Distant Peritoneal Metastasis to a Mesh-Plug Prosthesis in a Gastrointestinal Cancer Patient: Report of a Case

A case of distant metastasis to mesh-plug prosthesis in gastrointestinal cancer is presented herein. An 88-year-old man had received mesh-plug repair with high ligation for a recurrence of a right inguinal hernia. Six months later, advanced gastric cancer and advanced transverse colon cancer were detected, and therefore a distal gastrectomy and partial colectomy were performed. Two weeks after the operation, the patient complained of right groin tenderness, and the mesh-plug prosthesis was removed to control any infection. A histopathological investigation demonstrated adenocarcinoma in the plug prosthesis. The patient died of carcinomatosis peritonei 45 days after the last operation.     

A questionnaire survey on daily medical care problems at special schools for severely neurologically impaired students in southern Fukuoka prefecture

With increasing numbers of children having severe motor and intellectual disabilities, there is growing demand for daily medical care such as tube feeding and sputum suctioning in special schools. We devised a questionnaire survey for special school teachers investigating the need for daily medical care in four schools in southern Fukuoka prefecture. One-hundred fifty-two out of 633 (24%) students needed medical care; specifically, 38 of 152 (25%) needed tube feeding and 41 of 152 (27%) required sputum suctioning. Such patients lived in their houses, hospitals or medical centers for the severely disabled. Mothers whose children commuted from home had to go to school themselves to provide medical care for their children, such as sputum suctioning. School teachers were worried about their students' feeding difficulties and respiratory disorders. More support for teachers to care for students is needed and provision of medical care under supervision of school nurses and doctors should be promoted.     

Sesquiterpene phenylpropanoids from Ferula fukanensis and their nitric oxide production inhibitory effects

Five new sesquiterpene phenylpropanoid derivatives, fukanedone A (1), fukanedone B (2), fukanedone C (3), fukanedone D (4), and fukanedone E (5), and a novel phenyl-oxo-acetate ester, fukaneketoester A (6), were isolated from a 80% aqueous methanol extract of the roots of Ferula fukanensis. The structures were elucidated on the basis of spectroscorpic evidence, especially heteronuclear multiple-bond connectivity (HMBC) and high-resolution MS. The sesquiterpene phenylpropanoid derivatives inhibited nitric oxide (NO) production and inducible NO synthase (iNOS) gene expression by a murine macrophage-like cell line (RAW 264.7), which was activated by lipopolysaccharide (LPS) and recombinant mouse interferon-gamma (IFN-gamma).     

A sodium hyaluronate carboxymethylcellulose bioresorbable membrane prevents postoperative small-bowel adhesive obstruction after distal gastrectomy

Purpose

It is predictable that since distal gastrectomy (DG) with Billroth I anastomosis involves no procedures caudal to transverse colon, the effects of the surgical wound are the main cause of adhesive obstruction. Thus, it is an appropriate operation to test the efficiency of a synthetic absorbable adhesion barrier (Seprafilm).

Methods

The subjects were 282 patients diagnosed with gastric cancer who underwent open DG with Billroth I anastomosis between 2001 and August, 2005. Seprafilm was not used in any patients operated on before April, 2003 (n = 169), but it was used in all patients operated on from May 2003 onward (n = 113). We retrospectively compared the incidences of adhesive obstruction in the Seprafilm group and the non-Seprafilm group.

Results

The cumulative incidence of adhesive obstruction was significantly lower in the Seprafilm group than in the non-Seprafilm group (P = 0.021). The respective incidences of adhesive obstruction 2 years after surgery were 0.9% and 6.5%. Multivariate analysis of the occurrence of adhesive obstruction revealed no significant differences in sex, age, body mass index, operation time, blood loss, or degree of lymph-node dissection; however, it revealed a significant difference in relation to the use of Seprafilm (P = 0.049).

Conclusion

In this series, Seprafilm reduced the incidence of adhesive obstruction after DG significantly; however, a prospective randomized study will be necessary to confirm this result.     

Sesquiterpenoids from Ferula fukanensis and their inhibitory effects on nitric oxide production

Six sesquiterpene derivatives, 2,3-dihydro-7-methoxy-2S*, 3R*-dimethyl-2-[4,8-dimethyl-3(E),7-nonadienyl]furo[3,2-c]coumarin (1) and 2,3-dihydro-7-methoxy-2R*,3R*-dimethyl-2-[4,8-dimethyl-3(E),7-nonadienyl]furo[3,2-c]coumarin (2), nerolidol (3), 1-(2,4-dihydroxyphenyl)-3,7,11-trimethyl-3-ninyl-6(E),10-dodecadien-1-one (4), 1-(2,4-dihydroxyphenyl)-3,7-dimethyl-3-vinyl-8-(4-methyl-2-furyl)-6(E)-octen-1-one (5) and dshamirone (6) were isolated from an 80% aqueous methanol extract of the roots of Ferula fukanensis. The sesquiterpenoids inhibited nitric oxide (NO) production and inducible NO synthase gene expression by a murine macrophage-like cell line (RAW 264.7) [1], which was activated by lipopolysaccharide and recombinant mouse interferon-.     

Effects of calcium salts of acidic monomers on mineral induction of phosphoprotein immobilized to agarose beads

The aim of this study is to evaluate the mineralizing potential of acidic monomers and their calcium salts for mineralization, using an in vitro mineral induction model. Phosvitin (PV) was used as a model phosphoprotein in this study. PV was immobilized on agarose beads with divinyl sulfone. Five aliquots of agarose-immobilized PV, acidic monomers, and their calcium salts were incubated in mineralizing solution at various concentrations. The PV beads and acidic monomers were incubated at 37°C. Samples were taken at several time points during the incubation. Then, the agarose beads were analyzed for bound calcium by atomic absorption spectrometry. The mineral formed on the agarose beads was identified as an apatite by microarea X-ray diffraction. Additionally, the specimens were observed using scanning electron microscopy (SEM). Mineral induction time decreased with increasing solution saturation. 4-METCa salt [calcium salt of 4-methacryloxyethyl trimellitate (CMET)] significantly reduced the mineral induction time. Using these data, the interfacial tension for mineral induction of PV and CMET was determined to be 90.1 and 92.7 ergs/cm(2) , respectively. The mineral induced in each specimen after incubation for 24 h was identified by its X-ray diffraction pattern as apatite. SEM observation showed that lath-shaped crystals were formed on the surfaces of the CMET. We conclude that CMET could play a role in dentin remineralization. ? 2012 Wiley Periodicals, Inc. J Biomed Mater Res Part A 100A:2760-2765, 2012.     

A case report of long-term survival in the patient with anorectal malignant melanoma

Malignant melanoma of the anorectal region is rare, and the prognosis is considered to be poor. We present a case of long-term survival in a 56-year-old patient with primary malignant melanoma in the anorectal area, who complained of anal bleeding. Barium enema showed an elevated lesion in the anorectal region. Colonoscopy revealed a 3 cm sessile tumor with focal pigmentation, and a satellite nodule, 1 cm in diameter. Based on diagnosis of malignant melanoma by biopsy, abdominoperineal resection with lateral node dissection was performed. Pathologically the tumor remained in the mucosa, and no lymph node metastasis was found. This patient refused any adjuvant chemotherapy after the operation, and remains well without any sign of recurrence for seven years.