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An autopsy case of pseudosarcoma in the common bile duct is reported. An 82-year-old Japanese male complaining of jaundice was admitted to our hospital; he was examined by abdominal ultrasonography (US), revealing biliary calculus, dilatation of the common bile duct, and choledocholithiasis, considered to be the possible cause of the obstructive jaundice. Endoscopic retrograde biliary drainage (ERBD) and cholangioscopy were performed concurrently, revealing a vaguely whitish tumor near the papilla of Vater. Two months later, the patient died from complications of the liver, infection, and disseminated intravascular coagulation (DIC). An autopsy study revealed tumor cells with extreme pleomorphic changes, growing diffusely, very like sarcoma. Further examination revealed epithelioid arrangements in the metastatic lymph node. Twelve kinds of immunohistochemical examination showed a positive reaction, reflecting the presence of an epithelioid cytoskeleton. Of 28 cases of true and pseudosarcoma of the biliary system reported in the Japanese literature, only 1 case was reported, in 1990, to involve the common bile duct. We therefore report the present case of pseudosarcoma of the common bile duct. [ABSTRACT FROM AUTHOR]

ABSTRACT- The effect of colchicine on spontaneous in vitro contractions of bile canaliculi was assessed using time-lapse cinephotomicrography. Colchicine 2.5 μM and/or taurocholate 5 μM were added to the culture medium. The experiment was long-term, lasting for 13 h. Frame-by-frame analysis revealed that colchicine, after a lag period of 4 h, suppressed the number of contractions over the remainder of the 13-h experimental period, even in the presence of taurocholate (p<0.001). The number of contractions per hour decreased in both the colchicine and combined colchicine-plus-taurocholate-treated groups compared to untreated and taurocholate-treated controls. These results do not necessarily mean that colchicine has an effect on the contractile process per se, since the contractions, when they occurred, appeared normal. It is likely that the canalicular motility events are related to bile secretion. The reduction in contractions after a lag period likely indicates that secretion is impaired, and hence the need for contractions is reduced. These results support the view that for normal canalicular bile secretory function, microtubules as well as a normal microfilament system are required. [ABSTRACT FROM AUTHOR]

Improved methods for the synthesis of linear and cyclic poly(diphenylacetylene)s by polymerization of the corresponding diphenylacetylenes using MoCl 5 - and WCl 4 -based catalytic systems have been developed. MoCl 5 induces migratory insertion polymerization of diphenylacetylenes in the presence of arylation reagents such as Ph 4 Sn and ArSn n Bu 3 to produce cis-stereoregular linear poly(diphenylacetyelene)s with high molecular weights (number-average molar mass (M n )=30,000-3,200,000) in good yields (up to 98 %). On the other hand, WCl 4 induces ring expansion polymerization of diphenylacetylenes in the presence of Ph 4 Sn or reducing reagents to produce cis-stereoregular cyclic poly(diphenylacetylene)s with high molecular weights (M n =20,000-250,000) in moderate to good yields (up to 90 %). Both catalytic systems are applicable to the polymerization of various diphenylacetylenes having polar functional groups such as esters that are not efficiently polymerized by conventional methods using WCl 6 -Ph 4 Sn and TaCl 5 - n Bu 4 Sn systems., (© 2023 Wiley-VCH GmbH.)

