[Isolation of pancreatic lipase activity-inhibitory component of spirulina platensis and it reduce postprandial triacylglycerolemia].

In the process of investigating the hypolipidemic effects of Spirulina platensis, we found that the aqueous extract of S. platensis may inhibit the intestinal absorption of dietary fat by inhibiting pancreatic lipase activity. The aqueous extract of S. platensis (500 m/kg) reduced the elevation of rat plasma triacylglycerol levels after oral administration of the lipid emulsion 2 h after administration. To clarify the hypolipidemic effects of S. platensis, the active component was isolated and designated 1'-O-(palmitonyl)-2'-O-(caprylonyl) glyceryl-beta-alpha-D-galactopyranoside (glycolipid H-b2). Glycolipid H-b2 was found to inhibit pancreatic lipase activity in a dose-dependent manner. The fractions containing glycolipid H-b2 (250 mg/kg) reduced the elevation of rat plasma triacylglycerol levels after oral administration of the lipid emulsion 2 h after administration. Furthermore, we examined the effects of phycocyanin isolated from S. platensis on pancreatic lipase activity. Phycocyanin inhibited the pancreatic lipase activity in a dose-dependent manner. These results suggest that the inhibitory effects of S. platensis on postprandial triacylglycerolemia may be due in part to the inhibition of pancreatic lipase activity by glycolipid H-b2 and phycocyanin.

Peripheral neuropathy due to thiamine deficiency after inappropriate diet and total gastrectomy.

Peripheral polyneuropathy due to vitamin B1 deficiency was encountered after total gastrectomy for gastric signet cell carcinoma in a patient with a history of breast-conserving surgery for breast cancer. She had greatly reduced her intake of animal foods, believing that would be effective for the prevention of re-occurrence of cancer. Her daily intake of vitamin B1 was less than half of the usual daily requirement. Patients with malignancy tend to adopt unusual diets, and proper advice about food intake is important for such patients, especially those with gastrectomy.

A case report: spontaneous rupture of dissecting aneurysm of the middle colic artery.

Aneurysms of the superior mesenteric artery branches are rarely reported, even among them colic artery aneurysms are seldom. We report a case of 78-year-old male with ruptured dissecting aneurysm of middle colic artery. The patient complained abdominal pain and nausea during hospital stay for renal stone. The patient suddenly developed severe abdominal pain, leading to shock. He underwent emergency surgery under a preoperative diagnosis of intraperitoneal hemorrhage. At exploratory laparotomy, a large hematoma involving the mesentery root of the transverse colon was associated with a ruptured aneurysm measuring 15 x 10 mm in size, which was located to the mid-portion of middle colic artery. Right-hemicolectomy was carried out because of ischemic changes in the ascending colon. Histological examination demonstrated a ruptured dissecting aneurysm of the middle colic artery approximately 5 cm in length, associated with destruction of the tunica interna and media. The aneurysm was thought to result from idiopathic segmental arterial mediolysis, because no definitive evidence of atherosclerosis or arteritis was observed.

[A case of advanced gastric cancer with multiple liver metastases responding to TS-1 and CDDP].

A 44-year-old male presented to our hospital with abdominal pain. The upper endoscopy revealed advanced gastric cancer. On the abdominal CT, there was evidence of multiple, massive liver metastases. After total gastrectomy, the patient was treated with daily oral administration of 120 mg TS-1 for 4 weeks followed by 2 weeks' rest and 6 weekly infusions of 10 mg CDDP in an intra-hepatic artery as 1 cycle. On the follow-up CT, the liver metastases had decreased significantly both in size and number after 2 cycles. The current case suggests that TS-1 and CDDP may have a potent therapeutic efficacy in cases of advanced gastric cancer with multiple liver metastases.

Esophageal intramural pseudodiverticulosis treated by endoscopic balloon dilatation.

We here report a rare case of esophageal intramural pseudodiverticulosis with dysphagia. A 65-year-old man was suffering from intermittent dysphagia for 10 years, which had been worsening in recent months. Endoscopic examination revealed multiple, small, saccular diverticula and mild annular stricture with numerous white plaques from the cervical esophagus to the middle thoracic esophagus. Barium esophagography revealed stricture of the upper thoracic esophagus with multiple tiny flask-shaped outpouchings. Based on this characteristic appearance, we diagnosed esophageal intramural pseudodiverticulosis and inflammation of a narrow segment of the esophagus. Biopsy specimen showed acute and chronic esophagitis with Candida infection. Dysphagia persisted despite resolution of candidiasis, for which we successfully performed endoscopic balloon dilatation of the stricture. After the treatment, the patient has been well and has not been suffering from dysphagia.