The Impact of Neoadjuvant Chemotherapy for Borderline Resectable Pancreatic Cancer

( Manabu Kawai ),( Seiko Hirono ),( Ken-ichi Okada ),( Motoki Miyazawa ),( Yuji Kitahata ),( Ryohei Kobayashi ),( Masaki Ueno ),( Shinya Hayami ),( Hiroki Yamaue ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Backgrounds: According to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines, pancreatic ductal adenocarcinoma (PDAC) can be classified as resectable, borderline resectable, or unresectable. Although borderline resectable PDAC (BRPC) may technically be resectable, it has particularly high risks of margin-positive resection and postoperative recurrence. Therefore, preoperative treatment is recommended for BRPC patients in both the NCCN Guidelines and an expert consensus statement. However, the establishment of the most appropriate neoadjuvant therapy is needed by further studies. The aim of these studies is to evaluate the impact of neoadjuvant chemotherapy for BRPC and confirm the safety and efficacy of two regimens of neoadjuvant therapy for BRPC. Our Clinical Trials: First, we evaluated the impact of neoadjuvant chemotherapy for BRPC. 143 BRPC-A patients undergoing pancreatectomy were reviewed from among 330 pancreatic cancer patients, including 111 potentially resectable pancreatic cancer patients and 76 BRPC with portal vein involvement patients. We compared the clinicopathological factors of 40 BRPC-A patients treated with neoadjuvant treatment followed by surgery and those of 103 BRPC-A patients treated with upfront surgery. The R0 rate and progression-free survival of BRPC-A patients who received neoadjuvant therapy and subsequent surgical resection were significantly better compared to those who received upfront surgery (R0: P = 0.041; progression-free survival: P = 0.033), but overall survival was not significantly different. Neoadjuvant treatment followed by surgery might provide clinical benefits for BRPC-A patients; however, the establishment of the most appropriate neoadjuvant treatment is needed by further studies. To evaluate appropriate neoadjuvant treatment, two prospective pilot trials were conducted as follows; modified FOLFIRINOX (without bolus 5-FU and LV, also decreased the dose of irinotecan; FIRINOX) and nab-paclitaxel plus gemcitabine therapy. Modified FOLFIRINOX was given to the first five patients in the 4-cycle group of the regimen and next five patients in the 8-cycle group. The primary end point was the toxicity of the therapy and one of the secondary end points were the optimal duration. The overall rate of grade 3 and 4 events was 80 %: 3 patients (60%) in the four-cycle group and five patients (100%) in the eight-cycle group had grade 3 or 4 adverse events. There was no incidence of serious adverse effect such as febrile neutropenia, sepsis, liver abscess or uncontrollable diarrhea. There was no clinically relevant morbidity presented in patients who underwent surgery. R0 rates by intention to treat were 60.0% in the four-cycle group and 40 % in the eight-cycle group (P = 0.999). The histopathologic treatment effect based on the Evans grade revealed grade I (n = 1), IIa (n = 3) in the four-cycle group and grade I (n = 2), IIa (n = 1) in the eight-cycle group. Nab-paclitaxel plus gemcitabine therapy: the primary endpoint was the toxicity, and secondary endpoints were the resection rate, the R0 resection rate. The overall rate of any grade and grade 3-4 events were 100% and 90%. The majority of these adverse events represented expected neutropenia. The resection and R0 resection rates were 80% and 70%, respectively. Conclusion: FIRINOX therapy was feasible and safe for strictly selected patients with BRPC. On the other hand, nab-paclitaxel plus gemcitabine therapy was safe and feasible without strict selection of patients with BRPC. A multicenter phase II study is in progress to investigate the efficacy of neoadjuvant nab-paclitaxel plus gemcitabine therapy on overall survival (UMIN000024154).

New Record of Sargassum filicinum Harvey (Fucales, Phaeophyceae) in the Pacific Coast of Mexico

Aguilar-Rosas, Luis E.,Aguilar-Rosas, Raul,Kawai, Hiroshi,Uwai, Shinya,Valenzuela-Espinoza, Enrique The Korean Society of Phycology 2007 ALGAE Vol.22 No.1

Sargassum filicinum Harvey, a brown alga (Phaeophyceae) native to Northeastern Asia, has been recently reported from the coast of Southern California (USA). Here we report the occurrence and range extension of this introduced species, as we found the alga at La Jolla and Rancho Packard in Todos Santos Bay, Baja California, Mexico. The first collections of S. filicinum correspond to several immature plants, found on September 8, 2005, drifting in the intertidal zone at La Jolla. Later on November 9, 2006, we found a well-established population in Rancho Packard in the middle intertidal zone to 2 m depth. Since S. filicinum is an annual monoecious species with air bladders, the risk there is a high risk of spreading rapidly along the Pacific, as in the case for S. muticum. The population in Rancho Packard extends 500 m along the coast, consisting mainly of young plants with an average length of 30 cm and a density of 5 thallus/m2. This is the first record of this invasive species for the Mexican Pacific coast, and it represents the southern limit along the Pacific coast of North America. This finding suggests that this invasive species has successfully colonized the Pacific coast of North America and its distributional range is still expanding.

