[A Case of Solitary Inguinal Lymph Node Metastasis 15 Years after Colorectal Cancer Surgery].

The patient is a 69-year-old man. 17 years ago, a colectomy was performed for colorectal cancer, and a disseminated nodule was found during the operation, so the disseminated nodule was also resected. After the surgery, 12 courses of FOLFOX4 were administered, and there was no recurrence thereafter. He was diagnosed with hepatocellular carcinoma 12 years after the colectomy and underwent liver resection. Fifteen years after the colectomy, a mass shadow appeared in the right inguinal region, and inguinal lymph node metastasis of hepatocellular carcinoma or colorectal cancer was suspected. In the same year, he underwent the tumor resection and histopathological diagnosis revealed colon cancer inguinal lymph node metastasis. After the lymph node resection, he has been followed up for 2 years with no recurrence of colorectal cancer. It is extremely rare to have a solitary inguinal lymph node recurrence 15 years after colon surgery.

Total colectomy for poorly controlled hypokalaemia due to Gitelman syndrome.

Gitelman syndrome (GS) is an autosomal recessive tubulopathy caused by dysfunction of the thiazide-sensitive sodium-chloride cotransporter, which leads to hypokalaemia, metabolic alkalosis, hypomagnesaemia and hypocalciuria. Patients with GS show varied clinical features due to hypokalaemia: tetany, muscle weakness, periodical paralysis and constipation, which is one of the most frequent ones. This paper presents the case of a woman in her 40s referred to our endocrinology department for severe hypokalaemia. After biochemical and genetic analyses, a diagnosis of GS was established. Concurrently, the patient suffered from refractory constipation due to hypokalaemia and underwent a total colectomy with ileorectal anastomosis, which cured both disorders without any medication for 3 years.

[Three Cases in Which Long-Term Survival Was Obtained by Irradiation for Postoperative Lymph Node Metastasis].

Case 1: Left total mastectomy was performed for a 58-year-old woman for diagnosis of left breast cancer. Seven years after surgery, left internal mammary node metastasis revealed. Irradiation was performed on the left chest wall and left supraclavicular area. Six months later, the lymph node swelling disappeared. Thereafter 8 years have passed without recurrence. Case 2: A 65-year-old man had a semi-emergency total gastrectomy for bleeding from gastric cancer. Three years after surgery, anterior pancreatic lymph node metastasis was detected. Radiation therapy was selected because his general condition was not so good. Three months later, lymph node swelling disappeared. Thereafter 4 and a half years have passed without recurrence. Case 3: A 67-year-old man underwent surgery for middle thoracic esophageal cancer after neoadjuvant chemotherapy. Seven months after surgery, left tracheobronchial lymph node metastasis was found. Irradiation was performed to bilateral supraclavicular area and mediastinum in combination with chemotherapy. Three months later, the lymph node normalized, and 6 and a half years have passed without recurrence. All 3 cases in this study were recurrences of regional lymph node. Radiation therapy may be effective for regional lymph node recurrence outside the dissected area or in areas that have been inadequately dissected.

Compact polytetrafluoroethylene assembly-type capillary electrophoresis with chemiluminescence detection.

We have developed a compact polytetrafluoroethylene (PTFE) assembly-type capillary electrophoresis with chemiluminescence (CL) detection system. Luminol-microperoxidase-hydrogen peroxide chemiluminescence reaction was adopted. The device is rectangular in shape (60 mm x 40 mm x 30 mm) and includes three reservoirs (sample, migration buffer, and detection reservoirs) with electrodes. The detection reservoir includes an optical fiber to transport light at the capillary tip to a photomultiplier tube. Isoluminol isothiocyanate (ILITC) was analyzed as a model using this device with fused-silica or polytetrafluoroethylene capillary tubes 10 cm in length. We also used the sample reservoir as a reactor for an immune reaction between anti-human serum albumin immobilized on glass beads and isoluminol isothiocyanate-labeled human serum albumin. The present polytetrafluoroethylene assembly with the capillary tube was useful as a palm-sized analysis device for separation and detection, as well as a reactor.