Atomic-resolution STEM-EDS studies of cation ordering in Ti-Nb oxide crystals.

Ternary metal oxide compounds, such as Ti-Nb and Nb-W oxides, have renewed research interest in energy storage materials because these oxides contain multivalent metal ions that may be able to control the ion transport in solid lithium batteries. One of these oxides is Ti2Nb10O29, which is composed of metal-oxygen octahedra connected through corner-sharing and edge-sharing to form "block structures". In the early 1970s Von Dreele and Cheetham proposed a metal-atoms ordering in this oxide crystal using Rietveld refined neutron powder diffraction method. Most recent studies on these oxides, however, have not considered cation ordering in evaluating the battery electrode materials. In this paper, by utilizing the latest scanning transmission electron microscopy combined with energy dispersive X-ray spectroscopy imaging technology, the cation chemical ordering in those oxide crystals was directly revealed at atomic resolution.

Sigmoid colon diverticula perforation associated with sevelamer hydrochloride administration: A case report.

INTRODUCTION: Sevelamer is an anion exchange resin used to treat hyperphosphatemia. A common adverse effect of sevelamer is constipation. According to a review of the available literature, colon perforation associated with this resin agent was less common. PRESENTATION OF CASE: A 66-year-old man complaining of lower abdominal pain was transferred to our hospital. The patient had been undergoing hemodialysis for chronic renal failure due to rapidly progressive glomerulonephritis, and had been receiving sevelamer hydrochloride 4.5 g/day for 8years as treatment for hyperphosphatemia. Abdominal computed tomography revealed ascites, free air in the abdominal cavity, multiple diverticula of the sigmoid colon, as well as increased fat tissue surrounding the sigmoid colon. We diagnosed colonic perforation and performed emergency surgery, which revealed a 5 × 5 mm perforation in the sigmoid colon surrounded with soft stool. Histopathologically, sevelamer crystals were detected at the perforation site. DISCUSSION: We theorize that physical stimulation by sevelamer crystals contributed to colon perforation at the already vulnerable diverticulum site. CONCLUSION: When sevelamer is administered to patients with hemodialysis, the risk of intestinal perforation should be considered.

Evaluation of eligibility criteria in living donor liver transplantation for hepatocellular carcinoma by α-SMA-positive cancer-associated fibroblasts.

The eligibility criteria of liver transplantation (LT) for hepatocellular carcinoma (HCC) must clearly confirm the prognosis not only from pathological diagnosis but also from pre-operative imaging diagnosis. In the present study, we evaluated published eligibility criteria for LT based on both pre-operative imaging diagnosis and pathological diagnosis using living donor liver transplantation (LDLT) recipients at our hospital by α-smooth muscle actin (SMA)-positive cancer-associated fibroblasts (CAFs) in HCC. The Up-to-seven (Up-to-7), Asan and Tokyo criteria were evaluated, in both overall survival and HCC disease-free survival, to be statistically significantly beneficial criteria to define post-LDLT prognosis. Recipients only within Up-to-7 criteria based on both pre-operative imaging diagnosis and pathological diagnosis survived without HCC recurrence. Recipients with proliferation of α-SMA-positive CAFs in HCC had significantly poorer prognosis. All survival recipients without HCC recurrence, who were above the Up-to-7 criteria in pathological diagnosis, had no proliferation of α-SMA-positive CAFs. As a result of multivariate analysis, the significant independent factors defining prognosis of recipients after LDLT for HCC were Up-to-7 criteria and proliferation of α-SMA-positive CAFs. The ideal eligibility criteria for LDLT with HCC is Up-to-7 criteria and α-SMA-positive CAFs was considered to be an important factor in HCC recurrence. LDLT should be limited to recipients within Up-to-7 criteria or without proliferation of α-SMA-positive CAFs.

Sodium valproate blocks the transforming growth factor (TGF)-ß1 autocrine loop and attenuates the TGF-ß1-induced collagen synthesis in a human hepatic stellate cell line.

