A Case of Gallbladder Metastasis of Malignant Melanoma

In the clinical course of malignant melanoma, which can metastasize to multiple organs, gallbladder metastases are rarely detected. A 69-year-old man who underwent resection of a primary malignant melanoma was subsequently treated with nivolumab for lung metastases and achieved complete response. Seven years after surgery, multiple nodules were found in the gallbladder, and he underwent laparoscopic cholecystectomy. The postoperative diagnosis was metastases of malignant melanoma. He has been recurrence-free 8 months after surgery. If radical resection is possible, such surgery should be performed for gallbladder metastases found in patients with other controlled lesions of malignant melanoma

Plasma polymerization of silicon-containing monomers

Plasma depositions of ultra thin films from seven silicon-containing liquid monomers were investigated using a continuos wave (CW) plasma source. The deposition rate of plasma polymerized films were determined using a quartz crystal microbalance (QCM) technique while the film composition were determined spectroscopiclly using primarily X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared method (FT-IR). The wettability of the plasma-polymerized films was also investigated by measuring the contact angles of water on the film surfaces. It was observed that the C=C absorption band was not present in these films. This observation is consistent with selective polymerization through the double bond. Oxygen was present in all samples investigated and this may be attributed to the quenching of radicals in the film by reactions with oxygen when exposed to atmosphere

High-field phase diagram of a chiral-lattice antiferromagnet Sr(TiO)Cu4(PO4)4

High-field phase diagram of a chiral-lattice antiferromagnet Sr(TiO)Cu4(PO4)4 is studied by means of the ultrasound, dielectric, and magnetocaloric-effect measurements. These experimental techniques reveal two new phase transitions at high fields, which have not been resolved by the previous magnetization experiments. Specifically, the c66 acoustic mode shows drastic changes with hysteresis with applied fields along the c axis, indicating a strong magneto-elastic coupling. Combined with the cluster mean-field theory, we discuss the origins of these phase transitions. By considering the chiral-twist effect of Cu4O12 cupola units, which is inherent to the chiral crystal structure, the phase diagram is reasonably reproduced. The agreement between the experiment and theory suggests that this material is a unique quasi two-dimensional spin system with competing exchange interactions and chirality, leading to the rich phase diagram.Comment: 12 pages, 11 figures, 1 tabl

キョダイ チョクチョウ gastrointestinal stromal tumor（GIST） ノ 1セツジョレイ

A 75-year old woman, complaining of prolapse of the uterus, was detected a giant tumor in therectum by abdominal CT scan. Enhanced CT revealed a heterogeneous mass in the pelvic cavitymeasuring 8 cm. MRI demonstrated a mass in the rectovaginal seputum, showing heterogeneoushigh intensity on T1 and T2 weighed image. Abdominoperineal excision of the rectum was performed.Macroscopically, the resected specimen showed a solid tumor with central hemorrhagicnecrosis, 10×5 cm in size. Histological examination showed fascicular proliferated spindle-shapedcells invaded to subserosa. Immunohistochemical studies showed a GIST of the rectum withpositive staining for c-kit and CD34, and negative staining for α-SMA, S-100 protein. No evidenceof recurrence has been found in the 2 years since. We report a case of giant GIST of the rectum.Because the risk of the recurrence depends on operation curability adequate resection margin isneeded for surgical approach for GIST

Lower In-Hospital Mortality With Beta-Blocker Use at Admission in Patients With Acute Decompensated Heart Failure

