Risk factors for early recurrence after radical gastrectomy followed by adjuvant chemotherapy for stage II or III gastric cancer: a multicenter, retrospective study.

BACKGROUND: Radical gastrectomy followed by adjuvant chemotherapy is the standard treatment for stage II or III gastric cancer in Asian countries. Early recurrence during or after adjuvant chemotherapy is associated with poor prognosis; however, risk factors for early recurrence remain unclear. METHODS: In this multicenter, retrospective cohort study including six institutions, we evaluated the clinicopathological factors of 553 patients with gastric cancer undergoing gastrectomy followed by adjuvant chemotherapy between 2012 and 2016. Patients were divided into the following groups: early recurrence (recurrence during adjuvant chemotherapy or within 6 months after adjuvant chemotherapy completion) and non-early recurrence, which was further divided into late recurrence and no recurrence. Early-recurrence risk factors were investigated using multivariate Cox proportional hazard model. The chronological changes in the recurrence hazard were also examined for each factor. RESULTS: Early recurrence and late recurrence occurred in 83 (15.0%) and 73 (13.2%) patients, respectively. Based on the Cox proportional hazards model, a postoperative serum carcinoembryonic antigen level of ≥5 ng/mL (hazard ratio: 2.220, 95% confidence interval: 1.089-4.526) and a neutrophil-to-lymphocyte ratio of >1.8 (hazard ratio: 2.408, 95% confidence interval: 1.479-3.92) were identified as independent risk factors of early recurrence, but not late recurrence. The recurrence hazard ratios for neutrophil-to-lymphocyte ratio significantly decreased over time (P < 0.001) and carcinoembryonic antigen also had the same tendency (P = 0.08). CONCLUSIONS: A carcinoembryonic antigen level of ≥5 ng/mL and a neutrophil-to-lymphocyte ratio of >1.8 are predictors of early recurrence after radical gastrectomy and adjuvant chemotherapy for stage II or III gastric cancer.

A case of intestinal intussusception with unique hemorrhagic polyps due to AL amyloidosis and excessive anticoagulation.

Most adult intussusceptions are secondary to various pathological conditions that serve as a lead point. Because of their serious nature, intussusceptions often require emergency surgery. We report a surgical case of amyloidosis associated with intussusception, probably due to polypoid protrusions and bleeding tendencies. An 80-year-old man with abdominal pain was suspected of having jejunal intussusception on computed tomography. He had been prescribed warfarin for atrial fibrillation, and excessive anticoagulation was observed with a prolonged prothrombin time/international normalized ratio of 5.44 at presentation. After the excessive anticoagulation was resolved, emergency surgery was performed. The intussuscepted jejunum was resected, and a 7 cm long dark-red pedunculated polyp was identified as the lead point, which was accompanied by multiple small pedunculated polyps. Histopathological examination showed that these were all hemorrhagic polyps. Amyloid depositions were observed in the muscularis mucosae, submucosa, and the walls of the blood vessels. Immunohistochemical analysis revealed immunoglobulin light chain amyloidosis. This case is informative to discuss the clinical sequelae of gastrointestinal amyloid deposition.

A Programmable DNA Origami Nanospring That Reports Dynamics of Single Integrin Motion, Force Magnitude and Force Orientation in Living Cells.

Mechanical forces are critical for regulating many biological processes such as cell differentiation, proliferation, and death. Probing the continuously changing molecular force through integrin receptors provides insights into the molecular mechanism of rigidity sensing in cells; however, the force information is still limited. Here, we built a coil-shaped DNA origami (DNA nanospring, NS) as a force sensor that reports the dynamic motion of single integrins as well as the magnitude and orientation of the force through integrins in living cells. We monitored the extension with nanometer accuracy and the orientation of the NS linked with a single integrin by the shape of the fluorescence spots. We used acoustic force spectroscopy to estimate the force-extension curve of the NS and determined the force with an ∼10% force error at a broad detectable range from subpicoNewtons (pN) to ∼50 pN. We found single integrins tethered with the NS moved several tens of nanometers, and the contraction and relaxation speeds were load dependent at less than ∼20 pN but robust over ∼20 pN. Fluctuations of the traction force orientation were suppressed with increasing load. Our assay system is a potentially powerful tool for studying mechanosensing at the molecular level.

[A Case of Rectal Neuroendocrine Carcinoma with Iris Metastasis].

