No abstract

An eighty-year-old female was transferred to the hospital after experiencing abdominal pain and nausea. She had had a history of total gastrectomy for gastric cancer 14 years previously. Abdominal X-ray revealed a localized expansion of the small bowel. Computed tomography revealed a mass with a lamellar structure in a concentric circle. With a tentative diagnosis of small bowel obstruction due to intussusception, she underwent emergency operation. Laparotomy revealed a retrograde jejuno-jejunal intussusception. Bowel resection was performed due to the severe ischemic damage. All reported intussusception cases after total gastrectomy displayed retrograde characteristics and could occur both during the early and late period after surgery. It is important to consider the possibility of intussusception for patients presenting with acute abdomen who have previously undergone gastric resection.

This study failed to demonstrate the high predictive value of carcinoembryonic antigen messenger ribonucleic acid detection in the draining venous blood for the development of hepatic metastases. However, the authors demonstrated that the presence of cancer cells in the draining venous blood was the essential and initial step to the development of hepatic metastasis.

No abstract

Hyperthermic therapy has been applied in many advanced malignancies, but tumor regression occurs only in thermo-sensitive cancers. To elucidate ways to overcome thermo-resistance and to improve the therapeutic efficiency of treating thermo-resistant cancers, we devised a novel application of cancer gene therapy in conjunction with hyperthermia. This strategy allows for selective cancer gene therapy under control of the heat-inducible HSP promoter. Heat-inducible activity of HSP promoter was examined in FM3A breast cancer cell line and MKN45 gastric cancer cell line using a luciferase assay reporter gene system. HSP promoter activity increased markedly following heat shock, and this increase depended on temperature and duration of treatment. Based on these results, we designed a suicide gene therapy using the Herpes simplex virus thymidine kinase gene ligated to the heat-inducible HSP promoter (HSP-tk). In in vitro cytotoxic assays HSP-tk transduced cells following heat treatment became 50,000 times more sensitive than either non-transduced cells or HSP-tk transduced cells without heat treatment to ganciclovir (GCV). Immunohistochemical analysis revealed that Fas-mediated apoptosis was involved in the synergistic killing effect of combination therapy. Next, we examined the efficacy of HSP-tk gene therapy in vivo, cancer cell lines implants in subcutaneous or intraperitoneal models of balb/c nude mice were targeted using the HVJ-anionic-liposome method. Significant inhibition of tumor growth was observed in HSP-tk transduced tumors following hyperthermia as more than half of treated-mice showed complete tumor eradication. Prolonged survival was also observed in HSP-tk transducted mice with hyperthermia. In contrast, non-transduced mice treated with or without hyperthermia showed no prolongation of survival. Recently, another group reported an in vitro study that HSP promoter-mediated gene therapy is an effective treatment for prostate cancer studied. Taken together, these results demonstrate that the combined gene and hyperthermic therapy may be a feasible treatment that can target HSP-expressing carcinomas, even in advanced cases.