[A Case of Locally Advanced Adenosquamous Carcinoma of the Pancreas Accompanied by Hepatic Metastasis Treated by Resection of the Primary Lesion as Palliative Care].

A 61-year-old man presented to our hospital with appetite loss. Gastroscopy revealed a tumor on the upper body of the stomach. Persistent bleeding was observed from the tumor; therefore, the patient was immediately hospitalized. An abdominal CT scan revealed that the tumor arose from the pancreas and invaded the spleen, stomach, and transverse colon. Furthermore, a hepatic tumor was observed at the posterior segment and blood tests showed increased CA19-9 level. Therefore, the tumor was diagnosed as pancreatic cancer with invasion of the adjacent organs and hepatic metastasis. Although the tumor was classified as unresectable for the distant metastasis, resection of the primary lesion was performed to control the bleeding and obstruction at the invasion sites. The pathological diagnosis of the tumor was adenosquamous carcinoma. The patient subsequently underwent chemotherapy and was discharged from the hospital on postoperative day 34. The patient was able to spend time at home and was treated at an outpatient clinic until postoperative day 110, when his generalcondition deteriorated. In this case, resection of the primary lesion was ineffectual for a life prognosis but was beneficial for palliative care.

[A Case of Cystoid Macular Edema Secondary to Albumin-Bound Paclitaxel Therapy].

A 73-year-old woman diagnosed with unresectable pancreatic cancer received weekly gemcitabine(GEM)plus albuminbound paclitaxel(nab-PTX)therapy. Four months after nab-PTX therapy was initiated, she presented with a rapidly decreasing vision in her left eye at an ophthalmology clinic. On admission, her visual acuity was decreased, and optical coherence tomography(OCT)revealed a cystoid macular edema(CME)only in her left eye. She discontinued the nab-PTX therapy immediately. Her visual acuity improved on follow-up 6 months later. The CME finding on OCT was reduced but not completely resolved. CME is a rare adverse event induced by nab-PTX therapy, with only 14 cases reported since 2008. In most of the reported cases, the patients had breast cancer, and this is the first reported case of CME in a patient with pancreatic cancer. The time to CME onset from starting nab-PTX therapy was reported to range from3 to 30months, but the predilection time has not been clarified. Many reports indicated that symptoms improved in a short period after discontinuation of nab-PTX therapy, but effective treatment was not established, except discontinuation of nab-PTX therapy. In daily medical treatment, the incongruity of the ophthalmologic domain should be confirmed for early detection of CME.

Detailed studies of a high-capacity electrode material for rechargeable batteries, Li2MnO3-LiCo(1/3)Ni(1/3)Mn(1/3)O2.

Lithium-excess manganese layered oxides, which are commonly described by the chemical formula zLi(2)MnO(3)-(1-z)LiMeO(2) (Me = Co, Ni, Mn, etc.), are of great importance as positive electrode materials for rechargeable lithium batteries. In this Article, Li(x)Co(0.13)Ni(0.13)Mn(0.54)O(2-δ) samples are prepared from Li(1.2)Ni(0.13)Co(0.13)Mn(0.54)O(2) (or 0.5Li(2)MnO(3)-0.5LiCo(1/3)Ni(1/3)Mn(1/3)O(2)) by an electrochemical oxidation/reduction process in an electrochemical cell to study a reaction mechanism in detail before and after charging across a voltage plateau at 4.5 V vs Li/Li(+). Changes of the bulk and surface structures are examined by synchrotron X-ray diffraction (SXRD), X-ray absorption spectroscopy (XAS), X-ray photoelectron spectroscopy (XPS), and time-of-flight secondary ion mass spectroscopy (SIMS). SXRD data show that simultaneous oxygen and lithium removal at the voltage plateau upon initial charge causes the structural rearrangement, including a cation migration process from metal to lithium layers, which is also supported by XAS. This is consistent with the mechanism proposed in the literature related to the Li-excess manganese layered oxides. Oxygen removal associated with the initial charge on the high voltage plateau causes oxygen molecule generation in the electrochemical cells. The oxygen molecules in the cell are electrochemically reduced in the subsequent discharge below 3.0 V, leading to the extra capacity. Surface analysis confirms the formation of the oxygen containing species, such as lithium carbonate, which accumulates on the electrode surface. The oxygen containing species are electrochemically decomposed upon second charge above 4.0 V. The results suggest that, in addition to the conventional transition metal redox reactions, at least some of the reversible capacity for the Li-excess manganese layered oxides originates from the electrochemical redox reaction of the oxygen molecules at the electrode surface.

Mirizzi syndrome with an unusual type of biliobiliary fistula-a case report.

Gallstone obstruction of the cystic duct, resulting in chronic cholecystitis and pressure necrosis leads to the formation of biliobiliary fistula (BBF). We herein reported a case of Mirizzi syndrome (MS) with an unusual type of BBF (Corlette type I) that was successfully managed by a staged treatment strategy. The patient was diagnosed with a solitary gallstone, marked atrophy of the gallbladder, and BBF and underwent mucosal incineration of the atrophic gallbladder and simple closure, followed by extirpation of gallbladder. Although an optimal treatment strategy has not yet been established for MS with BBF because of its rarity and anatomical variations in fistulas, the current treatment strategy may be applicable. In conclusion, clinicians need to carefully diagnose and evaluate chronic cholecystitis in MS with BBF and adopt an optimal treatment strategy to avoid the complication associated with this disease.

Laparoscopic repair of a bilateral internal inguinal hernia with supravesical hernia - a case report.

INTRODUCTION: Supravesical hernia is an exceptional subtype of internal inguinal hernia, and it is located between the median umbilical ligament and the medial umbilical ligament. The hernia is classified as two types: internal supravesical hernia and external supravesical hernia. PRESENTATION OF CASE: Herein we report a rare case of external supravesical hernia successfully treated by laparoscopic procedure. The patient who complained right inguinal protrusion and mild frequent urination was diagnosed as right inguinal hernia and potential of left inguinal hernia using computed tomography. He underwent laparoscopic bilateral hernia repair, and intraoperative findings revealed right external supravesical hernia and left internal inguinal hernia. DISCUSSION: Laparoscopic hernia repair may make it possible to avoid overlooking of internal hernia such as supravesical hernia. Moreover it was possible to cover the hernia orifice and dissected layer of the dorsal site of urine bladder using bilateral approach in the current case. CONCLUSION: In conclusions, laparoscopic hernia repair might be a surgical option for supravesical hernia.

Low-temperature phase of Li2FeSiO4: crystal structure and a preliminary study of electrochemical behavior.

A nearly single-phase of a low-temperature (LT) phase of Li(2)FeSiO(4) is prepared by a hydrothermal method at 150 °C. We report the detailed crystal structure of LT-Li(2)FeSiO(4) (S.G. Pmn2(1)) by applying Rietveld/MEM analysis to the synchrotron XRD pattern. LT-Li(2)FeSiO(4) shows 150 mA h g(-1) as the positive electrode materials of rechargeable batteries.