A surgical case of small intestinal anisakiasis with symptoms of ileus

We report a surgical case of intestinal anisakiasis in which we identified a complete larva. A 48-year-old man complaining of epigastralgia after eating roasted mackerel was admitted to the hospital with a diagnosis of ileus with peritonitis. Abdominal CT showed dilatation and partial thickening of the small intestine. An emergency operation was carried out. On laparotomy, severe stricture of the jejunum was revealed. The affected intestine was resected. A larva whose head was invading the mucosa was found in the resected portion of the jejunum, and we diagnosed the case as intestinal anisakiasis

Genetic Markers for Differentiating Aspirin-Hypersensitivity

Aspirin-induced asthma (AIA) and aspirin-induced urticaria/angioedema (AIU) are two major aspirin-related allergies. We summarize recent findings related to their molecular genetic mechanisms in order to identify genetic susceptibility markers for differentiating AIU and AIA. The overproduction of cysteinyl leukotriene has been suggested as a mechanism in both AIU and AIA. Increased expression of CYSLTR1 with CYLSTR1 and CYSLTR2 polymorphisms are new findings in AIA, while the ALOX5 promoter polymorphism has been noted in AIU. An HLA study suggested that DPB1*0301 is a strong genetic marker for AIA, and that HLA DRB1*1302 and DQB1*0609 are markers for AIU susceptibility. Several single nucleotide polymorphisms (SNPs) in the promoters of EP2, TBX21, COX-2, FcεRIβ, and TBXA2R were associated with AIA, while an FcεRIα promoter polymorphism was associated with AIU. The functional studies of the key genes involved in AIA and AIU are summarized. The identification and functional study of genetic markers for AIA and AIU susceptibility would further elucidate the pathogenic mechanisms and facilitate the development of early diagnostic markers to establish therapeutic targets

Long-term follow-up study od total hip replacement in rheumatoid arthritis

A long-term follow up study was performed on 125 total hip replacements (THR) in 95 rheumatoid patients. The average follow up time was 8 years and 5 months, ranging from 5 to 17 years. Except in 26 cases of death or 9 incomplete histories at the follow-up, 62 cases were investigated both clinically and radiologically. For the operations, two types of prostheses (Charnley and C-Muller ) were used. According to the Japan Orthopaedic Association (JOA) hip score, the preoperative score improved from 32.9 to 57.1 points at the final postoperative evaluation. In the radiological assessment using the method by Nagaya and Uno, a clear zone was seen around the acetabular cup in 82.2% of the hips and around the femoral stem in 53.2%. Rate of loosening corresponding to stage Ⅲ and Ⅳ was 20.2% in the acetabular side and 32.9% in the femoral side. Charnley-type group was better than C-Muller type both in clinical and radiological assessments. Twelve cases had lost walking ability. As postoperative complications, deep infections occurred in 4 hips, femoral shaft fracture in 4 hips, dislocation in 1 hip and revision due to aseptic loosening in 4 hips. THR may be useful for rheumatoid patients and improve the quality of life in the case of long-term disease if careful pre-and post-operative care is provided