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Yu Monden, Chikako Nagashima, Noriko Yokote, Fumi Hotokezaka, Satoshi Maeda, Kensuke Sasaki, Ryoji Yamakawa, Shigeo Yoshida Department of Ophthalmology, Kurume University School of Medicine, Fukuoka, JapanCorrespondence: Yu MondenDepartment of Ophthalmology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830 0011, JapanTel +81-942-317574Fax +81-942-370324Email you@med.kurume-u.ac.jpPurpose: The aim of this study was to evaluate the clinical outcomes of management of recurrent pterygium with severe symblepharon using mitomycin C, double amniotic membrane transplantation, cryopreserved limbal allograft, and a conjunctival flap.Patients and Methods: This retrospective case series included 10 eyes of 10 patients with recurrent pterygium with severe symblepharon. Eight patients have diplopia in primary gaze. All patients underwent pterygium excision, application of mitomycin C (MMC), double amniotic membrane transplantation (AMT), cryopreserved limbal allograft (CLA) transplantation, and placement of a conjunctival flap. Outcome measures were visual acuity, astigmatism, and recurrence. Recurrence was defined as the presence of fibrovascular proliferative tissue crossing the limbus.Results: The patients’ mean age was 73.8 years. The mean follow-up period was 3.0 years. The mean preoperative and postoperative best-corrected visual acuities (logMAR conversion) were 0.43 and 0.30, respectively. The mean preoperative and postoperative astigmatism were – 3.89 diopters and – 1.54 diopters, respectively, and there was a significant difference. No recurrence occurred in any of the eyes. Symblepharon was released in all eyes. Diplopia in primary gaze was resolved in all eyes.Conclusion: Management of recurrent pterygium with severe symblepharon using MMC, double AMT, CLA, and a conjunctival flap was an effective treatment.Keywords: pterygium, symblepharon, limbal allograft, amnion, mitomycin C

Latrophilin2 (Lphn2) is an adhesion-class of G protein-coupled receptor with an unknown function in development. Here, we show that Xenopus laevis lphn2 (Xlphn2) is involved in the migration and differentiation of neural crest (NC) cells and placode patterning in Xenopus laevis embryos. Although Xlphn2 mRNA was detected throughout embryogenesis, it was expressed more abundantly in the placode region. Morpholino antisense oligonucleotide-mediated knockdown of Xlphn2 caused abnormal migration of NC cells, irregular epibranchial placode segmentation, and defective cartilage formation. Transplantation of fluorescently-labeled NC regions of wild-type embryos into Xlphn2 morpholino-injected embryos reproduced the defective NC cell migration, indicating that Xlphn2 regulates the migration of NC cells in a non-cell autonomous manner. Our results suggest that Xlphn2 is essential for placode patterning and as a guidance molecule for NC cells.

Background: The addition of bevacizumab to standard chemotherapy has significant clinical benefits in metastatic colorectal cancer. However, its use is often avoided due to patient condition or disease status., Methods: Of 228 consecutive patients receiving first-line FOLFOX-based regimens from June 2007 to June 2009, 96 patients (42 %) received FOLFOX alone without bevacizumab. We retrospectively examined the reasons why bevacizumab was not combined with FOLFOX., Results: Among 96 patients for whom the addition of bevacizumab was avoided, 73 patients (76 %) had bevacizumab-related contraindications including hypertension, proteinuria, bleeding, thromboembolic events, wound-healing complications and gastrointestinal perforation. Other avoidance reasons were conditions precluding the use of bevacizumab in 15 patients (16 %), economic problems and anxiety about adverse events in 8 patients (8 %), and unknown reasons in 3 patients., Conclusions: Bevacizumab-related contraindications were the main reason for drug avoidance, though economic problems and anxiety about rare but serious adverse events were also factors for avoidance of bevacizumab.

In Japan, although oral oxycodone is widely used for cancer pain treatment, there is no injection preparation of oxycodone used as a single ingredient. Only the compound injection of oxycodone and hydrocotarnine has received approval. Subcutaneous administration of the drug is approved, but there are few efficacy and safety reports about its intravenous administration. We compared 245 patients(187 intravenous administration patients and, 58 subcutaneous administration patients)to whom the compound injection of oxycodone and hydrocotarnine was administered from April, 2008 to September, 2011, in order to investigate the drug's efficacy and safety. The reasons for injection were the impossibility of oral administration in 105 patients, a need for dose adjustment in 56 patients, and that other drugs were not as effective in 37 patients, and side effect reduction in 33 patients. The average change in the numeric rating scale(0-10)was 3. 7→1. 8 in intravenous administration, and 3. 4→1. 2 in subcutaneous administration. The incidence of main adverse events(intravenous administration/subcutaneous administration)were constipation(37%/28%), vomiting(31%/34%), and somnolence(52%/50%). There was no significant difference in efficacy and safety. The conversion ratio differed in a case due to a change, and about 20 to 40% of addition was needed within four days after the start. It is considered that compound injection of oxycodone and hydrocotarnine is effective for cancer pain treatment.

