Study on the Segmentation of the Right Posterior Sector of the Liver

World Journal of Surgery - The border between segments VI and VII of the right posterior sector of the liver is controversial owing to lack of anatomical landmarks. This study aimed to examine the...     

Association between Grit Scales and adherence to regular hospital visits among Japanese patients with type 2 diabetes: Prospective observational study

This study examined the association between Grit Scales and adherence to a schedule of regular hospital visits among Japanese type 2 diabetes patients. Patients with type 2 diabetes who visited the outpatient clinic as new patients comprised the study’s participants. Self-administered Short Grit Scale data were obtained from 122 patients at the first consultation and were then observed for 1 year. As the results, 21 participants failed to attend the hospital. In a logistic regression analysis, the Grit Scale as a continuous variable was positively associated with adherence to regular clinical visits. Its odds ratio and 95% confidential interval was 9.68 and 2.87–32.65 (P = 0.0003). In conclusion, it is likely that the Grit Scale is closely associated with adherence to regular hospital visits among Japanese type 2 diabetes patients.     

Phosphorylation of extracellular signal‐regulated kinase 1/2, p38 mitogen‐activated protein kinase and nuclear translocation of nuclear factor‐κB are involved in upregulation of matrix metalloproteinase‐9 by tumour necrosis factor‐α

Background: Upregulation of matrix metalloproteinase‐9 (MMP‐9) induced by tumour necrosis factor‐α (TNF‐α) is reportedly involved in a variety of non‐neoplastic and neoplastic diseases. In this study, we examined which signalling pathways are involved in TNF‐α‐induced MMP‐9 upregulation in cholangiocarcinoma (CC). Methods: We used two CC cell lines: HuCCT‐1 and CCKS‐1. Results: In an ex vivo study using HuCCT‐1 and CCKS‐1 cells, TNF‐α treatment induced MMP‐9 production and activation via interaction with TNF receptor‐1 (TNF‐R1) but not with TNF receptor‐2 (TNF‐R2), shown by zymography, and increased MMP‐9 promoter activity (luciferase assay). As for the signalling pathway, TNF‐α stimulation led to the phosphorylation of extracellular signal‐regulated kinase 1/2 (Erk1/2) and p38 mitogen‐activated protein kinase (p38MAPK) and translocation of nuclear factor κB (NF‐κB) (p65) into the nuclei. Inhibition studies using SB203580 (inhibitor of p38MAPK), U0126 (inhibitor of mitogen‐activated or extracellular signal‐regulated protein kinase 1/2) and MG132 (inhibitor of NF‐κB) showed that the phosphorylation of Erk1/2 and p38MAPK with activation of NF‐κB was closely related to MMP‐9 upregulation in both cell lines. Conclusion: These data suggest that TNF‐α/TNF‐R1 interaction leads to the phosphorylation of Erk1/2 and p38MAPK and nuclear translocation of NF‐κB, which is closely associated with the production and activation of MMP‐9 in cultured CC cells of HuCTT‐1 and CCKS‐1. Upregulation of MMP‐9 with NF‐κB activation may be involved in the tumour invasion of CC.     

Aneurysm originating from the fenestration of the posterior cerebral artery: case report

OBJECTIVE AND IMPORTANCE: A rare case of an aneurysm arising at the fenestration of the P2 segment of the posterior cerebral artery is reported. CLINICAL PRESENTATION: A 37-year-old man presented with severe headache and disturbance of consciousness. Computed tomographic scanning showed diffuse subarachnoid hemorrhage. Cerebral angiography revealed an aneurysm at the fenestration of the P2 segment of the right posterior cerebral artery. The aneurysm was located at the middle portion of the lower trunk of the fenestration. An unruptured arteriovenous malformation was incidentally found in the right thalamus. INTERVENTION: A right frontotemporal craniotomy with orbitozygomatic osteotomy was made, and the aneurysm was successfully clipped. One year after the operation, gamma knife surgery was performed for the right thalamic arteriovenous malformation. CONCLUSION: This is the first reported case of an aneurysm originating from the middle portion of a fenestrated posterior cerebral artery.     

Successful use of continuation electroconvulsive therapy in a case of late-onset Leonhard's confusion psychosis

A 56-year-old married woman with late-onset Leonhard's confusion psychosis was treated successfully with acute electroconvulsive therapy (ECT) after failing to respond to antidepressants, neuroleptics, and benzodiazepines. Symptoms relapsed within 1 year despite the combined use of olanzapine and paroxetine. The patient responded to a second course of acute ECT, but a second relapse occurred within 3 months despite her use of olanzapine and paroxetine. The symptoms resolved with continuation ECT and lithium combined with paroxetine after response to a third course of acute ECT. To date, relapse has been prevented for 2 years. Continuation ECT and lithium combined with paroxetine after response to acute ECT may be effective in maintaining remission of Leonhard's confusion psychosis.     

Cerebral lipoma and the underlying cortex of the temporal lobe: pathological features associated with the malformation

Intracranial lipomas are believed to be congenital malformations rather than true neoplasms, resulting from the abnormal differentiation of the meninx primitiva, the undifferentiated mesenchyme. We report here the surgical pathological features of a lipoma that was located on the cerebral surface of an abnormally formed fissure, and the underlying cortex of the middle temporal gyrus of a 20-year-old woman. The mass was composed of typical adipose tissue in which a large number of blood vessels were present. Thick connective tissue associated with the arachnoid membrane covered the cortical surface. The cortex exhibited a polymicrogyric configuration in which the cortical ribbon was abnormally undulated and excessively folded. Reelin-immunolabeled Cajal-Retzius-cell-like cells were observed frequently in the fused molecular layer. The cortical lamination underlying the molecular layer was poorly defined. Along the border between the connective tissue and cortical surface, there was a narrow zone in which the mesenchymal and neuronal tissues were intermingled, and where immunohistochemical and ultrastructural investigations disclosed disruption of the basal lamina, prominent astrocytosis, and abundant axonal and synaptic profiles. These findings suggest that focal disturbances in cerebral cortical development occur in association with the development of lipomas.