Intestinal Nature in Gallbladder Carcinoma with Reference to its Histogenesis

Forty advanced cases of gallbladder carcinoma were examined by the use of histochemical and immunohistological methods, in which attention was focused on intestinal metaplasia seen in and around the lesions. Twenty-nine percent for cases of well-differentiated adenocarcinoma displayed goblet cell-type carcinoma cells within the lesions, while no similar cell was evident in cases of poorly differentiated adenocarcinoma. Ten percent for cases of gallbladder carcinoma included endocrine cells within neoplastic tissues, all of which consisted of well-differentiated adenocarcinoma and mucosal areas adjacent to which also contained similar cells. Mucosal areas in the proximity to foci of well-differentiated adenocarcinoma demonstrated a marked increase in the amount of non-sulfated acid mucin, but no such tendency was discernible around foci of poorly differentiated adenocarcinoma. Lysozyme immunoreactivity was identifiable in a high percent of well-differentiated adenocarcinoma foci and their surrounding mucosal areas, while similar reactivity was rarely present in cases of poorly differentiated adenocarcinoma. It may be suggested from these results that an intimate relationship would exist in between intestinal metaplasia and well-differentiated adenocarcinoma occurring in the gallbladder. It is, however, to be determined whether or not intestinal metaplasia alone would act as a precancerous lesion like adenoma, dysplasia and possibly hyperplastic polyp for the histogenesis of gallbladder carcinomas

Retroperitoneal hemorrhage with COVID-19

Introduction: Early prophylactic administration of anticoagulants is recommended in patients with coronavirus disease 2019 (COVID-19). A case of retroperitoneal hemorrhage during inpatient treatment for COVID-19 is reported. Case Presentation : A 69-year-old man was diagnosed with COVID-19 6 days after symptom onset. After admission for difficulty of breathing, he was treated with steroid pulse therapy, remdesivir, and heparin sodium. On day 16 after admission, his hemoglobin and blood pressure dropped. Computed tomography showed a left retroperitoneal hematoma and multiple areas of extravasation in bilateral iliopsoas muscles. Anticoagulation therapy was stopped, and blood transfusion therapy was chosen by considering poor general condition caused by severe pneumonia. On day 19, the hemoglobin and blood pressure improved, and blood transfusion was stopped. However, he died on day 25 due to pneumonia. Conclusion : When retroperitoneal hemorrhage occurs as a complication of COVID-19, appropriate treatment decision, transcatheter arterial embolization or conservative treatment, should be chosen based on patient’s condition

Reg3 alpha and Reg3 beta Expressions Followed by JAK2/STAT3 Activation Play a Pivotal Role in the Acceleration of Liver Hypertrophy in a Rat ALPPS Model

To explore the underlying mechanism of rapid liver hypertrophy by liver partition in associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), liver partition at different sites was investigated. Increased inflammatory cytokines owing to the liver partition have been reportedly responsible. If this were true, rapid liver hypertrophy should be achieved regardless of where the liver was split. A male Sprague-Dawley rat model was created, in which a liver split was placed inside the portal vein ligated lobe (PiLL), in addition to the ALPPS and portal vein ligation (PVL) models. Liver regeneration rate, inflammatory cytokine levels, activation status of the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) pathway and expressions of regenerating islet-derived (Reg)3 alpha and Reg3 beta were investigated. The liver regeneration rate was significantly higher in the ALPPS group than in the PiLL group, whereas inflammatory cytokine levels were nearly equal. Additional volume increase in ALPPS group over PVL and PiLL groups was JAK2/STAT3-dependent. Reg3 alpha and Reg3 beta expressions were observed only in the ALPPS group. An increase in inflammatory cytokines was not enough to describe the mechanism of rapid liver hypertrophy in ALPPS. Expressions of Reg3 alpha and Reg3 beta could play an important role in conjunction with an activation of the JAK2/STAT3 pathway

Surgical Resection of Hepatic Cystic Echinococcosis Impaired by Preoperative Diagnosis

Cystic echinococcosis (CE) is a rare afferent infectious disease in Japan. This paper reports a case of a hepatic cyst being diagnosed after surgical resection. A 40-year-old Syrian male was admitted for evaluation of a hepatic cyst. Serum antibodies of echinococcosis were negative. Enhanced computed tomography of the abdomen revealed a large cystic lesion, 9 cm in diameter, in the left lateral sector of the liver, which had many honeycomb-like septa and calcified lesions. Magnetic resonance imaging of this lesion revealed high intensity in the T2 weighted image. We preoperatively diagnosed this lesion as cystadenocarcinoma or CE and performed a left hepatectomy. Pathological examination revealed the presence of protoscolices in the fluid of the cysts and led to a diagnosis of this lesion as CE. In conclusion, on seeing patients with huge hepatic cysts who come from an epidemic area, we should consider hepatic CE

