Nuclear beta-catenin expression at the invasive front and in the vessels predicts liver metastasis in colorectal carcinoma.

UNLABELLED: Beta-catenin is a component of the Wingless/Wnt signaling pathway and can activate target genes associated with proliferation and invasion, linking with the APC gene. The purpose of this study was to investigate whether nuclear expression of beta-catenin in cells at the invasive front or in the vessels was associated with liver metastasis in human colon cancer. PATIENTS AND METHODS: One hundred and eighteen patients with colorectal carcinoma who underwent surgical resection (45 patients with liver metastasis and 73 patients without liver metastasis at least 5 years after surgery) were included in the study. Proliferative activity was determined in several areas (tumor center, invasive front and in the vessels) by immunohistochemistry and whether it was correlated with liver metastasis was examined. RESULTS: In 73.1% of primary tumors, positive staining for beta-catenin was detected in the membranes at the tumor center and in the nuclei at the invasive front. In 32 patients (26.9% of all cases), beta-catenin was expressed exclusively in the nuclei of the carcinoma cells throughout the tumors. Significant differences in expression of nuclear beta-catenin in the primary tumors were detected between the liver metastasis and non-liver metastasis groups at the tumor center (p=0.004), invasive front (p=0.021) and in the vessels (p<0.0001). CONCLUSION: Nuclear accumulation of beta-catenin in cellular cells at the invasive front and in the vessels was the most powerful predictor of liver metastasis in colorectal cancer. This may be an important marker in the selection of patients for adjuvant therapy or other treatment modalities.

Laparoscopic partial liver resection for hepatocellular carcinoma in liver cirrhosis.

BACKGROUND/AIMS: Liver resection by open surgery remains the treatment of choice for hepatocellular carcinoma (HCC). However, open surgery with a large skin incision carries the possibility of liver failure in patients with advanced liver cirrhosis, because large skin incisions lead to interruption of large collateral veins. Currently, laparoscopic liver resection is preferred to avoid postoperative liver failure in these circumstances. METHODOLOGY: We describe laparoscopic treatment of three patients with a single sub glissonian HCC, using small skin incisions. The tumor lesions were located in segment 3, segment 6 and segment 8, according to Couinaud's liver anatomy on each patient. In the patient with the S8 lesion, we approached the region from the pleural cavity using a THORACO-PORT. The diaphragm was incised with a Harmonic scalpel and the tumor was removed from the pleural cavity through a 5-cm long skin incision. In the patient with S3 and that with S6 lesion, we performed mobilization of the lateral segment or the right lobe by laparoscopy. We then used a mini-retractor and Nelaton tube to bring the tumor to the subcostal region and easily performed a partial resection, which was all that could be done under the circumstances. RESULTS: All the patients were able to start oral intake on the three postoperative days, and didn't require analgesic agent. The mean post operative stay was 8.7 days. CONCLUSION: in cases of hepatocellular carcinoma that require partial liver resection, a laparoscopic procedure is a reasonable approach to surgery, because of its lower invasiveness compared with conventional liver resection.

[A case of hepatocellular carcinoma with tumor thrombi in the first branch of the portal vein and hepatic vein trunks treated by transcatheter hepatic arterial chemoembolization and hepatic arterial infusion chemotherapy--two years and six months follow-up].

The patient was a 73-year-old man. In March 2002, abdominal computed tomography revealed hepatocellular carcinoma (HCC) with tumor thrombi in the first branch of the portal vein (Vp3) and two hepatic vein trunks (Vv2). He had no hepatitis virus. Serum AFP and PIVKA-II levels were as high as 6,919 ng/ml and 91,700 mAU/ ml, respectively. He was treated by transcatheter hepatic arterial chemoembolization (TACE) 3 times. On post 1st TACE week 8, he received hepatic arterial infusion chemotherapy (low-dose cisplatin and 5-FU) for Vp3 Vv2 HCC. The patient is still alive with no recurrence after two years and six months since the initial TACE treatment.

Psychological distress among evacuees of a volcanic eruption in Japan: A follow-up study.

Psychological distress in 248 evacuees from a volcanic eruption was evaluated using a 30-item General Health Questionnaire (GHQ-30) at four time points after evacuation: 6 months, 12 months, 24 months and 44 months. The proportion of evacuees with psychological distress (defined as a GHQ score >/= 8) significantly decreased from 66.1% (6 months) to 45.6% (44 months). The GHQ mean score significantly improved from 12.6 to 8.9. Investigation of each factor on the GHQ showed progressive improvement over time in 'anxiety, tension and insomnia' and 'anergia and social dysfunction'. However, 'depression' began to improve only after 44 months and 'interpersonal dysfunction' started to worsen after 12 months. The dysfunction in interpersonal relationships continued at 44 months. Examination of the relation between GHQ mean scores and age group showed that recovery from psychological distress was more difficult in middle-aged and older evacuees than in younger evacuees.

Wave-front tilt sensor with two quadrant detectors and its application to a laser beam pointing system.

A method that uses two quadrant detectors (QDs) for sensing wave-front tilt is described. The detectors are set at the front and back of the focal plane of the focusing optics. When the intensity distribution at the aperture of a telescope is not uniform because of atmospheric turbulence, the wave-front tilt can be measured more accurately with our two-QD method than with a conventional single-focal-plane QD. We proved this method to be effective by using it for fixed-star observation. Application of the method to a ground-to-satellite laser beam pointing system showed that it increases the intensity of the laser beam that is transmitted to a satellite.