[Adenocarcinoma with Aplastic Anemia as an Immune-related Adverse Event Caused by Pembrolizumab: Report of a Case].

A 74-year-old man was found a left completely atelectasis on chest X-ray. He had undergone left lower lobe resection because of an adenocarcinoma at the age of 58. Bronchoscopy revealed a tumor near the left upper lobe branch entry that obstructed the lumen, and a biopsy confirmed the diagnosis of adenocarcinoma. A left completion pneumonectomy was performed, but #4L and #10 lymph nodes could not be completely resected. Programmed cell death 1-ligand 1( PD-L1) was positive with tumor proportion score (TPS) 15%, so chemotherapy with pembrolizumab+pemetrexed+carboplatin was started about 1.5 months after surgery. Pancytopenia appeared from the seventh course and did not improve after discontinuation of chemotherapy, so we consulted to the hematologist. He was diagnosed as aplastic anemia by bone marrow biopsy. Aplastic anemia was unresponsive to treatment and chemotherapy could not be resumed. He died of exacerbation of lung cancer.

[Multiple Pulmonary Metastases Seven Years After Transurethral Bladder Tumor Resection for Non-muscle Invasion Bladder Cancer:Report of a Case].

A 64-year-old man was admitted because of multiple pulmonary nodules in right upper lobe on chest computed tomography (CT). He had non-muscle invasion bladder cancer resected by transurethral bladder tumor resection seven years ago. Partial resections of the right upper lobe were carried out at the video assisted thracoscopic surgery (VATS) for diagnostic purposes. The postoperative pathological examination revealed featuraes of pulmonary metastasis of bladder cancer. Although chemotherapy after biopsy was performed, a residual tumor in right S3 has grown. Partial resection of residual tumor was carried out thracoscopically and the tumor was diagnosed as metastasis of bladder cancer. He has been without recurrence for 1 year after the operation.

Designing the structure and relevant properties of semiclathrate hydrates by partly asymmetric alkylammonium salts.

Semiclathrate hydrates are host-guest materials that form from ionic guests and water. There are numerous options for ionic guests, such as quaternary ammonium salts, to tune the functional properties of these materials such as melting temperature, fusion heat, and gas capacity and selectivity. To design these materials, the stabilization mechanism of the side chains of quaternary ammonium salts must be understood based on both thermodynamic and crystallographic properties and relevant host-guest dynamics. In this paper, we studied semiclathrate hydrates formed from n-propyl, tri-n-butylammonium bromide (N3444Br) and tri-n-butyl, n-pentylammonium bromide (N4445Br). Their cation side chains are decremented or incremented from tetra-n-butylammonium (N4444 or TBA), which is one of the best fits for semiclathrate hydrate structures. The use of the widely used tetra-n-butylammonium bromide (N4444Br or TBAB) as an ionic guest, an increment of the carbon chain, i.e., N4445Br, caused disorders in its hydrate structure due to the oversizing of the cation. This suitably oversized cation selectively stabilized the orthorhombic structure, whose hydration number is relatively high. As a result, the fusion heat at the congruent composition of the hydrate phase was higher than that of the widely used N4444Br (TBAB) hydrates. The N3444Br hydrate showed both significantly decreased melting temperature and fusion heat compared to the N4444Br (TBAB) hydrates. The phase behaviour of the N3444Br hydrate was found to be analogous to that of the N4444Br (TBAB) hydrates. It was demonstrated that the semiclathrate hydrate structures and relevant properties can be modified by adjusting the alkyl side chain length of quaternary ammonium salts.

[Lung cancer incidentally detected at the treatment of pneumothorax ; report of two cases].

