Summary of “A Basic Study on Bodhisattva-caryā in Buddhâvataṃsaka-sūtra”

departmental bulletin pape

Histological differences among thrombi in thrombotic diseases

Citation: Atsushi Yamashita, Toshihiro Gi, Yuichiro Sato, Histological differences among thrombi in thrombotic diseases, Current Opinion in Hematology, 32(3), 146-156, 2025-02-07, https://doi.org/10.1097/MOH.000000000000086

Pleomorphic adenoma of the trachea: A case report

Introduction and importance Although pleomorphic adenoma is the most common type of parotid gland tumor, its occurrence in the trachea is rare. Here, we describe a successfully resected pleomorphic adenoma of the trachea in a woman with severe respiratory failure that had been preoperatively misdiagnosed as asthma. Case presentation A 69-year-old woman presented to the emergency department with symptoms of worsening dyspnea and subsequent loss of consciousness. She had a history of progressively worsening wheezing and stridor over the course of 2-years and had been diagnosed with asthma. Arterial blood gas sample analysis indicated type II respiratory failure. A chest computed tomographic scan revealed a tumor in the trachea, which was almost completely obstructing the lower tracheal lumen. The tumor was located just above the carina. To alleviate airway constriction and achieve complete resection, carinal resection with reconstruction was performed. The postoperative diagnosis was pleomorphic adenoma of the trachea. Clinical discussion Pleomorphic adenoma is a rare tracheal tumor that may present with obstructive airway symptoms that mimic asthma. Conclusion Tracheal tumors should be considered in patients with chronic respiratory symptoms that do not improve with medication

Primary pulmonary colloid adenocarcinoma: A case report of a rare subtype

Introduction and importance Pulmonary colloid adenocarcinoma is an extremely rare subtype of lung adenocarcinoma. Owing to its rarity, the detailed clinical features of colloid adenocarcinoma remain largely unknown. This report describes a case of early-stage colloid adenocarcinoma that recurred soon after resection, including its radiological findings. Case presentation During a routine checkup, a chest roentgenogram revealed an abnormal shadow in the right upper lung field of an asymptomatic 68-year-old man. Computed tomography (CT) showed a well-defined, low-attenuation nodule in the right upper lobe. Right upper lobectomy with mediastinal lymph node dissection was performed. The postoperative histopathological diagnosis indicated pulmonary colloid adenocarcinoma. The pathological stage was classified as T1bN0M0 (stage IA2). Follow-up CT 1 year after the resection revealed an enlarged supraclavicular lymph node and pulmonary nodule in the right lower lobe. Both lesions appeared as well-defined solitary hypoattenuated tumors with minimal enhancement on CT images. Excisional biopsies of both tumors were performed to obtain a definitive diagnosis. Both tumors consisted of abundant mucin in which some tumor cells were floating and were diagnosed as colloid adenocarcinoma recurrences. Clinical discussion Although colloid adenocarcinoma is generally considered to have indolent clinical behavior, it can recur even in early-stage cases. Conclusion Colloid adenocarcinoma is a distinct variant of lung adenocarcinoma, characterized by well-circumscribed mucinous lesions with alveolar wall destruction caused by mucin pools and scant tumor cells. The treatment strategy for colloid adenocarcinoma should follow the guidelines for primary lung cancer.Citation: Ryusei Yamada, Nobuyuki Oguri, Fumiya Kawano, Mayu Inomata, Yuichiro Sato, Ryo Maeda, Primary pulmonary colloid adenocarcinoma: A case report of a rare subtype, International Journal of Surgery Case Reports, 123, 110260-110260, 2024-10, https://doi.org/10.1016/j.ijscr.2024.11026

Optimal Number of Needle Punctures in EUS-FNA/B with ROSE for Solid Pancreatic Lesions

