Successful Late Management of Esophageal Perforation with T-Tube Drainage

The late management of spontaneous esophageal perforation is the most challenging problem for the surgeon. In this paper, we present a case in whom a spontaneous esophageal perforation was successfully treated by T-tube drainage after unsuccessful conservative treatment. The patient, a 68-year-old male, was admitted to the hospital with sudden upper abdominal pain. After 2 days, esophageal perforation was diagnosed, and conservative management was begun. Thereafter, the subcutaneous emphysema disappeared, and the patient's temperature decreased. However, on day 13, the patient's temperature spiked above 38°C, and computed tomography showed a mediastinal abscess. An emergency left thoracotomy with laparotomy was performed. Since a 2-cm longitudinal perforation with severe inflammatory reactions was observed, the T-tube drainage method was performed. The patient was discharged without postoperative complications and has not experienced any gastrointestinal symptoms, such as gastroesophageal reflux or dysphagia. In conclusion, the T-tube drainage method appears to be a simple and effective method for the late management of esophageal perforation with severe inflammatory reaction

A Delayed Recrudescent Case of Sigmoidocutaneous Fistula due to Diverticulitis

Colocutaneous fistula caused by diverticulitis is relatively rare, and a delayed recrudescent case of colocutaneous fistula is very uncommon. We herein report a rare case of a Japanese 56-year-old male with delayed recrudescent sigmoidocutaneous fistula due to diverticulitis. A colocutaneous fistula was formed after a drainage operation against a perforation of the sigmoid colon diverticulum. After 5 years from treatment, he was admitted to our hospital because of lower abdominal pain. We diagnosed the recrudescent sigmoidocutaneous fistula by abdominal computed tomography and gastrografin enema, and managed the patient with total parenteral nutrition and antibiotics. As the fistula formation did not improve, a low anterior resection with fistulectomy was performed. The postoperative course was uneventful and the patient was discharged. It has been reported that, in fistulas of the skin caused by diverticular disease, complete closure of the fistula by conservative therapy may not be possible. This case also implies the possibility of a recurrence of the fistula even if the conservative treatment was effective. In cases of colocutaneous fistulas due to diverticulitis, radical surgery is considered necessary because of possibility of recurrence of the fistula

Characteristics of heat balance during the snowmelt season in Ny-Alesund, Spitsbergen Island (scientific paper)

Heat balance observations were carried out at Ny-Ålesund, Spitsbergen Island during the snowmelt seasons in 1993 and 1994 in order to understand characteristics of heat balance at high latitude by comparing heat balance components at the snow surface before and after snowmelt initiation. In the snowmelt period, air temperature was higher than that in the pre-snowmelt period. Mean air temperature in the snowmelt period was about +3∿4℃, and daily minimum temperature never fell below 0℃. Water vapor pressure was also higher than that in the pre-period. Albedo of the snow surface was relatively high, and remained higher than 0.65 even in the snowmelt period. The main snowmelt heat source was net radiation in both years. Net radiation in the snowmelt period was about 20Wm^ larger than that in the pre-snowmelt period; however, the shortwave radiation budget was almost constant. Heat loss by the longwave radiation budget in the snowmelt period was less than that in the pre-period and consequently net radiation increased. The reason for the decrease of heat loss by the longwave radiation budget was the increase of atmospheric radiation accompanied by a decrease in solar radiation

Does monocarpic Phyllostachys nigra var. henonis regenerate after flowering in Japan? Insights from 3 years of observation after flowering.

