[A Case of 11-Year Patient Survival after the Resection of a Metastatic Pancreatic Tumor of Sigmoid Colon Cancer].

A 44-year-old woman underwent a sigmoidectomy for sigmoid colon cancer in March 2002. At 5 years after the primary surgery, she underwent 2 hepatectomies, 2 anastomotic resections, 1 lung resection, and 1 radiofrequency ablation. Computed tomography revealed a mass in the pancreatic tail in January 2008. We performed distal pancreatectomy. The specimen showed metastases ofthe sigmoid colon cancer. Computed tomography revealed metastases to the left iliac lymph node in September 2010. She underwent chemotherapy with IRIS for the lymph node metastases. After 16 chemotherapy sessions, the lymph node metastases disappeared. The patient is alive 11 years after the pancreatectomy. Resectable pancreatic metastasis from colorectal cancer is rare. Multimodal treatment that includes radical surgery may achieve long-term survival in some cases.

[A Case of Gastric Cancer with Splenic Artery Aneurysm, Intraoperative ICG Fluorography Is Useful in Evaluating the Blood Flow of Stomach and Spleen].

An 81-year-oldwoman with advancedgastric cancer was referredto our hospital. Preoperative contrast-enhancedCT revealeda roundcalcification of the splenic hilum with 15mm in diameter as a splenic artery aneurysm. She underwent transcatheter arterial embolization(TAE)for the splenic artery aneurysm. Celiac artery angiography showedcollateral arterial network of the spleen from left gastric artery. Surgery for the gastric cancer was performed1 4 days after TAE. We cut the right gastric andbilateral epigastric arteries. After the left gastric artery clamping, we performedintraoperative indocyanine green(ICG)fluorography. ICG fluorography confirmedthat the bloodflow of the upper thirdof the stomach andspleen were maintained. We safely performed distal gastrectomy, and the postoperative course was uneventful.

[Preoperative chemotherapy with modified FOLFOX + panitumumab for the treatment of descending colon cancer with multiple liver metastases - a case study].

A 40-year-old woman visited her primary care physician because she had pain in the upper right part of the abdomen. She was diagnosed with descending colon cancer with multiple liver metastases, and was referred to our department. After a laparoscopic abdominal colectomy for removal of the original lesion, chemotherapy was initiated with a modified combination of folinic acid, 5-fluorouracil, and oxaliplatin (mFOLFOX6) + panitumumab. After 12 courses of treatment with the mFOL FOX6 + panitumumab combination, followed by 13 courses of the simplified biweekly 5-fluorouracil and Leucovorin (sLV5FU2) + panitumumab combination, her liver tumors had regressed to about 90% of their original size. A laparoscopic partial hepatectomy was successfully performed. Histopathological examination indicated a Grade 2 regression of the tumor in response to chemotherapy. This report highlights the effectiveness of "conversion therapy" after chemotherapy with the mFOLFOX6+panitumumab combination, especially in those patients with multiple liver metastases from colorectal cancer.

[Mesorectal Lymph Node Metastasis Arising from Rectal Invasion by an Ovarian Cancer--A Case Report].

A 58-year-old woman presenting with abdominal distension was diagnosed with a tumor in the right ovary. A chest-abdominal-pelvic computed tomography scan revealed multiple lung metastases, multiple liver metastases, and peritoneal dissemination. Invasion of the rectum by peritoneal dissemination of the Douglas' pouch was suspected. She was diagnosed with Stage Ⅳ right ovarian cancer and was treated with preoperative chemotherapy. After chemotherapy, debulking surgery of the abdominal cavity (total hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy, and Hartmann's procedure) was performed. Because there was swelling observed in multiple mesorectal lymph nodes, lymph node dissection was performed based on methods used for rectal cancer surgery. Postoperative histopathological examination revealed multiple mesorectal lymph node metastases arising from ovarian cancer. We suggest that mesorectal lymph node dissection be considered a part of debulking surgery for ovarian cancers that have invaded the rectum.

[A case of advanced rectal cancer resected successfully after preoperative XELOX chemotherapy].

A-35-year-old female visited our hospital complaining of lower abdominal pain and atypical genital bleeding. A detailed examination revealed a rectal cancer with metastasis to the right ovary. Invasions to the uterus and right ureter were also detected. Three courses of XELOX therapy were administered as neoadjuvant chemotherapy. A subsequent examination revealed a significantly smaller metastatic lesion, and we therefore performed a radical resection. The pathological examination revealed that all surgical margins were negative for malignancy. We determined that there was no residual cancer and evaluated the surgery as curability A. The patient was administered XELOX therapy as adjuvant chemotherapy a month after the operation. Three months after the operation, the patient has remained in good condition with no signs or symptoms of tumor recurrence.

Technical characterization of dialysis fluid flow of newly developed dialyzers using mass transfer correlation equations.

Dialysis fluid flow and mass transfer rate of newly developed dialyzers were evaluated using mass transfer correlation equations of dialysis fluid-side film coefficient. Aqueous creatinine clearance and overall mass transfer coefficient for APS-15S (Asahi Kasei Kuraray) as a conventional dialyzer, and APS-15SA (Asahi Kasei Kuraray), PES-150Salpha (Nipro), FPX140 (Fresenius), and CS-1.6U (Toray) as newly developed dialyzers were obtained at a blood-side flow rate (QB) of 200 ml/min, dialysis fluid-side flow rates (QD) of 200-800 ml/min and a net filtration rate (QF) of 0 ml/min. Mass transfer correlation equations between Sherwood number (Sh) containing dialysis fluid-side mass transfer film coefficient and Reynolds number (Re) were formed for each dialyzer. The exponents of Re were 0.62 for APS-15S whereas approximately 0.5 for the newly developed dialyzers. The dialysis fluid-side mass transfer film coefficients of the newly developed dialyzers were higher than those of the conventional dialyzer. Based on the mass transfer correlation equations, introduction of short taper, full baffle of dialyzer jacket and further wave-shaped hollow fiber improves the dialysis fluid flow of the newly developed dialyzers.

Nanotechnological characterization of human serum albumin adsorption on wet synthetic polymer dialysis membrane surfaces.

The objective of the present study was to evaluate the characteristics of protein adsorption on the inner surface of various dialysis membranes, to develop protein adsorption-resistant biocompatible dialysis membranes. The adsorption force of human serum albumin (HSA) on the inner surface of a dialysis membrane and the smoothness of the membrane were evaluated from a nanoscale perspective by atomic force microscopy. The content ratio of the hydrophilic polymer, polyvinylpyrrolidone (PVP), was determined by attenuated total reflection Fourier transform infrared spectroscopy. Nine synthetic-polymer dialysis membranes on the market made of polysulfone (PSF), polyethersulfone (PES), polyester polymer-alloy (PEPA), and ethylene vinylalcohol (EVAL) were used in the present study. The HSA adsorption force on the surface of the hydrophobic polymer PEPA membrane was higher than that on the hydrophilic polymer EVAL membrane surface. It has been considered beneficial, for decreasing the HSA adsorption force, to cover a hydrophobic polymer membrane surface with PVP. However, there were some areas on PVP-containing membrane surfaces at which much higher HSA adsorption forces were observed. The HSA adsorption force gave a nearly linear correlation with the surface roughness on the PSF membrane surface. However, the HSA adsorption force was uncorrelated with the PVP content ratio for any of the PSF membrane surfaces tested. In conclusion, protein adsorption can be minimized by the use of dialysis membranes made of hydrophobic polymers containing PVP with a smooth surface.