New record of Sargassum filicinum Harvey (Fucales, Phaeophyceae) in thePacific coast of Mexico [Note]

Luis E. Aguilar-Rosas,Enrique Valenzuela-Espinoza,Shinya Uwai,Hiroshi Kawai,Ra?l Aguilar-Rosas 한국조류학회I 2007 ALGAE Vol.22 No.1

Sargassum filicinum Harvey, a brown alga (Phaeophyceae) native to Northeastern Asia, has been recently reported from the coast of Southern California (USA). Here we report the occurrence and range extension of this introduced species, as we found the alga at La Jolla and Rancho Packard in Todos Santos Bay, Baja California, Mexico. The first collections of S. filicinum correspond to several immature plants, found on September 8, 2005, drifting in the intertidal zone at La Jolla. Later on November 9, 2006, we found a well-established population in Rancho Packard in the middle intertidal zone to 2 m depth. Since S. filicinum is an annual monoecious species with air bladders, the risk there is a high risk of spreading rapidly along the Pacific, as in the case for S. muticum. The population in Rancho Packard extends 500 m along the coast, consisting mainly of young plants with an average length of 30 cm and a density of 5 thallus/m2. This is the first record of this invasive species for the Mexican Pacific coast, and it represents the southern limit along the Pacific coast of North America. This finding suggests that this invasive species has successfully colonized the Pacific coast of North America and its distributional range is still expanding.

MOCVD growth of single-crystal-like twin-free non-c-axis oriented thin films of Bi₂Sr₂CaCu₂O<SUB>8</SUB> superconductor

Kazuhiro ENDO,Shunichi ARISAWA,Toshiyuki KANEKO,Shinya KAWAI,Michiaki WADA,Isao TSUYUMOTO,Yasushi TATENO,Hiroshi KEZUKA,Petre BADICA 한국진공학회 2016 한국진공학회 학술발표회초록집 Vol.2016 No.8

Review : EUS-Guided Biliary Drainage

( Kenji Yamao ),( Kazuo Hara ),( Nobumasa Mizuno ),( Akira Sawaki ),( Susumu Hijioka ),( Yasumasa Niwa ),( Masahiro Tajika ),( Hiroki Kawai ),( Shinya Kondo ),( Yasuhiro Shimizu ),( Vikram Bhatia ) The Editorial Office of Gut and Liver 2010 Gut and Liver Vol.4 No.s1

Endoscopic ultrasonography (EUS) combines endoscopy and intraluminal ultrasonography, and allows imaging with a high-frequency transducer over a short distance to generate high-resolution ultrasonographic images. EUS is now a widely accepted modality for diagnosing pancreatobiliary diseases. EUS-guided fineneedle aspiration (EUS-FNA) using a curved linear- array echoendoscope was initially described more than 20 years ago, and since then many researchers have expanded its indications to sample diverse lesions and have also used it for various therapeutic purposes. EUS-guided biliary drainage (EUS-BD) is one of the therapeutic procedures that has been developed using a curved linear-array echoendoscope. Technically, EUS-BD includes rendezvous techniques via transesophageal, transgastric, and transduodenal routes, EUS-guided choledochoduodenostomy (EUS-CDS), and EUS-guided hepaticogastrostomy (EUS-HGS). Published data have demonstrated a high success rate, albeit with a comparatively high rate of nonfatal complications for EUS-CDS and EUS-HGS, and a comparatively low success rate with a low complication rate for the rendezvous technique. At present, these procedures represent an alternative to surgery or percutaneous transhepatic biliary drainage (PTBD) for patients with obstructive jaundice when endoscopic biliary drainage (EBD) has failed. However, these procedures should be performed in centers with extensive experience in linear EUS and therapeutic biliary ERCP. Large prospective studies are needed in the near future to establish standardized EUS-BD procedures as well as to perform controlled comparative trials between EUS-BD and PTBD, between rendezvous techniques and direct-access techniques (EUS-CDS and EUS-HGS), and between EBD and EUS-BD. (Gut Liver 2010;4(Suppl. 1):S67-75)

Effectiveness of Endoscopic Sclerotherapy with Aluminum Potassium Sulfate and Tannic Acid as a Non-Surgical Treatment for Internal Hemorrhoids

Yuichi Tomiki,Jun Aoki,Shunsuke Motegi,Rina Takahashi,Toshiaki Hagiwara,Yu Okazawa,Kosuke Mizukoshi,Masaya Kawai,Shinya Munakata,Shun Ishiyama,Kiichi Sugimoto,Kazuhiro Sakamoto 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.6

Background/Aims: Sclerotherapy with aluminum potassium sulfate and tannic acid (ALTA) has a potent effect on internalhemorrhoids. In this retrospective study, we compared the effects of endoscopic ALTA therapy and standard ALTA therapy. Methods: We investigated patients who underwent treatment for internal hemorrhoids at our institution between 2014 and 2016. Theywere divided into a standard ALTA group (n=33, treated using proctoscopy) and an endoscopic ALTA group (n=48). We compared theclinical findings between the 2 groups. Results: There were no intergroup differences in background factors. The mean ALTA dose was 21.9±7.2 mL and 17.8±3.4 mL inthe standard and endoscopic ALTA groups, respectively (p<0.01). Adverse events occurred in 4 patients (12.1%) from the standardALTA group and 6 patients (12.5%) from the endoscopic ALTA group. In both groups, the patients reported good satisfaction withthe therapeutic effect at 1 month after the procedure. Hemorrhoids recurred in 2 patients (6.3%) from the standard ALTA group and 4patients (8.3%) from the endoscopic ALTA group. Conclusions: Endoscopic ALTA sclerotherapy is equivalent to standard ALTA therapy in terms of efficacy, adverse events, andrecurrence. Therefore, it is a useful non-surgical option for patients with internal hemorrhoids who prefer a less invasive treatment.