Phyllostachys nigra var. henonis, a monocarpic bamboo with a 120-year flowering interval, is next predicted to flower in Japan in the 2020s. Because a huge area of the country is presently covered by stands of this species, post-flowering dieback of these stands and ensuing drastic changes in land cover may cause serious social and/or environmental problems. No study on the regeneration of this bamboo species was conducted during the last flowering event in the 1900s, and the regeneration process of this species is thus still unknown. In 2020, we encountered a localized flowering of P. nigra var. henonis in Japan and used this discovery as a rare opportunity to study the initial regeneration process of the species. Over 3 years, more than 80% of culms in the study site bloomed, but no seed was produced. In addition, no established seedlings were located. These facts strongly suggest that P. nigra var. henonis lacks the ability to produce seeds and cannot undergo sexual regeneration. Some bamboo culms were produced after flowering but died within 1 year of emergence. Small, weak culms (dwarf ramets) also appeared after flowering, but most died within 1 year as well. Three years after flowering, all culms had died, with no sign of regeneration detected. According to our 3 years of observation, this bamboo appears to be hard to regenerate-an idea completely contradicted by the fact that this species has long persisted in Japan. We thus considered other possible regeneration modes for P. nigra var. henonis

The DNA methylation profile of liver tumors in C3H mice and identification of differentially methylated regions involved in the regulation of tumorigenic genes

Abstract Background C3H mice have been frequently used in cancer studies as animal models of spontaneous liver tumors and chemically induced hepatocellular carcinoma (HCC). Epigenetic modifications, including DNA methylation, are among pivotal control mechanisms of gene expression leading to carcinogenesis. Although information on somatic mutations in liver tumors of C3H mice is available, epigenetic aspects are yet to be clarified. Methods We performed next generation sequencing-based analysis of DNA methylation and microarray analysis of gene expression to explore genes regulated by DNA methylation in spontaneous liver tumors of C3H mice. Overlaying these data, we selected cancer-related genes whose expressions are inversely correlated with DNA methylation levels in the associated differentially methylated regions (DMRs) located around transcription start sites (TSSs) (promoter DMRs). We further assessed mutuality of the selected genes for expression and DNA methylation in human HCC using the Cancer Genome Atlas (TCGA) database. Results We obtained data on genome-wide DNA methylation profiles in the normal and tumor livers of C3H mice. We identified promoter DMRs of genes which are reported to be related to cancer and whose expressions are inversely correlated with the DNA methylation, including Mst1r, Slpi and Extl1. The association between DNA methylation and gene expression was confirmed using a DNA methylation inhibitor 5-aza-2′-deoxycytidine (5-aza-dC) in Hepa1c1c7 cells and Hepa1-6 cells. Overexpression of Mst1r in Hepa1c1c7 cells illuminated a novel downstream pathway via IL-33 upregulation. Database search indicated that gene expressions of Mst1r and Slpi are upregulated and the TSS upstream regions are hypomethylated also in human HCC. These results suggest that DMRs, including those of Mst1r and Slpi, are involved in liver tumorigenesis in C3H mice, and also possibly in human HCC. Conclusions Our study clarified genome wide DNA methylation landscape of C3H mice. The data provide useful information for further epigenetic studies of mice models of HCC. The present study particularly proposed novel DNA methylation-regulated pathways for Mst1r and Slpi, which may be applied not only to mouse HCC but also to human HCC

Additional file 2: of The DNA methylation profile of liver tumors in C3H mice and identification of differentially methylated regions involved in the regulation of tumorigenic genes

Figure S1. Scatter plots for sample pairs. Scatter plots of % methylation values for each pair in normal tissues (n = 3) and tumor tissues (n = 3) were obtained using methylKit. Numbers on upper right corner denote pair-wise Pearson’s correlation scores. The histograms on the diagonal are methylation distribution of CpG sites for each sample. Figure S2/. Expression levels of Mst1r, Slpi and Extl1 in tumor tissues with (n = 6) and without (n = 5) Ha-ras mutation. Figure S3. Hepa1-6 cells show lower expression of Dnmts compared to Hepa1c1c7. cDNA was prepared from Hepa1c1c7 cells and Hepa1-6 cells and the expression was measured by real-time PCR (n = 3). All genes were normalized to the expression of rRNA.. *** p < 0.001. (PPTX 296 kb