A case of eosinophilic pancreatitis in a patient with ulcerative colitis.

Eosinophilic pancreatitis (EP) is very rare and characterised by infiltration of eosinophils into the pancreatic parenchyma. A 40-year-old man was diagnosed with total-colitis-type ulcerative colitis at the age of 15 years. He was then diagnosed with steroid-dependent ulcerative colitis. He was given golimumab, which resulted in remission. Ten months after beginning golimumab, he was urgently hospitalised with a diagnosis of acute pancreatitis. Hence, endoscopic ultrasound-guided fine needle biopsy was performed to obtain a definitive diagnosis. Pathologically, abundant infiltration of eosinophils was observed in the edematous intralobular stroma of the pancreas. He was diagnosed with EP, and treated with corticosteroids.

Pocket Creation Method of Endoscopic Submucosal Dissection to Ensure Curative Resection of Rectal Neuroendocrine Tumors.

PURPOSE: Pancreatic/gastrointestinal tract neuroendocrine neoplasm (NEN) is divided into neuroendocrine tumor (NET) and neuroendocrine carcinoma (NEC) according to the grade of malignancy, and differences are seen in clinical prognosis. NET, and rectal NET in particular, is often treated endoscopically. Endoscopic mucosal resection (EMR) was previously the main intervention for rectal NET, but EMR with a ligation device (EMR-L) and endoscopic submucosal dissection (ESD) are now also used. However, complete resection with these therapies is not always achieved. The pocket creation method (PCM) is a safe ESD method for colon tumors that offers a high en bloc resection rate compared with conventional colonic ESD. We performed ESD using the PCM for rectal NET and evaluated the complete resection rate. METHODS: We performed ESD using the PCM in 4 patients. This procedure was technically feasible in all patients. RESULTS: Endoscopically, all cases were resected en bloc, and pathological complete resection was achieved in all cases. No complications such as perforation or delayed postoperative bleeding were encountered. CONCLUSIONS: PCM should be considered when treating NET of appropriate size.

OBJECTIVO: As neoplasias neuroendócrinas (NEN) do tracto gastrointestinal e pâncreas são divididas em tumores neuroendócrinos (NET) e carcinomas neuroendócrinos (NEC), dependendo do seu grau de malignidade, com diferenças no seu prognóstico clínico. Os NET, em particular os retais, são frequentemente tratados por endoscopia. A mucosectomia (EMR) foi previamente o método endoscópico principal para a exérese de NET retais mas a mucosectomia com bandas (EMR-L) e a dissecção endoscópica da submucosa (ESD) são agora também utilizadas. Contudo, a ressecção endoscópica completa com estas técnicas não é sempre possível. O método de criação de pocket (PCM) é um método seguro da ESD para ressecção de tumores do cólon que oferece uma taxa alta de ressecção em bloco quando comparado com a ESD convencional do cólon. Realizamos ESD por PCM para NET retais e avaliamos as taxas de ressecção completa. MÉTODOS: Realizamos ESD por PCM em 4 doentes. Este procedimento foi tecnicamente possível em todos. RESULTADOS: Endoscopicamente, todas as lesões foram removidas em bloco e a ressecção patológica completa foi alcançada em todos os casos. Não se verificaram complicações. CONCLUSÕES: O método de PCM deve ser considerado no tratamento de NET retais de tamanho apropriado.

Dress-up chiral columns for the enantioseparation of amino acids based on fluorous separation.

In this paper, we report a new type of chiral high-performance liquid chromatography (HPLC) column--a so-called dress-up chiral column--featuring a chiral stationary phase adsorbed reversibly in a commercial fluorous HPLC column through fluorous interactions. We synthesized perfluroalkylated proline derivatives as chiral stationary phase compounds and then adsorbed them reversibly in the fluorous HPLC column through the pumping of their solutions. By using this dress-up chiral column and fluorophobic elution of an aqueous copper(II) sulfate/MeOH mixture, we could enantioseparate seven racemic amino acids within 40 min. When we washed the dress-up chiral column with fluorophilic tetrahydrofuran or MeOH, the adsorbed chiral stationary phase compounds desorbed from the column, completely destroying its enantioseparation ability. The relative standard deviation of the retention times, the number of theoretical plates, and the resolution for each of four preparations of the dress-up columns were all less than or equal to 9.53% in 20-times repeated analysis, and were all less than or equal to 18.7% in four different preparations, respectively.

A case of Adamantiades-Behçet disease with ischemic optic neuritis (posterior optic neuropathy).

Adamantiades-Behçet disease (ABD) may present with cutaneous and ophthalmologic findings. A 29-year old woman complained of fever and general fatigue, along with erythema nodosum and vesiculo-pustular lesions on the legs, acneiform lesions, genital ulcerations and painful oral ulcers. She also complained of reduced visual acuity, visual disturbance and blurred vision in the left eye. Her left visual acuity was 6/20. Light reflex in the left eye was reduced. The relative afferent pupillary defect (RAPD) was positive in the left eye where a central scotoma was present. The vitreous was clear; the optic disc, macula, retina and iris were all normal. Uveitis was not observed. The patient was diagnosed with ischemic optic neuritis (posterior optic neuropathy) with ABD. Histopathological findings taken from a blister on the leg showed subepidermal bulla, dense dermal neutrophil infiltration, and extravasation of erythrocytes, suggesting leukocytoclastic vasculitis. She was treated orally with high-dose corticosteroids (methylprednisolone 500 mg/d) for three days. Her general condition and ophthalmic symptoms resolved completely. Optic neuropathy with ABD is very rare; we know of two previous cases [1, 2] of ABD with ischemic posterior optic neuritis.