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The clinical value and predictors of a favorable histological response to preoperative chemoradiotherapy (CRT) in pancreatic ductal adenocarcinoma (PDAC) remains undefined.To assess the significance and predictors of a favorable histological response to preoperative CRT in patients with localized PDAC.The study included 203 patients with localized PDAC undergoing curative-intent resection after CRT. The rate of R0 resection and overall survival (OS) and recurrence-free survival (RFS) were correlated with the grading of histological response to determine optimal stratification. Clinical factors associated with a significant histological response were evaluated using multivariate regression analysis.Among all patients, eight patients (3.9%) had a grade 4 (pCR); 40 (19.4%) had a grade 3 estimated rate of residual neoplastic cells10% (near-pCR); and 155 (76.7%) had a grade 1/2 limited response. The 48 patients with pCR/near-pCR achieved significantly higher R0 resection rate (100%) than those with grade 1/2 (80.0%). The 5-year OS and RFS rates were significantly higher in the patients with pCR/near-pCR (45.3% and 36.5%) than in those with grade 1/2 (27.1% and 18.5%). Gemcitabine plus S-1 based CRT, serum CA19-9 level after CRT83 U/mL, and interval from initial treatment to surgery ≥4.4 months were independent predictive factors for pCR/near-pCR.pCR or near-pCR to preoperative CRT contributed to achieving a high rate of R0 resection and improving survival for localized PDAC. The use of gemcitabine plus S-1 as a radiosensitizer, lower serum CA19-9 level after CRT, and longer preoperative treatment duration were significantly associated with pCR or near-pCR.

Benign fibrous histiocytoma (BFH) is a rare benign primary bone lesion that occurs most frequently in the nonmetaphysis region of the long bones and the pelvic bones. The talus is a rare location for a BFH, which has not been reported previously in the literature. We report the case of a 19-year-old male patient with BFH of the talus, who was treated with curettage, followed by filling of the bone defect with calcium phosphate cement. The patient was free of pain and without local recurrence 5 years after the surgery. We describe the detailed radiographic findings of this rare lesion and discuss the differential diagnosis of such talar lesions.

Background We report a rare case of 10-month-old female who underwent living donor liver transplantation (LDLT) for syndromic biliary atresia with preduodenal portal vein (PV) and its severe stricture owing to the previous Kasai portoenterostomy. Because we successfully performed “left at right liver transplantation (LAR-LT) and graft rerotation” in this case, we are present tips and pitfalls for this operation. Methods Preoperative computed tomography scan showed that her preduodenal PV was stenotic from the confluence of the superior mesenteric vein and splenic vein to hepatic hilum, which made us consider the necessity of ≥3 cm interposition vein graft to complete a safe PV anastomosis. To reduce a gap between donor and recipient's PV, we decided to put a left lateral section graft at the right subphrenic space called left-at-right liver transplantation. Thus, LDLT was performed with an identical lateral sectional graft from her father. After total hepatectomy, we implanted a graft in her right subphrenic space, and anastomosed the donor left hepatic vein to her inferior vena cava. Then, we anastomosed an interposition graft harvested from her left internal carotid vein to her PV. Results Even after reflowing PV flow, because the duodenum compressed the interposition vein graft, PV flows were totally insufficient. Therefore, we flipped a liver graft 180° from right to left upper abdominal cavity, which could reduce the gap between PVs and acceptable PV flow was obtained. Conclusions In the present case, LAR-LT could reduce the distance of PVs. In addition, our rerotation method could be useful to alleviate tension on the PV anastomosis caused by preduodenal PV.

Purpose The objective of this study was to evaluate the major factors influencing on FDG uptake in non-small cell lung cancer (NSCLC) by investigating histological difference in the expression of glucose transporters 1 and 3 (Glut-1 and Glut-3) and tumour size. Methods This study enrolled 32 patients including 9 with squamous cell carcinoma (SCC) and 23 with adenocarcinoma (AC). The AC cases comprised 16 AC with mixed subtypes (AC-mixed) and 7 localized AC in situ (localized bronchioloalveolar carcinoma). Partial volume effect corrected maximum standardized uptake values (cSUVmax) and tumour size were obtained using FDG PET/CT. Glut-1 and Glut-3 expression were evaluated using five-point grading scales. Results Overexpression of Gluts was observed at high rates (88% for Glut-1 and 97% for Glut-3). They were mutually correlated. cSUVmax showed better correlation with size than with Gluts overexpression. AC and SCC showed a high positive expression rate for both Glut-1 and Glut-3, although the degree of overexpression was significantly higher in SCC than AC. In addition, localized AC in situ revealed a considerably higher positive expression rate and similar degrees of overexpression for both Glut-1 and Glut-3 compared with AC-mixed. By contrast, localized AC in situ alone was significantly smaller in both cSUVmax and size than either SCC or AC-mixed. No significant difference was found in cSUVmax or size between SCC and AC-mixed. Conclusions The FDG uptake of NSCLC might be dependent on size rather than on overexpression of Glut-1 or Glut-3. Low FDG uptake in localized AC in situ might result from its small size rather than Glut overexpression.