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: Spouses play an important role in their partners' eating behaviors, including both promoting and impeding healthy eating. The division of foodwork in the relationship (i.e., if there is individual or shared responsibility for food roles) may vary as a function of gender or sexual orientation and may be important in understanding eating behaviors., Method: Using cross-sectional, dyadic data from 462 heterosexual and gay married couples (N = 921 individuals) residing in the United States, we accordingly sought to examine which partner was most responsible for two food roles, food shopping and meal preparation (Aim 1); whether these roles differed by gender (Aim 1a) and sexual orientation (Aim 1b); whether these food roles were related to the frequency of eating healthy and unhealthy foods (Aim 2); and whether these associations differed by gender (Aim 2a) and sexual orientation (Aim 2b)., Results: We found that one individual was responsible for these roles in a majority of couples, although meal preparation was more likely to be shared in gay than in heterosexual couples. We also found that, in general, the person responsible for these food roles ate healthy more frequently compared to when their partner was responsible; findings for shared responsibility were more equivocal. These associations did not differ, however as a function of gender or sexual orientation., Conclusion: Our findings contribute to a further understanding of food dynamics among heterosexual and gay male couples and have important implications for health promotion and intervention efforts., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Prior studies have examined how individuals may undermine their partner's efforts to maintain a healthy diet, but gay couples have not been represented in this work. Additionally, research has not accounted for mixed-weight status [lighter partner (LP) and heavier partner] nor investigated the mechanisms through which undermining is associated with dietary outcomes., Objective/design/measures: Utilising dyadic data from 224 gay married couples across the United States, we tested associations between perceptions of partner's diet undermining strategies and diet quality with couple food disagreements and depressive symptoms as putative, serial mediators in an actor-partner interdependence mediation model., Results: Results revealed that more severe diet undermining was associated with both partners' poorer diet quality, which was explained by more frequent couple food disagreements and higher depressive symptoms for both heavier and LPs., Conclusion: These findings suggest that undermining strategies are detrimental to both partners' relational health (increased conflict), emotional health (depressive symptoms) and physical health (diet)-regardless of weight status-and provide valuable targets for prevention and intervention. Our study underscores the interdependence of couple relations in lifestyle changes and specifically highlight the need for health professionals to discuss the partner's indirect or unintended disruptions to the patient's plan.

An alternative reaction mechanism of the polymerization of diphenylacetylelnes using a catalytic system composed of tungsten(VI) chloride and tetraphenyltin has been proposed through the optimization of reaction conditions and investigation of the effect of the electronic nature of diphenylacetylene monomers on the polymerizability. The detailed structures of the polymers have been suggested by mass spectrometric analysis of the obtained polymers and oligomers, which suggested that a phenyl group of tetraphenyltin has been introduced to an initiating end of the polymer chain. Mass spectrometric analysis also provided information about the termination processes of the polymerization. The experimental results strongly suggested that the polymerization of diphenylacetylenes using tungsten(VI) chloride and tetraphenyltin proceeds through a migratory insertion mechanism rather than the long-accepted metathesis mechanism., (© 2020 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

This study aimed to examine multiple factors associated with happiness from the perspective of gender difference among a middle-aged Japanese population. A total of 865 participants (male = 344, female = 521) aged 40-64 years were divided into two groups (high and low) by their self-reported level of happiness. Logistic regression analysis by gender was carried out. In men, high levels of happiness were significantly correlated with living with spouse, occupation, enough sleep, leading a normal life, and regular checkups; while low levels of happiness were significantly correlated with smoking and having two or more diseases. In women, low levels of happiness were significantly correlated with caring for a family member. Our data suggested that the factors relevant to happiness levels might vary between men and women among middle-aged people in Japan. To increase the nation's level of happiness, the Japanese government must implement extended social services and policymaking, to alleviate caregivers' burdens, especially among Japanese women.

Up to 80% of individuals with eating disorders engage in dysfunctional exercise, which is characterized by exercising in excessive quantities often past the point of pain as well as compulsive feelings and negative affect when exercise is disrupted (Cook, Hausenblas, Crosby, Cao, & Wonderlich, 2015). Intuitive exercise involves an awareness of the senses while moving and attending to one's bodily cues for when to start and stop exercise, rather than feeling compelled to adhere to a rigid program (Reel, 2015). The purpose of this study was to design a measurement tool to evaluate the construct of intuitive exercise in research, treatment, and prevention settings. The 14-item Intuitive Exercise Scale (IEXS) was developed and validated in the current study with completed surveys from 518 female and male adult participants. Exploratory factor analysis was used to identify four latent constructs, including emotional exercise, exercise rigidity, body trust, and mindful exercise, which were supported via confirmatory factor analysis (CFI=0.96; SRMR=0.06). The IEXS demonstrated configural, metric, and scalar invariance across women and men. Correlations with measures of intuitive eating, exercise dependence, and exercise motivation supported convergent and discriminant validity., (Published by Elsevier Ltd.)

