Spontaneously Ruptured Giant Splenic Cyst with Elevated Serum Levels of CA 19-9, CA 125 and Carcinoembryonic Antigen

Splenic cyst is a relatively rare disease; however, the occurrence of complications associated with its rupture is even more rare. A 20-year-old female patient who had severe abdominal and left shoulder pain was admitted to our hospital. The patient's abdomen was hard and tender to the touch and she presented with a high fever. The patient's serum levels of the tumor markers carbohydrate antigen 19-9, cancer antigen 125 and carcinoembryonic antigen were high. Ultrasonography and computed tomography of the abdomen showed an 11-cm multilocular cystic lesion in the spleen and the presence of free intraperitoneal fluid. Peritonitis with ruptured splenic cyst was diagnosed, and the patient underwent an emergency laparotomy. The abdominal cavity was filled with purulent fluid. The cyst was localized to the spleen and had already ruptured. Total splenectomy and cyst resection were performed. The postoperative course was uneventful. The patient was discharged on day 9 following surgery. The histological findings showed the lesion to be a benign epidermoid cyst completely lined with inner stratified squamous epithelium with a capsule of connective tissue. In the immunostaining analyses, the squamous epithelium was positive for carcinoembryonic antigen. A ruptured splenic cyst causes sudden onset of severe peritonitis and elevation of serous tumor markers. An emergency operation is indicated as the treatment for a ruptured splenic cyst with peritonitis, after which a favorable outcome can be expected

Effects of Face and Background Color on Facial Expression Perception

Detecting others’ emotional states from their faces is an essential component of successful social interaction. However, the ability to perceive emotional expressions is reported to be modulated by a number of factors. We have previously found that facial color modulates the judgment of facial expression, while another study has shown that background color plays a modulatory role. Therefore, in this study, we directly compared the effects of face and background color on facial expression judgment within a single experiment. Fear-to-anger morphed faces were presented in face and background color conditions. Our results showed that judgments of facial expressions was influenced by both face and background color. However, facial color effects were significantly greater than background color effects, although the color saturation of faces was lower compared to background colors. These results suggest that facial color is intimately related to the judgment of facial expression, over and above the influence of simple color

Adult T-Cell Leukemia/Lymphoma with Gastric Lesion

A case of adult T-cell leukemia/lymphoma with a gastric tumor is presented. The patient was a 72-year-old woman who had been admitted to our hospital because of epigastric pain. Upper gastrointestinal endoscopy disclosed polypoid region in the antrum of the stomach. Specimens taken from this region revealed malignant lymphoma. Although the patient was serologically positive for human T-cell leukemia virus type I antibody. A chest X-ray, abdominal ultrasonography, and whole body computed tomography revealed no lymphadenopathy. We diagnosed her to have primary gastric malignant lymphoma and thus performed a total gastrectomy with regional lymph node excision and a splenectomy. Both histological and immunohistochemical studies of the resected specimen showed the lymphoma to be a diffuse pleomorphic type with a T cell phenotype. A radical surgical resection could be performed. At nine months postoperatively, she was again admitted to our hospital because of abdominal pain. Both ultrasonography and computed tomography revealed lymph node swelling around the surrounding the para aorta. She was treated with systematic chemotherapy. Unfortunately, she died at one year after the operation

Intestinal Perforation by Ingested Foreign Bodies

Seven cases with intestinal perforation by ingested foreign bodies (IFBs) were surgically treated in our hospital between January 2000 and August 2009. We reviewed the preoperative mental conditions, awareness of ingestion, preoperative diagnosis, the type of foreign bodies, perforation site, treatment and morbidity for these patients. The ratio of males to females was 4 : 3, and patient age ranged from 27 years to 85 years. Three of 7 patients had an abnormal mental condition, including neurosis with medication in 1, severe mental retardation in 1 and dementia in 1. Six patients were not aware they had IFBs. Preoperative diagnoses were perforative peritonitis in 6 cases and ileus in 1 case. The ingested objects consisted of fish bones in 4 cases, toothpicks in 2 cases and a press-through package in 1 case. Computed tomography (CT) showed the ingested fish bones in all 4 cases, while plain abdominal radiography demonstrated fish bone in only one of these cases. Toothpicks and a press-through package were not detected on CT or by plain abdominal radiography. The perforation sites were the small intestine in 5 cases and the large intestine (transverse colon) in 2 cases. Treatments were intestinal resection with or without omentectomy in 5 cases, suture alone in 1 case and omentectomy alone in 1 case. Postoperative complications were seen in 2 patients, including hepatic failure and bleeding from gastroesophageal reflux disease in 1 case, and removal and reinsertion of a V-P shunt tube in 1 case. The mortality rate was 0%

Efficacy and feasibility of dose-dense neoadjuvant chemotherapy versus conventional neoadjuvant chemotherapy in patients with HER2-negative breast cancer: A single-center retrospective study

