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To assess the pupil response with a new handheld pupillometer in healthy subjects.Sixty-four eyes of 32 healthy subjects (mean age 21.2 years) were tested. After dark adaptation for 10 min, pupil responses to 1 s red and blue light stimuli at 100 cd/mThe CV of all parameters have high reproducibility in the red (11.0-20.7%) and blue (5.5-12.1%) light stimuli. Bland-Altman plot analysis showed no bias with both light stimuli. "Almost perfect" and "substantial" correlations between the examiners were obtained in the red (ICC = 0.78-0.94) and blue (ICC = 0.71-0.89) light stimuli. "Excellent" and "good" correlations between the devices were obtained, except for the CR parameter in the red (D1: r = 0.90; p 0.001, D2: 0.72; p 0.001, and CR: 0.08; p = 0.631, respectively) and blue (D1: r = 0.87; p 0.001, D2: 0.70; p 0.001, and CR: 0.19; p = 0.274, respectively) light stimuli.The novel pupillometer is useful for assessing pupil response. However, because of their different constructions, the CR values cannot be compared directly between the devices.

Liver metastasis (LM) is associated with poor prognosis in patients with metastatic colorectal cancer (mCRC). Here, we investigated the prognostic utility of several serum factors in mCRC patients with or without LM who were treated with anti-angiogenic agents in first-line (FL) or salvage-line (SL) settings. A combined cohort of 125 patients was analyzed in this single institute pooled analysis: FL cohort receiving bevacizumab (n = 71) and SL cohort receiving regorafenib (n = 54). Blood samples were obtained at baseline (BL) and during treatment, and serum factors were measured by ELISA. Overall survival (OS) was analyzed using Kaplan–Meier curves, the log-rank test, and Cox proportional hazard regression methods. In univariate analysis of the combined cohort, right-sided CRC, primary unresected tumor, wild-type KRAS, LM, ≥ 2 metastatic sites, and SL were associated with shorter OS; in multivariable analysis, LM and SL remained significant. Serum angiopoietin-2 (Ang-2) levels ≥ 2190.3 pg/ml and interleukin (IL)-8 levels ≥ 15.1 pg/ml at BL were significantly associated with LM. Using these cut-off values, patients with higher Ang-2 or IL-8 levels at BL had shorter OS than those with lower BL levels (Ang-2: hazard ratio [HR] 2.57, 95% confidence interval [CI] 1.47–4.51, P = 0.001; IL-8: HR 4.31, 95%CI 2.11–8.79, P < 0.001). High serum IL-8 level remained a significant predictor of shorter OS in multivariable analysis (HR 3.24, 95%CI 1.47–7.16, P = 0.004). Circulating IL-8 and Ang-2 levels are associated with LM in mCRC patients. IL-8 may be a prognostic marker of response to anti-angiogenic therapy, regardless of the treatment timing.

The new binary chromium sulfide CrS3 has been synthesized by reaction of Cr3S4 and sulfur mixtures at 800 °C and 13 GPa. CrS3 crystallizes in an orthorhombic unit cell with a = 4.6742(7) A, b = 5.7...

Summary Background Unpalatable meal contents have several impacts on the dietary life of patients who undergo gastrectomy. However, few studies have focused on the unpalatable meal contents according to surgical procedure. This study aims to clarify the differences in the unpalatable meal contents between the patients who underwent total and distal gastrectomies (TG and DG, respectively). Methods This study involved patients (n = 341) who underwent TG or DG within 5 years, and a questionnaire of unpalatable meal contents was used. The data on the demographics, operation types, Dysfunction After Upper Gastrointestinal Surgery 20 (DAUGS20) scoring system, and nutrition conditions were confirmed. Furthermore, these were analyzed using descriptive statistics and compared between TG (n = 180) and DG (n = 161) groups. Results The unpalatable meal contents that were significantly different between two groups were big in size (p = 0.013), solid (p = 0.040), rough (p = 0.041), and dry (p = 0.045), which were more difficulty in the TG group. Furthermore, the strong sour taste was more difficulty in the DG group (p = 0.031). Discussion The meals which the TG group had difficulty eating were characteristic of sticking or stagnating in the digestive tract, making the passage of food more difficult in the TG patients. This was because they had a smaller storage for foods and a narrower space at the anastomotic region than those who underwent DG. Conclusion The meal contents were assumed to have been influenced by the surgical procedure. We conclude that the patients in the TG group felt more difficulty in eating the meal contents that could stagnate at the anastomotic region than those in the DG group.