Diverse dystonin gene mutations cause distinct patterns of

Loss-of-function mutations in dystonin (DST) can cause hereditary sensory and autonomic neuropathy type 6 (HSAN-VI) or epidermolysis bullosa simplex (EBS). Recently, DST-related diseases were recognized to be more complex than previously thought because a patient exhibited both neurological and skin manifestations, whereas others display only one or the other. A single DST locus produces at least three major DST isoforms: DST-a (neuronal isoform), DST-b (muscular isoform) and DST-e (epithelial isoform). Dystonia musculorum (dt) mice, which have mutations in Dst, were originally identified as spontaneous mutants displaying neurological phenotypes. To reveal the mechanisms underlying the phenotypic heterogeneity of DST-related diseases, we investigated two mutant strains with different mutations: a spontaneous Dst mutant (Dstdt-23Rbrcmice) and a gene-trap mutant (DstGt mice). The Dstdt-23Rbrc allele possesses a nonsense mutation in an exon shared by all Dst isoforms. The DstGt allele is predicted to inactivate Dst-a and Dst-bisoforms but not Dst-e There was a decrease in the levels of Dst-a mRNA in the neural tissue of both Dstdt-23Rbrc and DstGt homozygotes. Loss of sensory and autonomic nerve ends in the skin was observed in both Dstdt-23Rbrc and DstGt mice at postnatal stages. In contrast, Dst-e mRNA expression was reduced in the skin of Dstdt-23Rbrc mice but not in DstGt mice. Expression levels of Dst proteins in neural and cutaneous tissues correlated with Dst mRNAs. Because Dst-e encodes a structural protein in hemidesmosomes (HDs), we performed transmission electron microscopy. Lack of inner plaques and loss of keratin filament invasions underneath the HDs were observed in the basal keratinocytes of Dstdt-23Rbrc mice but not in those of DstGt mice; thus, the distinct phenotype of the skin of Dstdt-23Rbrc mice could be because of failure of Dst-e expression. These results indicate that distinct mutations within the Dst locus can cause different loss-of-function patterns among Dst isoforms, which accounts for the heterogeneous neural and skin phenotypes in dt mice and DST-related diseases

Discontinuous boundaries of slow slip events beneath the Bungo Channel, southwest Japan

The down-dip limit of the seismogenic zone and up-dip and down-dip limits of the deep low-frequency tremors in southwest Japan are clearly imaged by the hypocentre distribution. Previous studies using smooth constraints in inversion analyses estimated that long-term slow slip events (L-SSEs) beneath the Bungo Channel are distributed smoothly from the down-dip part of the seismogenic zone to the up-dip part of the tremors. Here, we use fused regularisation, a type of sparse modelling suitable for detecting discontinuous changes in the model parameters to estimate the slip distribution of L-SSEs. The largest slip abruptly becomes zero at the down-dip limit of the seismogenic zone, is immediately reduced to half at the up-dip limit of the tremors, and becomes zero near its down-dip limit. Such correspondences imply that some thresholds exist in the generation processes for both tremors and SSEs. Hence, geodetic data inversion with sparse modelling can detect such high resolution in the slip distribution

Acceleration effect of coupled oscillator systems

We have developed a curved isochron clock (CIC) by modifying the radial isochron clock to provide a clean example of the acceleration (deceleration) effect. By analyzing a two-body system of coupled CICs, we determined that an unbalanced mutual interaction caused by curved isochron sets is the minimum mechanism needed for generating the acceleration (deceleration) effect in coupled oscillator systems. From this we can see that the Sakaguchi and Kuramoto (SK) model which is a class of non-frustrated mean feild model has an acceleration (deceleration) effect mechanism. To study frustrated coupled oscillator systems, we extended the SK model to two oscillator associative memory models, one with symmetric and one with asymmetric dilution of coupling, which also have the minimum mechanism of the acceleration (deceleration) effect. We theoretically found that the {\it Onsager reaction term} (ORT), which is unique to frustrated systems, plays an important role in the acceleration (de! celeration) effect. These two models are ideal for evaluating the effect of the ORT because, with the exception of the ORT, they have the same order parameter equations. We found that the two models have identical macroscopic properties, except for the acceleration effect caused by the ORT. By comparing the results of the two models, we can extract the effect of the ORT from only the rotation speeds of the oscillators.Comment: 35 pages, 10 figure

Limited Resection for Lung Cancer

Based on clinical as well as experimental studies, limited operation of choice was evaluated for the management of lung cancer. From clinical analysis of 39 cases who underwent limited lung resection, our clinical experiences indicated that this operative procedure would be feasible for a large tumors of approximately 4cm in diameter. However, the incidence of lymphnode metastasis is more likely to be high when applied to the tumors of more than 3cm in diameter. The favorable indication, therefore, is for the cancer less than 3cm in diameter. By careful evalution of 7 cases with postoperative recurrence, it has become obvious that either the degree of cell differentiation or the existence of lymph nodes metastasis strongly participate in its prognosis. According to hemodynamic studies immediately after surgery, limited resection of the lung is preferred to conventional radical lobectomy for patients with cardiovascular malfunction because it serves to eliminate a possible left ventricular failure after surgery. An experimental research also demonstrated favorably hemodynamic benifits of limited resection for reducing left ventricular overloading on coronary diseased heart which is experimentally prepared by either creation of stenosis of the main left coronary artery or ligation of the left descending coronary artery. The immune response in the lymphnodes to a tumor growth also was attested in C3H mice with use of MH 134 tumor inoculated, especially in relation to the time of tumor resection. The results of our experiments confirmed that tumor resection on the 7th and 10t