-PCR products could also be used instead of crude clone DNA, although the performance of DOP-PCR products might be less sensitive.7 We have developed a microarray CGH system to identify rearrangements involving a subtelomeric region, using DOP-PCR that amplifies subtelomeric BAC/PAC DNA. Here we describe details of the method and the results of microarray CGH analyses of five cases of Wolf-Hirschhorn syndrome (WHS) associated with terminal 4p deletions as positive controls, and of 69 patients with idiopathic MR with or without multiple …

A coaxial 10-Gb/s 1.3-/spl mu/m distributed feedback (DFB) laser-diode module with a coupled differential feed has been developed. The differential cascaded feed with the characteristic impedance of 100 /spl Omega/, which consists of a 140-/spl Omega/ ground-signal-signal-ground (GSSG) leads, a small-sized 60-/spl Omega/ feed-through, and a 140-/spl Omega/ wire-bonding pad, provides less sensitivity to the lead length. Integrating with 25-/spl Omega/ matching resistances and a 60-/spl Omega/ differential microstrip line, whose length corresponds to one eighth of wavelength at 7 GHz, gives wide-band impedance matching between the feed and the laser diode portion with small power loss. Experiment shows good return loss of greater than 9 dB at 10 GHz, and small change of bit error rate (BER) up to the lead length of 4 mm. With a newly developed 250-/spl mu/m cavity laser chip, we have demonstrated stable eye diagrams with the mask margins of 31 and 29% at case temperature of 0 and 85/spl deg/C, respectively.

Solar CO2 gasification of coal was demonstrated under direct irradiation of the fluidized coal bed with the concentrated visible light from a solar furnace simulator in a small-scale quartz reactor. Pulverized Australian bituminous coal (the average particle size of 140 μm) was tested. The peak energy-flux density, FDpeak of the incident light beam was varied up to 1270 kW m-2. The light-to-chemical (enthalpy) energy conversion via the solar gasification increased with increasing the energy-flux density of irradiation. The maximum energy conversion of 8% was obtained at the optimum gas velocity for fluidization of 0.96 N m min-1.

症例は67歳男性.1985年3月,早期胃癌で幽門側胃切除術を受けた(L,Gre,IIc,tub1,sm,ly0,v0,n0,stage IA).1995年7月,貧血の精査で盲腸癌と診断し結腸右半切除術(D3)を行った.腫瘍は2型,35×25mmで病理組織所見は高分化腺癌,se,Iy3,v1,nl(+),stage IIIaであった.1997年1月,CEAが17.1ng/mlと上昇し,CTで膵尾部,脾の腫瘍と大動脈周囲リンパ節の腫大を認めた.1997年3月,膵体尾部切除,脾摘,残胃全摘,リンパ節郭清を施行した.病理組織学的に盲腸癌の膵,脾転移と診断された.術後CEAは3.1ng,/mlと正常化したが,1998年3月に多発肝転移を認め,1999年1月より癌性腹膜炎となり転移巣切除術後23カ月目に死亡した.大腸癌術後の切除可能な膵,脾転移は極めて稀であるが,切除後長期生存の報告もあり積極的に切除することが望ましい.

The beamline BL43IR at SPring-8 has been constructed as a beamline exclusively dedicated to the infrared spectroscopy. The beamline was designed to make use of infrared synchrotron radiation emitted from a bending magnet of 39.3 m bending radius with the acceptance angle of 36.5( H )×12.6( V ) mrad 2 and to cover a very wide wavelength range from 500 nm (20,000 cm −1 , 2.5 eV) to 100 μm (100 cm −1 , 12.5 meV). A Fourier transform interferometer and four experimental stations were installed to utilize the infrared synchrotron radiation at SPring-8.