Eiji Uchida

Genes Involved in Aniline Degradation by Delftia acidovorans Strain 7N and Its Distribution in the Natural Environment

Aniline-degraders were isolated from activated sludge and environmental samples and classified into eight phylogenetic groups. Seven groups were classified into Gram-negative bacteria, such as Acidovorax sp., Acinetobacter sp., Delftia sp., Comamonas sp., and Pseudomonas sp., suggesting the possible dominance of Gram-negative aniline-degraders in the environment. Aniline degradative genes were cloned from D. acidovorans strain 7N, and the nucleotide sequence of the 8,039-bp fragment containing eight open reading frames was determined. Their deduced amino acid sequences showed homologies to glutamine synthetase (GS)-like protein, glutamine amidotransferase (GA)-like protein, large and small subunits of aniline dioxygenase, reductase, LysR-type regulator, small ferredoxin-like protein, and catechol 2,3-dioxygenase, suggesting a high similarity of this gene cluster to those in P. putida strain UCC22 and Acinetobacter sp. strain YAA. Polymerase chain reaction (PCR) and sequencing analyses of GS-like protein gene segments of other Gram-negative bacteria suggested that Gram-negative bacteria have aniline degradative gene that can be divided into two distinctive groups.

Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain.

An Asymptomatic Hemorrhagic Hepatic Cyst with Solid Contents

We describe a patient who had an asymptomatic hemorrhagic hepatic cyst with solid contents that mimicked a malignancy. An 85-year-old woman was referred to our hospital because a hypoechoic mass was detected. She had no complications. The past medical history included hypertension and left femoral artery aneurysm. The results of initial laboratory tests were as follows: serum aspartate aminotransferase, 28 IU/L; serum alanine aminotransferase, 23 IU/L; serum C-reactive protein, 0.11 mg/dL; and serum hemoglobin concentration, 13.1 g/dL. The serum platelet count (17.3×104/μL) was slightly decreased. The serum concentration of carcinoembryonic antigen was 3.0 ng/mL, that of CA19-9 was 12.2 u/ml, and that of AFP was 3.8 ng/ml. The serum concentration of hyaluronic acid (147 ng/mL) was elevated. Hepatitis B virus antigen and hepatitis C virus antibody were negative. Ultrasonography revealed a protruding hypoechoic mass, 6 cm in diameter, with a central isoechoic structure in segment 7, accompanied by multiple hepatic cysts. The edge of the liver was dull, and the liver parenchymal echo was mildly rough. Computed tomography (CT) showed a slightly high-density area with calcification of the margin. Magnetic resonance imaging revealed a hypointense lesion with central hyperintensity on T1- weighted sequences and hyperintensity on T2-weighted sequences. On positron emission tomography- CT, there was no uptake of fluorodeoxyglucose in the liver. We diagnosed an old hemorrhagic cyst or abscess, but could not rule out a malignant neoplasm because of the damaged liver. A right lateral sectionectomy was therefore performed. The resected specimen had black solid contents, and the capsule lacked fluid. Pathological examination revealed an old hemorrhage with a thick fibrous capsule without epithelial components. The liver showed mild fibrosis with fatty changes. The lesion was considered an old hemorrhagic hepatic cyst because a nearby hepatic cyst had simple columnar epithelium.

Comprehensive Analysis of MicroRNA and mRNA Expression in Normal and Tumorous Human Esophageal Squamous Cell Lines Using Microarray Datasets

Despite the undisputed importance of altered microRNA (miRNA) expression in various cancers, there is limited information on the clinicopathologic significance of cancer-related miRNAs in esophageal squamous cell carcinoma (ESCC). Previously, it was reported that the expression of several miRNAs was dysregulated in ESCC. However, the target genes of these miRNAs have not been identified. Furthermore, additional miRNAs in humans have been discovered recently, indicating that revised miRNA and gene expression profiling for ESCC are necessary. Here, we provide datasets from microarray analyses to identify miRNA and mRNA expression comprehensively in Het-1A, a normal human esophageal squamous cell line, and three human ESCC cell lines.

A Case of Alpha-fetoprotein and Des-gamma-carboxy Prothrombin-Producing Gastric Carcinoma Mimicking Hepatocellular Carcinoma

A 77-year-old man presenting with diarrhea and upper abdominal pain was referred to our hospital owing to multiple liver nodules and bulky gastric lymph node noted on abdominal contrast computed tomography (CT). His serum alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) levels were 187,800 ng/mL and 135,000 mAU/mL, respectively. The liver tumors displayed an enhanced hepatocellular pattern on the contrast CT scan; however, there was no hepatitis viral infection or chronic liver cirrhosis. On contrast magnetic resonance imaging, the liver nodules showed high intensity on the T2-weighted image, and the differential diagnosis by CT was liver metastasis. Upper gastrointestinal endoscopy revealed an advanced gastric carcinoma (type 2) in the cardia, which was histopathologically diagnosed as gastric adenocarcinoma. The tumor cell expressed AFP, and histopathological findings of the liver tumor due to core needle biopsy were similar to those of the gastric lesion; however, the liver tumor was positive for AFP and DCP. Thus, the tumor was clinically diagnosed as a gastric carcinoma producing both AFP and DCP.