Purpose: To study the expected usefulness of the introduction of the DRG-PPS (Diagnosis-Related Group/Prospective Payment System, in which an insurer pays a fixed medical fee per hospitalization) into the current medical care of tuberculosis (TB) in Japan., Method: The medical fees were reviewed for all TB inpatients at 19 hospitals under the National Hospital Organization who were discharged in either June 2007 or February 2008. The sum of the fixed fee by the DRG was assumed based on the bivariate regression analysis of each patient's hospital days and his or her total actual fees during the hospital stay under the current (fee for care) system, since it was difficult to directly calculate the daily fees for every patient that would be the basis of DRG-PPS., Results: Linear regression analysis estimated that the medical fees (including fees for the medical examinations and the treatments) for a hospital stay of 60 days, which is the standard for TB treatment, was 1,192,470 yen (19,870 yen per person per day) in June 2007, and 1,167,600 yen (19,460 yen per person per day) in February 2008., Discussion: If we assume an average medical fee of about Y1.1-1.2 million yen for the standard hospital care of TB, the economic balance of the hospitals is negative, with a deficit of 0.6-0.7 million yen, given the estimated expenses of 1.8 million yen (i.e., 30,000 yen per person per day x 60 days)., Conclusion: If the DRG-PPS is to be implemented based on the current medical fee rating system, the hospital administrators could not accept its introduction to the TB medical care service as it is, because it may undermine the economic management of hospitals.

Background: The objective of this study was to find an optimal initial combination chemotherapy that includes clarithromycin (CAM) for treatment-naive patients with Mycobacterium avium complex (MAC) pulmonary disease, as assessed by microbiological conversion using a Mycobacterium growth indicator tube (MGIT)., Methods: Thirty-four patients with treatment-naive MAC pulmonary disease (determined using 1997 American Thoracic Society criteria) were evaluated retrospectively. They demonstrated a nodular and bronchiectatic pattern without cavity on high-resolution CT (HRCT) scans. The following three regimens were administered: regimen A (n = 9) consisted of CAM (400 mg/d), ethambutol (EB) [750 mg/d], and rifampicin (RFP) [450 mg/d]; regimen B (n = 12) consisted of CAM (800 mg/d), EB (750 mg/d), and RFP (450 mg/d); and regimen C (n = 13) consisted of CAM (800 mg/d), EB (1,000 mg/d), and RFP (600 mg/d) during the first 2 months followed by a reduction of the dosage of EB from 1,000 to 750 mg/d. Gender, age, BMI, and HRCT scan finding scores were not significantly different among the three groups. Chemotherapy was continued for 18 months. Sputum culture was periodically assessed by MGIT., Results: Culture conversion at 18 months in regimen A (55.6%), which included a daily dosage of 400 mg of CAM (9.5 mg/kg), was significantly inferior to that in regimen B (91.7%), which included daily 800 mg of CAM (17.6 mg/kg; p < 0.05), but regimen B and C (92.3%) showed no between-group difference after > 18 months of chemotherapy., Conclusions: The higher dose of CAM allowed for better culture conversion. Daily combination chemotherapy that includes CAM (800 mg) seems appropriate as an initial treatment against treatment-naive patients with nodular and bronchiectatic MAC pulmonary disease.

