RESUMO
A 74-year-old man presented to our hospital with the chief complaint of epigastric pain; upper gastrointestinal endoscopy revealed a 7-cm-sized type 3 gastric cancer in the lesser curvature of the lower part of the stomach. Abdominal contrast computed tomography revealed a tumor embolus in the right gastric vein; the preoperative diagnosis was cT4a(SE) N3aH0P0M0, cStage â ¢C. Because the cancer could spread during surgical manipulation, performing a safe radical resection was difficult; therefore, we decided to initiate chemotherapy. The patient received 3 courses of trastuzumab plus CapeOX, which led to reduction of the primarylesion, peri-gastric lymph node, and right gastric vein tumor embolus. Partial remission was achieved after chemotherapy; therefore, distal gastrectomy, D2 lymph node dissection, and Roux-en-Y reconstruction were performed. Histopathological examination did not reveal viable tumor cells in the primarylesion, lymph nodes, or tumor embolus, and the histological effect was Grade 3. Currently, the patient is alive without relapse at 9 months post operation. Advanced gastric cancer accompanied with tumor embolism in the gastric vein is commonly observed in patients with liver metastasis and in those with severely progressed state of cancer; many of these patients have poor prognosis. Preoperative chemotherapymaybe effective in cases in which tumor embolism in the gastric vein is identified through preoperative diagnostic imaging.
Assuntos
Células Neoplásicas Circulantes , Neoplasias Gástricas , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Gastrectomia , Humanos , Metástase Linfática , Masculino , Recidiva Local de Neoplasia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgiaRESUMO
BACKGROUND: The type of lifestyle guidance that is effective for preventing development of chronic kidney disease (CKD) is unknown. Here, we aim to investigate the effects of a participatory structured group education (SGE) program on the development of CKD in a population-based study. METHODS: We retrospectively analyzed 1060 adult special health check-up examinees with CKD. Examinees with an estimated glomerular filtration rate (eGFR) from 50 to 60 mL/min/1.73 m2 and/or proteinuria 1+ were encouraged to attend an SGE program. The SGE program included participatory small group discussions on the attendees' remaining risk factors. The primary outcome of this study was the change in eGFR per year. RESULTS: The changes in eGFR in examinees who attended the SGE program (n = 209, + 2.9 mL/min/1.73 m2 [95% confidence interval (CI) + 1.9 to + 3.9]) significantly improved compared with control (n = 383, + 1.2 mL/min/1.73 m2 [95% CI + 0.5 to + 1.9], p = 0.006). Attending an SGE program was independently and positively related to the changes in eGFR at 1 year after attendance, after adjusting for classical covariates (ß = 1.55 [95% CI 0.37-2.73], p = 0.01). Attending an SGE program was effective for the examinees with a lower eGFR compared with those with only proteinuria. CONCLUSIONS: Our SGE program showed the beneficial effects of preventing the development of CKD, independent of classical factors. The type of SGE program that is more effective for preventing development of CKD should be investigated in a long-term analysis.
Assuntos
Processos Grupais , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto/métodos , Participação do Paciente , Proteinúria/terapia , Insuficiência Renal Crônica/prevenção & controle , Comportamento de Redução do Risco , Idoso , Progressão da Doença , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/fisiopatologia , Masculino , Fatores de Proteção , Proteinúria/diagnóstico , Proteinúria/fisiopatologia , Proteinúria/psicologia , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/psicologia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
A 72-year-old woman with a history of surgery for left breast cancer was found to have sigmoid colon cancer and solitary pulmonary tumor of left upper lobe. We diagnosed adenocarcinoma of the unknown origin by a transbronchial biopsy. We performed left upper segmentectomy and sigmoidectomy. Left pulmonary tumor was diagnosed metastatic lung tumor from breast cancer. A right pulmonary tumor was confirmed by chest computed tomography(CT) after sigmoidectomy. It was also considered to be metastasis from breast cancer and treated with vinorelbine ditartrate. Since no effect was observed by chemotherapy, tumor was surgically removed by wedge resection. Right pulmonary tumor was pathologically diagnosed as metastasis from sigmoid colon cancer. In suspicious case of pulmonary metastases from double cancer, the possibility of different lesions from different primary site should be kept in mind.
