Accurate and molecular-size-tolerant NMR quantitation of diverse components in solution.

木質バイオマス中の各成分の物質量を正確に決定する手法の開発に成功 --木質バイオマスからの効率的なバイオエネルギー・製品原料の獲得にはずみ--. 京都大学プレスリリース. 2016-02-18.Determining the amount of each component of interest in a mixture is a fundamental first step in characterizing the nature of the solution and to develop possible means of utilization of its components. Similarly, determining the composition of units in complex polymers, or polymer mixtures, is crucial. Although NMR is recognized as one of the most powerful methods to achieve this and is widely used in many fields, variation in the molecular sizes or the relative mobilities of components skews quantitation due to the size-dependent decay of magnetization. Here, a method to accurately determine the amount of each component by NMR was developed. This method was validated using a solution that contains biomass-related components in which the molecular sizes greatly differ. The method is also tolerant of other factors that skew quantitation such as variation in the one-bond C-H coupling constant. The developed method is the first and only way to reliably overcome the skewed quantitation caused by several different factors to provide basic information on the correct amount of each component in a solution

A Case of Single-Incision Laparoscopic Surgery for Lipoma of the Terminal Ileum

A 52-year-old woman presented with a right lower abdominal mass, lower abdominal pain, and distension in July 2011. She had myasthenia gravis, but did not have any surgical history. Clinical examination showed a right lower abdominal mass, abdominal distension, decreased bowel sounds, and rebound tenderness in the lower abdomen. Abdominal computed tomography showed an intussusception involving the ileocecal junction. A gastrografin enema image of the colon showed a 30-mm filling defect in the ascending colon. The patient underwent resection of the intussuscepted intestine by single-incision laparoscopic surgery (SILS). The resected specimen contained a round tumor measuring 35 × 35 × 20 mm, which was diagnosed histopathologically as lipoma of the terminal ileum. The patient remains asymptomatic eight months after surgery

A Case of Gallstone Ileus

A 57-year-old woman was admitted to our hospital with abdominal pain and vomiting. Her abdomen was distended, and obstructive bowel sounds were discovered on examination. Diffuse abdominal tenderness was present, but no palpable masses were apparent. Abdominal computed tomography confirmed a large gallstone obstructing the small bowel. Colonoscopy revealed a large gallstone lodged at the terminal ileum, which was subsequently fragmented using electronic hydraulic lithotripsy (EHL). The patient has remained asymptomatic for over 3 years of follow-up after the EHL treatment. Here, we present this case of small intestinal obstruction caused by a large gallstone in the lower ileum

A Case of Ischemic Colonic Stenosis of the Splenic Flexure

Ischemic colitis is characterized by lesions arising from colonic ischemia. The treatment of choice is surgery, and resection of the affected segment is often life saving. This study presents a case of segmental ischemic colonic stenosis of the splenic flexure. A 70-year-old woman was admitted to our hospital with abdominal pain and distension. Physical examination revealed mild tenderness of the left-upper abdomen but no peritoneal signs. A computed tomography scan demonstrated a thickening of the splenic flexure of the colon with active inflammation. A gastrografin enema revealed a 5-cm-long tight stricture at the left transverse colon, which suggested a subileus. Surgery for segmental ischemic colonic stenosis was performed because the stricture did not respond to treatment. Pathological examination revealed features typical of ischemic colitis, including ulceration and segmental colonic stenosis of the splenic flexure, but revealed no evidence of tumors, lymph node swelling, or vascular disorder

Anastomotic Recurrence due to Tumor Implantation using the Double Stapling Technique after Curative Surgery for Sigmoid Colon Cancer

Recurrence at the site of a stapled anastomosis is generally believed to result from the luminal implantation of viable cancer cells during stapling. We report a 57-year-old woman who underwent radical surgery for sigmoid colon cancer and developed anastomotic recurrence ten months after the initial operation. Her serum carcinoembryonic antigen (CEA) levels were within normal limits during the postoperative follow-up. The patient subsequently underwent a partial colon resection for the anastomotic recurrence. The clinicopathological findings revealed that possible tumor cell implantation caused the recurrence. We encountered a case of anastomotic recurrence due to possible tumor implantation after curative surgery for sigmoid colon cancer. Follow-up colonoscopy was more helpful for the diagnosis of anastomotic recurrence than CEA monitoring