[Background] It remains unclear whether beta‐blocker use at hospital admission is associated with better in‐hospital outcomes in patients with acute decompensated heart failure. [Methods and Results] We evaluated the factors independently associated with beta‐blocker use at admission, and the effect of beta‐blocker use at admission on in‐hospital mortality in 3817 patients with acute decompensated heart failure enrolled in the Kyoto Congestive Heart Failure registry. There were 1512 patients (39.7%) receiving, and 2305 patients (60.3%) not receiving beta‐blockers at admission for the index acute decompensated heart failure hospitalization. Factors independently associated with beta‐blocker use at admission were previous heart failure hospitalization, history of myocardial infarction, atrial fibrillation, cardiomyopathy, and estimated glomerular filtration rate <30 mL/min per 1.73 m2. Factors independently associated with no beta‐blocker use were asthma, chronic obstructive pulmonary disease, lower body mass index, dementia, older age, and left ventricular ejection fraction <40%. Patients on beta‐blockers had significantly lower in‐hospital mortality rates (4.4% versus 7.6%, P<0.001). Even after adjusting for confounders, beta‐blocker use at admission remained significantly associated with lower in‐hospital mortality risk (odds ratio, 0.41; 95% CI, 0.27–0.60, P<0.001). Furthermore, beta‐blocker use at admission was significantly associated with both lower cardiovascular mortality risk and lower noncardiovascular mortality risk. The association of beta‐blocker use with lower in‐hospital mortality risk was relatively more prominent in patients receiving high dose beta‐blockers. The magnitude of the effect of beta‐blocker use was greater in patients with previous heart failure hospitalization than in patients without (P for interaction 0.04). [Conclusions] Beta‐blocker use at admission was associated with lower in‐hospital mortality in patients with acute decompensated heart failure

ヒドロコルチゾン投与は日本人心肺停止患者の生存率改善に関連する

There are few reports on hydrocortisone administration after cardiac arrest, and those that have been published included few subjects. This study aimed to evaluate the effect of hydrocortisone administration on the outcomes of patients who experienced cardiac arrest. We investigated the survival discharge rates and the length of hospital stay from cardiac arrest to discharge, stratified by use of hydrocortisone, using a Japanese health-insurance claims dataset that covers approximately 2% of the Japanese population. The study included the data of 2233 subjects who experienced either in-hospital or out-of-hospital cardiac arrest between January 2005 and May 2014. These patients were divided into two groups, based on the administration of hydrocortisone. We adjusted the baseline characteristics, medical treatment, and drug administration data of the two groups using propensity scores obtained via the inverse probability of treatment weighted method. The hydrocortisone group had a significantly higher survival discharge rate (13/61 [21.1%] vs. 240/2172 [11.0%], adjusted odds ratio: 4.2, 95% CI: 1.60–10.98, p = 0.004). In addition, the administration of hydrocortisone was independent predictor of survival to discharge (hazard ratio: 4.6, p < 0.001). The results demonstrate a correlation between hydrocortisone administration and the high rates of survival to discharge

Hydrolyzed eggshell membrane immobilized on phosphorylcholine polymer supplies extracellular matrix environment for human dermal fibroblasts

We have found that a water-soluble alkaline-digested form of eggshell membrane (ASESM) can provide an extracellular matrix (ECM) environment for human dermal fibroblast cells (HDF) in vitro. Avian eggshell membrane (ESM) has a fibrous-meshwork structure and has long been utilized as a Chinese medicine for recovery from burn injuries and wounds in Asian countries. Therefore, ESM is expected to provide an excellent natural material for biomedical use. However, such applications have been hampered by the insolubility of ESM proteins. We have used a recently developed artificial cell membrane biointerface, 2-methacryloyloxyethyl phosphorylcholine polymer (PMBN) to immobilize ASESM proteins. The surface shows a fibrous structure under the atomic force microscope, and adhesion of HDF to ASESM is ASESM-dose-dependent. Quantitative mRNA analysis has revealed that the expression of type III collagen, matrix metalloproteinase-2, and decorin mRNAs is more than two-fold higher when HDF come into contact with a lower dose ASESM proteins immobilized on PMBN surface. A particle-exclusion assay with fixed erythrocytes has visualized secreted water-binding molecules around the cells. Thus, HDF seems to possess an ECM environment on the newly designed PMBN-ASESM surface, and future applications of the ASESM-PMBN system for biomedical use should be of great interest