CHIHO OHBA YASHI5 and KEIICHI MIKASA2 Infectious Disease Department, Minami-Nara General Medical Cente.Y Center for Infectious Diseases, Nara Medical University2 Internal medicine, Saiseikai Chuwa Hospitaf Infectious disease department, Ebara Hospitaf Department of Pathology, Nara Medical University5 Received October 20, 2017 A 43-year-old homosexual man was referred to our hospital for chest pain and loss of consciousness. He was hypertensive, and had an uncontrolled viral load. Serum creatinine revealed acute renal failure, and he died 3 days later. On autopsy, aortic dissection (Type B) was found. No obvious inflammatory change, granulation, bacterial or fungal infection, or medionecrosis were seen at the dissection site. To our knowledge, this was the first case with HIV in whom aortic dissection was diagnosed at autopsy. Aortic dissection is a potential differential diagnosis even in young patients presenting with hypertension and chest pain.
Purpose/Objectives : This study was conducted to assess the feasibility and efficacy of definitive radiotherapy (RT) with a total dose of 66 Gy and concurrent carboplatin-paclitaxel chemotherapy for patients (pts) with stage m non-small cell lung cancer. Materials/ Methods : Between April 2007 and December 2013, 99 pts with non-small cell lung cancer were treated using RT with concurrent carboplatinpaclitaxel chemotherapy in our . hospital. Sixty-eight of them received RT with a total dose of 66 Gy. We analyzed 46 Stage m pts who had been treated with RT using three-dimensional radiotherapy treatment planning. The prophylactic mediastinal lymph nodes were included in the clinical target volume for RT. The survival rate after the start of RT was estimated using the Kaplan-Meier method. We estimated the cumulative local failure and distant metastasis rates with the Fine-Gray method. Adverse events were evaluated according to the CTCAE ( v.4.0) . Results : The median age of the pts was 70.9 (52.8-78.7) years old (y.o.) . The performance status (PS) of each pt was fairly good (ECOG PS 0: 25, PS 1: 20, PS3:1) , and their clinical stages (UICC 7th) were twenty-nine m A and seventeen m B. Diagnoses were pathologically confirmed in 32 pts. The median followup period was 35.7 (2.0-82.2) months among all pts, and 55.9 (40.182.2) months among survivors. The 3and 5-year Kaplan-Meier overall survival rates were 52.2 and 34.0%, respectively, and the median survival t ime was 36.6 months. The 3and 5-year Kaplan-Meier progression-free survival rates were 29.1 and 21.9%, respectively, and the median progression-free survival time was 9.9 months. The 5-year local failure rate was 37.6%, and the 5-year distant metastasis rate was 49.7%. Sixteen (34.8%) pts required steroid administration because of radiation pneumonitis (CTCAE Grade 2 or higher) and two of them died (Grade 5) . No other severe nonhematologic toxicity (Grade 3 or higher) was observed. Conclusion: These results suggest that definitive RT with a total dose of 66 Gy and concurrent carboplatin-paclitaxel chemotherapy is feasible and may be promising for pts with Stage m nonsmall cell lung cancer. (2) Kazuya INOUE et al.
Trans fatty acids (TFAs) are a recent focus of health problems. TFA is a definitive risk factor for cardiovascular diseases and the death. TF A is also possible risk factor for Alzheimer's disease, obesity, diabetes, fatty liver, and ovulation infertility. The relationship between TF A and carcinogenic risk is controversial; however, TF A is reported to increase the risk of breast cancer and prostate cancer. Elaidic acid (EA), a trans form of oleic acid, enhances cancer cell growth, invasion, and anti-apoptotic survival. In animal models, EA promotes tumor growth and metastasis to the lung, liver, and peritoneum. EA induces sternness in cancer cells through transactivation of EFGR via SRC from GPR40/120 as receptors in EA-integrated cholesterol rafts. Activated EGFR relays the signals to activate canonical and non-canonical wnt pathways and to inactivate notchl pathways. EA also increases miR-494, which inhibits cell differentiation through decrease of target genes. Continuous EA feeding with dosage alteration increased cancer cell sternness. EA diminishes the efficiency of 5-fluorouracil by increasing residual cancer stem cells. These findings suggest that TF A is a relevant cancer promoting factor. The decision to remove TF A from foods made by the FDA might have an impact on cancer clinics.
Background The optimal timing of the drain removal after gastrectomy has been unclear. The aim of this prospective randomized controlled study was to assess the optimal timing of removal of prophylactic drains after distal gastrectomy (DG) or pylorus-preserving gastrectomy (PPG). Methods : All patients undergoing DG or PPG for gastric cancer were eligible for this study. The exclusion criteria were combined organ resection, the use of postoperative anticoagulant therapy, intraoperative injury of other organs and anastomotic problems. Just after the operation, the eligible patients were randomly assigned to either the early removal group (n = 50), where the drain was removed in the morning of the postoperative day (POD) 1, or the control group (n = 50), where the drain was removed on POD 3 or later. We compared the surgical outcomes between the groups. Results : The rate of overall postoperative complications was 18% in the early removal group and 18% in the control group, with no significant difference between the groups. The severity of complications was also similar between the groups. There were no significant differences between the groups with regard to the postoperative recovery, pain or the length of the postoperative hospital stay. Conclusions : The present study demonstrated the safety and feasibility of the early removal of prophylactic drains in selected patients undergoing DG or PPG for gastric cancer.
The purpose of the present study was to find factors associated with dietary supplement consumption in menopausal women, and to examine nursing support for maintaining and improving their health. We surveyed menopausal women (aged 40-60 years) using an anonymous self-administered questionnaire. The relationship between dietary supplement consumption status and individual characteristics, menopausal symptoms, the perception regarding menopause, sense of selfefficacy, and health promotion behaviors (HPB) were examined. HPB were measured using the Japanese version of the Health-Promoting Lifestyle Profile (HPLP). Responses were obtained from 256 women (response rate: 67.9%). Of these, 187 responses were valid and were included in our data analyses. Among the factors associated with dietary supplement consumption, we found significant correlations between the severity of menopausal symptoms, age, change in menstruation, surgical history, and the HPB items participation in seminars and finding someone who can give advice. Of these, the most significant independent variable was the severity of menopausal symptoms. These results suggest that menopausal women became concerned about their health when their menstruation status changed and started taking dietary supplements according to these symptoms. To support health maintenance and improvement in menopausal women, nurses should provide information regarding menopause before its onset, hold health classes, and establish a consultation office for menopausal women.
