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Background: Helicobacter pylori has a high infection rate, and it is possible that more than half of the world's population is infected. The route of transmission of H. pylori has not been completely elucidated yet. The coccoid form of H. pylori is generally considered to be in a VBNC (viable but nonculturable) state, and this form in the environment is thought to play an important role in infection and transmission, but its stability and survivability are still unknown. Materials and methods: In order to promote its changing to coccoid form, the spiral form of H. pylori grown in a culture medium was exposed to sterile distilled water, and we investigated the bacterial cell number and the morphological changes by using fluorescence staining methods and electron microscopic observation. We also examined the dynamics of its growth ability by measuring the colony forming unit on an agar‐plate medium. Results: After exposure to sterile distilled water, the H. pylori spiral form rapidly lost its growth ability at 37°C. One day after exposure, approximately 95% of the spiral form disappeared and the proportion of the coccoid form increased. The total number of bacteria also decreased to less than half and continued to decrease over time. Epi‐microscopic and electron microscopic observations revealed that deformation of bacterial cells, collapse, and leaking out of cell contents were promoted in exposure to sterile distilled water. Conclusion: Helicobacter pylori quickly begins to transform into the coccoid form after exposure to sterile distilled water, rapidly loses its growth ability, and then lyses and dies. Water‐exposure is lethal for H. pylori and it is unlikely to survive in the VBNC state in water. [ABSTRACT FROM AUTHOR]

The patient was a 73-year-old man who had undergone surgery for gastric cancer in January 2020 and was subsequently attending an outpatient clinic. In May, he presented with right upper abdominal pain. A computed tomography (CT) scan revealed an intraparenchymal rupture of a pseudoaneurysm in a segmental branch of the hepatic artery, and a transcatheter arterial embolization was performed. A follow-up CT scan in August showed a tumor in the same area. Retrospectively, the pseudoaneurysm in the segmental branch of the hepatic artery, which had experienced intraparenchymal rupture, was identified as the feeding artery for the tumor. In October, a right hepatic lobectomy was performed. Pathological examination confirmed a diagnosis of poorly differentiated hepatocellular carcinoma (HCC). This case highlights a rare instance of HCC causing intraparenchymal rupture.

A 73-year-old woman was admitted with the chief complaint of abdominal pain. Computed tomography suggested malignant tumor of the gallbladder infiltrating the liver, duodenum, and transverse colon. Extended cholecystectomy with en bloc resection of the involved liver, transverse colon, and duodenum was performed to achieve curative resection. Pathologic evaluation led to the diagnosis of stage IVA squamous cell carcinoma (T4aN0M0), according to the biliary tract cancer classification established by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. Hepatic hilar lymph node recurrence was identified 3 months later and heavy ion radiotherapy was performed. The patient was hospitalized after 8 months with acute cholangitis, which improved with conservative treatment;however, heart failure worsened during treatment and she died 9 months after surgery.