Indication for Endoscopic Resection of Submucosal Colorectal Carcinoma: Special Reference to Lymph Node Metastasis

We investigated the relationship between histological factors and lymph node metastasis in 77 lesions with submucosally invasive colorectal carcinomas to establish useful criteria for lesions in which endoscopic treatment alone results in cure of malignancy. There were positive correlations between histological factors, including the level of invasion, the histologic grade, presence or absence of lymphatic invasion, presence or absence of budding, and lymph node metastasis (p < 0.05, p < 0.05, p < 0.005, p < 0.01). The presence or absence of venous invasion did not influence lymph node metastasis. Laparoscopic surgery involving lymph node dissection should be indicated for sm1 carcinoma lesions with unfavorable histological factors. In lesions diagnosed as sm2 or sm3 prior to resection, intestinal resection involving lymph node dissection by laparoscopic surgery should be directly performed without endoscopic resection

Truncated KCNQ1 mutant, A178fs/105, forms hetero-multimer channel with wild-type causing a dominant-negative suppression due to trafficking defect

AbstractWe identified a novel mutation Ala178fs/105 missing S3–S6 and C-terminus portions of KCNQ1 channel. Ala178fs/105-KCNQ1 expressed in COS-7 cells demonstrated no current expression. Co-expression with wild-type (WT) revealed a dominant-negative effect, which suggests the formation of hetero-multimer by mutant and WT. Confocal laser microscopy displayed intracellular retention of Ala178fs/105-KCNQ1 protein. Co-expression of the mutant and WT also increased intracellular retention of channel protein compared to WT alone. Our findings suggest a novel mechanism for LQT1 that the truncated S1–S2 KCNQ1 mutant forms hetero-multimer and cause a dominant-negative effect due to trafficking defect

A Case of Perforated Sigmoid Diverticulitis in Which Gram Staining of Ascitic Fluid Was Useful for Diagnosis

An 85-year-old woman was admitted to our hospital for steroid therapy for relapsing nephrotic syndrome. During hospitalization, she complained of sudden epigastric pain at night. Although there were signs of peritoneal irritation, CT showed a large amount of ascitic fluid, but no free intraperitoneal gas. Gram staining of ascitic fluid obtained by abdominal paracentesis showed Gram-negative rods, which raised a strong suspicion of gastrointestinal perforation and peritonitis. Therefore, emergency surgery was performed. Exploration of the colon showed multiple sigmoid diverticula, one of which was perforated. The patient underwent an emergency Hartmann's procedure. Imaging studies failed to reveal any evidence of gastrointestinal perforation, presenting a diagnostic challenge. However, a physician performed rapid Gram staining of ascitic fluid at night when laboratory technicians were absent, had a strong suspicion of gastrointestinal perforation, and performed emergency surgery. Gram staining is superior in rapidity, and ascitic fluid Gram staining can aid in diagnosis, suggesting that it should be actively performed. We report this case, with a review of the literature on the significance of rapid diagnosis by Gram staining

A case report of crystalline light chain inclusion-associated kidney disease affecting podocytes but without Fanconi syndrome

RATIONALE:Crystalline light chain inclusion-associated kidney disease affects mainly tubular epithelial cells and is often clinically manifested as Fanconi syndrome. However, only very few case reports about the crystalline deposits within the podocytes are available, and the nature of the pathogenic monoclonal light chain implicated in these cases is still unknown. We report a case of crystalline inclusion-associated kidney disease manifested as crystalline podocytopathy in which we identified the complete structure of the pathogenic monoclonal light chain as belonging to the germ-line gene of Vκ1-39.PATIENT CONCERNS:We describe a 65-year-old woman with crystalline light chain inclusion-associated kidney disease showing mild proteinuria and renal insufficiency with monoclonal gammopathy of undetermined significance without Fanconi syndrome. She had crystalline inclusions mainly within podocytes, tubular epithelial cells and histiocytes in the kidney. Light microscopy showed vacuolation of podocytes and tubular epithelial cells, while eosin negative pale needle-like crystals were present within these cells. Electron microscopy showed accumulation of club-like crystals with high electron density in podocytes, proximal tubular epithelial cells and interstitial histiocytes. Clonal analysis revealed that a pathogenic monoclonal light chain was derived from germline gene, Vκ1-39.DIAGNOSES:The diagnosis of crystalline light chain inclusion-associated kidney disease was made.INTERVENTIONS AND OUTCOMES:Bortezomib and dexamethasone were started and her renal function improved to eGFR 36 mL/min/1.73 m after 9 courses of therapy.LESSONS:Patients with light chain crystalline podocytopathy may have a similar pathogenic monoclonal light chain derived from the same germline gene, Vκ1-39, to that of patients with light chain proximal tubulopathy