A brand-new self-folding biscavitand was synthesized from a feet-to-feet-connected bisresorcinarene. The X-ray crystal structure of the biscaivtand showed that the two cavities are tightly connected with four butylene linkages. The conformationally coupled two cavities accommodated two cationic guests, showing a homotropic negative cooperativity in nonpolar solvents (toluene and chloroform). A polar tetrahydrofuran solvent weakened the cyclic hydrogen bonding interactions of the biscavitand, which resulted in noncooperative guest binding.

The vascular endothelial growth factor (VEGF)/VEGF receptor (VEGFR) axis is an essential regulator of angiogenesis and important therapeutic target in cancer. Ramucirumab is an anti-VEGFR2 monoclonal antibody used for the treatment of several cancers. Increased circulating VEGF-A levels after ramucirumab administration are associated with a worse prognosis, suggesting that excess VEGF-A induced by ramucirumab negatively affects treatment efficacy and that neutralizing VEGF-A may improve treatment outcomes. Here, we evaluated the effect of combination treatment with an anti-VEGFR2 antibody and anti-VEGF-A antibody on gastric tumor progression and normal tissues using a preclinical BALB/c-nu/nu mouse xenograft model. After anti-VEGFR2 antibody treatment in mice, a significant increase in plasma VEGF-A levels was observed, mirroring the clinical response. The elevated VEGF-A was host-derived. Anti-VEGF-A antibody co-administration enhanced the anti-tumor effect of the anti-VEGFR2-antibody without exacerbating the toxicity. Mechanistically, the combination treatment induced intra-tumor molecular changes closely related to angiogenesis inhibition and abolished the gene expression changes specifically induced by anti-VEGFR2 antibody treatment alone. We particularly identified the dual treatment-selective downregulation of ZEB1 expression, which was critical for gastric cancer cell proliferation. These data indicate that the dual blockade of VEGF-A and VEGFR2 is a rational strategy to ensure the anti-tumor effect of angiogenesis-targeting therapy.

Background Tumours consist of heterogeneous cancer cells and are likely to contain drug-tolerant cell subpopulations, causing early relapse. However, treatment strategies to eliminate these cells have not been established. Methods We established gastric cancer patient-derived cells (PDCs) to examine the contribution of CD44 splicing variant 9 (CD44v9)-positive cells in gastric cancer drug tolerance. We performed gene expression signature-based in silico screening using JFCR_LinCAGE, our anticancer compound gene expression database and subsequent validation in BALB/c-nu/nu mouse xenograft to identify agents targeting the drug-tolerant cancer cells. Results CD44v9-positive cancer cells were enriched among residual cancer cells after treatment with SN-38, an active metabolic of irinotecan. CD44v9 protein was responsible for this drug resistance. We identified epidermal growth factor receptor (EGFR) inhibitors as agents that can target CD44v9-positive cell populations in gastric cancer PDCs. CD44v9 promoted cell proliferation, and EGFR inhibition attenuated CD44v9 protein expression through downregulation of the AKT and the ERK signalling pathways, leading to preferential suppression of CD44v9-positive cells. Importantly, EGFR inhibitors significantly reduced the number of residual cancer cells after cytotoxic anticancer drug treatment and enhanced the antitumor effect of irinotecan in vivo. Conclusions EGFR inhibitors could be potential agents to eradicate cytotoxic anticancer drug-tolerant gastric cancer cell populations.

