Duodenoportal fistula caused by peptic ulcer after extended right hepatectomy for hilar cholangiocarcinoma

BACKGROUND: A fistula between the duodenum and the main portal vein near a peptic ulcer is extremely rare, and only two cases of duodenal ulcers have been reported in the past. CASE PRESENTATION: We report a 68-year-old man with a diagnosis of anemia who had a history of extended right hepatectomy for hilar cholangiocarcinoma 20 months previously. The first endoscopic examination revealed a giant peptic ulcer with active bleeding at the posterior wall of the duodenal bulbs, and hemostasis was performed. Endoscopic treatment and transarterial embolization were performed repeatedly because of uncontrollable bleeding from the duodenal ulcer. Nevertheless, he died of sudden massive hematemesis on the 20(th )hospital day. At autopsy, communication with the main portal vein and duodenal ulcer was observed. CONCLUSION: It should be borne in mind that the main portal vein is exposed at the front of the hepatoduodenal ligament in cases with previous extrahepatic bile duct resection

A Retinoid X Receptor Agonist Directed to the Large Intestine Ameliorates T-Cell-Mediated Colitis in Mice

Retinoid X receptor (RXR) is a nuclear receptor that heterodimerizes with several nuclear receptors, integrating ligand-mediated signals across the heterodimers. Synthetic RXR agonists have been developed to cure certain inflammatory diseases, including inflammatory bowel diseases (IBDs). However, pre-existing RXR agonists, which are lipophilic and readily absorbed in the upper intestine, cause considerable adverse effects such as hepatomegaly, hyperlipidemia, and hypothyroidism. To minimize these adverse effects, we have developed an RXR agonist, NEt-3IB, which has lipophilic and thus poorly absorptive properties. In this study, we evaluated the effects of NEt-3IB in an experimental murine colitis model induced through the adoptive transfer of CD45RB(high)CD4(+) T cells. Pharmacokinetic studies demonstrated that the major portion of NEt-3IB was successfully delivered to the large intestine after oral administration. Notably, NEt-3IB treatment suppressed the development of T cell-mediated chronic colitis, as indicated by improvement of wasting symptoms, inflammatory infiltration, and mucosal hyperplasia. The protective effect of NEt-3IB was mediated by the suppression of IFN-gamma-producing Th1 cell expansion in the colon. In conclusion, NEt-3IB, a large intestine-directed RXR agonist, is a promising drug candidate for IBDs

Characterization of Clonal Polyp Strains Established from Aurelia sp. Inhabiting the Seto Inland Sea of Japan

ミズクラゲ(Aurelia sp.)の生活環の中で，ポリプからストロビラを経てエフィラに形態変化する過程はストロビレーションと呼ばれる。ストロビレーションの分子機構の解明に向けて分子生物学的および生化学的研究を進めるために，瀬戸内海産のミズクラゲからポリプのクローン系統を7株確立した。実験室内でストロビレーションを誘導する条件を検討した結果，これらのクローン系統は，25℃から10℃への低温処理によって32- 42日でストロビレーションを開始し，indomethacin (25μM)の投与によって25℃条件下で4-8日でストロビレーションを開始した。また，短期間だけ低温処理をおこなう飼育実験の結果，ストロビレーションは一旦開始すると低温条件下でなくても正常に進行し完了することが明らかになった。さらに，分子系統解析の結果，今回確立したクローン系統がAurelia sp.1(Dawson et al., 2005)であることが示唆された。In the life cycle of Aurelia sp., the transition from polyp to strobila/ephyra is called“strobilation”. To study the molecular mechanisms of strobilation with molecular biological and biochemical approaches, we established 7 clonal polyp strains from Aurelia sp. inhabiting the Seto Inland Sea of Japan. In laboratory condition, the clonal strains started strobilation in 32 - 42 days by a temperature change from 25˚C to 10˚C, or in 4 - 8 days at 25˚C by administration of indomethacin (25 μM). The experiments of short-term low-temperature treatments revealed that strobilation proceeded to the end independently of temperature after strobilation had been initiated. Further, molecular phylogenetic analysis suggested that the clonal strains could be Aurelia sp. 1 (Dawson et al., 2005).本研究は，平成20年度広島大学後援会・教育研究一般助成および平成20年度広島大学大学院生物圏科学研究科・研究科長裁量経費研究助成の支援のもとで実施されたものである

