Clear cell carcinoid tumor of the distal common bile duct

BACKGROUND: Carcinoid tumors rarely arise in the extrahepatic bile duct and can be difficult to distinguish from carcinoma. There are no reports of clear cell carcinoid (CCC) tumors in the distal bile duct (DBD) to the best of our knowledge. Herein, we report a CCC tumor in the DBD and review the literature concerning extrahepatic bile duct carcinoid tumors. CASE PRESENTATION: A 73-old man presented with fever and occult obstructive jaundice. Ultrasonography, computed tomography (CT) and magnetic resonance cholangiopancreaticography (MRCP) demonstrated a nodular tumor projection in the DBD without regional lymph node swelling. Under suspicion of carcinoma, we resected the head of the pancreas along with 2(nd )portion duodenectomy and a lymph node dissection. The surgical specimen showed a golden yellow polypoid tumor in the DBD (0.8 × 0.6 × 0.5 cm in size). The lesion was composed of clear polygonal cells arranged in nests and a trabecular pattern. The tumor invaded through the wall into the fibromuscular layer. Immunohistochemical stains showed that neoplastic cells were positive for neuron-specific enolase (NSE), chromogranin A, synaptophysin, and pancreatic polypeptide and negative for inhibin, keratin, CD56, serotonin, gastrin and somatostatin. The postoperative course was uneventful and he is living well without relapse 12 months after surgery. CONCLUSION: Given the preoperative difficulty in differentiating carcinoid from carcinoma, the pancreaticoduodenectomy is an appropriate treatment choice for carcinoid tumors located within the intra-pancreatic bile duct

The effect of measurement position on brachial-ankle pulse wave velocity

Arterial stiffness measurements are primarily used for the early detection of arteriosclerosis. Methods and devices that can easily measure arterial stiffness at home are in demand. We propose a simple method for measuring brachial-ankle pulse wave velocity (baPWV) at home using a reclining chair and investigate the effects of positioning on baPWV measurement. We measured baPWV in 50 healthy men (21-70 years) in seven different measurement positions, including the supine position, sitting, sitting with the knees flexed at 45°, sitting with the knees flexed at 0°, reclining at 37°, reclining at 50°, and standing. BaPWV was significantly lower in the supine position (P < 0.01) than in the other positions. It was significantly higher in the sitting position (P < 0.01) than in the reclining position (37°). No changes in baPWV were seen changing the knee flexion angle alone while sitting. Strong correlations were also observed between baPWV in the supine position and that in other positions. We showed that baPWV in the supine position can be calculated by making corrections to baPWV measured in the sitting position at a reclining angle. Utilizing this corrected value would allow easy measurement at home using a reclining chair

Palladium and Platinum Nanoparticles Attenuate Aging-Like Skin Atrophy via Antioxidant Activity in Mice

<div><p>Cu-Zn superoxide dismutase (<i>Sod1</i>) loss causes a redox imbalance as it leads to excess superoxide generation, which results in the appearance of various aging-related phenotypes, including skin atrophy. Noble metal nanoparticles, such as palladium (Pd) and platinum (Pt) nanoparticles, are considered to function as antioxidants due to their strong catalytic activity. In Japan, a mixture of Pd and Pt nanoparticles called PAPLAL has been used to treat chronic diseases over the past 60 years. In the present study, we investigated the protective effects of PAPLAL against aging-related skin pathologies in mice. Transdermal PAPLAL treatment reversed skin thinning associated with increased lipid peroxidation in <i>Sod1</i>^−/− mice. Furthermore, PAPLAL normalized the gene expression levels of <i>Col1a1</i>, <i>Mmp2</i>, <i>Has2</i>, <i>Tnf-α</i>, <i>Il-6</i>, and <i>p53</i> in the skin of the <i>Sod1</i>^−/− mice. Pt nanoparticles exhibited marked SOD and catalase activity, while Pd nanoparticles only displayed weak SOD and catalase activity <i>in vitro</i>. Although the SOD and catalase activity of the Pt nanoparticles significantly declined after they had been oxidized in air, a mixture of Pd and Pt nanoparticles continued to exhibit SOD and catalase activity after oxidation. Importantly, a mixture of Pd and Pt nanoparticles with a molar ratio of 3 or 4 to 1 continued to exhibit SOD and catalase activity after oxidation, indicating that Pd nanoparticles prevent the oxidative deterioration of Pt nanoparticles. These findings indicate that PAPLAL stably suppresses intrinsic superoxide generation both <i>in vivo</i> and <i>in vitro</i> via SOD and catalase activity. PAPLAL is a potentially powerful tool for the treatment of aging-related skin diseases caused by oxidative damage.</p></div

PAPLAL is non-toxic in wild-type mice.

<p>(A) Hematoxylin and eosin staining of the skin on the backs of <i>Sod1</i>^+/+ mice (17–20 weeks of age). E, epidermis; D, dermis. The scale bars represent 20 µm (top) or 100 µm (bottom). The thickness of the (B) epidermal and (C) dermal layers of the skin on the backs of <i>Sod1</i>^+/+ mice treated with PAPLAL (n = 5).</p

Pd nanoparticles protected the SOD and catalase activity of Pt nanoparticles against oxidative degradation <i>in vitro</i>.

<p>(A) The SOD and (B) catalase activity of 1.03 mM Pt nanoparticles and PAPLAL that had been stored at room temperature for four weeks. (C) The SOD and (D) catalase activity of Pt nanoparticles and PAPLAL that had been rotated for 24 hours in a tube in order to oxidize the nanoparticles. Data are shown as the mean ± SD; *<i>p</i><0.05, **<i>p</i><0.01.</p

PAPLAL improved the transcriptional profiles of skin-related genes in the skin of <i>Sod1</i>^−/− mice.

<p>(A) The relative mRNA expression levels of <i>Col1a1</i>, <i>Has2</i>, <i>Mmp2</i>, <i>Decorin</i>, <i>Ki67</i>, <i>Tnf-α</i>, <i>Il-6</i>, <i>p53</i>, and <i>Mdm2</i>. Each mRNA expression level was determined using qRT-PCR. Data are shown as the mean ± SD; *<i>p</i><0.05 vs. <i>Sod1</i>^+/+, **<i>p</i><0.01 vs. <i>Sod1</i>^+/+, ^#<i>p</i><0.05 vs. <i>Sod1</i>^−/−.</p

Pd nanoparticles protected the SOD activity of Pt nanoparticles against oxidative degradation at various molar ratios.

<p>Pd nanoparticles were added to Pt nanoparticles at various molar ratios, and the SOD activity of each mixture was measured after four weeks of storage at room temperature.</p

PAPLAL attenuates cellular damage in skin.

<p>(A) Relative number of outgrowing fibroblasts in cultured <i>Sod1</i>^+/+ and <i>Sod1</i>^−/− skin specimens. (B) LDH activity in the medium used to culture the <i>Sod1</i>^+/+ and <i>Sod1</i>^−/− skin specimens. Data are shown as the mean ± SD; *<i>p</i><0.05, **<i>p</i><0.01.</p

Pt nanoparticles possess SOD and catalase activity.

<p>PAPLAL includes 2.82 mM of Pd nanoparticles and 1.03 mM of Pt nanoparticles. (A) The SOD and (B) catalase activity of 2.82 mM Pd nanoparticles, 1.03 mM Pt nanoparticles, and PAPLAL. Five nM of SOD derived from bovine erythrocytes (A) and 0.2 µM of catalase derived from bovine liver tissue (B) were used as positive controls for SOD and catalase, respectively.</p