We report on 3 patients aged 9–12 years with pancreatic injury involving the main pancreatic duct. None of them presented with shock. They were initially transported to secondary emergency care ...facilities, leading to delays in diagnosis and treatment. Two patients underwent organ (spleen and pancreatic tail)-preserving surgery and one underwent non-operative management (NOM). They recovered and were discharged without major complications. Although the indications for NOM for paediatric pancreatic injury might increase in the future, we believe that it is preferable for patients to be transferred to the tertiary care hospital from the very beginning to recieve appropriate diagnosis and treatment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
We recently succeeded in purifying a novel multipotential progenitor or stem cell population from bone marrow stromal cells (BMSCs). This population exhibited a very high frequency of colony forming ...units-osteoblast (CFU-O; 100 times higher than in BMSCs) and high expression levels of osteoblast differentiation markers. Furthermore, large masses of mineralized tissue were observed in in vivo transplants with this new population, designated highly purified osteoprogenitors (HipOPs). We now report the detailed presence and localization of HipOPs and recipient cells in transplants, and demonstrate that there is a strong relationship between the mineralized tissue volume formed and the transplanted number of HipOPs.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Peritoneal dialysis (PD)‐related peritonitis is sometimes complicated with other infections; however, few cases of splenic abscess have been reported. We present the case of a 64‐year‐old PD patient ...with complicated splenic abscesses diagnosed following relapsing sterile peritonitis. After PD induction, he presented with turbid peritoneal fluid and was diagnosed with PD‐related peritonitis. A plain abdominal computed tomography (CT) did not reveal any intra‐abdominal focus of infection. After empiric intravenous antibiotics, the peritoneal dialysate was initially cleared, with a decrease in dialysate white blood cells (WBC) to 20/µL. However, WBC and C‐reactive protein (CRP) levels remained elevated. A contrast‐enhanced abdominal CT showed two areas of low‐density fluid with no enhancement in a mildly enlarged spleen, making it difficult to distinguish abscesses from cysts. Due to relapsing sterile peritonitis, we performed an abdominal ultrasonography, and suspected splenic abscesses due to rapid increase in size. Repeated imaging tests were useful in establishing a diagnosis of splenic abscesses. Considering the persistent elevation of WBC and CRP levels, imaging findings, and episodes of relapsing peritonitis, we comprehensively formed the diagnosis, and performed a splenectomy as a rescue therapy. We should consider the possibility of other infectious foci with persistent inflammation after resolving PD‐related peritonitis.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Studies describing the effects of leukemia inhibitory factor (LIF) on adipocyte differentiation in murine cells have shown varying results. For example, LIF has been reported to have a suppressive ...effect on adipocyte differentiation in the 3T3-L1 cell line, whereas it promoted adipocyte differentiation in the Ob1771 and 3T3-F442A cell lines. Thus, it is possible that the effects of LIF on adipogenesis vary with the developmental stage of the cells or tissues, but the details remain unclear. To further elucidate the role of LIF in adipogenesis, we investigated the effects of LIF on murine bone marrow stromal cells at the early and late stages of adipogenesis. LIF decreased the number of lipid foci and suppressed the expression levels of adipocyte differentiation markers at day 5; however, it enhanced these same traits at day 15. A previous report showed that the expression levels of Wnt signaling molecules are different at the early and late differentiation stages; therefore, we investigated the relationship between LIF and Wnt signaling. LIF affected the mRNA expression levels of different Wnt signaling molecules but inhibited the expression level of β-catenin protein at both days 5 and 15. Our data suggest that LIF has reciprocal roles during the early and late stages of adipocyte differentiation, regulating the Wnt signaling pathway.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Carcinoid of the small intestine often metastasizes to the lymph nodes, even when the lesions are small. We encountered a case of carcinoid tumor of the ileum, in which the lymph node metastatic ...tumor was larger than the primary lesion. A 62-year-old man presented to his primary care doctor with a history of constipation and diarrhea. Abdominal CT revealed an ileocecal tumor, and the patient was referred to our hospital. We diagnosed the patient as having an ileocecal mesenteric tumor and performed laparoscopic ileocecal resection with lymph node dissection. However, a carcinoid tumor was found in the terminal ileum, and the ileocecal mesenteric tumor was histopathologically diagnosed as a lymph node metastasis from the carcinoid tumor. The primary and metastatic lesions measured 15 mm and 30 mm in diameter, respectively. In cases of lymph node metastasis from carcinoid tumors of the small intestine, metastatic tumors are not uncommonly larger than the primary lesion. It is important to differentiate such lymph node metastases from mesenteric tumors.
Purpose: Auto-transplantation of teeth is a viable treatment option for tooth loss because the transplanted tooth resembles a natural tooth histologically. Several studies have reported the ...advantages of this procedure. However, autotransplantation is often complicated by the size and shape of the donor tooth, thus necessitating careful consideration before implementation. Generally, donor teeth are single-rooted and almost straight, which makes transplantation and root canal treatment easier. However, in this report, we present the favorable results obtained after transplantation of a maxillary third molar with curved and hypertrophied roots in place of a maxillary second molar. Case report: A 37-year-old man presented at the Osaka University Dental Hospital with gingival swelling around the left maxillary molars. At presentation, both buccal and palatal gingivae of the left maxillary second molar were swollen and had a fistula. Removal of the full cast crown resulted in a fracture of the pulpal floor, necessitating tooth extraction. The patient opted for autogenous transplantation of the right maxillary third molar (donor tooth) into the socket of the left maxillary second molar. We chose to proceed with the transplantation even though cone-beam computed tomography (CBCT) revealed that the donor tooth had hypertrophic curved roots. Following extraction of both teeth, endodontic treatment was performed extraorally on the donor tooth by using Ni-Ti rotary file systems. The resin-wire splint used for fixation was removed 1 month postoperatively, the tooth was built up with core materials, and a temporary crown was placed. Successful periodontal reattachment of the donor tooth was seen and prosthetic treatment was performed 6 months postoperatively. Discussion: Hypercementosis and dilaceration of the roots make extraction of teeth difficult and increase the risk of periodontal ligament injury and rejection of the transplant by the recipient site, contributing to the low success rate of tooth transplantation. The shape of dilacerated teeth especially complicates root canal treatment. In general, the exposure time of the donor tooth to the extra-oral environment is correlated with the success rate; the prognosis is usually better when the exposure time is short. However, we opted to perform extraoral treatment taking into consideration the difficulty of root canal treatment in this case. Conclusion: A careful examination of the recipient site with CBCT is recommended and the operative procedure should be chosen depending on the case, even if the donor teeth are curved and hypertrophied, so as to increase the success rate of autotransplantation.
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