Timely diagnosis and treatment of intra-abdominal arterial aneurysms before rupture are highly recommended. We successfully prevented rupture through arterial aneurysm excision, highlighting the ...importance of the lack of reports on resection before rupture.
A 60-year-old male with previous history of ureteral stones presented complaining primarily of left-sided abdominal pain. Computed tomography (CT) revealed a left ureteral stone and incidentally identified a submucosal gastric tumor and right gastric artery aneurysm, leading to referral to our department. Blood tests showed no abnormalities. CT revealed a 23-mm submucosal tumor protruding outward from the middle gastric body wall. A 13-mm aneurysm was observed in the right gastric artery, and no other aneurysms were detected, including intracranially. Upper gastrointestinal endoscopy revealed a smooth elevation covered by normal mucosa in the middle gastric body. Endoscopic ultrasound-fine needle aspiration resulted in a diagnosis of gastrointestinal stromal tumor (GIST) and surgery. We performed simultaneous surgery involving laparoscopic local resection of the gastric GIST and identification and excision of the right gastric artery aneurysm due to its enlargement (7 mm on CT conducted six years ago). The patient's postoperative course was uneventful, and he was discharged on postoperative day 6. Pathological examination confirmed a diagnosis of segmental arterial mediolysis.
Intra-abdominal arterial aneurysms affect approximately 1 % of the population. Splenic artery aneurysms are the most common at 58.7 %, whereas the gastric artery and gastroepiploic artery account for only 4.7 %.
Right gastric artery aneurysms are exceedingly rare, with no reported cases of successful resection before rupture.
The case was a man in his 60s. With a complaint of loss of appetite, a peripheral type 3 lesion was found from the lower body of the stomach to the vestibule, and a biopsy revealed poorly ...differentiated adenocarcinoma. CT examination revealed that the tumor had invaded the left lobe of the liver and the transverse colon, and that the para-aortic lymph nodes were swollen and multiple nodules of the gastrocolonic mesentery were found. After 6 courses of S-1 plus cisplatin(SP)therapy were performed, the tumor shrank and lymph node swelling and nodule disappearance were observed. Laparotomy and pyloric gastrectomy, partial liver resection, D2 dissection, and Roux-en-Y reconstruction were performed. As a result of histopathological examination, R0 was resected. After the operation, S-1 was taken orally for 1 year, and no recurrence or metastasis has been observed 6 and a half years after the operation. This time, we report a valuable case in which SP therapy was successful for unresectable gastric cancer and long-term survival was obtained by conversion surgery.
Electrowetting has a potential to realize stand-alone point-of-care (POC) devices. Here we report droplet-migration characteristics on oil-infused electrowetting-on-dielectric (EWOD) substrates. We ...prepare sparse micropillars to retain the oil layer in order to exploit the layer as a lubricating film. A physical model of the droplet velocity is developed, and effects of the lubrication, the oil viscosity, the droplet volume, and the thickness of solid and liquid dielectric layers are discussed. It is found that the droplet velocity is scaled as square of E, which differs from a relationship of cube of E for droplets sliding down on liquid-infused surfaces by gravity. Furthermore, our device achieves droplet velocity of 1 mm/s at the applied voltage of 15 V. The velocity is approximately tenfold as high as the same condition (applied voltage and oil viscosity) on porous-structure-based liquid-infused surfaces. The achieved high velocity is explained by a lubrication-flow effect.
A woman in her seventies visited a previous doctor because she was reported to have abnormal opacity in her right lung. Computed Tomography (CT) revealed pulmonary tuberculosis. An upper abdominal ...mass was also found, and she was referred to our hospital. Contrast-enhanced abdominal CT showed a heterogeneously mass lesion with a long diameter of approximately 83 mm in the pancreatic caudal region. Endoscopic ultrasound revealed a tumor at the pancreatic tail with distinct boundaries and internal mosaic echo. Magnetic Resonance Imaging showed a mass with heterogeneous and partially cystic degeneration. Based on these findings, solid pseudopapillary neoplasm (SPN) and other malignant lesions of the pancreas tail region were suspected. By laparotomy with subarachnoid arc incision, distal pancreatectomy, splenectomy, and regional lymph node dissection were performed. The specimen was a cystic mass covered with an 80×75×65 mm membrane in the pancreatic tail region. Initially, in the results of the pathological diagnosis, epithelial cells were not observed, and a hematoma was diagnosed. However, subsequent diagnosis indicated bizarre idioblasts and numerous osteoclast-like giant cells in the surrounding capsule. This area was initially thought to be a reactive pseudotumor lesion due to hemorrhage; however, the presence of CK7, p53-positive atypical spindle-shaped tumor cells and polynucleated tumor cells led to the diagnosis of anaplastic pancreatic carcinoma with osteoclastic polynucleic giant cells with extensive necrosis. We report a case of a rare pancreatic tumor with extensive intratumoral necrosis, which was difficult to diagnose pathologically, and present our findings with literature review.