The assessing the left bronchial invasion of esophageal cancer in computed tomography

Background and aims: The prognosis of esophageal squamous cell carcinoma varies according to the degree of invasion of the tumor in the organ wall. When the trachea and the main bronchus are involved in esophageal carcinoma, the disease is classified as incurable and the mortality is lower than that for patients who can be treated with curative surgery. To evaluate the carcinoma invading the trachea and main bronchus, retrospectively, we investigated computed tomography (CT) findings. Methods: Of 74 patients with or without proven tracheobronchial involvement who underwent thoracotomy for esophagectomy and Surgery disclosed tumor invasion in pericardium, aorta, pleura, trachea, left main bronchus and parenchyma. Ten patients were not operated upon but exhibited invasion to respiratory tract by broncho-fiber scope. Results: Lt. main bronchus (NMS angle) were statistically significant in patients with and without invasion. (P<0.05) Conclusion: It is our conclusion that preoperative evaluation by CT plays an important role whether the tumor is resectable or not. Correspondence to: Hiroshi Makino, MD, Department of Surgery, Nippon Medical School, Tama Nagayama Hospital, Tokyo, Japan. 1-7-1, Nagayama, Tama-city, Tokyo, Japan; Tel: +81-42-371-2111; Fax: +81-42-372-7384; E-mail: himiyumo@nms.ac.jp

Novel microRNA Cloning Using Bioinformatics

MicroRNAs (miRNAs) participate in several biological processes, including development, differentiation, apoptosis, and proliferation (1, 2) through imperfect pairing with target messenger RNAs (mRNAs) of protein-coding genes and transcriptional or posttranscriptional regulation of their expression (3, 4). Approaches to miRNA detection, such as parallel sequencing technologies may replace conventional sequencing (5). The GS 454 technology can produce a similar number of longer (100–150-nucleotides (nt)) sequence reads in a single analysis run, with the advantage that this method can derive the complete sequence of the mature miRNA. Moreover, recent studies on miRNA profiling performed with cloning techniques suggest that sequencing methods are suitable for the detection of novel miRNAs, modifications, and precise compositions, and that cloning frequencies calculated by clone count analysis strongly correlate with the concentrations measured by Northern blotting, and are reproducible. The achievement of comprehensive profiling of miRNA in human diseases requires exhaustive qualitative and quantitative analyses. Here we show the techniques and the some of the results of the miRNA transcriptomes in the liver using sequencing. This serves as a critical step in clarifying the functional significance of specific miRNAs as they relate to liver diseases.

Endoscopic Clipping and Application of Fibrin Glue for an Esophago-Mediastinal Fistula

Anastomotic leakage is one of the most serious complications following surgery of the esophagus. Post-surgical fistula and anastomotic leakage are major causes of morbidity and mortality. The reported incidence of anastomotic leakage after an esophagectomy is between 2.3 % and 5.9 % [1,2]. It is associated with a high rate of mortality. Conservative treatment with nutritional support and antibiotic therapy is usually adopted at first, but this is sometimes insufficient to obliterate leakage or can take 20-30 days, even if it is successful. Anastomotic leakage is usually improved simply by draining the anastomotic site [3], but sometimes an esophago-respiratory fistula occurs due to penetration by the abscess to the trachea or main bronchus [4-6]. This causes a very serious clinical condition, predisposing the patient to life-threatening pneumonia.

A Case of Prolapse of the Intestine Caused by a Stingray Injury

水棲動物エイによる刺傷は, その鋭利な刺棘と刺毒による著しい局所の損傷と炎症などが特徴である. 今回我々は, 腹部エイ刺傷により腸管脱出を来した極めてまれな症例を経験したので報告する. 症例は39歳の男性で, 船上での仕事中, 巨大エイの毒棘により右鼠径部を刺傷したため, 救急車で当院に搬送された. 来院時, 腹腔外へ脱出した腸管が認められたため緊急手術となった. 脱出した腸管を還納し, 刺創部をデブリードマンした後40℃以上の温生食で十分に洗浄し, 腹壁を縫合閉鎖した. タンパク毒であるエイ毒には温浴が有効であり, 治療として先行される. この症例では腸管脱出に対する処置を先行せざるをえなかったが, 術中高温生食による十分な洗浄などが毒素に対しても有効であったと考えられた.

A Case of Malignant Hemangiopericytoma of the Retroperitoneum Successfully Treated by Combined Modality Therapy.

症例は17歳の男性. 主訴は腹部膨満感, 右下肢の疼痛としびれ感. Computed tomography, magnetic resonance imagingなどにより右後腹膜に巨大腫瘤を認め, 開腹生検にてmalignant hemangiopericytomaと診断した. Linac照射, Cisplatinにより腫瘍の著明な縮小がみられたため, いったん退院. 腫瘍はその後5か月間増大傾向なく, 再入院となった. 出血予防の目的で第III, IV, V腰動脈などを塞栓した後, 摘出を行った. 術後Vincristin, Farmombicin, Cisplatinを投与し, 退院となる. 初回化学療法より13か月現在, 外来において経過観察中であるが, 再発, 転移は認めていない.後腹膜の本悪性腫瘍はまれで, 本邦では自験例を含めて14例にすぎず, 2年以上の長期生存例はない. 今回, 集学的治療が有効であったmalignant hemangiopericytomaの1例を経験したので報告する.