Gallbladder torsion: case report and review of 245 cases reported in the Japanese literature

We report here a case of torsion of the gallbladder in a 73-year-old woman. The patient was admitted to our hospital with right hypochondralgia. Ultrasonography and computed tomography demonstrated a distended gallbladder, with a multilayered wall, which contained no stones. Since the symptoms did not respond to antibiotics, laparotomy was performed. The gallbladder was found to be twisted around its pedicle and to be gangrenous. Cholecystectomy was performed, and the patient had an uneventful postoperative course. We also reviewed 245 cases reported in the Japanese literature. The clinical features of gallbladder torsion, which include low frequency of fever and jaundice, poor response to antibiotic therapy, and acute onset of abdominal pain, may be helpful in the differential diagnosis from acute cholecystitis. Moreover, a highly suggestive sign of gallbladder torsion observed by ultrasonography or computed tomography is a markedly enlarged “floating” gallbladder with a continuous hypoechoic line indicating edematous change in the wall.     

Changing trends in the proportion of adenocarcinoma of the esophagogastric junction in a large tertiary referral center in Japan

Introduction: A dramatic increase in incidence of adenocarcinoma of the esophagogastric junction (EGJ) over the past two decades has been reported in the West. However, epidemiological data from Asian countries have not shown a similar trend. The aim of this study was to determine the incidence of adenocarcinoma of the EGJ in a cohort of consecutive patients operated on for gastric adenocarcinoma at a major cancer referral center in Japan. Method: We reviewed pathological reports of all patients who underwent surgery for advanced gastric adenocarcinoma between 1962 and 2005 at the National Cancer Centre Hospital in Tokyo. Adenocarcinoma of the EGJ was defined from images recorded for each patient, in accordance with the classification of Siewert and Stein. The proportion of adenocarcinoma at the EGJ among operated gastric adenocarcinoma patients was compiled at five‐year intervals and serial comparison made. Results: A total of 6953 patients with advanced gastric adenocarcinoma were operated on; adenocarcinoma of EGJ was found in 520 patients. The overall proportion of adenocarcinoma of the EGJ increased from 2.3% (1962–1965) to 10.0% (2001–2005). The proportion of Siewert Type II rose from 28.5% (1962–1965) to 57.3% (2001–2005), while that of Type I remained at around 1%. Conclusion: An increasing trend of adenocarcinoma of EGJ is observed in this study of patients operated on for gastric adenocarcinoma from 1962 to 2005 in a large tertiary referral center in Japan.     

Cardiovascular effects of lysophosphatidic acid and its structural analogs in rats

Injection of lysophosphatidic acid into anesthetized rats induced immediate hypertension, the effect depending on the structure of the sn-1-acyl moiety of the molecule. A hydroxyl group at the sn-2-position was not necessary, but a wedgeshaped structure was suitable for hypertensive activity. Most lysophospholipids with a chemical group attached to the phosphate portion had only weak hypotensive effects, but the sn-2-acetylated analogs of these depressor lysophospholipids elicited a hypotension at much lower doses. The durations of the hypotensions evoked by the sn-2-acetylated choline phospholipids were longer than those produced by 1-palmitoyl-2-acetoyl-sn-glycerol-3-phosphorylmethanol, ethanol and propanol.     

Novel endoscopic activity index is useful for choosing treatment in severe active ulcerative colitis patients

Aim  

Clinical symptoms are the most important factors used by physicians to evaluate the severity and extent of ulcerative colitis (UC). In this context, colonoscopy is also a useful diagnostic tool. We have recently developed an endoscopic activity index (EAI) to assess the severity of UC. Here, we assess the correlations among the EAI, other endoscopic indices, and clinical scores. The usefulness of the EAI for choosing treatment options, such as intravenous corticosteroid or cyclosporine A (CsA), in severe UC patients was also evaluated.     

High-resolution computed tomography findings of diffuse pulmonary involvement by mycosis fungoides

The authors describe a case of diffuse pulmonary involvement by mycosis fungoides in a 55-year-old man who presented with progressive exertional dyspnea. Although he had a long history of skin lesions, mycosis fungoides remained undiagnosed at initial presentation. High-resolution computed tomography revealed hazy ground-glass opacities along the thickened bronchovascular bundles and interlobular septa, particularly in the mid and upper lung fields, and traction bronchiectasis in the central regions. Skin biopsy confirmed the diagnosis of mycosis fungoides in the plaque stage. Transbronchial lung biopsy revealed diffuse infiltration of the atypical lymphoid cells in the peribronchial and perivascular regions. In this case, high-resolution computed tomography played an important role for suggesting the lymphoproliferative disease in this patient with undiagnosed mycosis fungoides.     