A 62-year-old man with anal pain was diagnosed with rectal neuroendocrine carcinoma. There were multiple metastases in the liver, lung, paraaortic lymph node, and bone of the patient. After performing a diverting colostomy, irinotecan and cisplatin were administered. Partial response was obtained after 2 courses, and anal pain improved. However, after 8 courses, multiple skin metastases were found on his back. At the same time, the patient also complained of redness, pain, and impaired vision in the right eye. Iris metastasis was diagnosed clinically by ophthalmologic examination and with contrast- enhanced MRI. Iris metastasis was treated with 5 doses of 4 Gy irradiation, ameliorating the eye symptoms. The patient died of the original disease 13 months after the initial diagnosis; however, multidisciplinary treatment appeared effective for palliating cancer symptoms.

Clinical Impact of Two-Week Placement of a Subcutaneous Suction Drain in Preventing Incisional Surgical Site Infection in Open Gastrointestinal Surgery with Class 4 Dirty Wound: A Retrospective Study.

Background: Two recent randomized controlled trials demonstrated the beneficial effects of subcutaneous drainage in preventing incisional surgical site infection (SSI) in colorectal surgery. This study aimed to evaluate the efficacy of subcutaneous suction drains (SSDs) compared with primary skin closure (PC) in class 4 dirty wound surgery. Patients and Methods: Eighty-one patients undergoing open gastrointestinal surgery with class 4 dirty wounds were enrolled in this study, 30 of whom underwent SSD insertion, whereas the other 51 were treated with PC. Because several studies have reported that the median onset of the development of incisional SSI was eight to 13 days after surgery, we used a two-week placement of an SSD. Comparison of patients treated with SSD and PC and multivariable analysis were performed to test the ability of SSD in decreasing the SSI rate. Results: No differences were observed between the two groups in terms of gender, body mass index, American Society of Anesthesiology score, steroid use, presence of diabetes mellitus, peri-operative transfusion, and surgery type. Surgical site infection incidence was lower in the SSD group (6.6%; 2/30) than that in the PC group (23.5%; 12/51; p = 0.069). Multivariable analysis revealed that the presence of diabetes mellitus was an important independent risk factor for incisional SSI, and the placement of an SSD has substantial preventive effects on incisional SSI (p = 0.018 and p = 0.014, respectively). Conclusions: This study suggested the potential importance of a two-week placement of an SSD for preventing incisional SSI in class 4 dirty wound surgery.

Differences in risk factors for surgical site infection between laparotomy and laparoscopy in gastrointestinal surgery.

Extensive gastrointestinal surgery surveillance data in Japan were analyzed to examine the differences in the risk factors for surgical site infection (SSI) between laparotomy and laparoscopic abdominal procedures. Surgical procedures investigated in the study were gastrectomy, cholecystectomy, colectomy, rectal resection, and appendectomy. A total of 32,629 patients were included in the study. The study participants were divided into two groups according to the year of surgery, 2003-2009 (first study period) and 2010-2015 (second study period), due to the increase in the number of laparoscopic surgeries in the second study period. The incidence of SSI was stratified by three SSI classifications (superficial incisional, deep incisional, and organ/space SSI). Multiple logistic regression analysis was performed to predict the risk factors for SSI. The percentage of laparoscopic surgeries performed has increased linearly since 2010. Patients in the second study period were significantly older and had a higher prevalence of SSI risk factors compared with those in the first study period. In addition, the predictive factors changed substantially in most surgical procedures between the two study periods. Wound class ≥ 3 was a ubiquitous risk factor for superficial incisional SSI (SI-SSI) and organ/space SSI (OS-SSI) in both open (laparotomy) and laparoscopic procedures in the first study period. Meanwhile, in the second study period, operative duration was a ubiquitous risk factor in both procedures. The risk factors for SI-SSI differed from those for OS-SSI in the five abdominal surgeries investigated in the study. Periodic examination of risk factors for SSI is recommended in an aging society.

[A Case of Jejunal Cancer Treated by Laparoscopic Partial Jejunectomy].

The patient was a 30s male visited our hospital with the complaints of abdominal pain and melena. The internal medicine physician could not detect the cause of the melena by upper and lower gastrointestinal endoscopy. Although the patient resolved with a fast as conservative management so he left our hospital once, he relapsed nausea and abdominal pain. He visited our department. We performed surgery under a preoperative diagnosis of intestinal obstruction. The histopathological diagnosis was moderate differentiated jejunal adenocarcinoma(Stage ⅡA). At present, 1 year 7 months since surgery, the patient survives although with lymphnode recurrence.

