An intrathoracic scapular prolapse with hemorrhagic shock after a thoracotomy

We herein present a case in which an emergency operation was performed for an intrathoracic hemorrhage resulting from a scapular prolapse after a thoracotomy, a rare complication of this procedure. A 59-year-old man had undergone a right upper lobectomy with an extended resection of the posterior chest wall including the second to fourth ribs due to a direct invasion by a lung cancer. On postoperative day 80, we performed an emergency operation as the patient had gone into shock due to an intrathoracic hemorrhage with a right scapular prolapse. The scapula protruded through the enlarged fourth intercostal space. The prolapsed scapula was reduced and the defect in the chest wall was covered with Marlex mesh.ArticleINTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY. 12(2):326-327 (2011)journal articl

Coexistence of a pulmonary adenocarcinoma with a focal organizing pneumonia

We report a case of a pulmonary adenocarcinoma in coexistence with an organizing pneumonia. A 73-year-old male presented with an abnormal shadow on a chest X-ray. The pathological diagnosis, made via a partial resection, was a focal organizing pneumonia with reactive proliferation of the bronchial epithelium. Three years later, two tumors adjacent to the staple line were revealed by computed tomography. A left lower lobectomy was performed and both tumors were diagnosed as an adenocarcinoma. Because the histological findings for the atypical epithelial areas of the previous tumor were similar to the two new lesions in this patient, we regarded these tumors as a marginal recurrence.ArticleINTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY. 13(4):444-446 (2011)journal articl

Difference in Temperature between Shallow and Deep Valleys of the Bhutan Himalaya

The differences in temperature between Khasadrupchu and Lumitsawa and between Yusipang and Lamperi, located at a similar altitude along different valleys, are analyzed to clarify the difference in thermal condition between the shallow and deep valleys. The annual mean temperature is almost same between the shallow and deep valleys. However, the annual mean maximum and minimum temperature, the annual variation in monthly temperature and the diurnal variation in temperature are found to differ between the shallow and deep valleys. One of the main causes of differences in temperature between Khasadrupchu and Lumitsawa and between Yusipang and Lamperi is the relative height from the valley bottom, as the altitudinal difference between the shallow and deep valleys varies. The diurnal range of temperature is found to be larger along the shallow valley than along the deep valley. One of the causes of large diurnal range of temperature along the shallow valley is due to the valley wind of the deep valley that invades the shallow valley and cause föhn like phenomena

A Surprisingly Non-attractiveness of Commercial Poison Baits to Newly Established Population of White-Footed Ant, Technomyrmex brunneus (Hymenoptera: Formicidae), in a Remote Island of Japan

The white-footed ant, Technomyrmex brunneus, was newly introduced and established in a remote island of Japan and has caused unacceptable damage to the daily life of residents. To establish proper control measures, the present study investigated whether T. brunneus is effectively attracted to commercially available poison baits used to exterminate common household pest ants and the Argentine ant in Japan. Cafeteria experiments using three types of nontoxic baits and eight types of commercial poison baits for ants were conducted in the field, and the attractiveness was compared among the baits. The liquid poison bait “Arimetsu,” which consists of 42.6% water, 55.4% sugar, and 2.0% borate, and nontoxic 10% (w/v) sucrose water showed the highest attractiveness. On the other hand, other commercial poison baits were not as attractive. Therefore, sucrose liquid is the most effective attractive component to use in poison baits for T. brunneus

Successful lung lobectomy for a lung cancer following thoracic endovascular aortic repair for a thoracic aortic aneurysm: report of a case

Lung cancer and a thoracic aortic aneurysm were detected simultaneously in a 79-year-old male patient with diabetes. The aneurysm was first treated by thoracic endovascular aortic repair. A right lower lobectomy was subsequently performed after the blood flow of the bronchial and intercostal arteries was confirmed by computed tomographic angiography. The bronchial stump was covered with an intercostal muscle flap. The patient's postoperative course was uneventful. Thoracic endovascular aortic repair is a useful and less invasive treatment for such cases, but a blood flow evaluation of the aortic branches should be done following this procedure before a lung resection is considered.ArticleSURGERY TODAY. 44(5):940-943 (2014)journal articl

Up-regulation of ICAM-1 expression on human dermal fibroblasts by IFN β in the presence of TNF-α

AbstractUnstimulated human fibroblasts show low or undetectable ICAM-1 expression. Interferon-beta (IFN-β) at concentrations of 10,100, and 1000 IU/ml in the presence of tumor necrosis factor-alpha (TNF-α) significantly increased the ICAM-I expression of fibroblasts in a dose-dependent manner. Treatment with IFN-β alone, however, did not up-regulate the ICAM-1 expression. Furthermore the attachment of peripheral blood mononuclear cells (PBMCs) to cytokine-treated fibroblasts was increased. This augmented attachment was partly inhibited by anti-ICAM-1 antibody. These results suggest that IFN-β and TNF-α may cooperatively modulate the attachment of PBMCs in the dermis