Seasonal variation in adhesive tape stripping of the skin

Background/aims: The seasonal variation in various properties of adhesive tapes on the skin was evaluated.
Methods: In February, April, and August, five general-purpose adhesive tapes were applied on the forearms of 12 healthy male volunteers for 24 h. The dermal peeling force, the accumulation of fluid, the amount of stripped corneocytes, and the dermal reaction at 1 h after removal of the tapes were evaluated.
Results/Conclusions: The various properties of adhesive tapes on the skin were closely related to the accumulation of fluid beneath the applied tape. Because the accumulation of fluid was significantly higher in summer than in winter, the dermal peeling force was lower in summer than winter. However, the number of stripped corneocytes and the dermal reaction of the inner area under the applied tapes were larger in summer than in winter. Though tha dermal peeling force, the accumulation of fluid, and the number of stripped corneocytes are generally considered as dermal irritation factors, the accumulation of fluid and the number of stripped corneocytes may exert a great influence on the seasonal variation in dermal irritation. On the other hand, the dermal reaction of the edge section had no tendency to vary with season. Because the edge reaction should be caused by interference with skin movement by the stiff backing or the adhesive, it seems to be uninfluenced by the accumulation of fluid.     

Histological changes of the gallbladder and liver after extracorporeal shock wave lithotripsy for gallbladder

The histological changes of the gallbladder and liver following extracorporeal shock wave lithotripsy (ESWL) were investigated in a canine model. After performing ESWL on human cholesterol stones placed in the gallbladder of 8 dogs, the gallbladder and livers were removed for pathological study. The mucosa of the gallbladder showed erosion and ulceration in three of the eight dogs. Edema and bleeding were found in the stroma of the gallbladder beds. Hemorrhagic necrosis and vacuolar degeneration occured in liver parenchyma adjacent to the gallbladder bed, but the portal area was fairly well preserved. It can be said that ESWL caused damage to both the liver and the gallbladder, but its effects on the liver may be only slight because of the preservation of the portal area.     

Skin irritation due to repetitive application of adhesive tape: the influence of adhesive strength and seasonal variability

BACKGROUND/PURPOSE: Influence of the repetitive application of pressure-sensitive adhesive tapes on skin was evaluated. METHODS: Two kinds of tapes with different adhesive strengths were repetitively applied to the inside of the forearm of six volunteers in winter and summer, in order to examine the dermal peeling force, the amount of stripped corneocytes, transepidermal water loss (TEWL), hydration and deepened skin furrows (changes in skin surface topography) in the epidermal stratum corneum. RESULTS AND CONCLUSION: As adhesive tapes were applied repetitively, dermal peeling force gradually increased while the amount of stripped corneocytes decreased. As the cumulative amount of stripped corneocytes increased with repetitive applications, the skin irritation worsened as measured by increased destruction of the skin surface topography and TEWL. These phenomena were more marked with the stronger adhesive tape, and there was seasonal variability.     

A novel apoptosis-inducing monoclonal antibody (anti-LHK) against a cell surface antigen on colon cancer cells

Background Apoptosis is a crucial element in the behavior of mammalian cells in many different situations. We here report the establishment of a novel monoclonal antibody (anti-LHK mAb) that has apoptosis-inducing activity against colon cancer Colo205 cells. Methods The mechanism of anti-LHK mAb-induced cell death was assessed by microscopic morphology, Annexin V/Hoechst 33528 staining, and detection of DNA fragmentation. The molecular weight of LHK antigen was determined by Western blotting. Growth inhibition of Colo205 cells induced by anti-LHK mAb was determined by in vitro and in vivo studies. Results Anti-LHK reacted with a 70-kDa antigen and completely blocked the proliferation of Colo205 cells bearing LHK in vitro in a manner characteristic of apoptosis. Strikingly, anti-LHK mAb suppressed tumor growth in a murine peritoneal dissemination model. Conclusions LHK antigen, which is restricted to epithelial cells, may be a novel death receptor that plays a critical role in controlling the growth, invasion, and metastasis of human colon cancer cells.     

The role of hematopoietic stem cell transplantation for relapsed and refractory Hodgkin lymphoma

The optimal treatment strategy with the use of hematopoietic stem cell transplantation (HSCT) for relapsed and refractory Hodgkin lymphoma (HL) remains unclear. We performed a retrospective analysis using registry data from the Japanese Society for Hematopoietic Cell Transplantation. Adult patients with HL who underwent a first autologous or a first allogeneic HSCT between 2002 and 2009 were included. Patients who underwent HSCT in first complete remission (CR) were excluded. Autologous and allogeneic HSCT were performed in 298 and 122 patients, respectively. For autologous HSCT, overall survival at 3 years (3yOS) was 70%, and sex, age, disease status, and performance status (PS) at HSCT were prognostic factors. OS was favorable even in patients who underwent autologous HSCT in disease status other than CR. For allogeneic HSCT, 3yOS was 43%, and sex and PS at HSCT were prognostic factors. Disease status at HSCT, previous autologous HSCT, and conditioning intensity did not affect OS. Moreover, graft‐versus‐host disease did not affect progression‐free survival or relapse/progression rate. A first allogeneic HSCT without a previous autologous HSCT was performed in 40 patients. 3yOS was 45%, and was significantly inferior to that in patients who underwent their first autologous HSCT. This result was retained after the correction by the different patient characteristics according to the type of HSCT. In conclusion, autologous HSCT is effective in prolonging survival in patients with relapsed and refractory HL. Allogeneic HSCT might be beneficial even to relapsed HL after autologous HSCT, although establishing the role of allogeneic HSCT remains a challenge. Am. J. Hematol. 90:132–138, 2015. © 2014 Wiley Periodicals, Inc.