Fluctuation of Blood Pressure in a Patient With Pheochromocytoma.

Treatment with a combination of norepinephrine and doxazosin was effective in a patient with pheochromocytoma who had blood pressure fluctuation, hypotension, and recurrent syncope. After adrenalectomy, his blood pressure, heart rate, and plasma levels of catecholamines remained normal and stable without any medication. ().

Visceral Adipose Tissue and Skeletal Muscle Index Distribution Predicts Severe Pancreatic Fistula Development After Pancreaticoduodenectomy.

Background/aim: In this study, we investigated the effect of body composition on pancreatic fistula (PF) development after pancreaticoduodenectomy (PD).

Materials And Methods: All consecutive patients with pancreatic and extrahepatic biliary malignancy following PD who were treated between 2006 and 2016 were enrolled.

Results: PF developed in 30.

Primary biliary cholangitis metachronously complicated with combined hepatocellular carcinoma-cholangiocellular carcinoma and hepatocellular carcinoma.

Primary biliary cholangitis (PBC) is a progressive cholestatic liver disease characterized by the presence of highly specific antimitochondrial antibodies, portal inflammation and lymphocyte-dominated destruction of the intrahepatic bile ducts, which leads to cirrhosis. While its pathogenesis remains unclear, PBC that shows histological progression to fibrosis carries a high risk of carcinogenesis; the same is true of viral liver diseases. In patients with PBC, the development of hepatocellular carcinoma (HCC) is rare; the development of combined hepatocellular carcinoma and cholangiocellular carcinoma (cHCC-CCC) is extraordinary.

Hyperkalemia in both surgically and medically treated patients with primary aldosteronism.

Hyperkalemia is an important complication of adrenalectomy for patients with primary aldosteronism (PA). The frequency of hyperkalemia after medication using mineralocorticoid receptor antagonists (MRAs) for PA is unclear. The aim of this study is to investigate the frequency and the risk factors of hyperkalemia after surgery and medication for PA.

Effects of Iterative Reconstruction Algorithms on Computer-assisted Detection (CAD) Software for Lung Nodules in Ultra-low-dose CT for Lung Cancer Screening.

Rationale And Objectives: This study aimed to evaluate the effects of iterative reconstruction (IR) algorithms on computer-assisted detection (CAD) software for lung nodules in ultra-low-dose computed tomography (ULD-CT) for lung cancer screening.

Materials And Methods: We selected 85 subjects who underwent both a low-dose CT (LD-CT) scan and an additional ULD-CT scan in our lung cancer screening program for high-risk populations. The LD-CT scans were reconstructed with filtered back projection (FBP; LD-FBP).

A multi-institutional feasibility study of S-1/oxaliplatin plus bevacizumab in patients with advanced/metastatic colorectal cancer: the HiSCO-02 prospective phase II study.

Purpose: FOLFOX is a standard combination chemotherapy regimen for metastatic colorectal cancer (CRC). 5-Fluorouracil (5-FU) is infused continuously through a pump for 46 h; therefore, replacement of infused 5-FU with oral S-1 would be more convenient for patients. We investigated the efficacy and safety of S-1/oxaliplatin (SOX) plus bevacizumab regimen in a community setting.

Preoperative Systemic Inflammation and Complications Affect Long-term Gallbladder Carcinoma Outcomes Following Surgery with Curative Intent.

Background/aim: Gallbladder carcinoma (GBCA) has extremely poor outcomes. We aimed to investigate clinicopathological prognostic variables, including the modified Glasgow prognostic score (mGPS), for patients with resected GBCA.

Patients And Methods: This retrospective study included 54 patients with GBCA resected between 1996 and 2014.

Significance of adrenal computed tomography in predicting laterality and indicating adrenal vein sampling in primary aldosteronism.

Although laterality assessed by computed tomography (CT) in primary aldosteronism (PA) is not always concordant with that assessed by adrenal vein sampling (AVS), it is unclear whether all patients diagnosed with PA should undergo AVS for subtype classification. The aim of the current study was to investigate the accuracy of CT in subtype classification and to develop a prediction score for bilateral subtype in patients without adrenal tumour. As part of the WAVES-J study, 393 patients with PA were analysed.

KRAS mutation leads to decreased expression of regulator of calcineurin 2, resulting in tumor proliferation in colorectal cancer.

KRAS mutations occur in 30-40% of all cases of human colorectal cancer (CRC). However, to date, specific therapeutic agents against KRAS-mutated CRC have not been developed. We previously described the generation of mouse models of colon cancer with and without Kras mutations (CDX2P-G22Cre;Apc(flox/flox); LSL-Kras(G12D) and CDX2P-G22Cre;Apc(flox/flox) mice, respectively).

Reassessment of the cosyntropin stimulation test in the confirmatory diagnosis and subtype classification of primary aldosteronism.

Objective: Although corticotropin is a representative secretagogue of aldosterone, the utility of the cosyntropin stimulation test (C-ST) in diagnosing primary aldosteronism (PA) has not been elucidated. Aim of the study was to evaluate the clinical utility of C-ST for confirmatory testing and subtype classification of PA.

Design, Setting And Patients: In this retrospective study, we identified patients with hypertension and positive case-detection results for PA who underwent C-ST and saline infusion testing (SIT) between 2006 and 2013 at eight referral centres in Japan.

Rationale and design of a multicenter randomized study for evaluating vascular function under uric acid control using the xanthine oxidase inhibitor, febuxostat: the PRIZE study.

