Direct observation diverticulectomy for Zenker’s diverticulum carcinoma

Zenker’s diverticulum carcinoma is a rare disease. Recent technological endoscopic innovation has enabled the detection of early stage Zenker’s diverticulum carcinoma. Here we report a case in which a 56-year-old woman was diagnosed with early stage Zenker’s diverticulum carcinoma. Narrow band imaging (NBI) endoscopic examination was useful for diagnosis and identifying the borders of the carcinoma. A successful surgical treatment was performed using direct observation diverticulectomy. A minimally invasive cervical procedure was used, and the area of the carcinoma was confirmed intraoperatively with Lugol’s solution.     

Utility of sampling perfection with application optimized contrasts using different flip angle evolutions method in carotid artery plaque magnetic resonance imaging

In the carotid artery plaque diagnosis, it is said that properties evaluation is important. For this inspection, it is general to use electrocardiogram (ECG)-trigger-dark blood (DB)-fat suppression (fs)-turbo spin echo (TSE)-T1 weighted image (T1WI), T2WI, and magnetization prepared rapid gradient echo (MPRAGE) methods though many problems still remain. This time, a comparative study of the carotid artery plaque diagnosis that used the sampling perfection with application optimized contrasts was made. This used different flip angle evolutions method sampling perfection with application optimized contrasts using different flip angle evolutions (SPACE) method that was 3 dimension (3D) imaging procedure that used variable flip angle with the law so far. The subjects were normal volunteers, handmade phantoms changed by T1 and T2 value, and the five patients on five cases who had taken carotid endoarterectomy (CEA) (male, mean 70.6 yr). Findings by the pathologist were obtained for the CEA enforcement patient. There is an excellent result in the contrast ratio by phantom, the signal intensity ratio of a clinical patient, and the comparison with pathological findings. The SPACE method can solve various problems, be evaluated by a properties evaluation of the plaque, a grasp of the range, and an arbitrary section, and be devised as a useful imaging procedure.     

Unique Physicochemical Properties of Perfluorinated Compounds and Their Bioconcentration in Common Carp <Emphasis Type="Italic">Cyprinus carpio</Emphasis> L.

Carp (Cyprinus carpio L.) was exposed to perfluorinated compounds (PFCs)—perfluoroalkyl carboxylic acids (number of carbon atoms, C = 8, 11, 12, 14, 16, and 18) and perfluorooctane sulfonate (PFOS)—in bioconcentration tests to compare the bioconcentration factors (BCFs) and physicochemical properties of each specific compound. Despite having the same number of carbon atoms (C = 8), the BCFs of perfulorooctanoic acid (PFOA) and PFOS differed by more than two orders of magnitude (PFOA BCF = < 5.1 to 9.4; PFOS BCF = 720 to 1300). The highest BCFs were obtained from perfluorododecanoic acid (BCF = 10,000 to 16,000) and perfluorotetradecanoic acid (BCF = 16,000 to 17,000). The longest observed depuration half-lives were for perfluorohexadecanoic acid (48 to 54 days) and PFOS (45 to 52 days). The concentrations of PFCs were highest in the viscera, followed by the head, integument, and remaining parts of the test fish. PFCs concentrations in the integument, which was in direct contact with the test substances, were relatively greater than that of other lipophilic substance (hexachlorobenzene). It is likely that Clog P would be a better parameter than log K _ow for the prediction of BCFs for PFCs. Threshold values for PFCs bioaccumulation potential (molecular weight = 700, maximum diameter = 2 nm) seemed to deviate from those generally reported because of the specific steric bulk effect of molecule size.     

Altered anterior‐posterior connectivity through the arcuate fasciculus in temporal lobe epilepsy

How the interactions between cortices through a specific white matter pathway change during cognitive processing in patients with epilepsy remains unclear. Here, we used surface‐based structural connectivity analysis to examine the change in structural connectivity with Broca's area/the right Broca's homologue in the lateral temporal and inferior parietal cortices through the arcuate fasciculus (AF) in 17 patients with left temporal lobe epilepsy (TLE) compared with 17 healthy controls. Then, we investigated its functional relevance to the changes in task‐related responses and task‐modulated functional connectivity with Broca's area/the right Broca's homologue during a semantic classification task of a single word. The structural connectivity through the AF pathway and task‐modulated functional connectivity with Broca's area decreased in the left midtemporal cortex. Furthermore, task‐related response decreased in the left mid temporal cortex that overlapped with the region showing a decrease in the structural connectivity. In contrast, the region showing an increase in the structural connectivity through the AF overlapped with the regions showing an increase in task‐modulated functional connectivity in the left inferior parietal cortex. These structural and functional changes in the overlapping regions were correlated. The results suggest that the change in the structural connectivity through the left frontal–temporal AF pathway underlies the altered functional networks between the frontal and temporal cortices during the language‐related processing in patients with left TLE. The left frontal–parietal AF pathway might be employed to connect anterior and posterior brain regions during language processing and compensate for the compromised left frontal–temporal AF pathway. Hum Brain Mapp 37:4425–4438, 2016. © 2016 Wiley Periodicals, Inc.     

Hepatocellular carcinoma in patients with non-alcoholic steatohepatitis

We describe six patients with non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC). From 1990 to 2001, we treated 82 patients with NASH and observed six patients (three men and three women, aged 56-72 years) in this group who were referred with HCC or developed the complication during follow-up. In five of these six patients, NASH was associated with obesity (cases 3, 4 and 5), hyperlipidemia (case 5), or diabetes mellitus (cases 1, 3 and 6). We confirmed the presence of HCC by ultrasonography-guided tumor biopsy or surgery except in case 3 where we diagnosed the tumor by ultrasonography, computed tomography and selective hepatic arteriography. The carcinomas measured 1.5-6.0 cm in diameter and three were well differentiated. When HCC was diagnosed, cirrhosis was present in all instances. Four of the six tumor patients also had esophageal varices but only one patient had a history of variceal bleeding and ascites. Treatment of HCC consisted of surgery (cases 1 and 5), transcatheter arterial embolization or infusion and/or percutaneous ethanol injection (cases 2, 3, 4, and 6). In patients with NASH cirrhosis, the development of treatable HCC is sufficiently common to warrant regular screening for this grave complication.