Surgical Resection of Hepatic Cystic Echinococcosis Impaired by Preoperative Diagnosis

Cystic echinococcosis (CE) is a rare afferent infectious disease in Japan. This paper reports a case of a hepatic cyst being diagnosed after surgical resection. A 40-year-old Syrian male was admitted for evaluation of a hepatic cyst. Serum antibodies of echinococcosis were negative. Enhanced computed tomography of the abdomen revealed a large cystic lesion, 9 cm in diameter, in the left lateral sector of the liver, which had many honeycomb-like septa and calcified lesions. Magnetic resonance imaging of this lesion revealed high intensity in the T2 weighted image. We preoperatively diagnosed this lesion as cystadenocarcinoma or CE and performed a left hepatectomy. Pathological examination revealed the presence of protoscolices in the fluid of the cysts and led to a diagnosis of this lesion as CE. In conclusion, on seeing patients with huge hepatic cysts who come from an epidemic area, we should consider hepatic CE

オウヨウセイブツカガクブ1ネンセイ ヲ タイショウ トシタ ショクイクトライアル ノ ジッシ ト ヒョウカ ジュギョウサンカシャ ヘノ アンケート ニヨル ケントウ

応用生物科学部1年生を対象に,食育トライアル授業として,食の生産,安全管理,健康管理などに関する10回の講義と2回の農業体験(種まき,収穫作業等)を実施し,学生の授業への出席状況及び授業前後のアンケートによって,プログラムの内容および学生の食育に対する知識,意欲等の変化を評価した。応用生物科学部全学科の学生に授業への参加を呼びかけた結果,授業の出席者は27名であり,栄養科学科の学生が20名と最も多く,参加学生の学科構成に偏りがみられた。授業の初回に行ったアンケートの回答者は24名,最終回に行ったアンケートの回答者は11名であった。授業後のアンケートでは,「食育活動への興味は深まったか」「知りたい情報は得られたか」「参加後,農業と食の関連に対する考えが変わったか」「授業として開講された場合受講するか」という問いに対し,それぞれ73～91%が「はい」と回答し,「授業への総合的な満足度」についても73%が「(非常に)満足である」と回答した。「農業」に原点をおいた食育トライアル授業によって,食べ物の成長を通した気づきと感動,生産者への感謝の気持ち,環境への配慮,栄養と健康との関連知識の習得等に寄与することができたと考えられる。今後は授業への参加者数を増やし,結果の一般化可能性について検討するとともに,授業の実現に向けた人的・物的資源の問題について検討する必要がある。We aimed to evaluate changes in both knowledge of dietary education (Shokuiku) and in motivation, in first-year students of the Faculty of Applied Biosciences who attended a voluntary Shokuiku program in 2008. The program comprised 10 lectures on food production, safety management, and health management, as well as 2 farming practicum classes (seed sowing, harvesting, etc.). Twenty of the 27 students who attended the courses belonged to the Department of Nutritional Sciences. We received responses from 24 and 11 students to questionnaires administered before and after the program, respectively. We obtained a "yes" answer 73-91% of the time in response to the following questions : 1) Was your interest in dietary education activities enhanced? 2) Were you able to obtain the information you sought? 3) After attending these courses, did your understanding of the relationship between farming and diet change? and 4) Would you take this course if it were officially offered as a class? Seventy-three percent of students replied that they were very satisfied with the courses. By placing "farming" as the central principle, these courses contributed to food awareness and appreciation, feelings of gratitude toward producers, consideration for the environment, and knowledge acquisition about the relationship between nutrition and health. Future studies should address the generalizability by examining a larger pool of participants. In addition, other issues such as human and material resources should be considered in realization of the Shokuiku program curriculum

Placement of a self-expandable metallic stent as a bridge to surgery for large bowel obstruction induced by effective neoadjuvant therapy: report of three cases

Abstract Background Self-expandable metallic stent placement is a widely performed palliative procedure or bridge to surgery for obstructive colorectal cancer. However, the feasibility of this procedure for large bowel obstruction induced by effective neoadjuvant therapy is unclear. Case presentation We herein report three such cases involving a 61-year-old man who underwent neoadjuvant chemoradiotherapy for lower rectal cancer, a 56-year-old woman who underwent neoadjuvant chemotherapy for lower rectal cancer, and a 63-year-old woman who underwent neoadjuvant chemotherapy for lower rectal cancer. All were emergently hospitalized with large bowel obstruction that developed while undergoing neoadjuvant therapy. Colonoscopy revealed smooth strictures caused by effective neoadjuvant therapy. Self-expandable metallic stents were placed across the obstruction as a bridge to surgery, and laparoscopic low anterior resection was uneventfully performed in all patients. Conclusions We successfully treated three patients with large bowel obstruction induced by a good response to neoadjuvant therapy using self-expandable metallic stents as a bridge to surgery. Further studies with larger sample sizes are warranted to assess the feasibility of this strategy

Medical Treatment for Hepatocellular Carcinoma in Japan

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Management of Simple Hepatic Cyst

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