Granulomatous interstitial nephritis associated with atypical drug-induced hypersensitivity syndrome induced by carbamazepine

We report the case of a 70-year-old female patient with granulomatous interstitial nephritis (GIN) induced by carbamazepine (CBZ). The patient had a 22-year history of bipolar disorder. Approximately 50 days before admission to our hospital, she was switched from valproic acid to 200 mg/day CBZ for mood swings. Forty days later, she presented with mild transient platelet depletion and liver dysfunction along with a C-reactive protein (CRP) level of 2.65 mg/dL. At that time, she discontinued CBZ without consulting the doctor. She subsequently developed high fever and a pruritic maculopapular rash. Laboratory tests revealed an elevated CRP level (11.98 mg/dL) and serum creatinine (sCr) of 1.6 mg/dL. Hence, she was admitted to our hospital, where she showed eosinophilia and immunoglobulin suppression. She was diagnosed with atypical drug-induced hypersensitivity syndrome (DIHS). All drugs prescribed by the previous doctor were discontinued. A lymphocyte transformation test showed CBZ positivity; a renal biopsy revealed many granulomatous lesions connected to arterioles, without angionecrotic findings. The patient had no history of allergic disorders or tuberculosis. Because of psychological instability, we treated her conservatively without steroid administration. She had a good recovery except for mild residual renal insufficiency (sCr, 1.0 mg/dL). Although granuloma formation has been observed in kidney biopsy specimens of rare cases with DIHS, no previous studies have reported on the relationship between arterioles and granuloma formation

Ex vivo hepatic venography for hepatocellular carcinoma in livers explanted for liver transplantation

<p>Abstract</p> <p>Background</p> <p>Hepatocellular carcinoma (HCC) is supposed to have a venous drainage system to a portal vein, which makes intrahepatic metastasis possible. However, the mechanism of extrahepatic recurrence, including the possibility of a direct route to the systemic circulation from the HCC nodules, remains unclear. Therefore, we performed retrograde hepatic venography for HCC in livers that had been explanted for liver transplantation in order to explore the possible direct connection between the hepatic vein and HCC nodules.</p> <p>Methods</p> <p>Of 105 living-donor liver transplantations (LDLT) performed up to July, 2009 at the Department of Surgery, Nagasaki University Hospital, dynamic hepatic venography was performed with contrast media under fluoroscopy for the most recent 13 cases with HCC. The presence of a tumor stain for each HCC case was evaluated and compared with the histological findings of HCC.</p> <p>Results</p> <p>Hepatic venography revealed a tumor stain in 2 of 13 cases (15%). Neither showed any microscopic tumor invasion of HCC into the hepatic vein. In the other 11 cases, there were 4 microscopic portal venous invasions and 2 microscopic hepatic venous invasions. No patients have shown HCC recurrence in follow-up (median period, 13 months).</p> <p>Conclusion</p> <p>Using <it>ex vivo </it>hepatic venography, a direct connection to the hepatic vein from HCC in whole liver was revealed in 2 cases without demonstrated histopathological invasion to hepatic vein for the first time in the literature. The finding suggests that there is direct spillage of HCC cells into the systemic circulation via hepatic vein.</p

Upregulation of Angiogenic Factors via Protein Kinase C and Hypoxia-induced Factor-1α Pathways under High-glucose Conditions in the Placenta

Abnormal glucose metabolism during pregnancy is an established risk factor for preeclampsia (PE). Disruption of the balance between placental angiogenic factors is linked to PE pathophysiology. We examined whether hypoxia-induced factor-1α (HIF-1α) and protein kinase Cβ (PKCβ) are involved in the regulation of placental angiogenic factors under high-glucose conditions in vitro. The human choriocarcinoma cell lines BeWo and JEG-3, and the human trophoblast cell line HTR-8/SVneo were cultured with 10 and 25 mmol/L glucose [control glucose group (CG) and high-glucose group (HG), respectively]. We examined the changes in HIF-1α, soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) expression in the CG and HG by real-time PCR and ELISA. PKC activation was also measured by ELISA. The expressions of HIF-1α, sFlt-1, PlGF, and VEGF were significantly higher in the HG than in the CG. PKC activity was significantly increased in the HG. High glucose affected the expression of angiogenic factors in choriocarcinoma cells via the PKCβ and HIF-1α pathways, suggesting their involvement in PE pathogenesis