Assuntos
Adenocarcinoma/secundário , Neoplasias da Mama/patologia , Neoplasias Pulmonares/secundário , Neoplasias Primárias Múltiplas/patologia , Neoplasias do Colo Sigmoide/patologia , Adenocarcinoma/diagnóstico , Idoso , Antineoplásicos Fitogênicos/uso terapêutico , Neoplasias da Mama/cirurgia , Feminino , Humanos , Neoplasias Primárias Desconhecidas/diagnóstico , Neoplasias do Colo Sigmoide/diagnóstico , Neoplasias do Colo Sigmoide/terapia , Tomografia Computadorizada por Raios X , Vinorelbina/uso terapêuticoRESUMO
Chalcones, flavanones, and flavonols, including 8-methoxybutin isolated from Coreopsis lanceolata L. petals, were successfully synthesized with total yields of 2â»59% from O-methylpyrogallols using the Hornerâ»Wadsworthâ»Emmons reaction as a key reaction. Aurones, including leptosidin, were also successfully synthesized with 5â»36% total yields using the Aldol condensation reaction as a key reaction. Each chalcone, flavanone, flavonol, and aurone with the 3,4-dihydroxy groups in the B-ring showed high antioxidant activity. Additionally, each of the chalcones, flavanones, flavonols, and aurones with the 2,4-dihydroxy groups in the B-ring showed an excellent whitening ability.
Assuntos
Antioxidantes/síntese química , Coreopsis/química , Flavonoides/síntese química , Antioxidantes/química , Antioxidantes/farmacologia , Benzofuranos/síntese química , Benzofuranos/química , Benzofuranos/farmacologia , Chalcona/síntese química , Chalcona/química , Chalcona/farmacologia , Flavonas/síntese química , Flavonas/química , Flavonas/farmacologia , Flavonoides/química , Flavonoides/farmacologia , Flores/química , Estrutura Molecular , Extratos Vegetais/químicaRESUMO
We have newly synthesized two solution-stable luminescent dinuclear copper(I) complexes, [Cu2(µ-I)2(dpppy)2] (Cu-py) and [Cu2(µ-I)2(dpppyz)2] (Cu-pyz), where dpppy = 2,3-bis(diphenylphosphino)pyridine and dpppyz = 2,3-bis(diphenylphosphino)pyrazine, using chelating diphosphine ligands composed of N-heteroaromatic rings. X-ray analysis clearly indicates that the molecular structures of Cu-py and Cu-pyz are almost identical with that of the parent complex, [Cu2(µ-I)2(dppb)2] [Cu-bz; dppb = 2,3-bis(diphenylphosphino)benzene]. Complexes Cu-py and Cu-pyz exhibit luminescence [emission quantum yield (Φem) = 0.48 and 0.02, respectively] in the solid state at 298 K. A wide emission color tuning, from 497 to 638 nm (energy = 0.55 eV, with an emission color ranging from green to reddish-orange), was achieved in the solid state by the introduction of pyridinic N atoms into the bridging phenyl group between the two diphenylphosphine groups. Density functional theory calculations suggest that the emission could originate from the effective combination of the metal-to-ligand charge-transfer excited state with the halide-to-ligand charge-transfer excited state. Thus, the emission color change is due to stabilization of the π* levels of the central aryl group in the diphosphine ligand. Furthermore, these copper(I) complexes exhibit thermally activated delayed fluorescence at 298 K because of the small singlet-triplet energy difference (ΔE = 523 and 564 cm(-1) for Cu-py and Cu-pyz, respectively). The stability of these complexes in chloroform, due to the rigid bonds between the diphosphine ligands and the Cu(I) ions, enables the preparation of emissive poly(methyl methacrylate) films by the solution-doping technique.
RESUMO
The methanol extract of Coreopsis lanceolata L. petals was acid-hydrolysed, and 7,3',4'-trihydroxy-8-methoxyflavanone (1) and 6,3',4'-trihydroxy-7-methoxyaurone (leptosidin) (2) were successfully isolated. The structure of compound 1 is designated to flavanone based on X-ray crystallographic analysis and NMR spectroscopic analysis. Compound 1 showed high-antioxidant effects based on diphenylpicrylhydrazyl radical scavenging assay (94.3% scavenging rate) and superoxide dismutase-like activity assay (23.9% inhibition rate).