Rho family protein regulates variety of cellular functions as cytoskeletal organization, cell proliferation and apoptosis. In the present study, we demonstrate that RhoB-overexpressed prostate cancer cells showed an enhanced cell motility and the administration of the GSK-3 inhibitors inhibited this increase in migration. Among the extracellular matrix and adhesion-related molecules, MMP1 RNA expression was increased in RhoB-overexpressed cells, administration of MMP inhibitor suppressed the collagen gel invasion in these cells. This is the first report evaluating RhoB function and the downstream signaling events in prostate cancer cell. Our results indicate that RhoB promotes cell motility and invasion in a metastatic prostate cancer cell.

The number of nucleolar organizer regions (NOR) of human bladder cancers was evaluated at the light- and electron-microscopic level. The average number of argyrophilic NOR (AgNOR), stained by the one-step silver colloid method, was measured in benign and malignant urothelial cells in the human urinary bladder using a light microscope. The average number of nucleolar fibrillar centers (FC) per nucleus was also calculated by quantitative ultrastructural morphometry in the specimens from the same patients. Statistical evaluations revealed that the average number of AgNOR per nucleus was significantly correlated with the elevation of tumor grade and stage (p < 0.05). An average FC number per nucleus also increased in association with tumor grade and stage (p < 0.05). Although the average number of FC was 5.6 times higher than that of AgNOR, the correlation between the average number of FC and AgNOR was statistically significant. In conclusion, these results suggested that the silver staining method was a useful and convenient tool for the evaluation of the differentiation and invasive potential of bladder cancer cells at the light-microscopic level.

Ectopic pancreas is a relatively common lesion as gastric submucosal tumor (SMT), but it makes little mention of cytological findings in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Herein, we present a case of ectopic pancreas diagnosed by EUS-FNA, and discuss the cytological differential diagnosis from ACC. A 41-year-old woman was admitted to our hospital with gastric SMT, measuring 19 mm in diameter. EUS-FNA was performed. Cytologic specimens showed clustered or scattered small cells. Nuclei were relatively small and slightly irregular shaped. Their chromatin pattern was fine granular, and nucleoli were small but conspicuous. Most cells had pink granular substance on Pap staining. Histologic specimens were prepared from tiny pieces simultaneously obtained at EUS-FNA, which revealed benign pancreatic tissue with small nucleoli and eosinophilic granules. Immunohistology showed positivity for chymotrypsin. The lesion was diagnosed as ectopic pancreas. Ectopic pancreas has been reported to show slightly nuclear atypia and small nucleoli in EUS-FNA. In this case, benign acinar cells also showed slightly nuclear atypia. The findings indicate some similarities with ACC. However, ACC usually shows high cellularity compared with ectopic pancreas. It also lacks pink granular substance on Pap staining. These findings are useful to differentiate from ACC.

The role of urine in epithelial-stromal interactions in urinary bladder carcinogenesis was investigated using the ‘Stroma’ bladder model established in our laboratory. Rats treated with 0.05% N-butyl-N-(4-hydroxybutyl) nitrosamine (BHBN) in drinking water for 4 weeks or age-matched untreated rats served as donors of bladders with denuded epithelium (‘stroma’ bladders), which were resurfaced 4 days later with urothelial cells from rats treated with 0.05% BHBN for 4 weeks. Subsequently, the transplants received weekly injections of normal rat urine or saline. In the urine-free environment, cell implants developed hyperplastic changes but few tumor formations with no significant difference between the two types of ‘stroma’ bladder. In contrast, urine instillation stimulated neoplastic growth, and tumor-enhancing effect was significantly accelerated in the BHBN-treated ‘stroma’ bladder group as compared to the control group. These results suggest that epithelial-stromal interactions are altered in such a way that bladder carcinogenesis is enhanced by prior exposure of the bladder stroma to carcinogen and subsequent urine contact.

Purpose To evaluate whether radiofrequency (RF) ablation following arterial injection of miriplatin-iodized-oil suspension expands ablative zone size, providing tissue platinum concentration with antitumor activity in the swine liver. Materials and Methods A total of 6 swine (mean weight, 49.3+/-1.7kg; weight range, 48.2-52.7 kg) underwent liver RF ablation. RF ablation alone was done in 2 animals (control), following arterial injection of iodized-oil (iodized-oil group) or miriplatin-iodized-oil suspension (miriplatin group) in 2 animals each. Ablative zones were created in 3 sites of each animal (total of 18 RF applications). Both the long- and short-axis diameters of ablative zones were measured. In the miriplatin group, tissue platinum concentrations were measured both in central and surrounding zones that were defined as white and red zones, respectively. Results The long- and short-axis diameters of the white zone were 27.0+/-3.1 mm and 18.0+/-0.6 mm in the control. Although significant expansion of long-axis diameter was not found in the iodized-oil group (30.2+/-2.8mm, p=0.09), it was significantly larger in the miliplatin group (33.5+/-2.4mm, p=0.02) than that in the control. The short-axis diameter was significantly expanded in the iodized-oil group (20.8+/-2.6mm, p=0.03) than that in the control, and it was significantly larger in the miriplatin group (27.2+/-1.9mm) than that in the iodized-oil group (p=0.001). Tissue platinum concentration reached effective antitumor activity levels both in white (16.5+/-5.8μg/g) and red zones (18.0+/-5.1μg/g). Conclusion RF ablation following arterial injection of miriplatin-iodized-oil suspension expands ablative zone size, providing tissue platinum concentration with antitumor activity.