Utility of gastric biopsy in diagnosing IgG4‐related gastrointestinal disease

The utility of gastric biopsy for diagnosing immunoglobulin (Ig)G4‐related gastrointestinal disease (IgG4‐GID) remains unclear. Bottom‐heavy plasmacytosis (BHP) is a distinct feature of IgG4‐GID. To clarify the feasibility of using gastric biopsies to diagnose BHP in IgG4‐GID, we analyzed the histological features and immunostaining of gastric biopsy specimens from 31 known IgG4‐related disease (IgG4‐RD) patients and we assessed the presence of BHP in 1696 consecutive routine gastric biopsies. Cases with both >10 IgG4‐positive plasma cells per high‐power field and an IgG4/IgG‐positive ratio >40% were defined as IgG4‐high. Ten of the 31 IgG4‐RD patients were concluded to have IgG4‐GID, in which IgG4‐positive plasma cells were notably detected at the deeper part of the mucosa. Six cases displayed BHP whereas the remaining four cases showed transmural infiltration with concomitant Helicobacter pylori‐associated gastritis. In addition to BHP, we identified two unique histologic features for IgG4‐GID: plasmacytic aggregation in the muscularis mucosae and permeative plasmacytic infiltration between fundic glands in the non‐atrophic mucosa. Six of the routine cases (0.35%) displayed BHP, including a case with IgG4‐RD. IgG4‐GID can be suspected by the presence of gastric biopsy specimens with characteristic histological features. Such cases are recommended to undergo further examinations to determine whether IgG4‐RD is present

「複数国家からなる一つの世界におけるグローバルな正義」

早大学位記番号:新7078早稲田大

術前放射線照射が延長仮骨形成におよぼす影響について

取得学位 : 博士（医学）, 学位授与番号 : 医博乙第1568号, 学位授与年月日 : 平成14年12月4日, 学位授与大学 : 金沢大

放射線照射が延長仮骨に及ぼす影響について

金沢大学医薬保健研究域医学系(対象と方法)3.0Kgの雄の日本白色家兎を使用した。静脈麻酔後、右下腿に15Gyの放射線照射を行い、直ちに脛骨に創外固定器を設置し骨切りを行った。照射を行わず同様の処置を行ったものを対照群とした。7日間の待機期間の後、0.5mm/日の速度で4週間延長した。各週毎にレントゲン撮影を行った。延長終了時と延長終了4週で屠殺し標本を採取し、組織学的検討と、微小血管造影による血管の分布と形態を観察した。(結果)レントゲンによる変化。対照群は延長中より延長仮骨が出現し、延長中心部から両端にかけて仮骨の成熟が規則正しく見られ、延長終了4週ではほぼ仮骨は成熟しているように見られた。これに対し照射群では、延長中には全く仮骨は出現せず、延長部には何も見られなかった。延長終了後より徐々に、斑状に骨化が見られたが、成熟には至らなかった。組織学的には、対照群では膜様骨化がほとんどであり、延長の中心から規則正しい骨化様式が観察された。照射群ではほとんどが内軟骨骨化でレントゲン上骨化が認められなかった部分は軟骨であった。また、対照群に見られたような規則性は見られず、斑状の骨化層を認めるのみであった。微小血管造影では延長部のみならず脛骨全体の血管分布が照射群で少なく既存の血管の障害と、血管新生の障害が示唆された。内軟骨骨化は局所の低酸素状態で生じやすいことから、血管障害及び血管新生の障害により仮骨形成が障害され、内軟骨骨化中心になったと推測する。研究課題/領域番号:12770778, 研究期間(年度):2000-2001出典：「放射線照射が延長仮骨に及ぼす影響について」研究成果報告書　課題番号 12770778（KAKEN：科学研究費助成事業データベース（国立情報学研究所））（https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-12770778/)を加工して作

Preoperative Use of Alpha-1 Receptor Blockers in Male Patients Undergoing Extracorporeal Shock Wave Lithotripsy for a Ureteral Calculus

In this retrospective single-center cohort study, we investigated the impact of preoperative use of an alpha-1 adrenergic receptor (AR) blocker on the outcome of single-session extracorporeal shock wave lithotripsy (SWL) in 193 male patients who underwent SWL for a single ureteral calculus between 2006 and 2016. We reviewed their medical records to obtain the data on the preoperative use of alpha-1 AR blockers. The primary outcome was treatment success after single-session SWL. We performed a multivariable logistic regression analysis adjusting for clinically important confounders to examine the association between preoperative use of alpha-1 AR blockers and the treatment success of SWL. Among the 193 patients, 15 (7.8%) were taking an alpha-1 AR blocker preoperatively. A multivariable analysis showed that preoperative use of an alpha-1 AR blocker was a significant negative predictor for treatment success of SWL (adjusted odds ratio 0.17; 95% confidence intervals, 0.04-0.74). Our findings suggest that the preoperative use of an alpha-1 AR blocker was a negative predictor of treatment success of SWL in male patients with a single ureteral calculus. Clinicians should pay more attention to the preoperative drug use in determining an appropriate stone therapy modality

Alternative redo sternotomy in a patient with tracheostoma and patent grafts.

We describe a redo mitral valve replacement operation in a 71-year-old man with a tracheostoma and patent bypass grafts to the coronary arteries. Preoperative investigations revealed that the patent right internal thoracic artery graft ran directly under the sternum just anterior to the ascending aorta, and a saphenous vein graft was adhering to a surgical wire. To prevent injury to the patent grafts and cardiac structures, and to avoid communication with the tracheostoma, the redo procedure was performed via an anterior minithoracotomy combined with a low T-shaped partial sternotomy. The reoperation was successfully completed without any complications

A Remote Operated Quadruped Robot System for Investigation of Reactor Building

ABSTRACT A remote operated quadruped robot has been developed for disaster site which can move on stairs, slopes, and uneven floor under the radiation-polluted environment, such as TEPCO Fukushima Daiichi nuclear power plants In particular, the control method for stable walking and the remote operation system have been developed to move on stairs in the reactor building. We applied this robot to investigation of suspicious water leakage points in reactor building at Fukushima Daiichi nuclear power plants unit

Power scalable 30-W mid-infrared fluoride fiber amplifier

A fluoride-fiber-based master oscillator power amplifier (MOPA) for 30-W class continuous-wave (cw) operation at 2.8-μm wavelength has been demonstrated. To overcome the low durability of ZBLAN fibers, various novel technologies for using fluoride glass with a ZBLAN-fiber-based side-pump combiner have been adopted in the system. A maximum cw output power of 33 W and stable operation under 23-W output have been demonstrated. We suggest that such fiber MOPA systems will open up advanced fluoride fiber technology for next-generation high-power mid-IR lasers

Successful Treatment of Cardiac Diffuse Large B-cell Lymphoma : A Report of Two Cases

Cardiac lymphoma is a rare neoplasm of the heart,defined as an extranodal lymphoma exclusively located in the heart and/or pericardium. Multiple imaging modalities may help to diagnose cardiac tumors ; however, pathological diagnosis is difficult because of the limited approaches for obtaining tissue samples. This report describes two cases of prompt histological diagnosis of cardiac lymphoma as diffuse large B-cell type and their successful treatment with chemotherapy. Immunohistochemical analyses revealed one case as CD5-positive and the other as CD5-negative lymphoma. This report highlights the necessity of histological diagnosis and the importance of clinicopathological characterization of cardiac lymphoma. Shinshu Med J 59 : 177―183, 2011 (Received for publication January 7, 2011; accepted in revised form February 16, 2011)Article信州医学雑誌 59(3): 177-183(2011)departmental bulletin pape