Background and Objectives: Endoscopic ultrasonography (EUS)-guided fine-needle aspiration/biopsy (FNA/B) is widely used for solid pancreatic lesions; however, the optimal number of needle punctures required to achieve high diagnostic accuracy remains unclear. This study aimed to identify the ideal number of punctures required for solid pancreatic lesions using EUS-FNA/B. Methods: This single-center retrospective study included 598 patients who underwent EUS-FNA/B for solid pancreatic lesions. We analyzed the cumulative tissue acquisition rates and diagnostic accuracy rates for cytology and histology, and identified the factors associated with diagnostic accuracy using univariate and multivariate analyses. Rapid on-site cytological evaluation was performed in all cases. Results: Cumulative tissue acquisition rates were 95.6% and 92.5% for cytology and histology, respectively. The diagnostic accuracy for cytology increased from 72.6% in the first puncture to 78.8% in the second puncture (p = 0.0233). In contrast, the diagnostic accuracy of histology increased from 72.0% at the first puncture to 83.2% at the third puncture (p = 0.0412). Statistically significant differences were noted between the first and second punctures for cytology, and between the first, second, and third punctures for histology. Univariate and multivariate analyses were conducted to identify factors associated with diagnostic accuracy. In cytology, sex was identified as a significant contributing factor, whereas no independent predictors were found in histology. Conclusions: These findings suggest that two-needle punctures are optimal for cytology, and three-needle punctures are optimal for the histological diagnosis of solid pancreatic lesions using EUS-FNA/B

Combination of laparoscopy and open technique in management of large extravesical urinary bladder leiomyoma; a case report

Introduction and importance Leiomyoma is a rare benign bladder tumor, classified into intravesical, intramural and extravesical types according to the location. Because of the difficulty of accurate preoperative diagnosis, resection is performed in the majority of the cases. Case presentation A 37-year-old Japanese man presented to the hospital with a chief complaint of abdominal swelling. Abdominal computed tomography (CT) revealed a large solid mass (20 cm in size) from the abdominal wall to bladder. The tumor was successfully removed by a combination of laparoscopic and open surgery. The histological diagnosis was compatible with leiomyoma, and the patient remained free from recurrence at 3 years after surgery. Clinical discussion The possibility of urachal carcinoma could not be ruled out preoperatively because of the location and internal heterogeneous findings by contrast CT. Although imaging is useful in the diagnosis of leiomyoma, the need for histological examination for a conclusive diagnosis has been noted. Therefore, surgical intervention is reported as a major treatment option. In the present case, laparoscopic approach was performed in accordance with partial cystectomy. The procedure was useful for observation of the positional relationship between the tumor and adjacent intestinal organs, and antegrade resection was performed without incident. Conclusion Laparoscopic approach may be a useful and safe procedure for the resection of extravesical bladder leiomyoma.Citation: Kaoru Ito, Hiroki Takamori, Shoichiro Mukai, Atsuro Sawada, Yuichiro Sato, Toshiyuki Kamoto, Combination of laparoscopy and open technique in management of large extravesical urinary bladder leiomyoma; a case report, International Journal of Surgery Case Reports, 123, 110216-110216, 2024-10, https://doi.org/10.1016/j.ijscr.2024.11021

Low-Density Lipoprotein Receptor-Related Protein 11 Promotes Proliferation in Lung Adenocarcinoma

Low-density lipoprotein receptor-related protein 11 (LRP11) is reported to be overexpressed in various cancers; however, its functional role in lung adenocarcinoma remains poorly understood. This study aimed to elucidate the tumor-promoting function of LRP11 in lung adenocarcinoma. We assessed the expression and function of LRP11 in lung adenocarcinoma cell lines through both silencing and overexpression experiments. RNA sequencing was performed to identify genes associated with LRP11 expression. The clinical relevance was evaluated using public datasets (The Cancer Genome Atlas and the Singapore Oncology Data Portal). LRP11 was overexpressed in lung adenocarcinoma cells and promoted their proliferation in vitro. RNA sequencing identified multiple genes negatively correlated with LRP11, all of which contained predicted C/EBPβ binding motifs in their promoter regions. Clinically, high LRP11 expression was associated with poor prognosis in patients with lung adenocarcinoma. In conclusion, LRP11 promotes lung adenocarcinoma progression by enhancing cell proliferation and modulating transcriptional activity. These findings suggest that LRP11 may serve as a potential therapeutic target and prognostic biomarker in lung adenocarcinoma