The Synergic Role of Actomyosin Architecture and Biased Detachment in Muscle Energetics: Insights in Cross Bridge Mechanism Beyond the Lever-Arm Swing.

Muscle energetics reflects the ability of myosin motors to convert chemical energy into mechanical energy. How this process takes place remains one of the most elusive questions in the field. Here, we combined experimental measurements of in vitro sliding velocity based on DNA-origami built filaments carrying myosins with different lever arm length and Monte Carlo simulations based on a model which accounts for three basic components: (i) the geometrical hindrance, (ii) the mechano-sensing mechanism, and (iii) the biased kinetics for stretched or compressed motors. The model simulations showed that the geometrical hindrance due to acto-myosin spatial mismatching and the preferential detachment of compressed motors are synergic in generating the rapid increase in the ATP-ase rate from isometric to moderate velocities of contraction, thus acting as an energy-conservation strategy in muscle contraction. The velocity measurements on a DNA-origami filament that preserves the motors' distribution showed that geometrical hindrance and biased detachment generate a non-zero sliding velocity even without rotation of the myosin lever-arm, which is widely recognized as the basic event in muscle contraction. Because biased detachment is a mechanism for the rectification of thermal fluctuations, in the Brownian-ratchet framework, we predict that it requires a non-negligible amount of energy to preserve the second law of thermodynamics. Taken together, our theoretical and experimental results elucidate less considered components in the chemo-mechanical energy transduction in muscle.

Community-acquired fulminant Clostridioides (Clostridium) difficile infection by ribotype 027 isolate in Japan: a case report.

BACKGROUND: Clostridioides (Clostridium) difficile infection (CDI) has become an increasingly significant disease not only as healthcare-associated infection, but also as community-acquired (CA) infection worldwide. CDI caused by the NAP1/BI/027 strain is reported to be more severe, difficult to cure, and frequently associated with recurrences in North America and Europe. CASE PRESENTATION: A 68-year-old woman was referred to our hospital for continuous lower abdominal pain 4 weeks after eradication therapy against Helicobacter pylori. While she was treated with fasting on the suspicion of ischemic colitis, she experienced septic shock. Emergent subtotal proctocolectomy revealed fulminant pseudomembranous C. difficile colitis. The C. difficile isolate recovered from the patient was identified as ribotype 027, which has been reported to be uncommon in Japan. CONCLUSION: We report a rare case of CA fulminant pseudomembranous colitis caused by ribotype 027 C. difficile after H. pylori eradication therapy.

Comparison of 5-year postoperative outcomes after Billroth I and Roux-en-Y reconstruction following distal gastrectomy for gastric cancer: Results from a multi-institutional randomized controlled trial.

AIM: We previously reported in a randomized controlled trial that Billroth I and Roux-en-Y reconstructions were generally equivalent regarding body weight change and nutritional status 1 year after distal gastrectomy for gastric cancer. We describe the long-term follow-up data 5 years after distal gastrectomy. METHODS: We analyzed consecutive gastric cancer patients who were randomly assigned to undergo Billroth I or Roux-en-Y reconstruction after distal gastrectomy. We evaluated body weight change, nutritional status, late complications, quality of life (QOL) using the European Organization for Research and Treatment of Cancer Core QOL Questionnaire, and dysfunction using the Dysfunction After Upper Gastrointestinal Surgery for Cancer, 5 years after surgery. RESULTS: A total of 228 patients (Billroth I = 105; Roux-en-Y = 123) were eligible for efficacy analyses in this study. Body weight loss 5 years after surgery did not differ significantly between the Billroth I and Roux-en-Y groups (10.0% ± 7.9% and 9.6% ± 8.4%, respectively; P = .70). There were no significant differences in other aspects of nutritional status between the two groups. Reflux esophagitis occurred in 19.0% of the patients in the Billroth I group vs 4.9% in the Roux-en-Y group (P = .002). Regarding QOL, Billroth I was significantly inferior to Roux-en-Y on the diarrhea scale (Billroth I: 28.6, Roux-en-Y: 16.0; P = .047). Regarding dysfunction, no score differed significantly between the two groups. CONCLUSIONS: Billroth I and Roux-en-Y reconstructions were generally equivalent regarding body weight change, nutritional status, and QOL 5 years after distal gastrectomy, although Roux-en-Y more effectively prevented reflux esophagitis and diarrhea.