We report 2 cases of lung cancer incidentally detected following pneumothorax. Case 1:A 40-year-old man complaining of dyspnea was admitted with right pneumothorax. Chest computed tomography (CT) after chest drainage showed a cavitary nodule with pleural indentations in the right lower lobe. It was indicated at surgery that pneumothorax was caused by perforation of the tumor into the pleural cavity. Right lower lobectomy was performed because the pathological diagnosis of the nodule was a large cell carcinoma. The final histopathological diagnosis was stage II A (pT2aN1M0). The patient died of recurrence 14 months after surgery. Case 2:A 47-year-old man who admitted with right pneumothorax was found to have a nodule with pleural indentations closely a bulla at the apex of the right lung by chest CT after chest drainage. Pneumothorax was indicated to be caused by rupture of the bulla at surgery. Right upper lobectomy was performed because the pathological diagnosis of the nodule was a squamous carcinoma. The final histopathological diagnosis was stage I A (pT1bN0M0). The patient is alive at 2 years after the operation without recurrence. Lung cancer detected following pneumothorax which was caused by perforation of the tumor is generally considered to have poor prognosis. Whereas, prognosis of lung cancer incidentally detected following pneumothorax depends on its staging.

[Mediastinal goiter; report of a case].

A 76-year-old female was admitted to our hospital because of an abnormal shadow on chest computed tomography (CT) which showed the tumor extending from left lower end of the thyroid to the aortic window along the left side of the trachea, indicating the retrosternal goiter. Serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were within normal ranges. The tumor was resected through cervical collar incision and median sternotomy. The pathological diagnosis was an adenomatous goiter. The patient was discharged without complications.

[Catamenial pneumothorax; report of a case].

A 39-year-old woman was referred to our hospital because of pneumothorax related to menstruation. Chest X-ray showed right pneumothorax. Right thoracoscopy revealed 3 fenestrations on the diaphragm. Partial resection of the diaphragm including these lesions were performed. Intrathoracic minocycline was applied expecting pleural adhesion after surgery. Histopathological examination confirmed the presence of endometriosis on the resected diaphragm.

[Efficacy of concomitant therapy with S-1, CDGP, and radiation for laryngeal cancer].

OBJECTIVE: Several clinical trials examining treatment strategies for advanced laryngeal cancer have demonstrated that concurrent chemoradiotherapy is the most effective treatment for improving the patient response to radiotherapy and laryngeal preservation. We evaluated a new regimen of S-1/CDGP(Nedaplatin) with radiotherapy (RT), and established that it represented an effective new treatment option that allowed for the preservation of the larynx. METHODS: A total of 16 patients with stage II to IV laryngeal cancer(excluding T4 stage)who had been treated at our institution from 2001 to 2007 were recruited for the present study. All patients had histologically-confirmed squamous cell carcinomas. RESULTS: The administration of S-1/CDGP/RT led to a complete response (CCR) in all patients with stage II or IV disease, with preservation of the larynx in all of these cases. For patients with stage III disease, 6 (85%) experienced CR, and 1 patient (15%) had a partial response. The laryngeal preservation rate for these patients was 85%. Severe toxicities, i. e., neutropenia, thrombocytopenia, and dermatitis of grade 3, were observed. The overall five-year survival rate was 72%, and the disease specific survival rate was 92%.

[Clinical phase trial of concurrent chemoradiotherapy combined TS-1 and nedaplatin].

We have treated head and neck carcinoma by concurrent chemoradiotherapy combined with 5-fluorouracil (5-FU) and cisplatin (CDDP). However,this chemoradiotherapy could not show an enormous effect in the advanced carcinoma of Stage III and IV. Therefore,we changed the contents of the chemotherapy, i.e., we replaced 5-FU, one of the agents with time dependency, to continuous administration of TS-1 for 2 weeks,also replacing CDDP, one of the agents with dose dependency, to nedaplatin (CDGP) in order to reduce kidney dysfunction. In this concurrent chemoradiotherapy, oral TS-1 was continued for 2 weeks and CDGP was administered on the 4 th day from the start of TS-1. In addition, radiotherapy was performed concurrently. In this way,we performed a phase I clinical trial of concurrent chemoradiotherapy combining TS-1 and nedaplatin (CDGP). As for the incidence of adverse events,grade 3 mucositis due to radiation was observed in two patients. As a result of the phase I clinical trial,we decided the maximum-tolerated dose (MTD) of TS-1 to be 80 mg/m2 (maximum 120 mg/body) and 100 mg/m2 for CDGP, and then determined the recommended dose(RD) of TS-1 as 80 mg/m2 (maximum 120 mg/ body) TS-1 and of CDGP as 9 0 mg/m2 CDGP.