神津島における黒曜石原産地と菊若遺跡の石器

Articledepartmental bulletin pape

Bilateral long ureteral strictures were successfully replaced by ileum in inverse seven configuration: A case report

Introduction and importance Ureteral stricture is a potential postoperative complication of pelvic surgery. Repair is performed in the intraoperative or postoperative phase for various reasons. Ileal reconstruction of ureter is considered for extensive and bilateral ureteral injuries. Case presentation A 44-year-old female presented to the hospital where she had undergone hysterectomy two months prior, with acute renal failure due to bilateral hydronephrosis. Radiological examination revealed bilateral distal ureteral stricture measuring 5 cm in length. After failed balloon-dilation, ileal reconstruction was successfully performed without perioperative complications; and she has remained free from hydronephrosis with normal renal function for four years. Clinical discussion Ileal interposition can be used for reconstruction of long lengths or bilateral ureteral injuries. High success rates and low rates of complication have been reported, and the long-term outcome was also acceptable. Apparent ureteral injury was not observed in our case; however, narrowing of ureteral lumen due to submucosal and sub-adventitial edema was observed as a possible cause of strictures. Although, some minor occult injuries during hysterectomy, including thermal effect, ischemia or physical damage due to traction on the ureters were suggested, we were unable to conclusively determine the etiology. Conclusion Ileal ureter replacement is a useful reconstruction, and the inverse seven configuration is suitable for long bilateral strictures of distal ureter.Citation: Takamori H, Akioka T, Otsuka I, Mukai S, Sato Y, Kamoto T. Bilateral long ureteral strictures were successfully replaced by ileum in inverse seven configuration: A case report. Int J Surg Case Rep. 2024 Feb 9;116:109357. doi: 10.1016/j.ijscr.2024.109357. Epub ahead of print. PMID: 38340626

Clinical significance of para-aortic lymph node metastasis for prognosis in patients with pancreaticobiliary cancer who underwent radical surgical resections

Objective To elucidate surgical strategies for patients undergoing radical resection, in cases where solitary distant lymph node metastasis is identified intraoperatively, we investigated the prognostic significance of para-aortic lymph node (PALN) metastases and other regional lymph node (RLN) metastases in pancreatic carcinomas (PC) and biliary duct cancers (BDC). Material and Methods This study retrospectively analyzed data from 181 PC patients and 116 BDC patients who underwent radical resections at two institutions between 1994 and 2021. Results Among PC patients, metastases were observed in RLN and PALN in 54% and 9% of cases, respectively. Similarly, RLN and PALN metastases were present among BDC patients in 39% and 9% of cases, respectively. Survival analysis revealed that patients with BDC and PALN metastases exhibited significantly reduced disease-free (DFS) and overall survival (OS) compared to those without PALN involvement. Multivariate analysis identified PALN metastasis as an independent predictor of OS in BDC patients (p<0.05), while RLN metastasis was independently associated with DFS (p<0.05). Additional clinicopathological factors associated with PALN and RLN metastases were also identified. Preoperative serum levels of Duke Pancreas II monoclonal antibody were significantly elevated in patients with PALN metastases. Histological findings of lymphatic or perineural infiltration and hepatic or pancreatic invasion were independently associated with RLN metastases. Conclusion Based on these findings, radical resection may be considered for PC patients with isolated PALN metastases only in the absence of additional adverse prognostic factors. Prospective clinical trials are warranted to further refine the criteria for surgical intervention when solitary PALN metastases are detected intraoperatively