Introduction: Helicobacter pylori (Hp) leads to chronic gastritis and eventually causes gastric cancer. Recently, several studies have shown the existence of a small number of Hp—negative gastric cancers (HPNGC). With the decline of the Hp infection rate, the HPNGC should increases. However, the clinichopathological and endoscopic features of HPNGC are still unclear. The aim of this study is to clarify the characteristics of HPNGC. Methods: We analyzed 628 lesions of early gastric cancer that underwent endoscopic resection at our hospital from April 2009 to June 2017, retrospectively. Thirty—five HPNGC cases (38 lesions, 6.1%) were enrolled in this study, and evaluated clinichopathologically. Hp—negative status was defined as the fulfillment of all the following criteria: no eradication history, no mucosal atrophy in endoscopic and pathological findings, negative rapid urease test or urease breathe test or serum Hp—immunoglobulin G test or stool antigen. Results: In HPNGC (n=38), the frequency according to the histology was as follows: gastric adenocarcinoma of fundic gland type (GAFG) / gastrointestinal phenotype of well—differentiated adenocarcinoma (GI—WDA) / gastric phenotype of WDA (G—WDA) / signet—ring cell carcinoma (Sig) = 23(60.5%) / 7(18.5%) / 1(2.5%) / 7(18.5%). GAFG was presented as a whitish elevated lesion in the upper to middle part of the stomach. Although GAFGs exhibited submucosal invasion despite the small size of the lesions, neither lymphatic nor venous invasion was observed. GI—WDA presented as a reddish lesion in the lower part of the stomach. G—WDA presented as a whitish elevated lesion in the upper part of the stomach. Sig presented as a whitish flat or depressed lesion in the middle to lower part of the stomach. In magnifying endoscopy simple diagnostic algorithm for gastric cancer (MESDA—G) diagnosis, WDA was diagnosed as a cancer, GAFG and Sig were diagnosed as non—cancer. Conclusion: HPNGC has distinct endoscopic and clinicopathological features by each histological type and may be classified into 3 types; 1. Whitish elevated lesion in the upper or middle part of the stomach (GAFG and G—WDA), 2. Reddish lesion in the lower part of the stomach (GI—WDA), 3. Whitish flat or depressed lesion in the middle or lower part of the stomach (sig). Early detection of HPNGC enables minimally invasive treatment which preserves the patient's quality of life. Endoscopists should fully understand the characteristics and endoscopic findings of HPNGC.1219 Figure 1 No Caption available.
The muscular system of the tarsier was first described by Burmeister (1846), who noted that brachial extensors (triceps complex) have six heads. The first three heads, respectively, correspond to the long, lateral and medial heads of the triceps brachii muscle in man. The fourth head is the anconaeus and the fifth is the dorsoepitrochlearis. Schultz (1984) divided the sixth head into two different parts (preaxial and postaxial) from the viewpoint of nerve supply. The present study found that the whole sixth head is innervated by the ulnar nerve, and we propose that it is recognized as the proximal and distal heads of the (preaxial) epitrochleoanconaeus muscle. The proximal head may have developed specially in the tarsier in addition to the distal head observed in other prosimians. It is thought to support the extension of the elbow joint and contribute to the tarsier’s effective locomotion.
Amelogenesis imperfecta (AI) is a collection of isolated (non-syndromic) inherited diseases affecting dental enamel formation or a clinical phenotype in syndromic conditions. We characterized three consanguineous AI families with generalized irregular hypoplastic enamel with rapid attrition that perfectly segregated with homozygous defects in a novel gene: RELT that is a member of the tumor necrosis factor receptor superfamily (TNFRSF). RNAscope in situ hybridization of wild-type mouse molars and incisors showed specific Relt mRNA expression by secretory stage ameloblasts and by odontoblasts. Relt
Although the protective effect of obesity on bone mass has been ascribed to high body fat content, this is still controversial. The present study of 215 postmenopausal Japanese women investigated whether circulating leptin concentration was correlated with per cent fat mass or age-adjusted bone mineral density (Z-score). In this study population, the mean circulating leptin concentration was 10.15 +/- 5.42 (range 1.7-29.6) ng/ml. Significant correlations were found between circulating leptin concentrations and per cent fat mass (r = 0.514, p < 0.0001) and Z-score (r = -0.516, p < 0.0001), confirming the existence of an inverse relationship between leptin concentration and postmenopausal bone density. By contrast, no significant correlation was found between per cent abdominal fat mass and vertebral bone mineral density (r = -0.071). Serum leptin concentration reflects fat mass and postmenopausal bone mass in human subjects. Increased serum leptin levels might cause bone loss in postmenopausal Japanese women, and our results do not support the hypothesis that leptin induces or mediates the bone-protective effects of obesity.
Nivolumab has been clinically successful in prolonging the overall survival of patients with recurrent and metastatic head and neck cancer, complete remission is rare. Synergistic combinations of immunotherapy and conventional cancer treatments, such as radiotherapy or chemotherapy, are likely to be the most viable strategies for improving patient responses.Immune checkpoint inhibitors have revolutionized recurrent, metastatic oral cancer treatment; however complete remission in advanced stages is unusual. We present a case of complete remission of advanced oral squamous cell carcinoma for >4 years in a 64-year-old Japanese woman, that responded poorly to chemoradiotherapy but well to subsequent nivolumab treatment.
A 57-year-old female presented with a chief complaint of odynophagia during medical treatment for systemic lupus erythematosus (SLE). Endoscopy revealed sloughed mucosa along the entire esophageal length, and normal mucosa was easily stripped by withdrawal of the biopsy forceps. Blistering eruptions subsequently appeared on her upper extremities, trunk, and oral cavity. Direct immunofluorescence of a skin biopsy specimen demonstrated linear deposits of IgG, IgM, and complement at the dermoepidermal junction. On the basis of these findings, a diagnosis of bullous SLE was made. This autoimmune blistering disease can occur in the course of SLE and is rarely accompanied by sloughing of the esophageal mucosa.
Saline irrigation (Irg) cools electrode-tissue interface (ETI) and prevents thrombus while producing larger RF lesions. However, Irg also cools the electrode, compromising the use of electrode temp...
