A case of fulminant amebic colitis that could be saved

An 80-year-old man was admitted to a neighboring hospital with severe diarrhea and bloody stools. He did not have a remarkable medical history, was not homosexual, and had not traveled outside the country for several years. Colonoscopy was performed on the day of admission and revealed multiple ulcerations with edematous mucosa throughout the colorectum. Histopathological findings of biopsy specimen could not identify the reason for the inflamed colon. On postadmission day 6, the patient developed severe abdominal pain and underwent an emergent surgery for pan-peritonitis due to bowel perforation. The laparotomy revealed glossy fecal pan-peritonitis with perforation of the sigmoid colon; necrosis was observed through the entire length of the colon. The colonic tissue was extremely fragile and exhibited a blotting paper-like appearance. Total colectomy, sigmoid mucous fistula, ileostomy, and intraperitoneal drainage were performed. On postadmission day 12, histopathological findings of resected specimen raised the suspicion of amebic dysentery, and we accordingly treated him with metronidazole (2,250 mg/day) administered orally. Abdominal CT images taken on days 12 and 20 postadmission showed multiple liver abscesses, which improved following metronidazole administration. Metronidazole was discontinued 14 days after initiation as the patient’s general condition improved. His condition remained stable thereafter, and he was transferred two months after admission

CpG Island Methylator Phenotype in Primary Gastric Carcinoma

Gastric cancers (GC) with methylation of multiple CpG islands have a CpG island methylator phenotype (CIMP) and they can have different biological features. The aim of this study was to investigate the DNA methylation status of GCs and its association with their clinicopathological features. We evaluated the methylation status of four genes (MINT1, MINT2, MINT25 and MINT31) in 105 primary GCs using bisulfite-pyrosequencing analysis. We classified tumors as CIMP-high (CIMP-H), CIMP-low (CIMP-L) or CIMP-negative (CIMP-N) based on the methylation of MINT1, MINT2, MINT25, and MINT31. Overall, the prevalence of CIMP-H, CIMP-L and CIMP-N was 22% (23/105), 52% (55/105) and 26% (27/105), respectively. We observed a significant difference in tumor stage (stages I-II vs. stages III-IV) between CIMP-H and CIMP-N tumors (P = 0.0435). No significant differences were observed in clinicopathological characteristics (gender, age, location and tumor differentiation) among the CIMP phenotypes. The prognoses of patients with a CIMP-H tumor is likely to be better than those with CIMP-L or CIMP-N tumors, but these differences are not statistically significant (P = 0.074 and P = 0.200). Our results suggest that CIMP may define a subgroup of GCs with distinct biological features

川崎医科大学におけるブース形式診療科別説明会の学内開催

川崎医科大学は,中核市の倉敷市内と政令指定都市の岡山市内に二つの附属病院を有している。両病院の卒後臨床研修プログラムは独立しているが,研修は両方の病院の診療科から選択することが可能である。平成27年7月,初めて川崎医科大学生を対象にした大学附属病院診療科の説明会をブース形式で学内開催した。研修プログラム説明会とは趣を異にし,各診療科の特徴や業務内容を広報することを目的とした。1年生から6年生までの学生が参加し,アンケート調査に回答した52名全員が将来の研修病院の選択に役に立ったと答え,うち27%は非常に役立ったと高い満足度を示した。また,研修医だけで計画した学生向けのミニシンポジウムも同時に開催し,来場した約70%の学生が参加し貴重な情報収集の場となった。次年度以降も改善を加えながら,学生が身近に附属病院スタッフや先輩研修医と交流できるイベントとして育てていきたい。Kawasaki Medical School has one hospital in Kurashiki City, a core city, and another in Okayama City, an ordinance-designated city. These hospitals have independent postgraduate clinical training programs. However, departments of both hospitals can be selected for training. In July 2015, a boothtype meeting regarding Kawasaki Medical School Hospital departments was held for Kawasaki Medical School students for the first time. The intent of the meeting differed from that of other training program meetings, and its goal was to provide information on the characteristics and tasks of each department. First- to sixth-year students participated in the meeting. All 52 students who responded to a questionnaire survey answered that the meeting was useful in helping them select a hospital for their future training, and 27% of them reported that the meeting was very useful and showed high levels of satisfaction. A mini symposium for students planned only by residents was also held at the same time. About 70% of visiting students participated in the symposium and were given a valuable opportunity to gather information. By making improvements, we will cultivate the meeting as an event in which students can have contact with hospital staff and junior residents from the next year