A Case of Pneumatosis Cystoides Intestinalis Mimicking Intestinal Perforation

An 85-year-old man was referred to the Department of Gastroenterological and General Surgery after complaining of abdominal pain and distention. Abdominal computed tomography (CT) revealed intra-abdominal free air, mimicking perforated peritonitis, with air collection within the jejunum bowel wall. On the basis of these findings, we made a diagnosis of pneumatosis cystoides intestinalis (PCI) with intra-abdominal free air. The PCI signs had disappeared completely by Day 7 of hospitalization. The patient was discharged from hospital after 15 days. At the time of writing, the patient’s PCI has not reappeared. This case highlights the clinical importance of PCI, and that the lung window settings of abdominal CT are useful tools to enable an accurate diagnosis of PCI

Case Report of a Crohn\u27s Disease (CD) Patient with Anastomotic Stenosis Unrelated to Postoperative Recurrence of CD

Crohn\u27s disease (CD) is an idiopathic inflammatory bowel disease that can involve any part of the gastrointestinal tract. It frequently involves the ileum, colon, and anorectum. A 66-year-old man with CD had undergone a partial intestinal resection of the ileum for CD 27 years previously, and had been hospitalized several times, including two months prior to referral. The patient was admitted to our hospital with abdominal pain and distension. A computed tomography (CT) scan demonstrated an anastomotic stenosis with active inflammation and proximal intestinal extension. Colonoscopic examination revealed no abnormalities in the colon or rectum. A contrast Gastrografin enema revealed a stenosis in the ileum and a tight stricture at 3 cm with inflammation. We performed an ileocecal resection for an anastomotic stenosis due to possible recurrence of CD. Pathological examination showed no evidence of CD activity at the anastomotic region, indicating no recurrence of CD

A Case of Laparoscopic Ileocecal Resection for Intussusception Secondary to Cecal Cancer

An 83-year-old woman presented with a right lower abdominal mass, lower abdominal pain, and distension. She had no medical or surgical history. Clinical examination revealed a right lower abdominal mass, abdominal distension, and decreased bowel sounds in the lower abdomen. Abdominal computed tomography showed an intussusception involving the ileocecal junction. A Gastrografin enema showed a tumor shadow with an irregular defect caused by the intussusception in the transverse colon. The protruding tumor was also pushed back into the cecum by the enema pressure. Colonoscopy revealed a protruding mass at the leading edge of the intussusception in the ascending colon, and biopsy results of the cecal mass indicated an adenocarcinoma. The patient underwent laparoscopic ileocecal resection of the intussuscepted cecal cancer using reduced port surgery. The resected specimen contained a type 1 tumor measuring 40mm that was histopathologically diagnosed as cecal cancer. The patient remains asymptomatic 8 months after surgery

A Case of Intestinal Obstruction Secondary to a Strangulated Obturator Hernia in an Elderly Woman

In this report, we present a case of intestinal obstruction secondary to a strangulated obturator hernia in an elderly woman. An 88-year-old woman was admitted to our hospital because she had been experiencing abdominal pain and vomiting for 24h. Her abdomen was distended, and bowel sounds indicating obstruction were heard on auscultation. Diffuse abdominal tenderness was present, but no palpable masses were apparent. The diagnosis of an obturator hernia was confirmed preoperatively by computed tomography. During the emergency laparotomy, the incarcerated intestine was reduced and removed. The obturator foramen was repaired using a simple suture. The patient recovered completely and was discharged seven days after the surgical procedure because no postoperative complications occurred. An early diagnosis and prompt surgical treatment are important to reduce the morbidity and mortality associated with an obturator hernia

A Case of Ischemic Ileal Obstruction Secondary to Seat Belt Trauma

We report a case of seat belt trauma with delayed ischemic ileal obstruction. A 62-year-old woman presented with symptoms and signs of bowel obstruction three weeks after an automobile traffic accident. A plain radiograph of the abdomen showed dilated small bowel loops with air fluid levels that were consistent with intestinal obstruction. Enhanced computed tomography clearly demonstrated a stenotic ileal loop with mural thickening that was associated with a mesenteric hematoma. Upper endoscopy revealed an ulcer of the ischemic ileal obstruction. The patient underwent resection of the stenotic ileal loop by single-incision laparoscopic surgery. The stenotic ileal loop was located 120 cm oral side from the terminal ileum. In gross finding, the wall of stenotic ileal loop was thickened and the adjacent mesentery was shortened with a hematoma. The mucosa of the ischemic ileal obstruction showed ulcerative changes. The abnormal ileal loop, which was 15 cm in length, was resected. Postoperative recovery was uneventful