Well-differentiated papillary mesothelioma, possibly giving rise to diffuse malignant mesothelioma: a case report.

Well-differentiated papillary mesothelioma (WDPM) is a distinct subtype of mesothelial tumor from diffuse malignant mesothelioma (DMM), with an uncertain malignant potential. The relationship between WDPM and DMM, with regard to the ability of the former to develop into the latter, is also unknown. A 58-year-old woman, diagnosed with a rectal carcinoid tumor, underwent removal of the lymph nodes via the abdomen in 2004. A large number of white miliary nodules were identified on the mesentery and peritoneum, which were histologically diagnosed as WDPM. No further therapy was administered, but the patient was followed-up using imaging methods. Seven years later, an abdominal wall mass was discovered using positron emission tomography-computed tomography, and a laparotomy biopsy was performed. DMM was diagnosed, because mesothelioma with extended invasion had been histologically identified. Mesothelioma similar to papillary proliferation was present on the outer layer of the peritoneum, and an infiltrating lesion with continuous restiform or solid-like structures was noted. WDPM was believed to have undergone malignant transformation. Compared to DMM, WDPM has a good prognosis and is considered a benign or borderline neoplasm. Our findings suggest that WDPM does have malignant potential, however, because histological findings indicated a malignant transformation of WDPM to DMM.

Meal services after the Great East Japan Earthquake at nursery schools in a tsunami-affected town: focus group observations.

BACKGROUND AND OBJECTIVES: This study aimed to collect information on experiences in the Great East Japan Earthquake (hereafter, 3.11), current preparedness, and barriers to building up stockpiles in nursery schools in affected areas. Based on the needs heard from the staff, we decided what contents should be included in our manual developed with the Japan Dietetic Association. METHODS AND STUDY DESIGN: A group interview was held in September 2012. We interviewed a principal, nurses, and registered dietitians working for a public and a private nursery school in Town A. We also invited an administrative dietitian who was an employee of Town A. RESULTS: One of the barriers to building up stockpiles was that they did not have any idea of what and how many items they should store. To deal with this situation, we developed a formula that could be used to calculate the quantity of stockpiles for their facilities in a newly developed feeding manual. In terms of current preparedness, the registered dietitians were not prepared for alternative menus in emergencies or how to manage garbage when the garbage collection was disrupted by disasters. The manual recommends to obtain the services of at least two food service personnel and spare space for storing filled garbage bags until garbage collection resumes. CONCLUSION: Some improvements in stocks were found in both of the public and private nursery schools. To improve the situation further, more financial support and detailed guidelines should be provided by the local government and authoritative organizations. Our manual should be a great asset for all nursery schools to improve their stockpiles.

Four-color flow cytometric analysis of myeloma plasma cells.

We monitored the behavior of residual myeloma plasma cells in patients with multiple myeloma after high-dose therapy and autologous or allogeneic transplantation using 3 methods of a flow cytometric technique using 4-color staining, immunofixation, and polymerase chain reaction approaches. We analyzed 17 cases by a relatively simple flow cytometric technique using CD38/CD45/CD19/CD56. Detectable myeloma plasma cells were found in 5 patients at diagnosis and 9 patients after treatment. Of 14 cases, 9 (64%) had CD19-CD56+ myeloma plasma cells, and 5 (36%) of 14 had CD19-CD56- myeloma plasma cells. When 37 bone marrow samples that had less than 5% myeloma plasma cells were assessed, myeloma plasma cells were detected in all 20 immunofixation-positive cases and 3 of 17 immunofixation-negative cases (P = .002). All 4 polymerase chain reaction-negative samples characterized as immunofixation-negative contained no detectable myeloma plasma cells. Flow cytometry can provide effective information to detect low levels of myeloma plasma cells.

Development and Validation of a Data-Based Food Frequency Questionnaire for Adults in Eastern Rural Area of Rwanda.

This study aimed to develop and evaluate the validity of a food frequency questionnaire (FFQ) for rural Rwandans. Since our FFQ was developed to assess malnutrition, it measured energy, protein, vitamin A, and iron intakes only. We collected 260 weighed food records (WFRs) from a total of 162 Rwandans. Based on the WFR data, we developed a tentative FFQ and examined the food list by percent contribution to energy and nutrient intakes. To assess the validity, nutrient intakes estimated from the FFQ were compared with those calculated from three-day WFRs by correlation coefficient and cross-classification for 17 adults. Cumulative contributions of the 18-item FFQ to the total intakes of energy and nutrients reached nearly 100%. Crude and energy-adjusted correlation coefficients ranged from -0.09 (vitamin A) to 0.58 (protein) and from -0.19 (vitamin A) to 0.68 (iron), respectively. About 50%-60% of the participants were classified into the same tertile. Our FFQ provided acceptable validity for energy and iron intakes and could rank Rwandan adults in eastern rural area correctly according to their energy and iron intakes.