島根県の妊娠初期における妊婦の栄養摂取状況について(第1報) : 分娩歴による比較

島根県における妊娠初期の妊婦の栄養摂取状況を明らかにすることを目的とし、分娩歴による違いがあるかに注目して研究を行った。妊娠10 週から12 週の妊婦29 名に食物摂取頻度調査を行い、初産婦（15名）、経産婦（14 名）の２群に分けて比較した。各種栄養素摂取量および食品群別栄養素摂取量については、２群間で有意な差はみられなかった。食品群別摂取量の「嗜好品飲料類」について、初産婦の摂取量が有意に多かった。栄養素摂取量の多くが２群とも平均必要量に満たないことが明らかになった

島根県の妊娠初期における妊婦の栄養摂取状況について(第2報) : BMIおよび欠食状況による比較

島根県の低出生体重児の出生割合は高いことが報告されており、児の将来において様々なリスクの可能性がある。　　　我々は、島根県内の妊婦に対して栄養摂取状況の調査を行い、低出生体重児との関連性について検討している。本研究では、妊娠初期における妊婦29 名に食物摂取頻度調査を行い、体格指数（Body Mass Index（BMI））の区分および妊娠後の欠食状況の違いによる栄養素摂取量および食品群別摂取量を算出し検討した。非妊娠時BMI が低い群は、エネルギー、炭水化物、ナトリウム、マンガン、鉄、食物繊維の摂取量が多いことが示唆された。また、妊娠初期の妊婦の44.8％が週一回以上の欠食をし、その結果、栄養素の多くが推奨量に満たないことが示唆された

Wnt5 is required for notochord cell intercalation in the ascidian Halocynthia roretzi

Background information. In the embryos of various animals, the body elongates after gastrulation by morphogenetic movements involving convergent extension. The Wnt/PCP (planar cell polarity) pathway plays roles in this process, particularly mediolateral polarization and intercalation of the embryonic cells. In ascidians, several factors in this pathway, including Wnt5, have been identified and found to be involved in the intercalation process of notochord cells

Geographic disparity of pathophysiological coronary artery disease characteristics: Insights from ASET trials

The geographical disparity in the pathophysiological pattern of coronary artery disease (CAD) among patients undergoing percutaneous coronary intervention (PCI) is unknown. To elucidate the geographical variance in the pathophysiological characteristics of CAD. Physiological indices derived from angiography-based fractional flow reserve pullbacks from patients with chronic coronary syndrome enrolled in the ASET Japan (n = 206) and ASET Brazil (n = 201) studies, which shared the same eligibility criteria, were analysed. The pathophysiological patterns of CAD were characterised using Murray law-based quantitative flow ratio (μQFR)-derived indices acquired from pre-PCI angiograms. The diffuseness of CAD was defined by the μQFR pullback pressure gradient index. Significant functional stenoses pre-PCI (μQFR ≤0.80) were more frequent in ASET Japan compared to ASET Brazil (89.9% vs. 67.5%, p < 0.001), as were rates of a post-PCI μQFR <0.91 (22.1% vs. 12.9%, p = 0.013). In the multivariable analysis, pre-procedural μQFR and diffuse disease were independent factors for predicting a post-PCI μQFR <0.91, which contributed to the different rates of post-PCI μQFR ≥0.91 between the studies. Among vessels with a post-PCI μQFR <0.91, a consistent diffuse pattern of CAD pre- and post-PCI occurred in 78.3% and 76.7% of patients in ASET Japan and Brazil, respectively; only 6.3% (Japan) and 10.0% (Brazil) of vessels had a major residual gradient. Independent risk factors for diffuse disease were diabetes mellitus in ASET Japan, and age and male gender in Brazil. There was geographic disparity in pre-procedural angiography-based pathophysiological characteristics. The combined pre-procedural physiological assessment of vessel μQFR and diffuseness of CAD may potentially identify patients who will benefit most from PCI. [Abstract copyright: Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.