Magnetic Correlation Engineering in Spin-Sandwiched Layered Magnetic Frameworks.

The insertion of "sandwiched spins" between magnetic layers could efficiently affect the interlayer magnetic correlations, but doing so increases the complexity in the interlayer spin alignment because of competition between the inserted spin-layer interaction JNNI and the interlayer through-space interaction JNNNI if the magnitude of JNNI is of the same order as JNNNI with reciprocal signs of the respective interactions. Herein, systematic tuning of the magnetic phase variations by JNNI and JNNNI in two kinds of metal-variable isostructural series of supramolecular pillared layer magnets [MCp*2 ][{Ru2 II,II (2,3,5,6-F4 CO2 )4 }2 (TCNQ)]⋅2 DCE (M=Co, Fe, Cr; 2,3,5,6-F4 PhCO2 - =2,3,5,6-tetrafluorobenzoate; TCNQ=7,7,8,8-tetracyano-p-quinodimethane; DCE=1,2-dichloroethane) and their DCE-free series, in which [MCp*2 ]+ (Cp*=η5 -C5 Me5 ) species with S=0, 1/2, and 3/2 for M=Co, Fe, Cr, respectively, are sandwiched between ferrimagnetic layers of [{Ru2 }2 (TCNQ)]- , is demonstrated. The results showed that the flexible magnetic natures of these magnets are changeable in dependence on JNNI and JNNNI , as well as on interlayer inserted spins M.

3D Vessel Image Reconstruction by MDCT for Surgical Indication and Timing of Strangulating Small Bowel Obstructions.

BACKGROUND: Patients with strangulating small bowel obstructions (SBOs) can rapidly deteriorate, in condition; therefore, immediate and appropriate diagnosis is required. However, some cases of SBO are difficult to diagnose using axial computed tomography (CT) images alone. The impact of 3D vessel imaging for the diagnosis, surgical indication, and timing of strangulating SBOs was investigated, prospectively. METHODS: Clinical data were collected for 111 strangulating SBOs and 48 simple SBOs from patients receiving surgical interventions from January 2009 to March 2018. The accuracy of preoperative diagnoses for the type of SBO was evaluated. Among 159 patients, 27 underwent contrast-enhanced CT imaging as well as prospectively reconstructed 3D vessel imaging of the superior mesenteric artery, vein, and branches. The concordance rate of operative findings and preoperative diagnoses of the type of SBO were compared between axial CT imaging alone and combination of axial and 3D vessel imaging. RESULTS: Overall concordance rate of diagnosis for the type of SBO by axial imaging was 93.1% and that of strangulating and simple SBOs was 92.8% and 93.8%, respectively. Combined axial and 3D vessel imaging resulted in 100% accuracy of preoperative diagnoses for both types of SBO. In addition, abnormalities could be classified from 3D vessel images as central twists or peripheral twists, and deteriorated vascular flow could also be detected. CONCLUSIONS: The combination of axial imaging and 3D vessel imaging can be used to accurately diagnose SBOs, and this imaging technique may be useful for determining the surgical indication and suitable timing of strangulating SBOs.

The association between the increased performance of laparoscopic colon surgery and a reduced risk of surgical site infection.

PURPOSE: Surgical site infection (SSI) is the most frequently occurring nosocomial infection. Remarkable surgical progress has recently been made in laparoscopic surgery. Therefore, our objective was to investigate the association between increased rates of laparoscopic colon surgery and SSI. METHODS: We retrospectively investigated SSI surveillance data from July 2003 to December 2015. Two university hospitals and 25 university-affiliated hospitals participated in prospective SSI surveillance. Univariate and multivariate analyses were performed to detect significant associations. RESULTS: We investigated 9655 colon surgeries. The year in which surgery was performed was significantly associated with the SSI rate (p = 0.0381). The rate of laparoscopic surgery gradually increased during the study period, and by 2012 it was routinely used for > 50% of colon surgeries. Laparoscopic surgery became a significant factor associated with reduced SSI rates compared with conventional open surgery once the performance rate of laparoscopic surgery reached > 50%. CONCLUSIONS: Increasing rates of laparoscopic colon surgery tended to be associated with a reduction in the SSI risk after surgical treatment of colonic disease. The results of this study might encourage surgeons to view laparoscopic surgical techniques as an evidence-based approach for reducing the risk of SSI.