広島における原爆・核・被ばく関連の史・資料の集積と研究の現況

研究成果の概要～核・被ばく学の方向性と課題～…小池　聖一 1 第一部　研究会速記録　 広島県立文書館所蔵原爆関係資料について…安藤　福平 5　 広島平和記念資料館の所蔵資料について…落葉　裕信 44　 原爆被災資料の収集・整理・保存～広島大学勤務期…宇吹　暁 94　 広島市公文書館が所蔵する原爆関係資料について…渡辺　琴代 139　 広島大学文書館所蔵平和関係資料について…小池　聖一 174　 第二部　個別研究　 「原子のペスト」と低線量被爆…布川　弘 201　 2010年―2013年の核をめぐる動向と課題…水本　和実 209　 第三部　調査報告　 原爆報道…石田　雅春 261　 被爆者対策の国際比較…川野　徳幸 266　 平和教育…小宮山道夫 271　 核の戦争責任論…永井　均 277　広島における核・被ばく学研究基盤の形成に関する研究（課題番号：23300096） 平成23年度科学研究費補助金基盤研究（B）研究成果報告

Common Variants in MAGI2 Gene Are Associated with Increased Risk for Cognitive Impairment in Schizophrenic Patients

Schizophrenia is a complex psychiatric disorder characterized by positive symptoms, negative symptoms, and cognitive impairment. MAGI2, a relatively large gene (∼1.5 Mbps) that maps to chromosome 7q21, is involved in recruitment of neurotransmitter receptors such as AMPA- and NMDA-type glutamate receptors. A genetic association study designed to evaluate the association between MAGI2 and cognitive performance or schizophrenia has not been conducted. In this case-control study, we examined the relationship of single nucleotide polymorphism (SNP) variations in MAGI2 and risk for schizophrenia in a large Japanese sample and explored the potential relationships between variations in MAGI2 and aspects of human cognitive function related to glutamate activity. Based on the result of first schizophrenia genome-wide association study in a Japanese population (JGWAS), we selected four independent SNPs and performed an association study using a large independent Japanese sample set (cases 1624, controls 1621). Wisconsin Card Sorting Test (WCST) was used to evaluate executive function in 114 cases and 91 controls. We found suggestive evidence for genetic association of common SNPs within MAGI2 locus and schizophrenia in Japanese population. Furthermore in terms of association between MAGI2 and cognitive performance, we observed that genotype effect of rs2190665 on WCST score was significant (p = 0.034) and rs4729938 trended toward significance (p = 0.08). In conclusion, although we could not detect strong genetic evidence for association of common variants in MAGI2 and increased schizophrenia risk in a Japanese population, these SNPs may increase risk of cognitive impairment in schizophrenic patients

Assessment of Velopharyngeal Function : Comparison of Various Methods.

Precise estimation of velopharyngeal function is the essential first step in treating cleft palate speech either by surgery or by speech therapy. The methods in use at our daily clinic include judgement of speech, oral-inspection, rhinometric mirror, pneumotachography, velopharyngeal radiography, videonasoendofiberscopy, videofluororadiography and computerized tomography. Evaluation of velopharyngeal function on the basis of auditory impression, especially of nasality, is clinically important but requires accumulated experiences. This paper emphasizes the usefulness of 3 methods in particular : videonasoendofiberscopy, videofluororadiography and computerized tomography. Videonasoendofiberscopy provides direct visual information on the velopharyngeal closure during speech activity but quantitative analysis is impossible. There is also a problem in reproducibility and reliability due to possible different position of the fiberscope on each test. Videofluororadiography permits dynamic and quantitative assessment of velopharyngeal closure when the video-images are repeatedly displayed for measurement. Two directional projections--lateral and antero-posterior--are recommended for full understanding of the velopharyngeal function. It is also advantageous in that the relation between velopharyngeal function and articulatory lingual movement can be well visualized. A most modern computerized tomography can demonstrate the velopharyngeal aperature on a calibrated scale