An 84-year-old man presented with anorexia and epigastric pain. Endoscopic examination revealed a type 3 tumor of the entire circumference of the antrum. The pathological diagnosis of a biopsy ...specimen was squamous cell carcinoma. Thoracoabdominal pelvic contrast CT revealed no distant metastasis. Squamous cell carcinoma or adenosquamous carcinoma was diagnosed and distal gastrectomy with Roux-en-Y anastomosis, D2 lymph node dissection, omentectomy, and cholecystectomy were performed. The histological diagnosis of the resected tumor was pure squamous cell carcinoma without an adenocarcinomatous component, of which most carcinoma cells were immunoreactive to p40 antibody. The pathological findings were as follows: pT3 (SS), int, INFb, ly0, v2, pN0, M0, P0, CY0, H0, and Stage IIA. Primary gastric squamous cell carcinoma is considered very rare and the incidence of this histological type is approximately 0.09%. Here we report a rare case of primary gastric squamous cell carcinoma diagnosed by immunohistochemical analysis of p40.
An experimental and design study has been commenced for a dual-frequency gyrotron (28 and 35 GHz). The target output power at 28 GHz is 2 MW. For a modified 28 GHz 1 MW gyrotron, an output power of ...1.25 MW and operation of 0.6 MW for 2 s have been achieved at 28 GHz. For the 35.45 GHz oscillation test, a cavity oscillation power of 1.2 MW and an efficiency of 33.9% have been confirmed by considering the calculated transmission efficiency of 72%. These results support the development of dual-frequency gyrotrons for lower frequency ranges.
Aim: The present study was designed to assess whether prophylactic use of bicarbonated Ringer's solution ameliorates metabolic acidosis in patients undergoing aortic surgery. Methods: Twenty patients ...undergoing elective infrarenal aortic aneurysm repair were randomly assigned to receive either bicarbonated Ringer's solution or acetated Ringer's solution. The pH, PaCO2, and base excess (BE) were measured before surgical incision (T0), 5 min before reperfusion (T1), 5 min after reperfusion (T2), and 30 min after reperfusion (T3). Data were compared between the two groups. Results: Both pH and BE initially showed a slight decrease in both groups during clamping. After unclamping of the aorta, an additional decrease in pH was observed in both groups (T0 to T2, and T3). There were no significant differences in pH between the groups throughout the study period. Conclusions: Aortic cross-clamping leads to the development of metabolic acidosis, with a decrease in pH and BE. The effect of administration of bicarbonated infusion fluid during elective abdominal aortic surgery had not significant compared with that of acetated Ringer's solution with respect to acid-base homeostasis.
A 57-year-old man was admitted to our hospital with a diagnosis of metastatic abdominal wall tumor measuring 8×8 cm. Incisional biopsy indicated adenocarcinoma. The patient had undergone laparoscopic ...cholecystectomy (LC) after endoscopic excision of the papilla of Vater and lithotomy for cholecysto choledocholithiasis in another hospital 3 years and 7 months previously. The patient underwent abdominal wall all-strata abscission of 13×13 cm and reconstruction using the flap of the left fascia lata. Operative findings showed no signs of recurrence of peritoneal dissemination or lymph node metastasis in the hepatic hilum. On macroscopic examination, the tumor existed mainly across the strata of the port site and progressed along the anterior layer of the rectus sheath. Immunohistochemistry was positive for CK7, CA19-9, and CEA and negative for CK20. There were no malignant findings on pathological re-examination of the gallbladder specimen, but the patient was diagnosed with port site recurrence (PSR) of incidental gallbladder carcinoma. He subsequently underwent laparectomy twice for tumor recurrence and died of cancer. Death occurred 7 years and 2 months from the initial laparectomy and 11 years after the LC. Most patients with PSR have a poor prognosis, but long-term survival may be possible with laparectomy in patients without peritoneal dissemination.
We have investigated the alignment of poly (9,9-dioctylfluorenyl-2,7-diyl) (PFO) induced by a photo-aligned polyimide film, which is optically, thermally, and chemically stable. The ∼30
nm-thick PFO ...layer was spin-coated onto a photo-aligned polyimide film. Slow cooling and quenching of the sample from the liquid crystalline phase of PFO formed uniaxially-aligned crystalline and glassy layers of PFO, respectively. For comparison, we also investigated the alignment of PFO induced by a rubbed polyimide film. For the crystalline PFO layer on the photo-aligned film, an extremely high polarization ratio was observed in photoluminescence (PL), which was ∼30. It was much larger than that of the crystalline PFO layer formed on the rubbed film (∼20). Indeed, such a high PL polarization ratio has not previously been reported in crystalline PFO layers formed by any other alignment method. For the glassy PFO layer formed on the photo-aligned film, the PL polarization ratio was 10.8. It was slightly larger than that of the glassy PFO layer on the rubbed film (9.5). These results show that the photo-aligned polyimide film used in this study is an excellent alignment film for PFO layers, especially for crystalline layers.
Methylmalonic acidemia (MMA) is caused by the deficient activity of
l-methylmalonyl-CoA mutase, which is a vitamin B
12 (or cobalamin, Cbl)-dependent enzyme. MMA due to the effect of insufficient Cbl ...metabolism is classified into three forms (
cblA,
cblB, and
cblH). Recently, the genes responsible for
cblA and
cblB were identified as
MMAA and
MMAB, respectively. The
MMAA protein likely transports Cbl into the mitochondria for adenosylcobalamin synthesis, while the MMAB protein appears to be an adenosyltransferase. We performed a mutation analysis of 10 unrelated Japanese patients with vitamin B
12-responsive MMA. Seven patients had mutations in
MMAA, whereas the other three patients showed no disease-causing substitutions in either
MMAA or
MMAB. Five novel mutations were identified in
MMAA (R22X, R145X, L217X, R359G, and 503delC). The 503delC mutation was observed in five of the seven
MMAA patients, suggesting that the mutation is prevalent in Japanese patients. This finding may facilitate the DNA diagnosis of vitamin B
12-responsive MMA within the Japanese population.
Patients with hematologic malignancies are immunosuppressive and may develop cutaneous or invasive infections as a primary sign of immune suppression. Acute promyelocytic leukemia (acute myeloid ...leukemia M3) is caused by translocation of reciprocal chromosomal rearrangement t(15;17), which produces an oncogenic protein. We herein describe a 71-year-old man having cellulitis with leukocytopenia as a first sign of acute promyelocytic leukemia. Dermatologists and hematologists should keep in mind that patients with a hematologic malignancy, such as acute promyelocytic leukemia, can develop cellulitis with leukocytopenia.
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