[A Case of Successful Surgical Treatment for Paraaortic Lymph Nodes Recurrence of Gallbladder Cancer].

Cholecystectomy with gallbladder bed resection and regional lymphadenectomy was performed in a 75-year-old man with advanced gallbladder cancer. Pathological examination revealed adenocarcinoma in the gallbladder with regional lymph node metastases. Cancer recurrence was found in paraaortic lymph nodes behind the duodenum 9 months after the surgery. Although chemotherapy using S-1 was initiated, the lymph nodes remained the same size after 2 courses without any new recurrent regions. Lymphadenectomy was then performed as a curative surgery. The patient has remained alive without recurrence for 46 months after the second surgery.

[The Current Status of Palliative Care for Cancer on a Questionnaire Survey].

We evaluated the current status of palliative care for cancer by questionnaire survey in 34 medical institutions belonging to the Hyogo Society for Oncology of the Colon and Rectum. Although 29 institutions(85%)had palliative care teams, the profiles of team members differed between the institutions. The inclusion rates of psychiatrists, nutritionists, medical social workers, clinical psychologists, and rehabilitation therapists was half or less. Ten institutions had some positive screening systems for objective patients. Consultation from a surgical or medical oncologist to a palliative care doctor was most frequently performed at the end of chemotherapy(46%)but was widely distributed from the beginning of chemotherapy to the period of best supportive care. Most institutes positively adopted surgical palliation and palliative radiotherapy as non-pharmacological options. While palliative care teams were prevalent in this survey, the systematic supply of palliative care may be under development with limited resources.

Magnetic Sponge with Neutral-Ionic Phase Transitions.

Phase transitions caused by the charge instability between the neutral and ionic phases of compounds, i.e., N-I phase transitions, provide avenues for switching the intrinsic properties of compounds related to electron/spin correlation and dipole generation as well as charge distribution. However, it is extremely difficult to control the transition temperature (Tc) for the N-I phase transition, and only chemical modification based on the original material have been investigated. Here, a design overview of the tuning of N-I phase transition by interstitial guest molecules is presented. This study reports a new chain coordination-polymer [Ru2(3,4-Cl2PhCO2)4TCNQ(EtO)2]∙DCE (1-DCE; 3,4-Cl2PhCO2- = 3,4-dichlorobenzoate; TCNQ(EtO)2 2,5-diethoxy-7,7,8,8-tetracyanoquinodimethane; and DCE = 1,2-dichloroethane) that exhibits a one-step N-I transition at 230 K (= Tc) with the N- and I-states possessing a simple paramagnetic state and a ferrimagnetically correlated state for the high- and low-temperature phases, respectively. The Tc continuously decreases depending on the content of DCE, which eventually disappears with the complete evacuation of DCE, affording solvent-free compound 1 with the N-state in the entire temperature range (this behavior is reversible). This is an example of tuning the in situ Tc for the N-I phase transition via the control of the interstitial guest molecules.

Magnetic Switching by the In Situ Electrochemical Control of Quasi-Spin-Peierls Singlet States in a Three-Dimensional Spin Lattice Incorporating TTF-TCNQ Salts.

Magnetic phase switching in a coordination polymer is reported, which is demonstrated by combining two processes: (A) the pre-organization of magnetic/redox-active molecules into a framework, and (B) a post-treatment through electrochemical tuning of the pre-organized molecules. A TTF.+ -TCNQ.- salt (TTF=tetrathiafulvalene; TCNQ=7,7,8,8-tetracyano-p-quinodimethane) was incorporated into a three-dimensional framework with paddlewheel-type dimetal(II, II) units ([M2II,II ]; M=Ru with S=1, 1; and Rh with S=0, 2), where the [M2II,II ] and TCNQ.- units form the coordinating framework, and TTF.+ is located in the pores of framework, forming an irregular π-stacking alternating column with the TCNQ.- in the framework. In 1, the spins of [Ru2II,II ] and TCNQ.- units make a magnetic correlation through the framework upon decreasing the temperature from 300 K, which is, however, suddenly suppressed below 137 K (=Td (1)) by the formation of a spin singlet in the TTF.+ -TCNQ.- columns, as seen in the spin-Peierls transition (Td (2)=200 K). This material was incorporated as a cathode in a Li-ion battery (LIB); a long-range ferrimagnetic correlation was formed through the three-dimensional [{Ru2II,II }2 TCNQ]- framework at Tc =78 K in the discharge process. The reversible magnetic phase switching between the non-volatile ferrimagnetic and paramagnetic states, resulting from the local spin tuning of quasi-spin-Peierls singlet, is demonstrated through the discharge/charge cycling of the LIB.