Background: Xanthine oxidase inhibitors are anti-hyperuricemic drugs that decrease serum uric acid levels by inhibiting its synthesis. Xanthine oxidase is also recognized as a pivotal enzyme in the production of oxidative stress. Excess oxidative stress induces endothelial dysfunction and inflammatory reactions in vascular systems, leading to atherosclerosis.

Assessment of cancer pain in a patient with communication difficulties: a case report.

Background: The number of patients who have difficulty with mutual understanding has been increasing recently due to an aging society. This emerging issue needs to be addressed. We report an instructive case of a patient who had communication difficulties due to dementia and sequelae of alcoholic encephalopathy.

Bilateral aldosterone suppression and its resolution in adrenal vein sampling of patients with primary aldosteronism: analysis of data from the WAVES-J study.

Context: In adrenal vein sampling (AVS) for patients with primary aldosteronism, the contralateral ratio of aldosterone/cortisol (A/C) between the nondominant adrenal vein and the inferior vena cava is one of the best criteria for determining lateralized aldosterone secretion. Despite successful cannulation in some patients, the A/C ratios in the adrenal veins are bilaterally lower than that in the inferior vena cava (bilateral aldosterone suppression; BAS).

Objectives: To investigate the prevalence of BAS in AVS and how to resolve this condition.

Defocus-aware Dirichlet particle filter for stable endoscopic video frame recognition.

Background And Objective: A computer-aided system for colorectal endoscopy could provide endoscopists with important helpful diagnostic support during examinations. A straightforward means of providing an objective diagnosis in real time might be for using classifiers to identify individual parts of every endoscopic video frame, but the results could be highly unstable due to out-of-focus frames. To address this problem, we propose a defocus-aware Dirichlet particle filter (D-DPF) that combines a particle filter with a Dirichlet distribution and defocus information.

Adrenal Venous Sampling in Patients With Positive Screening but Negative Confirmatory Testing for Primary Aldosteronism.

Adrenal venous sampling is considered to be the most reliable diagnostic procedure to lateralize aldosterone excess in primary aldosteronism (PA). However, normative criteria have not been established partially because of a lack of data in non-PA hypertensive patients. The aim of the study was to investigate aldosterone concentration and its gradient in the adrenal vein of non-PA hypertensive patients.

Complete Nucleotide Sequence of pKOI-34, an IncL/M Plasmid Carrying blaIMP-34 in Klebsiella oxytoca Isolated in Japan.

We determined the complete nucleotide sequence of a self-transmissible IncL/M plasmid, pKOI-34, from a Klebsiella oxytoca isolate. pKOI-34 possessed the core structure of an IncL/M plasmid found in Erwinia amylovora, pEL60, with two mobile elements inserted, a transposon carrying the arsenic resistance operon and a Tn21-like core module (tnp and mer modules) piggybacking blaIMP-34 as a class 1 integron, In808, where blaIMP-34 confers a resistance to carbapenems in K. oxytoca and Klebsiella pneumoniae.

Case of angina pectoris at rest and during effort due to coronary spasm and myocardial bridging.

We present a case of a 71-year-old male who had chest symptoms at rest and during effort. He had felt chest oppression during effort for 1 year, and his chest symptoms had recently worsened. One month before admission he felt chest squeezing at rest in the early morning.

Optimum position of left adrenal vein sampling for subtype diagnosis in primary aldosteronism.

Context: Although adrenal vein sampling (AVS) is the standard method for subtype diagnosis in primary aldosteronism (PA), protocol details including the sampling position in the adrenal vein are not standardized.

Objective: To establish the optimum sampling position in the left adrenal vein based on postoperative outcome in PA patients.

Design And Setting: Retrospective study in nine referral centres.

Complete nucleotide sequence of the IncN plasmid encoding IMP-6 and CTX-M-2 from emerging carbapenem-resistant Enterobacteriaceae in Japan.

We have determined the DNA sequence of Klebsiella pneumoniae multidrug resistance plasmid pKPI-6, which is a self-transmissible IncN-type plasmid. pKPI-6 harboring blaIMP-6 and blaCTX-M-2 confers a stealth-type carbapenem resistance phenotype on members of the family Enterobacteriaceae that is not detectable with imipenem. pKPI-6 is already epidemic in Japan, favoring the dissemination of IMP-6 and CTX-M-2 in members of the family Enterobacteriaceae.

Vasculo-smooth muscle hamartomatous structure is linked to morphogenesis of colorectal polypoid adenoma.

To investigate the difference of surrounding stromal structure between the polypoid and flat adenomas in the colorectum, we performed microscopic study including immunohistochemistry in a total of 32 colorectal adenomas (typical 24 polypoid and eight flat adenomas), especially focusing on vessels around muscularis mucosa. All 24 polypoid adenomas accompanied vasculo-smooth muscle hamartomatous structure in association with muscularis mucosa and submucosal vessels, whereas none of eight flat adenomas had vasculo-smooth muscle hamartomatous structure; surrounding muscularis mucosa and submucosa of the flat adenomas are identical to those of normal colorectal tissue. Vasculo-smooth muscle hamartomatous structure is linked to the morphogenesis of colorectal polypoid adenomas.

True incidence of uterine adenomatoid tumors.

Uterine adenomatoid tumors (UATs) are benign tumors of the uterine serosa and myometrium that originate from the mesothelium and forming gland-like structures. This study was conducted in order to determine the true incidence of UATs, which are usually an incidental finding during uterine surgery performed for other causes. UATs may resemble pre-existing vessels and lymphatic ducts, as well as metastatic adenocarcinomas.