A 33-year male was readmitted to our hospital for the treatment of multi-drug resistant pulmonary tuberculosis in February 1993. Six years after the treatment, the left pleuropneumonectomy was done because of the enlargement of cavitary lesions with formation of fluid. Four years after the operation, M. tuberculosis from the patient was resistant to all first- and second-line anti-tuberculosis drugs. Apical lesion and cavitary lesion on the upper lung were still seen on chest X ray and sputum smear and culture were continuously positive. Minocycline and gatifloxacin were prescribed after five years of the operation. Sixteen months after changing the regimen sputum smear and culture converted negative. Chemotherapy was terminated in August 2007, two years after the negative conversion. One year after the termination of treatment no relapse occurred. We considered minocycline was effective in this case, because gatifloxacin was resistant by the drug susceptibility test and was previously used.

Objective: It has been understood that cough-generated aerosols act as an important vector for the spread of pulmonary tuberculosis. Humans commonly exhale aerosols during the normal respiration process that contain small droplets of the airway lining fluid. We aimed to determine whether aerosols exhaled by active pulmonary tuberculosis (AP-TB) patients may contain droplets with Mycobacterium tuberculosis (M-TB) during normal breathing., Methods: Preliminarily, the collection efficiency of M-TB that was suspended in normal saline or distilled water was examined after subjecting the suspension to centrifugation at 3,000 g for 20 minutes. Better collection efficiency was observed in case of M-TB suspended in distilled water than that suspended in normal saline after centrifugation. Therefore, we selected distilled water instead of normal saline to prepare the fluid that was bubbled with exhaled breath. AP-TB patients with smear positive pulmonary tuberculosis who were being treated with anti-TB drugs for less than 7 days or those before the initiation of therapy expired into a 50-ml tube containing 10 ml distilled water for 30 minutes. We also prepared an exhaled breath condensate by cooling exhaled air through the tubing apparatus., Results: In case of 20 AP-TB patients, the distilled water bubbled with the exhaled breath were negative for M-TB on smear, culture, and PCR (polymerase chain reaction) detection methods. The exhaled breath condensates were also negative in 24 AP-TB patients., Conclusion: These results suggest that exhaled breath-generated aerosols from AP-TB patients during normal breathing do not act as a vector for the spread of pulmonary tuberculosis.

A 63-year old male was referred with intraductal papillary adenocarcinoma of the pancreas. The patient had been treated previously with a distal gastrectomy for duodenal ulceration. This surgery left the patient with esophagitis, residual gastritis, and decreased appetite. A modification of the Imanaga reconstructive method using a double-jejunal pouch was performed for the pancreatic carcinoma. This method allows a better quality of life by not only preventing reflux esophagitis and residual gastritis but also increasing a food volume. Here we illustrate the usefulness of a pancreaticoduodenectomy using the pouching operation.

A case of systemic lupus erythematosus (SLE) associated with serositis presenting with disseminated intravascular coagulation (DIC) is reported. A 53-year-old woman was admitted because of a fever. Laboratory tests revealed increased plasma levels of fibrinogen degradation products (FDP) and FDP-D-dimer, high titers of anti-nuclear antibody, high serum levels of anti-DNA antibody, immune complexes, decreased serum complements, and persistent proteinuria. A CT scan showed massive ascites and pleural effusion, marked edema and swelling of the mesenterium. The patient's condition and immunological abnormalities improved after steroid therapy. The association of DIC and lupus serositis has never been described in the literature.