Histone acetylation and deacetylation have been thought to be related to gene expression, and there are many reports indicating that histone deacetylase inhibitors (HDACis) exert antifibrogenic effects in several organs. In injured livers, hepatic stellate cells (HSCs) are activated in response to profibrogenic mediators and produce large amounts of extracellular matrix. In particular, transforming growth factor-ß1 (TGF-ß1) is considered as a key factor in accelerating hepatic fibrosis because it is released from activated HSCs and further stimulates them. The present study aimed to clarify whether sodium valproate (VPA) has suppressive effects on cultured human HSCs (LI90). We showed that treatment with VPA had no significantly suppressive effect on cell proliferation at a concentration of 1 mM, which corresponded approximately to the serum concentration obtained by the administration of a clinical dose. However, VPA prevented the morphological changes characteristic for activation and inhibited the expression of collagen type 1 α1 (COL1A1) and TGF-ß1 in activated LI90 cells at the mRNA and protein levels. Our results support the hypothesis that VPA exerts antifibrogenic activity with little cytotoxicity at 1 mM, and HDACis are expected to be used in clinical practice for the treatment of fibrotic diseases.

[The role of renin-angiotensin system independent angiotensin II production in progression and fibrosis of intrahepatic cholangiocarcinoma].

Angiotensin II (Ang II) plays an important role in stromal fibrosis and tumor progression in cancer tissues. Now we investigated the role of Ang II in the cross-interaction between intrahepatic cholangiocarcinoma (ICC) cells and hepatic stellate cells (HSCs). The concentrations of Ang II in ICC tissues were significantly higher than those of hepatocellular carcinoma and normal liver. The expression of Ang II type 1 receptor (AT-1) in ICC specimens, two ICC cell lines, and HSC cell line, LI-90 was demonstrated by immunostain and Western blot. The proliferative activity of ICC cells and HSCs added Ang II dose-dependently increased and telmisartan inhibited the proliferative effects in MTT assay. HSCs added Ang II showed a higher expression of α-smooth muscle actin (α-SMA) compared with control cells. Telmisartan also inhibited the activation of HSCs added Ang II. Ang II in ICC tissues may play a pivotal role in tumor growth and stromal fibrosis and Ang II receptor blocker will be a potential therapy in cancer tissue expressing AT-1.

Nerve plexus invasion in pancreatic cancer: spread patterns on histopathologic and embryological analyses.

OBJECTIVES: Although extrapancreatic nerve plexus (PLX) invasion is an important prognostic factor in pancreatic carcinoma, the spreading patterns of carcinoma via PLX have not been carefully explored because of the complex anatomical structures around the pancreas. METHODS: Fifty-eight patients underwent pancreaticoduodenectomy for carcinoma of the head of the pancreas. The patterns of PLX invasion were evaluated by careful pathological examination. The relationship between tumor location considering the embryological structure of the pancreas and the site of PLX invasion was investigated with an immunohistochemical study using pancreatic polypeptide. RESULTS: Forty-six patients (79%) had PLX invasion. The typical patterns of PLX invasion were detected by pathological examination. Patients with carcinoma in ventral pancreas frequently had pancreatic head plexus 1, pancreatic head plexus 2, and superior mesenteric arterial plexus invasion. Patients with carcinoma in dorsal pancreas had invasion into common hepatic artery plexus and plexus within the hepatoduodenal ligament. A significant correlation between tumor location and the site of PLX invasion was observed. CONCLUSIONS: Extrapancreatic nerve plexus invasion by carcinoma of the head of the pancreas could be divided into 2 patterns based on an embryological structure of the pancreas and the location of the tumor. These results about PLX invasion may provide important information to determine surgical strategy for carcinoma of the head of the pancreas.

Nonclosure technique with saline-coupled bipolar electrocautery in management of the cut surface after distal pancreatectomy.

BACKGROUND/PURPOSE: Management of the pancreatic remnant after distal pancreatectomy is still debated, the most serious complication is development of a pancreatic fistula. We developed a nonclosure technique with saline-coupled bipolar electrocautery for preventing fistula formation after distal pancreatectomy as an alternative to traditional stump closure methods. METHODS: The distinguishing feature of this technique is nonclosure of the stump, relying instead upon dependable ligation of the main pancreatic duct and sealing of the cut surface by shrinkage accomplished by low-temperature coagulation using saline-coupled bipolar electrocautery. A recent addition has been intraoperative stenting of the remnant pancreatic duct. RESULTS: To date we have used the nonclosure technique in 40 cases, among which 5 (12.5%) developed fistulas: 4 in the nonstenting subgroup (14.8%) and 1 in the stenting subgroup (7.7%). According to a recent classification, 4 fistulas were considered grade A; 1, grade B; and 0, grade C. The grade B patient did not undergo stenting. CONCLUSION: Our preliminary experience should prompt more widespread evaluation of the nonclosure technique.