Background:Ellagitannins have attracted much attention because of the biological and pharmacological activities. In the total synthesis of ellagitannins, 3,4,5-tri-O-benzylgallic acid has been a key compound to introduce the protected galloyl group. From the perspective of coordination chemistry, 3,4,5-tri-O-benzylgallic acid is an interesting carboxylate ligand which might be capable of dinuclear carboxylate complex. Such a dinuclear carboxylate complex might be interesting as a new example of copper acetate type complexes.Objectives:The objective of the work is to synthesize a copper acetate type complex by using 3,4,5-tri-O-benzylgallic acid and to see a new feature of copper acetate compounds, by elucidating the crystal structure, magnetic property, and adsorption property for N2gas.Methods:Copper(II) 3,4,5-tri-O-benzylgallate has been synthesized by a reaction of 3,4,5-tri-O-benzylgallic acid and copper(II) nitrate at pH=9 condition. The isolated complex was characterized using single-crystal X-ray structure analysis, XRD analysis, UV-visible spectroscopy, IR spectroscopy, and temperature dependence of magnetic susceptibility.Results:The crystal structure shows a crystallographically centrosymmetric dinuclear molecule with four carboxylato-bridges and axial dimethylformamide molecules and crystal dmf molecules [Cu···Cu 2.6345(12) Å]. In the crystal, 1D supramolecular assembly by π-π interaction between the benzyl aromatic rings of dinuclear molecules was observed. Temperature dependence of magnetic susceptibilities showed a considerable antiferromagnetic interaction between the two copper(II) ions (2J = –214 cm–1). Type-II gas-adsorption property was observed for N2.Conclusion:A key-compound for the total synthesis of ellagitannins, 3,4,5-tri-O-benzylgallic acid (Htbng), was shown to be a new ligand for the synthesis of dinuclear copper acetate analogue with a lantern-type core, extending the realm of copper acetate clusters.

A 53-year-old woman was referred to our hospital because of upper abdominal pain and expansion of the pancreatic main duct. Enhanced computed tomography revealed expansion of the main pancreatic duct from the head to the tail; in addition, a 30 mm cystic tumor was observed in the pancreatic head and a 56 mm tumor was observed in the ventral side of the pancreatic body. Endoscopy revealed fistula formation in the duodenum of the Vater papilla on the oral side. The patient was diagnosed with an intraductal papillary mucinous carcinoma(IPMC). In addition, PET-CT revealed accumulation of FDG in the ventral side of the pancreatic body, and a disseminated nodule in the omental bursa was suspected. We administered 6 courses of gemcitabine plus nab-paclitaxel therapy, after which, the tumor in the ventral side of the pancreatic body disappeared. We then performed sub-stomach-preserving pancreatoduodenectomy. The results of abdominal cavity washing cytology were negative, and there were no disseminated nodules in the omental bursa. Therefore, we could perform R0 excision.

Three carbo[5]helicenes ([5]CHs) containing benzylmaleimide groups displayed columnar stacked organizations, including dislocated, parallel, and alternating (P)- and (M)-helix molecular arrangement...

This work was supported by a JSPS KAKENHI Grant-in-Aid for Scientific Research (B) (Grant No. JP16H04133), a Grant-in-Aid for Challenging Exploratory Research (Grant No. JP16K13982), and the Electric Technology Research Foundation of Chugoku.

Structural, transport and magnetic properties of single-crystalline samples of a praseodymium-based cubic compound PrMgNi4 were studied. The single-crystal X-ray structural analysis revealed that Mg atoms are substituted for the Pr atoms at the 4a site by 4.5%. The chi(T) data follow the Curie-Weiss law with an effective moment for the Pr3+ ion. The magnetic specific heat divided by temperature, Cm/T, shows a broad maximum at around 3 K, which is reproduced by a two-level model with a ground state doublet. On cooling below 1 K, Cm/T approaches a constant value, which behavior is reproduced by a random two-level model. The twofold degeneracy of the ground state is lifted by symmetry lowering due to the substituted Mg atoms for the Pr atoms or strong hybridizations between the 4f2 electron states and conduction bands, which hinders the long-range quadrupole order.

