Does restricting fluid volume impact post-ERCP pancreatitis in patient with heart disease?

METHODS: Two hundred and forty seven of 480 patients with naïve papilla undergoing therapeutic ERCP between April 2013 and March 2018 were enrolled for the study. The following patient characteristics were investigated: age, sex, body mass index, previous diseases (heart disease, renal failure, cerebrovascular disorders, coexisting malignancy and pulmonary disease), history of PEP, common bile duct diameter, diverticula and volume of fluid infused 24 hours after the procedure. All ERCP cases had naïve papilla and had undergone treatment. RESULTS: The incidence of PEP was 8.5%. Significant differences were observed in the volume of fluid infused between patients without and with a history of heart disease (1,380 vs. 1,755 mL). The mean volume of the infused fluid was significantly lower in the PEP than non-PEP group (1,483 vs. 1,688 mL, P = 0.02). Moreover, PEP incidence differed according to a fluid infusion cutoff of 1,000 mL (7 vs. 11 cases of PEP in those with ≦1,000 mL and >1,000 mL fluid volume, respectively, P < 0.001). CONCLUSION: Restricted fluid volume was a newly identified risk factor for PEP, particularly in patients with heart and renal diseases as comorbidities.

Mucinous Cystadenocarcinoma of the Pancreas with Cyst Infection in a Male Patient.

Follow-up computed tomography revealed a 40-mm pancreatic tail cyst in a 59-year-old man with type 1 diabetes mellitus. An intraductal papillary mucinous neoplasm was suspected; mucinous cystic neoplasm (MCN) was not considered because the patient was a man. During follow-up, cyst infection occurred but was improved by conservative treatment. At the 24-month follow up examination, cyst nodules had developed, corresponding to an increase in the carbohydrate antigen 19-9 level. Mucinous cystadenocarcinoma (MCC) was diagnosed pathologically based on distal pancreatectomy. A diagnosis of male MCN/MCC is often delayed, which may lead to a poor prognosis. MCN infection is also rare and poorly recognized. We observed an atypical male case of MCN/MCC.

Successful Management of Hemosuccus Pancreaticus due to Pancreatic Adenocarcinoma by Chemoradiotherapy.

Management of hemosuccus pancreaticus (HP) due to pancreatic adenocarcinoma is problematic. This is the first report of the successful management of HP caused by pancreatic adenocarcinoma by chemoradiotherapy, which is a treatment option for cases with a high surgical risk that are not suitable for interventional radiology. In the present case, bloody pancreatic juice was detected in the main pancreatic duct, and anemia worsened without repeated blood transfusions. The patient ultimately underwent chemoradiotherapy comprising radiation of 3 Gy in 15 fractions concomitant with systemic chemotherapy of S-1. After the treatments, the anemia improved, and the patient was discharged on day 45.

[Case of computed tomography (CT) gastrography for the detection of multiple gastric submucosal tumors: a case report].

A 66-year-old female underwent esophagogastroduodenoscopy, which revealed a 17-mm gastric submucosal tumor (SMT) located in the posterior wall of the upper area of the stomach. She was referred to our hospital for further investigation because of accumulation of radioactive substance in the gastric wall by PET-CT. CT gastrography (CTG) revealed three gastric SMTs in total. Partial gastrectomy was performed; histopathologically, they were diagnosed as gastrointestinal stromal tumor (GIST), benign schwannoma, and necrotic tissue. Gastric schwannoma is very rare, and we could find no cases with both GIST and schwannoma. Additionally, the three gastric SMTs were only detected clearly via CTG. We report on the details of this case and the usefulness of CTG for the detection of gastric SMT.

The coat protein gene of tobamovirus P 0 pathotype is a determinant for activation of temperature-insensitive L 1a-gene-mediated resistance in Capsicum plants.

Tobamovirus resistance in Capsicum plants, which is mediated by L genes (L(1), L(2), L(3) or L(4)), is known to be temperature sensitive. However, the L(1a ) gene, a newly identified tobamovirus resistance gene that is mapped to the L locus, confers temperature-insensitive resistance against the tobamovirus P(0) pathotype. To identify the viral elicitor that activates the L(1a )-gene-mediated resistance, several chimeric viral genomes were constructed between tobacco mosaic virus-L (P(0) pathotype), paprika mild mottle virus-J (P(1 )pathotype) and pepper mild mottle virus-J (P(1,2) pathotype). Infection patterns of these chimeric viruses in L(1a )-harboring plants revealed that the L(1a )-gene-mediated resistance was activated by the CP of a particular pathotype of tobamovirus, like other L-gene-mediated resistances, but the L(1a )-gene-mediated resistance differs from those conferred by other L genes in terms of temperature sensitivity.

Carbon isotopic composition of fatty acids in the marine aerosols from the western North Pacific: implication for the source and atmospheric transport.

A combined molecular and isotopic approach was used in this study to reveal the source and transport of aerosols at a remote oceanic site. Fatty acid distributions and stable carbon isotopic compositions of individual fatty acids were determined in the aerosol samples collected at Chichi-Jima in the western North Pacific over a period of 41 months. Fatty acid concentration and isotopic composition delta13C (vs PDB) exhibited temporal variations. Concentrations of fatty acids (C12-C34) ranged from 7.6 to 20.7 ng/m3. The concentrations of lower molecular weight (LMW) fatty acids (C12 -C19) tend to decrease in winter and increase in summer, whereas the higher molecular weight (HMW) C20-34 fatty acids exhibited a reversed trend. Compound-specific isotopic analysis revealed that the LMW fatty acids exhibited consistently less negative delta13C values than the HMW fatty acids. However, both the LMW and HMW fatty acids displayed a similar trend of temporal variations in delta13C, suggesting thatthe fatty acids experienced similar atmospheric pathways and transport processes to the remote marine atmosphere, whereas the difference in absolute delta13C reflects the different sources of the fatty acids.

Detection of a single copy gene on a mitotic metaphase chromosome by fluorescence in situ hybridization (FISH) in the sawfly, Athalia rosae (Hymenoptera).

Mitotic metaphase chromosomes of Athalia rosae (Hymenoptera) haploid males were subjected to fluorescence in situ hybridization (FISH) analysis using an rDNA probe and two vitellogenin (Vg) cDNA probes (one representing the 5' half and the other the 3' half of the gene, each about 3 kb long, and together covering the entire coding region). The rDNA probe produced signals in four chromosomes, all in pericentromeric regions (haploid chromosome number = 8), and the Vg probes, either the combined probes or the 3' region alone, produced a twin signal in the middle of a chromosome arm of a single chromosome. Arch.