Carcinomas of the ventral and dorsal pancreas exhibit different patterns of lymphatic spread.

In patients with carcinoma of the head of the pancreas with positive lymph nodes, the extent of an adequate lymph node dissection beyond peripancreatic area has remained controversial. Based on the two anlagens, the ventral or dorsal pancreas, we assessed the lymphatic spread pattern in 58 primary adenocarcinoma of head of the pancreas. Detection of lymph node metastasis was based on microscopic detection of carcinoma in consecutive serial sections of resected specimens including lymph nodes. When the tumor was confined to the ventral pancreas domain (n=20), the lymph node metastases were limited to areas along the superior mesenteric artery (SMA) besides peripancreatic lymph nodes. When the tumor was in the dorsal pancreas domain (n=6), the lymph node metastases were limited to areas along the common hepatic artery (CHA) and the hepatoduodenal ligament besides peripancreatic lymph nodes. When the tumor was extended into both domains (n=32), the lymph node metastases were distributed widely in areas along the SMA, CHA and the hepatoduodenal ligament besides peripancreatic lymph nodes. Based on these findings, the lymphatic spread of carcinomas of the head of the pancreas can be divided into two patterns by tumor location based on the two anlagens of the pancreas.

A case of autoimmune pancreatitis associated with retroperitoneal fibrosis.

CONTEXT: Autoimmune pancreatitis is characterized by diffuse enlargement of the pancreas, diffuse irregular narrowing of the main pancreatic duct, severe lymphoplasmacytic infiltration and fibrosis of the pancreas. Retroperitoneal fibrosis may occasionally be associated with autoimmune pancreatitis. CASE REPORT: We report a 77-year-old man with autoimmune pancreatitis associated with retroperitoneal fibrosis. Abdominal ultrasonography and computed tomography demonstrated diffuse enlargement of the pancreas and a capsule-like rim. Furthermore, a retroperitoneal mass was recognized anterior to the abdominal aorta. Antinuclear antibody, IgG and IgG4 values were elevated. Therefore, this patient was diagnosed as having autoimmune pancreatitis associated with retroperitoneal fibrosis. We performed steroid therapy using prednisolone. After 4 weeks, both IgG and IgG4 values decreased and both the swelling of the pancreas and also the retroperitoneal mass were obviously diminished. CONCLUSION: This is a rare case of autoimmune pancreatitis associated with retroperitoneal fibrosis.

Mineralogy and petrology of comet 81P/Wild 2 nucleus samples.

The bulk of the comet 81P/Wild 2 (hereafter Wild 2) samples returned to Earth by the Stardust spacecraft appear to be weakly constructed mixtures of nanometer-scale grains, with occasional much larger (over 1 micrometer) ferromagnesian silicates, Fe-Ni sulfides, Fe-Ni metal, and accessory phases. The very wide range of olivine and low-Ca pyroxene compositions in comet Wild 2 requires a wide range of formation conditions, probably reflecting very different formation locations in the protoplanetary disk. The restricted compositional ranges of Fe-Ni sulfides, the wide range for silicates, and the absence of hydrous phases indicate that comet Wild 2 experienced little or no aqueous alteration. Less abundant Wild 2 materials include a refractory particle, whose presence appears to require radial transport in the early protoplanetary disk.

[A case of breast cancer with lung and bone metastasis treated successfully by oral combination chemotherapy of 5'-deoxy-5-fluorouridine and cyclophosphamide].

The patient was a 52-year-old woman who underwent left partial mastectomy on April 30, 1999. The stage was T0N1bM1 (bone). After operation, adjuvant therapy consisting of 6 cycles of CMF therapy and radiation was performed. On September 2000, the tumor marker (NCC-ST 439) was at a high level. On January 2001, chest CT examination revealed multiple lung metastases of the right lobe. Oral combination chemotherapy of 5'-deoxy-5-fluorouridine (5'-DFUR, 1,200 mg/day) and cyclophosphamide (CPA, 100 mg/day) was thus performed, and definite improvement resulted in the lung. No adverse reactions occurred except for anemia and thrombocytopenia of grade 1. It is suggested that this oral combination chemotherapy may be useful for advanced recurrent breast cancer patients and applicable in ambulatory chemotherapy administered with consideration for the patient's quality of life.