Dehydration behavior of a natural hydrated Ca-chabazite with composition (Ca1.57Na0.49)(Al3.39Si8.55)O24·12.47H2O has been studied by the structure analyses based on the in-situ high-temperature single-crystal X-ray diffraction data at 100, 200 and 250 °C. Among the five water sites (OW1–OW5) and four exchangeable-cation sites (Ca1–Ca4) found previously in the room-temperature (RT) structure, the present structure analyses revealed the presence of OW1, OW4, Ca3 sites at 100 °C and of OW3, Ca3, Ca4 sites at 200 and 250 °C. The presence of the new extraframework sites was also revealed: OW2’ site at 100 °C and Ca5 site at 200 and 250 °C. From the temperature dependence of the occupation for these extraframework sites, the dehydration and cation migration processes are summarized and rationalized as follows. With heating up to 100 °C, OW3 water molecules, having no bonds to exchangeable cations, are completely desorbed. Simultaneously, Ca1 and Ca2 cations lose the large amounts of water molecules as ligands (OW1 and OW5 for Ca1, OW4 for Ca2); this brings about the simultaneous migration of both cations to adjacent Ca3 site, surrounded by more ligands. With further heating up to 250 °C, OW2’ water molecules, having no bonds to exchangeable cations, are completely desorbed. Simultaneously, most of the Ca3 cations migrate to adjacent Ca4 and Ca5 sites by losing the large amounts of water molecules as ligands (OW1, OW4). A part of the water molecules desorbed in the temperature range of 100–250 °C migrate to OW3 site to be bonded to the remaining Ca3 cations. The peculiar temperature dependence of Si/Al−O1, −O2 and −O3 bond lengths in the framework structure can be explained in terms of their bond-valence variations due to such dehydration and cation migration processes. On the other hand, the variation of Si/Al−O4 bond length is dominated by thermal expansion effect rather than the bond valence effect.

// Mitsukuni Suenaga 1 , Tetsuo Mashima 2 , Naomi Kawata 1, 2 , Takeru Wakatsuki 1 , Yuki Horiike 1 , Satoshi Matsusaka 1 , Shingo Dan 3 , Eiji Shinozaki 1 , Hiroyuki Seimiya 2 , Nobuyuki Mizunuma 1 , Kensei Yamaguchi 1 , Toshiharu Yamaguchi 4 1 Department of Gastroenterological and Chemotherapy Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135–8550, Japan 2 Division of Molecular Biotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135–8550, Japan 3 Division of Molecular Pharmacology, Cancer Chemotherapy Center, Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135–8550, Japan 4 Department of Gastroenterological and Surgery Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo 135–8550, Japan Correspondence to: Mitsukuni Suenaga, email: m.suenaga@jfcr.or.jp Keywords: regorafenib, metastatic colorectal cancer, VEGF-A, CCL5, prognostic marker Received: December 27, 2015 Accepted: April 16, 2016 Published: May 05, 2016 ABSTRACT Regorafenib is an oral multi-kinase inhibitor used as salvage therapy for metastatic colorectal cancer (mCRC). We tested whether serum cytokine levels are associated with clinical outcome in the mCRC patients receiving regorafenib. Serum samples were collected before treatment start, day 21, and progressive disease, and eleven angiogenic and inflammatory cytokine serum levels were examined. Fifty-four patients of a total of 62 enrolled patients were eligible for the analyses. The chemokine ligand 5 (CCL5) levels ≤ cut-off value (59959 pg/ml) at baseline was associated with relative tumor shrinkage ( P = 0.021), better progression-free survival (PFS) ( P = 0.036) and overall survival (OS) ( P = 0.019). Vascular endothelial growth factor A (VEGF-A) levels showing a decrease on day 21 were significantly associated with a better PFS ( P = 0.021). CCL5 levels ≤ cut-off was associated with any grade hand-foot skin reaction (HFSR) ( P = 0.025) and thrombocytopenia ( P = 0.013). Low chemokine ligand 2 levels at baseline were associated with grade 2 ≤ HFSR. High angiopoietin-2 and basic fibroblast growth factor (bFGF) levels at baseline were associated with grade 3 ≤ total bilirubin increase and transaminases increase, respectively. Low bFGF levels at baseline were associated with grade 3 ≤ hypertension. No correlation with severe events was observed. Baseline serum CCL5 levels and decrease of the serum VEGF-A levels may serve as potential predictive markers for survival or treatment-specific toxicities in mCRC patients receiving regorafenib.

