Adult umbilical hernia with vertical dislocation

We present a case of adult umbilical hernia with vertical dislocation along the abdominal wall. The hernial sac arose from the internal ring and connected to the umbilicus 20?mm below the internal ring. The postoperative course was uneventful. Two years and four months after the operation there was no evidence of recurrent hernia even when abdominal pressure was increased, and the umbilicus looked acceptable. An umbilical hernia is usually within the umbilicus. The hernial sac arose from the internal ring so should be called an umbilical hernia not an epigastric hernia. It is unusual that the umbilical hernia dislocates vertically along the abdominal wall, while the umbilicus stays depressed. This atypical form of umbilical hernia has not been described previously as far as we know.     

Malignant solitary fibrous tumor of the soft tissue: a cytogenetic study

We report on a case of a solitary fibrous tumor that developed in the thigh of an 82-year-old woman. The tumor was composed of areas of high-grade sarcoma and typical solitary fibrous tumor. Its karyotype was: 70,XXX,+X[4],+1[2],add(1)(p36)[4],add(1)[2],+2[4],-3[4],+6[4],add(6)(p11)x2[4],+7[4],+9[3],-11[4],-12[4],-13[4],add(13)(p11)x2[4],-14[4],+15[4],-16[3],-17[4],-19[4],+20,[4],+21[4],+22[2],+mar1x2[4][cp4].     

Colonization and differentiation of transplanted embryonic stem cells in the irradiated intestine of mice

Radiation-induced intestinal injury is a common complication in radiotherapy for the cancer located in abdomen or pelvis. However, there is no effective treatment for radiation-induced intestinal injury now. It is therefore important to develop new treatments for radiation-induced intestinal injury. In this study, we investigated whether embryonic stem (ES) cells could be transplanted directly into the radiation-damaged intestine and could colonize and differentiate into the intestinal epithelial cells. The intestines of female nude mice (ICR nu/nu) were irradiated at a single dose of 30 Gy, and were immediately transplanted with male 129/Sv-derived ES cells into the wall of the irradiated intestine by direct injection. The intestine was removed on days 13 to 27 after transplantation. The Y-chromosome DNA of transplanted ES cells in the irradiated intestine was determined by polymerase chain reaction. Colonization and differentiation of transplanted ES cells in the irradiated intestine were analyzed by histological and immunohistochemical methods with antibodies against stage-specific embryonic antigen-1, alpha-smooth muscle actin and cytokeratin AE1/AE3. The cells of donor origin were identified in the intestine of irradiated mice, and intestinal crypt-like structures were observed on day 13 after transplantation. Importantly, we observed that ES cells could differentiate into epithelial cells in the submucosa of irradiated intestine on day 13 and 27 after transplantation. These results suggest that transplanted ES cells could colonize and differentiate in the intestinal intestine. Such a new approach for damaged intestine with transplanted stem cells would be promising.     

Treatment strategies for aortic and peripheral prosthetic graft infection

Purpose

The aim of this study was to investigate the outcomes correlated with our treatment strategy for prosthetic graft infection.

Methods

Seventeen patients were treated for prosthetic graft infections between 1997 and 2009. Initially, total graft excision was applied in five cases, partial graft excision was applied in six cases and graft preservation with drainage and irrigation was applied in six cases. Among the graft-preserved cases, four patients were infected with methicillin-resistant Staphylococcus aureus (MRSA) and treated with gentian violet (GV).

Results

The overall survival rate was 88 % at 30 days and 82 % at 1 year in this series. Of the excised cases, nine patients survived; however, two patients died. Among the cases in which MRSA-infected grafts were preserved, three patients survived; however, one patient died under a septicemic state. Infected graft preservation was applied at a high rate of 36 %, and the mortality rate remained at 16 %, without any signs of graft reinfection.

Conclusions

In the treatment of infected grafts, the patient’s condition should be considered in order to select the appropriate treatment in each case. Graft preservation should be considered as an alternative treatment option, especially in high-risk patients, and GV can be effective for conservative treatment of prosthetic graft infections, including MRSA infections.