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This is a rare case of a patient with a double-layered lateral meniscus, undergoing surgical treatment. A 17-year-old woman who was a member of a volleyball club had a two-year history of right knee pain with episodes of locking, although she had no history of trauma. She was referred to our hospital because her condition did not improve after conservative treatment. On presentation to the hospital, she had full range of motion in the right knee. McMurray’s test revealed no clicks; however, it produced pain in the lateral part. Plain radiography revealed no abnormal findings, whereas magnetic resonance imaging showed high signal in the posterior segment of the lateral meniscus and an increase in its volume. Arthroscopic findings showed an accessory meniscus with a flat surface overlying a normal-sized lateral meniscus. It was firmly connected to the posterior root and middle segment of the lower normal meniscus. The accessory meniscus was markedly mobile as revealed by probing. The patient was diagnosed with double-layered lateral meniscus and underwent resection of the accessory meniscus. Postoperatively, she initiated strengthening of muscles and range of motion training without weight-bearing restrictions. Two months postoperatively, she had completely recovered and participated in volleyball practices. In the last follow-up at 18 months, she had no restrictions in daily or sports activities.

Loss-of-function mutations of filaggrin (FLG) gene (FLG) are the strongest known genetic risk factor for atopic dermatitis (AD). It is still debatable how FLG gene mutations and the resulting abnormal amount of FLG protein contribute to skin barrier function and symptoms of AD. In this study, we examined the effects of loss-of-function mutations of FLG gene on the severity of skin lesions and skin barrier function in 55 patients with AD by evaluating eight patients with AD with FLG gene mutations and 47 patients with AD without mutations. The results showed that the FLG gene mutation did not affect the duration of AD, severity of AD, degree of local inflammatory symptoms, skin water content and trans-epidermal water loss of the lesions. Next, in these eight mutation carriers and the 47 non-carriers, stratum corneum was collected from the three site of skin lesions using tape-stripping method, and the amounts of FLG protein and total amino acid contained in the stratum corneum was measured to investigate the effect of the FLG gene mutation on the amount of FLG gene product in the local lesion. FLG abnormalities had little effect on FLG protein and total amino acid content in the stratum corneum in the lesional skin. The amount of the FLG products, especially amino acids derived from FLG, in the stratum corneum of AD lesional skin is influenced by development of dermatitis. The results obtained from this study supports that the activation of Th2-dominant inflammatory cells, together with FLG abnormality, plays a role in suppressing the production of FLG in skin lesions.

Purpose This paper challenges the assumption in cross-cultural research of liability of foreignness (LOF). The literature review demonstrates that LOF comes from pressures for isomorphism, while asset of foreignness (AOF) can derive from the active process of breaking norms. The purpose of this paper is to explore how leaders can initiate and sustain AOF. Design/methodology/approach The paper analyzes the case of the Nissan revival led by Carlos Ghosn and the impact in the years after. The analysis is based on the authors’ interviews and discussions with Ghosn and senior leaders at Nissan and Renault, complemented with published interviews and assessments. Findings Analysis confirmed the potential for AOF, and further uncovered four patterns of behavior that created AOF virtuous cycles among Nissan leaders: initiating trust, shaping identity, anchoring and transcending common language, and acting positively on ignorance. The virtuous cycles were sustainable and transformed into new global strategic perspectives. Research limitations/implications The paper proposes a research model identifying moderators between foreignness and performance. Generalizability is limited by the focus on a single case study. Practical implications The four sets of behaviors can serve as guides to action for leaders when working in foreign contexts. Originality/value This research goes beneath the surface of a famous example to analyze leadership dynamics over time, and provides insight on positive aspects of foreignness.

A 53-year-old woman had been receiving an antithyroid agent for Basedow disease since 2 years and 5 months before was pointed out multiple calcified picture in the bilateral thyroid lobes on ultrasonography and CT. An elastic soft and diffused goiter was palpated in the anterior region of the neck but no tumor was felt. Thyroid hormone levels were in normal range. Aspiration biopsy cytology of the calcified portion locating a little to the stenosed site in the left lobe indicated papillary adenocarcinoma. Operation was performed. The thyroid glands diffusively swelled and a total of 4 nodules, 6-10mm in size, locating at the upper polars and close to stenosed sites in the bilateral lobes was palpated. Total thyroidectomy with bilateral cervical lymph node dissection were carried out. Histologically all 4 nodules were papillary adenocarcinoma. The patient was diagnosed as multiple microcarcinoma of the thyroid associating with Basedow disease. No lymph node metastasis was found. We often find difficulties in palpating the tumor in diagnosis of thyroid carcinoma associated with Basedow disease. The importance of early detection by imaging methods, especially aggresive aspiration biopsy cytology for calcified pictures, should be emphasized.

最近の高令化に伴い, 大腸癌の増加が謂われており, われわれは農村地域における大腸癌の実態を知るため調査を行なった。昭和48年より15年間の大腸癌症例は, 338例で性差はなく, 60才代がもっとも多く, 次いで70才代と60才以上の患者が62%を占めた。部位に関しては, 直腸が140例41%ともっとも多く次いでS状結腸であった。切除率は94.3%, 治癒切除は68.3%に可能で, 治療切除例の累積5年生存率は77%, 10年生存65.9%であった。大腸早期癌は24例と小数で, ほとんどが進行癌であり, 糞便潜血スクリーニング検査による大腸癌集検もようやく普及の段階になり, 今後は検診数を増して早期発見, 治療に努めねばならない。このほかpm癌, 腸閉塞をきたした癌などについても検討を加えた。

昭和47年9月以降15年間余の胃癌症例808例を検討した。性比は1.7と男性が多かった。胃切除率88%, 治癒切除率59.2%, 手術死亡率は1.8%, 累積5年生存率はStage I 96.4%, II 68.6%, III48.7%, IV4.5%であり, 胃集検, 人間ドック等の普及により早期胃癌症例の発見率はこの間2倍の増加を見たが, 65才以上の高令者ではいぜん進行癌が多く, この年代での検診強化が必要と思われる。胃切除は75才以上の高令でも安全に施行できるが, 年令, Stage, Quality of lifeを考えた術式の選択が必要と思われる。