172 Background: Liver metastasis (LM) confers poor prognosis in metastatic colorectal cancer (mCRC). It has not been well understood whether tumor microenvironment (TM) varies throughout cancer treatment in the presence of LM. We therefore investigated the difference of TM between first-line (FL) and savage-line (SL) anti-angiogenic therapies and tested whether specific angiogenic cytokines could predict clinical outcome in mCRC patients. Methods: A combined cohort consisting of two cohorts (N = 125) was included in this study: 71 patients received first-line treatment with bevacizumab (FL cohort: median age, 60; median follow-up, 28.9 mos) and 54 patients received salvage-line regorafenib (SL cohort: median age, 65; median follow-up, 17.2 mos). Blood samples were obtained from all patients at baseline (BL) and during the treatment, and serum levels of nine angiogenic cytokines were measured using ELISA. Progression-free survival and overall survival (OS) were analyzed using Kaplan-Meier curves, log-rank test, and Cox proportional hazard regression. Results: In univariate analysis for the combined cohort, right-sided CRC, primary unresected, KRAS wild-type, LM, metastatic site ≥2 and SL were associated with shorter OS, and LM and SL remained in multivariable analysis. Ang-2 and IL-8 levels at BL were significantly associated with LM and their cut-off values were 2190.3 pg/ml (COAng2) and 15.1 pg/ml (COIL8), respectively, and no significant interaction was shown between cytokines and cohorts. Patients with Ang-2 levels ≥COAng2 had shorter OS than those with Ang-2 levels < COAng2 (HR2.57, 95%CI: 1.47–4.51, P = 0.001), while IL-8 levels ≥COIL8 was associated with shorter OS than < COIL8 (HR4.31, 95%CI: 2.11–8.79, P < 0.001). IL-8 levels ≥COIL8 remained as significant in multivariable analysis (HR 3.24, 95%CI: 1.47–7.16, P = 0.004). In change analysis, there was no significant correlation of variation of IL-8 and Ang-2 levels with clinical outcome after the first treatment cycle in both cohorts. Conclusions: Circulating IL-8 and Ang-2 levels reflect the TM in the presence of LM, of which IL-8 may serve as solid prognostic marker of anti-angiogenic therapy regardless of the timing of treatment for mCRC.

79 Background: Ramucirumab (RAM) showed significantly improved survivals of gastric cancer in the second line with paclitaxel or single use. It is known that RAM causes pharmacodynamic changes of plasma VEGF-A family levels during treatment. However, its clinical significance is still unclear. The aim of this study is to reveal the changes of plasma biomarker levels until disease progression, and to examine associations between plasma biomarker levels at disease progression and survival after RAM treatment failure. Methods: Plasma samples were collected at three points: base line, day 8, and disease progression. Nine kinds of plasma biomarker related to angiogenesis: VEGF-A, C, D, PlGF, sVEGFR-1, 2, Neuropilin-1 (NRP1), Angiopietin-1, and SDF-1α, were measured by means of ELISA. The dynamics of plasma biomarkers were compared using the ANOVA. Patients were dichotomized by optimal cut-off value in each biomarker. Survival after RAM treatment failure was estimated by Kaplan-Maier methods and compared by log-rank test. Results: Plasma samples were collected from 21 patients. Median age was 67 y.o and female was dominant (57%). Plasma VEGF-A and PlGF levels sharply increased at day 8 and these higher plasma levels were sustained until disease progression: the median VEGF-A and PlGF levels at baseline, day 8, and disease progression were 20.2, 350.2, and 596.7 pg/ml for VEGF-A (p