Regulation of NO Uptake in Flexible Ru Dimer Chain Compounds with Highly Electron Donating Dopants.

On-demand design of porous frameworks for selective capture of specific gas molecules, including toxic gas molecules such as nitric oxide (NO), is a very important theme in the research field of molecular porous materials. Herein, we report the achievement of highly selective NO adsorption through chemical doping in a framework (i.e., solid solution approach): the highly electron donating unit [Ru2(o-OMePhCO2)4] (o-OMePhCO2- = o-anisate) was transplanted into the structurally flexible chain framework [Ru2(4-Cl-2-OMePhCO2)4(phz)] (0; 4-Cl-2-OMePhCO2- = 4-chloro-o-anisate and phz = phenazine) to obtain a series of doped compounds, [{Ru2(4-Cl-2-OMePhCO2)4}1-x{Ru2(o-OMePhCO2)4}x(phz)] (x = 0.34, 0.44, 0.52, 0.70, 0.81, 0.87), with [Ru2(o-OMePhCO2)4(phz)] (1) as x = 1. The original compound 1 was made purely from a "highly electron donating unit" but had no adsorption capability for gases because of its nonporosity. Meanwhile, the partial transplant of the electronically advantageous [Ru2(o-OMePhCO2)4] unit with x = 0.34-0.52 in 0 successfully enhanced the selective adsorption capability of NO in an identical structurally flexible framework; an uptake at 95 kPa that was 1.7-3 mol/[Ru2] unit higher than that of the original 0 compound was achieved (121 K). The solid solution approach is an efficient means of designing purposeful porous frameworks.

[A Case of Metachronous Liver Metastases of Gall Bladder Cancer Successfully Treated by Liver Resection].

A 73-year-old woman was diagnosed with gall bladder cancer by contrast enhanced CT images.The tumor was detected at the fundus of the gall bladder and enhanced heterogeneously.She underwent radical cholecystectomy including Japanese D2 lymph node dissection for gall bladder cancer.After 4 courses of oral S-1(80mg/m2 administered for 4 weeks and then stopped for 2 weeks)as adjuvant chemotherapy, a liver metastasis at segment 5 appeared 11 months postoperatively.It showed a ring enhanced tumor on contrast enhanced CT images.FDG accumulated in a similar lesion on PET-CT images.The patient successfully underwent partial hepatectomy of segment 5 of the liver.However, another liver metastasis at segment 7 appeared 5 months after the second operation, but it was resected successfully.The primary lesion and both liver metastases showed similar microscopic appearances.Seven courses of gemcitabine therapy(gemcitabine 1,000mg/m2 once every week for 3 weeks and then stopped for 1 week)were administered as adjuvant chemotherapy.She is now doing well without any sign of recurrence 2 years after the initial operation and 14 months after the secondary liver resection.

Electron-Transferred Donor/Acceptor Ferrimagnet with T(C) = 91 K in a Layered Assembly of Paddlewheel [Ru2] Units and TCNQ.

The donor (D)/acceptor (A) assembly reaction of the paddlewheel-type diruthenium(II,II) complex [Ru2(2,4,6-F3PhCO2)4(THF)2] (2,4,6-F3PhCO2(-) = 2,4,6-trifluorobenzoate; abbreviated hereafter as [Ru2]) with 7,7,8,8-tetracyano-p-quinodimethane (TCNQ) in a p-xylene/CH2Cl2 solvent system led to the formation of a two-dimensional layered compound, [{Ru2(2,4,6-F3PhCO2)4}2(TCNQ)]·2(p-xylene)·2CH2Cl2 (1). As expected from this D/A combination, 1 has a one-electron-transfer ionic state with the D(0.5+)2A(-) formulation. This state formally derives a heterospin state composed of S = 1 for [Ru(II,II)2], S = 3/2 for [Ru(II,III)2](+), and S = ½ for TCNQ(•-), possibly causing intralayer ferrimagnetic spin ordering. Most of these types of compounds have an antiferromagnetic ground state because of the coupling of ferrimagnetically ordered layers in dipole antiferromagnetic interactions. However, 1 became a three-dimensional ferrimagnet with T(C) = 91 K because of the presence of interlayer ferromagnetic interactions.