INTRODUCTIONTimely diagnosis and treatment of intra-abdominal arterial aneurysms before rupture are highly recommended. We successfully prevented rupture through arterial aneurysm excision, ...highlighting the importance of the lack of reports on resection before rupture.CASE PRESENTATIONA 60-year-old male with previous history of ureteral stones presented complaining primarily of left-sided abdominal pain. Computed tomography (CT) revealed a left ureteral stone and incidentally identified a submucosal gastric tumor and right gastric artery aneurysm, leading to referral to our department. Blood tests showed no abnormalities. CT revealed a 23-mm submucosal tumor protruding outward from the middle gastric body wall. A 13-mm aneurysm was observed in the right gastric artery, and no other aneurysms were detected, including intracranially. Upper gastrointestinal endoscopy revealed a smooth elevation covered by normal mucosa in the middle gastric body. Endoscopic ultrasound-fine needle aspiration resulted in a diagnosis of gastrointestinal stromal tumor (GIST) and surgery. We performed simultaneous surgery involving laparoscopic local resection of the gastric GIST and identification and excision of the right gastric artery aneurysm due to its enlargement (7 mm on CT conducted six years ago). The patient's postoperative course was uneventful, and he was discharged on postoperative day 6. Pathological examination confirmed a diagnosis of segmental arterial mediolysis.DISCUSSIONIntra-abdominal arterial aneurysms affect approximately 1 % of the population. Splenic artery aneurysms are the most common at 58.7 %, whereas the gastric artery and gastroepiploic artery account for only 4.7 %.CONCLUSIONRight gastric artery aneurysms are exceedingly rare, with no reported cases of successful resection before rupture.
Summary
Reduction of the level of arsenic (As) in rice grains is an important challenge for agriculture. A recent study reported that the OsABCC1 transporter prevents the accumulation of As in grains ...by sequestering As–phytochelatin complexes into vacuoles in the upper nodes. However, how phytochelatins are provided in response to As remains unclear. Here, we show that the phytochelatin synthase OsPCS1 plays a crucial role in reducing As levels in rice grains. Using a forward genetic approach, we isolated two rice mutants (has1 and has2) in which As levels were much higher in grains but significantly lower in node I compared with the wild type. Map‐based cloning identified the genes responsible as OsABCC1 in has1 and OsPCS1 in has2. The levels of As in grains and node I were similar between the two mutants, suggesting that OsABCC1 preferentially cooperates with OsPCS1 to sequester As, although rice has another phytochelatin synthase, OsPCS2. An in vitro phytochelatin synthesis assay indicated that OsPCS1 was more sensitive to activation by As than by cadmium, whereas OsPCS2 was more weakly activated by As than by cadmium. Transgenic plants highly expressing OsPCS1 showed significantly lower As levels in grains than did wild‐type plants. Our results provide new knowledge of the relative contribution of rice PCS paralogs to As sequestration and suggest a good candidate tool to reduce As levels in rice grains.
Significance Statement
Reducing arsenic (As) levels in rice grains is an important challenge for improving human health because rice is a major contributor to dietary intake of As. Here we show that the phytochelatin synthase OsPCS1 is a key player in reducing As levels in rice grains and a candidate tool to allow the breeding of low‐As rice cultivars.
Paddy fields are anaerobic and facilitate arsenite (As(III)) elution from the soil. Paddy-field rice accumulates arsenic (As) in its grains because silicate transporters actively assimilate As(III) ...during the reproductive stage. Reducing the As level in rice grains is an important challenge for agriculture. Using a forward genetic approach, we isolated a rice (Oryza sativa) mutant, low arsenic line 3 (las3), whose As levels were decreased in aerial tissues, including grains. The low-As phenotype was not observed in young plants before heading (emergence of the panicle). Genetic analyses revealed that a deficiency in alcohol dehydrogenase (ADH) 2 by mutation is responsible for the phenotype. Among the three rice ADH paralogues, ADH2 was the most efficiently produced in root tissue under anaerobic conditions. In wild-type (WT), silicon and As concentrations in aerial tissues increased with growth. However, the increase was suppressed in las3 during the reproductive stage. Accordingly, the gene expression of two silicate transporters, Lsi1 and Lsi2, was increased in WT around the time of heading, whereas the increase was suppressed in las3. These results indicate that the low-As phenotype in las3 is due to silicate transporter suppression. Measurement of intracellular pH by 31P-nuclear magnetic resonance revealed intracellular acidification of las3 roots under hypoxia, suggesting that silicate transporter suppression in las3 might arise from an intracellular pH decrease, which is known to be facilitated by a deficiency in ADH activity under anaerobic conditions. This study provides valuable insight into reducing As levels in rice grains.
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