669 Background: Trifluridine (FTD) incorporation into DNA is the main anti-tumor mechanism of action of TAS-102. We performed preclinical analysis and translational validation study to identify the candidate cytokines for TAS-102 efficacy in metastatic colorectal cancer (mCRC) patients (pts). Methods: As a first preclinical process, we selected candidate cytokines according to our transcriptomic and cell biological analysis. We then validated predictive value of the cytokines in mCRC pts receiving TAS-102 (discovery) and regorafenib (control). Blood samples were obtained at baseline (BL), before second cycle (2nd) and progressive disease (PD), and cytokine levels were measured using ELISA. The change patterns were defined as ‘increased’ or ‘decreased’ from BL. Results: 93 pts were included in this study: 67 received TAS-102 and 26 received regorafenib. Preclinical cDNA microarray analysis with colon cancer cell lines demonstrated marked changes in the RNA expression of interleukin-8, VEGF-A and epiregulin (EREG) after FTD treatment. Particularly, in preclinical model, EREG secretion was highly measured after FTD treatment in FTD-sensitive cells, while not in FTD-resistant cells. In the discovery cohort, increased EREG levels at 2nd showed trend toward longer PFS and OS than decreased changes (2.6 vs 2.3 mos, P= 0.096; 10.8 vs 6.2 mos, P= 0.091). Meanwhile, decreased EREG levels at PD were marginally associated with longer PFS and significantly with longer OS than increased (4.0 vs 2.3 mos, P= 0.130; 9.8 vs. 6.2 mos, P= 0.016). Combined analysis of EREG changes showed that pts with either increased at 2nd or decreased at PD had significantly longer PFS and OS compared to those with both decreased at 2nd and increased at PD (3.0 vs 2.0 mos, HR: 0.47, 95%CI: 0.24-0.93, P= 0.031; 10.8 vs 5.3 mos, HR: 0.30, 95%CI: 0.14-0.61, P= 0.001). The findings were confirmed in the multivariate analysis for OS (HR: 0.311, 95%CI: 0.15-0.66, P= 0.002), and no significant differences were observed in the control cohort. Conclusions: Our preclinical data-based translational validation study suggests that serum EREG levels may predict clinical outcome in mCRC pts receiving TAS-102.

In recent years, the deterioration of irrigation facilities has been progressing in the countries of Southeast Asia, as well as Japan. Hence, it is vital to introduce the concept of stock management, which decreases their life cycle costs. Life cycle costs of each scenario that combined construction methods and timing of implementation were compared by using single curves degradation prediction model and the Markov chain model as method of degradation prediction based on the result of the functional diagnosis executed in Laos Tha Ngon project area. Scenarios were made from combined types of frequency of operation and maintenance (O&M) of facilities, which were low-frequency, medium-frequency and high-frequency, with types of quality of construction method, which were low-quality, medium-quality and high-quality. As a result, in case of Laos Tha Ngon, a scenario combined middle-frequency of O&M with middle-quality of construction method has become the lowest cost in the four scenarios. This process was shown as a method in stock management which attempts to maintain long life for irrigation facilities and contributes to efficient budget implementation through the reduction of the rehabilitation and the renewal of projects expense.

症例は74歳,男性.総胆管結石に対し内視鏡的乳頭拡張術を行った後,腺筋腫症を伴う胆嚢結石の診断で腹腔鏡下胆嚢摘出術を行った.胆嚢の組織学的検索では腺筋症なく,免疫染色でcytokeratinとvimentin陽性, thrombomodulin一部陽性, CEA陰性の腫瘍があり悪性中皮腫の転移と診断された.改めて初診時からの胸部レントゲンとCTを読影したが,右肺のブラと両側副腎腫大以外に異常は指摘できなかった.退院翌々日から左肩と背部痛出現, 7日目の来院時に初めて左胸水を認めた.胸腔穿刺での細胞診は陰性で,胸腔鏡下胸膜生検で悪性胸膜中皮腫と診断された.副腎腫大もその転移と考えられた.本疾患の早期診断の困難さを痛感させられるとともに,本疾患の胆嚢転移の報告は見当たらず貴重な症例と考えられたので報告した.

Chemosensitivity to the drugs plays a crucial role in the treatment of ovarian cancer. In this study, we evaluate the cytotoxicity of chemotherapeutic agents in six ovarian cancer cell lines; four clear cell adenocarcinoma and two serous papillary adenocarcinoma, using seven single drugs and seven sets of drug combinations with tetrazolium-based semiautomated colorimetric (MTT) assay. The drug concentration which produced 50% growth inhibition (IC50) of cisplatin was within clinically achievable range in five cell lines. The area under the curve (AUC) at IC50 of cyclophosphamide was below the clinically achievable AUC in two serous papillary cell lines. Paclitaxel was more effective in clear cells than serous papillary cells. The intensification of cytotoxicity was observed in the combinations of paclitaxel and cisplatin, and cyclophosphamide and cisplatin or 5-fluorouracil irrespective of histopathological characteristics of the original tumor. Our results indicate that ovarian cancer cell lines respond to chemotherapeutic agents heterogeneously depending upon histopathological features, indicating individualized regimens may improve survival in ovarian cancer patients.

