Vascular access interventional therapy of early arteriovenous fistula occlusion leading to long-term patency: A case report.

Arteriovenous fistulas (AVFs) are frequently used for hemodialysis access, but approximately 15%-20% of AVFs fail to mature within 3 months of their creation. Vascular access interventional therapy (VAIVT) is typically performed for treating an immature AVF. However, it should be performed 4-6 weeks or later after AVF creation. Here, we present a case in which VAIVT effectively addressed AVF occlusion that occurred only 9 days after its creation. The patient was an 82-year-old woman with chronic kidney disease who underwent surgery to create a left radiocephalic AVF for hemodialysis. Nine days postoperatively, disappearance of the AVF sound prompted an angiography, revealing thrombosis near the AVF anastomosis. VAIVT successfully restored blood flow, resulting in AVF maturation, and with no thrombosis or flow dysfunction at 21 months after VAIVT. To the best of our knowledge, this case presents the earliest successful intervention for an occluded AVF.

Humin-promoted microbial electrosynthesis of acetate from CO2 by Moorella thermoacetica.

Humin, an insoluble fraction of humic substances at any pH, has been reported to be an extracellular electron mediator (EEM) that functions in carbon dioxide (CO2 )-fixing acetogenesis. Here, we show that humin promotes the microbial electrosynthesis (MES) of acetate from CO2 using Moorella thermoacetica. Yeast extract, essential for the reaction of M. thermoacetica, resulted in the heterotrophic production of organic acids including acetate, hydrogen, and methane. Excluding the effect of yeast extract, MES with 13 g/L of suspended humin poised at -510 mV (vs. Ag/AgCl) achieved a CO2 -fixing acetate production of 24.2 mg-acetate/L/day (1.9 mg-acetate/day/g-humin); this is 10-folds higher than the humin-free MES, with 90.3% of the coulombic efficiency. Although M. thermoacetica is an electroactive bacterium, it obtains electrons for acetogenesis mostly via humin. The suspended humin-assisted MES poised at -810 mV (vs. Ag/AgCl) increased the acetate production rate to 39.3 mg-acetate/L/day using electrons mainly from electrolyzed hydrogen and humin. Immobilization increased the humin's EEM efficiency, as indicated by the acetate production rate of 20.8 mg-acetate/L/day (6.9 mg-acetate/day/g-humin) with a 98.7% coulombic efficiency in MES with 3 g/L of immobilized humin poised at -510 mV (vs. Ag/AgCl). These results suggest that humin-assisted MES has high potential for microbial CO2 fixation.

[A case of recurrent rectal cancer successfully treated for a long period with capecitabine plus oxaliplatin and bevacizumab therapy].

A 62-year-old woman was diagnosed as having rectal cancer and underwent low anterior resection. The final pathological diagnosis was RS, type 3, circ, mod>muc>por>,pSE, ly1, v1, pN2, sH0, sP0, cM0, fStage IIIb, with KRAS mutation. Adjuvant chemotherapy with tegafur-uracil( UFT) plus Leucovorin( LV) was administered for 6 months. Ten months after surgery, right internal iliac and common iliac lymph node metastasis and peritoneal dissemination were diagnosed. In October 2009, capecitabine plus oxaliplatin (CapeOX) plus bevacizumab (Bmab) therapy was initiated. In May 2010, diagnostic imaging revealed a complete response after 42 months. In the present report, we describe the case of a patient with rectal cancer who experienced postoperative recurrence and achieved long-term complete response with CapeOX plus Bmab therapy. We also include a brief review of the literature.

[Repeated resections for originally unresectable liver metastasis from colorectal cancer after multiagent chemotherapy].

We describe the case of a 74-year-old man with liver resection for originally unresectable liver metastasis from colorectal cancer after multiagent chemotherapy. Eleven bilobar liver metastases appeared four months after curative resection for double cancer of sigmoid colon and upper rectum. After 6 courses of multiagent chemotherapy (mFOLFOX 6 with bevacizumab), the number of liver metastasis decreased from 11 to 5. The patient underwent curative resection for liver metastasis. A new lesion of 7 mm in the segment 6 appeared 8 months after an initial liver resection. After 3 months' observation, two more liver metastases appeared. All liver metastases were resected. Solitary lung metastasis appeared 10 months after the second liver resection. The lung metastasis was also resected. The patient was alive with no evidence of disease in 33 months after the initial liver resection. We experienced the case with repeated liver resections after multiagent chemotherapy for originally unresectable bilobar liver metastasis. The therapeutic strategy which combines surgical resection with cytotoxic chemotherapy will be important more than ever.

[A case with liver resection of metastasis from rectal cancer after bevacizumab treatment].

The advancement of systemic chemotherapy for colorectal carcinoma has improved a clinical response rate and expanded a possibility of resection, which we thought we could not have been operable at the initial visit. It also improved a prognosis of patients. We report here a case with liver resection of metastasis from rectal cancer followed by bevacizumab treatment.