Background: Dose-dense chemotherapy (DDCT) is a standard treatment for patients with high-risk breast cancer. Although there are numerous reports regarding DDCT, it is unclear whether sequential DDCT is effective or feasible as preoperative treatment for Japanese patients. We evaluated the efficacy and safety of neoadjuvant DDCT for patients with human epidermal growth factor receptor 2 (HER2)-negative breast cancer.Methods: This retrospective study evaluated 39 patients with breast cancer, who were preoperatively treated with anthracyclinecontaining regimens and taxanes. According to the chemotherapy regimens patients were divided into the DDCT group (ddgroup) and the conventional chemotherapy (CCT) group (q3w-group). The efficacy of neoadjuvant chemotherapy was evaluated based on the pathological complete response (pCR) rate. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Events version 5.0.Results: There were no apparent differences in tumor stage, histopathological subtype, or surgical procedure. There was not significant difference in the pCR rate (dd-group, 17.6%; q3w-group, 22.7%). Three-year disease-free survival rates were similar in two groups. The rates of dose reduction, delay of treatment, and discontinuation of treatment in the two groups did not differ to a statistically significant extent. There were no significant differences in the adverse events of the two groups

Effects of angiotensin II on the pericyte-containing microvasculature of the rat retina

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65918/1/jphysiol.2004.073098.pd

Inhibition of cell movement and proliferation by cell–cell contact-induced interaction of Necl-5 with nectin-3

Immunoglobulin-like Necl-5/Tage4/poliovirus receptor (PVR)/CD155, originally identified as the PVR, has been shown to be up-regulated in cancer cells and to enhance growth factor–induced cell movement and proliferation. In addition, Necl-5 heterophilically trans-interacts with nectin-3, a cell–cell adhesion molecule known to form adherens junctions in cooperation with cadherin. We show here that Necl-5 was down-regulated from cell surface upon cell–cell contacts in NIH3T3 cells. This down-regulation of Necl-5 was initiated by its interaction with nectin-3 and was mainly mediated by clathrin-dependent endocytosis. Then, the down-regulation of Necl-5 induced in this way reduced movement and proliferation of NIH3T3 cells. These results indicate that the down-regulation of Necl-5 induced by its interaction with nectin-3 upon cell–cell contacts may be at least one mechanism underlying contact inhibition of cell movement and proliferation

The preoperative prediction of postoperative symptomatic hypocalcemia in patients with Graves\u27 disease.

In Graves\u27 disease, one of the postoperative complications of surgical treatment is symptomatic hypocalcemia, which is defined as symptoms of hypocalcemia such as tetany, paresthesia, and muscle cramps. The aim of this study was to evaluate the preoperative factors predicting the development of symptomatic hypocalcemia after thyroidectomy in Graves\u27 patients. One hundred nine patients with Graves\u27 disease underwent surgery between January 2005 and August 2010 in our department. We investigated the relationship between postoperative symptomatic hypocalcemia and the serum levels of preoperative thyroid hormones, preoperative biochemical tests, and operating states in these patients. A univariate analysis determined that the preoperative serum free triiodothyronine (T3), free thyroxin (T4), and alkaline phosphatase (ALP) levels before the administration of potassium iodide were significantly higher in the symptomatic hypocalcemia patients. A multivariate analysis shows the preoperative serum free T4 level before the administration of potassium iodide to also be significantly higher in the symptomatic hypocalcemia patients. In conclusion, the preoperative serum free T4 level before the administration of potassium iodide was thus determined to be a risk factor for developing postoperative symptomatic hypocalcemia

Universality and superiority in preference for chromatic composition of art paintings

Color composition in paintings is a critical factor affecting observers' aesthetic judgments. We examined observers' preferences for the color composition of Japanese and Occidental paintings when their color gamut was rotated. In the experiment, observers were asked to select their preferred image from original and three hue-rotated images in a four-alternative forced choice paradigm. Despite observers' being unfamiliar with the presented artwork, the original paintings (0 degrees) were preferred more frequently than the hue-rotated ones. Furthermore, the original paintings' superiority was observed when the images were divided into small square pieces and their positions randomized (Scrambled condition), and when the images were composed of square pieces collected from different art paintings and composed as patchwork images (Patchwork condition). Therefore, the original paintings' superiority regarding preference was quite robust, and the specific objects in the paintings associated with a particular color played only a limited role. Rather, the original paintings' general trend in color statistics influenced hue-angle preference. Art paintings likely share common statistical regulations in color distributions, which may be the basis for the universality and superiority of the preference for original paintings.- We thank Dr. Yukinori Misaki at Kagawa National Institute of Technology, Japan and Ms. Nobuyo Okada and Ms. Kanako Maruchi at Toyohashi City Museum of Art and History, Japan for assisting in the measurement of art paintings. This work was supported by JSPS KAKENHI Grant Number JP19H01119 and 20H05956, and by the Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding UIDB/04650/2020

Gastric perforation caused by Candida infection：Report of a case

An 89-year-old female was admitted to our hospital because of fever and abdominal pain. The patient had used an antihypertensive agent, but had not used either antibiotics, steroids, or potent antacids. An abdominal CT scan revealed free air and ascites. An emergency operation was performed for acute peritonitis caused by a gastrointestinal perforation. A perforated ulcer was observed at the posterior wall of the gastric body. A distal gastrectomy with intraperitoneal drainage and a Billroth II reconstruction was performed. A histological examination demonstrated a perforated ulcer surrounded by Candida infection. The patient developed an abscess in the abdominal cavity, but was discharged on the 52nd postoperative day. Although gastrointestinal Candida infection is commonly seen in immunocompromised host with diabetics or malignant diseases, habitual use of strong antacids can also cause severe Candida infection of the stomach in healthy persons. In this case, it was thus concluded that there may have been a decrease in immunity in this patient because of her advanced age 89 years old and malnutrition