Purpose: Treatment-related infertility is an important issue facing breast cancer survivors of childbearing age. A previous study at the National Cancer Center Hospital between 2000 and 2004 analyzed 136 postoperative breast cancer patients under 40 years old, and found that only 7% of them had been provided with information on fertility-related issues by their treating physicians. However, the way in which information is shared may have changed, given the recent publication of national and international guidelines on fertility issues in cancer patients, and we hypothesized that there will be an increase in the percentage of cases in which information about fertility-related issues is provided., Methods: We retrospectively analyzed patients 40 years old or younger who underwent surgery for primary breast cancer in this hospital between 2007 and 2009. We assessed patients' and oncologists' backgrounds, pathological stage, treatment plans, and whether or not oncologists provided explanations regarding fertility-related issues., Results: One hundred cases were analyzed. Five percent, 15%, and 80%of patients were < 30, 30-35, and $gt;35 years old, respectively. Sixty-one percent of patients had partners, while 29%had prior deliveries. Information on fertility-related issues was provided to 56% of patients. Significant factors influencing whether information was provided were patients' reproductive history (odds ratio(OR): 5. 717, 95% confidence interval(CI): 1.752- 18.66, p=0. 004) and recommended treatment(OR: 24.22, CI: 3.150-186. 2, p=0. 017). By contrast, oncologists' background( specialty, gender, and duration of career as a physician)was not significant. The frequency with which treatment plans were changed did not correlate statistically with the provision of information on fertility-related issues., Conclusions: Information on treatment-related infertility is now provided much more frequently than in the past. We should encourage both patients and medical professionals to increase their awareness about this important issue.

Capecitabine, an oral prodrug of 5-fluorouracil (5-FU), is a promising treatment for colorectal, breast and gastric cancers, but often causes hand-foot syndrome (HFS), the most common dose-limiting toxicity. The current study was conducted to investigate the relationship between HFS and efficacy of capecitabine in 98 patients with metastatic breast cancer. Possible associations between HFS and efficacy endpoints, including time-to-treatment failure (TTF), tumor response in metastatic lesions and changes in tumor markers, were investigated retrospectively using electronic medical records. The TTF of group with HFS of grade 1 and ≥2 was significantly longer than that of group with no HFS, respectively (hazard ratio (HR), 0.39; 95% confidence interval (CI), 0.18-0.87 for group with grade 1; HR, 0.42, 95% CI, 0.19-0.90 for group with grade ≥2). Significantly higher disease control rates for the liver metastasis were observed in patients with HFS (grade 1 and greater) than in those without HFS (92.9 vs. 42.9%, p=0.009). Furthermore, prevention of increases in tumor marker levels (carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA15-3) and National Cancer Center-Stomach-439 (NCC-ST439)) was evident in patients with HFS. This study clearly showed a significant correlation between HFS and some efficacy markers of capecitabine therapy in patients with metastatic breast cancer, and suggests that early dose adjustment based on severity of HFS might improve efficacy. Studies are needed to explore predictive biomarkers for HFS/efficacy, so that capecitabine therapy can be further tailored to patient response.

A simple and sensitive high-performance liquid chromatographic (HPLC) method was developed for determination of amrubicin and its metabolite amrubicinol in human plasma. After protein precipitation with methanol without evaporation procedure, large volume samples were injected and separated by two monolithic columns with a guard column. The mobile phase consisted of tetrahydrofuran-dioxane-water (containing 2.3 mM acetic acid and 4 mM sodium 1-octanesulfonate; 2:6:15, v/v/v). Wavelengths of fluorescence detection were set at 480 nm for excitation and 550 nm for detection. Under these conditions, linearity was confirmed in the 2.5-5000 ng/mL concentration range of both compounds. The intra- and inter-day precision and intra- and inter-day accuracy for both compounds were less than 10%. The method was successfully applied to a clinical pharmacokinetic study of amrubicin and amrubicinol in cancer patients., (2009 John Wiley & Sons, Ltd.)

ge of the Japanese version of the International Chemical Safety Cards (ICSC). We prepared the Japanese text files of ICSC, converted them into HTML files and also prepared the dictionary database for the retrieval system, using programs which we developed. These programs shortened the time of work remarkably. 2D- and 3D-structures of chemicals were also incorporated in each ICSC page. Approximately 900 ICSCs in Japanese are provided at the moment on the homepage.

Preparation of International Chemical Safety Cards (ICSC) is described. The main characteristics of the ICSC are the use of standard phrases, a compiler's guide and a program for their preparation by personal computer. Standard phrases harmonize expressions on ICSC and also facilitate translation into other languages. In our case more than 900 cards have been translated into Japanese and published. Recently, a new program to aid translation by personal computer has been developed.