New allene compounds bearing 1,8-diphenoxy or bis(3,5-di-tert-butylphenyl) oxyacridene (diaryloxyacridene) moieties were synthesized. These compounds were more easily oxidized than Cl-substituted compounds. The allene compounds were oxidized to generate thermally stable triplet carbenes. Electron spin resonance and electron spin transient nutation spectra of the oxidation reaction products suggested the generation of triplet species; however, the main isolated product from the 1,8-diphenoxy allene was a cyclized compound that was characterized by X-ray analysis. The product derived from diaryloxy allene was also characterized by X-ray analysis as a singlet species, which included a vinyl cation stabilized by a neighboring O(3,5-di-tert-butylphenyl) group. This singlet species was stable even at room temperature and did not show any electron spin resonance signals in solution, indicating that the triplet species was not in equilibrium with the singlet. Copyright © 2016 John Wiley & Sons, Ltd.

症例は72歳の男性で, 微熱, 体重減少, 左季肋部痛を主訴に当院を受診した.表在リンパ節, 脾は触知しなかったが, 腹部超音波およびcomputed tomography検査で脾に腫瘤が発見された.ガリウムシンチでは同部に強い集積が認められた.脾悪性リンパ腫疑いの診断で手術を行った.腫瘤は脾から膵尾部に浸潤し, 脾動脈幹, 下膵リンパ節に腫大が認められ, 脾膵体尾部切除リンパ節郭清術を行った.腫瘤は弾性硬で15×12×12cm, 充実性, 黄白色境界鮮明であった.組織学的にはHodgkin病, 混合細胞型と診断され, 膵への浸潤, リンパ節転移が認められた.Cyclophosphamide, vincristine, procarbazine, predonizoloneによる術後化学療法を6クール行い, 術後3年半経過した現在も健在である.ほとんどすべてのHodgkin病は表在リンパ節から発生するとされており, 脾原発のものは非常にまれであるので報告した.

A 73-year-old woman underwent pectoralis-preserving mastectomy for left breast cancer (papillotubular carcinoma, f, T2, ly0, v0, N1 (21/21), T2N1M0 (Stage IIB), ER (-), PgR (-), HER2 (-)) in August 2004. It was called a triple negative breast cancer. She received systemic chemotherapy using AC followed by paclitaxel. In February 2006 (disease- free interval of one year and five months), skin and chest wall recurrences in the left breast were revealed. Systemic chemotherapy using capecitabine (1,800 mg/body/day) monotherapy resulted in PD after 4 courses. Subsequently, treatment with capecitabine+cyclophosphamide combination therapy resulted in PD after 6 courses. Since November 2006, treatment with capecitabine+docetaxel combination chemotherapy was initiated. Each course consisted of capecitabine at a dosage of 1,800 mg/body/day for 2 weeks and docetaxel at a dosage of 60 mg/body (day 8 only) followed by withdrawal for 1 week. After 3 courses, a marked response was seen, and a total of 6 courses were performed. No serious side effect was revealed, and a marked response has been maintained. It is suspected that capecitabine+docetaxel combination therapy is useful for a triple negative recurrent breast cancer which is refractory to systemic chemotherapy.

We have experienced a case of extremely rare sarcomatoid carcinoma of the breast. A 60-year-old woman noticed a left breast lump. The tumor was about 3.5cm in size and was located in the lateral area of the left breast. A standard radical mastectomy was performed. Histopathological examination revealed sarcoma-like appearance rather than carcinoma. But we could not rule out a possibility of carcinoma histopathologically. We diagnosed this tumor as anaplastic sarcomatoid carcinoma. This case of anaplastic sarcomatoid carcinoma is very rare as well as very interesting.