Differential diagnosis of gastric ulcer and gastric cancer in elderly patients

Along with the growing elderly population, patients with gastric ulcers caused by low-dose aspirin have increased. Gastric cancer is also common among the elderly population, but is sometimes difficult to distinguish from gastric ulcers, especially those stemming from aspirin use. To differentiate the diagnostic symptoms of gastric ulcers and gastric cancers in elderly patients, we compared the endoscopic findings of 198 subjects (92 benign ulcers and 106 cancers) aged 65 years and older. Despite their benign nature, aspirin-induced ulcers tended to have more irregularity of the ulcer edge and heterogeneous formation of regenerating epithelium than ulcer unrelated to aspirin. Asking about the use of low-dose aspirin is therefore important when confronted with such lesions in elderly patients.     

The use of Mitomycin-C to reduce synechia in middle meatus in sinus surgery: preliminary results

Synechia is the most frequent complication after sinus surgery and has been reported in up to 36% of cases. Several types of materials have been used to reduce the incidence of synechia, including Mitomycin C (MMC).ObjectiveThis prospective study aimed to assess the effectiveness of topical MMC in the prevention of synechia after sinus surgery in humans.MethodsAt the end of surgery, MMC solution (1.0 mg/ml) was topically applied randomly to one of the middle meatuses (MMC group) of 14 patients while saline solution was applied to the contralateral meatus (control group). The author remained blind to the medicated side. Synechiae were classified as partial or total.ResultsThree patients had middle meatus synechia in the MMC group (21.43%) versus nine (64.29%) in the control group (p = 0.054). In the MMC group, all three middle meatus synechia were partial, while in the control group there were four partial (28.57%) and five total (35.71%) cases of synechia (p = 0.025).ConclusionsMitomycin C was not effective in preventing middle meatus synechia, but reduced the probability of total synechia formation.     

Systemic sarcoidosis associated with double cancers of the esophagus and stomach

To discriminate between sarcoidosis and sarcoid reaction in the lymphadenopathy of malignancy is sometimes clinically important. We describe a case of sarcoidosis associated with double cancers of the esophagus and stomach. A patient who six months previously was found to have early gastric cancer, was then found to have esophagus cancer. The chest radiography demonstrated bilateral hilar lymphadenopathy. Pathological analysis of the lymph nodes and lungs showed non-caseating epithelioid cell granuloma, revealing the existence of sarcoidosis. The findings suggest that the possibility of systemic sarcoidosis should be considered in cases with established malignancy and newly disclosed radiographic findings.     

Effects of Asian sand dust particles on the respiratory and immune system

Epidemiologic studies have reported that Asian sand dust (ASD) particles can affect respiratory health; however, the mechanisms remain unclear. We investigated the effects of ASD on airway epithelial cells and immune cells, and their contributing factors to the effects. Human airway epithelial cells were exposed to ASD collected on 1–3 May (ASD1) and on 12–14 May (ASD2) 2011 in Japan and heat‐treated ASD1 for excluding heat‐sensitive substances (H‐ASD) at a concentration of 0, 3, 30 or 90 µg ml^–1 for 4 or 24 h. Furthermore, bone marrow‐derived dendritic cells (BMDC) from atopic prone mice were differentiated by culture with granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) then these BMDC were exposed to the ASD for 24 h. Also splenocytes as mixture of immune cells were exposed to the ASD for 72 h. All ASD dose dependently reduced viability of airway epithelial cells. Non‐heated ASD showed a dose‐dependent increase in the protein release of interleukin (IL)‐6 and IL‐8. The raises induced by ASD1 were higher than those by ASD2. ASD1 and ASD2 also elevated ICAM‐1 at the levels of mRNA, cell surface protein and soluble protein in culture medium. In contrast, H‐ASD did not change most of these biomarkers. Non‐heated ASD showed enhancement in the protein expression of DEC205 on BMDC and in the proliferation of splenocytes, whereas H‐ASD did not. These results suggest that ASD affect airway epithelial cells and immune cells such as BMDC and splenocytes. Moreover, the difference in ASD events and components adhered to ASD can contribute to the health effects. Copyright © 2013 John Wiley & Sons, Ltd.