Background/aims: In the small intestine, lymphocytes migrate through Peyer's patches. The distribution of lymphatic microvessels in rat Peyer's patches and lymphocyte traffic through them were studied., Methods: Vital dyes were injected via a micropipette into the Peyer's patches tissue to fill lymphatic microvessels and to stain lymphocytes in lymphatic microvessels., Results: Direct microscopic observation revealed a dense plexus of lymphatic microvessels in the perifollicular and interfollicular areas. Injection of the dyes into the germinal center failed to delineate lymphatic microvessels. The lymphatic microvessels in the perifollicular area were filled with lymphocytes. Most lymphocytes in the perifollicular lymphatics stayed in the lymphatic microvessels. Some lymphocytes became detached and drained into lymphatic microvessels in the interfollicular areas. Lymphocytes then moved toward the submucosal lymphatics beneath the villi around the Peyer's patches. The interfollicular lymphatics did not display contractile activity but had valves. Opening and closing of valves was synchronized with the respiration and the back and forth flow of lymphocytes., Conclusions: There are numerous lymphocytes in a dense lymphatic network in the perifollicular and interfollicular areas of Peyer's patches. This well-developed lymphatic network has the potential capacity for storage of lymphocytes and modulation of lymphocyte migration.

Rat hepatocytes, when isolated and maintained in primary culture, are capable of producing forceful contractions of their bile canaliculi, with contractions occurring on a regular basis once every 5.5 minutes. To determine whether the contraction of one bile canaliculus affected the contraction of a neighboring canaliculus, cinephotomicrographic studies of pairs of contiguous canaliculi were undertaken. The activity of 10 pairs of contiguous canaliculi, and 10 pairs of noncontiguous canaliculi which served as a control group, was recorded for a period of 12.5 hours at the rate of 1 frame every 15 seconds. Using frame-by-frame analysis of this period of observation, we determined the time of contraction of each of the canaliculi in the pairs. Cross-correlations were obtained for the contraction times of each of the 10 pairs of contiguous canaliculi and 10 control pairs. A peak in activity was found, with that peak occurring five frames or 75 seconds from the midline, whereas the noncontiguous controls showed no correlation in contractile activity. This finding indicates that, when one bile canaliculus contracts, a neighboring canaliculus is likely to contract after an interval of 1.25 minutes. That there is coordination of contractile activity of bile canaliculi suggests that, within the intact liver lobule, ordered motility function of the bile canaliculi may facilitate bile flow.

The influence of sodium taurocholate on bile canalicular contractions was examined by time-lapse cinephotomicrography of isolated rat hepatocytes in primary monolayer cultures. Frame-by-frame analyses indicates that as the dose of taurocholate increased, the number of contractions increased in a dose-dependent manner up to 5 microM. Because bile canaliculi are the smallest biliary passages across which bile secretion occurs, and because it is known that taurocholic acid within the dose range used in these studies causes a linear increase in bile secretion, the results suggest that canalicular contractions may be a function of canalicular bile secretion.

Pathological and pathophysiological study on the intestinal lymphatics was carried out clinically and experimentally. Jejunal biopsy study revealed marked dilatation of intestinal lymphatics in liver cirrhosis with ascites and Behçet's disease as well as protein-losing enteropathy. Lymphangiographic study showed also abnormal findings in above-mentioned diseases. In cases of McKee dogs in which mechanism of blockade of lymphatic flow was already clarified, McKee dogs showed marked malabsorptive of fat. When lymphatic flow was blocked mechanically at the thoracic duct, fat accumulation was seen in the absorptive cells as well as in dilated intestinal lymphatics. In administration of colchicine to rats, fat accumulation was seen in the matrix of absorptive cells as well as in the endoplasmic reticulums and Golgi apparatus. However, amorphous substances instead of chylomicrons were seen in dilated intestinal lymphatics. These studies suggested that a tract of fat transportation from intestinal cells to the thoracic duct should be considered as a functional unit in fat absorption.

We observed the motility of bile canaliculi in isolated rat hepatocytes obtained from animals that were pretreated with phalloidin (500 micrograms/kg body wt) for 1 and 3 days. Time-lapse cinephotomicrographs were taken in each experiment and in controls for 16.25 h. As we previously reported in normal hepatocytes, active contractions of bile canaliculi were observed. The number of contractions was 127.6 in controls, compared with 58.0 in 1-day phalloidin pretreated and 16.2 in 3-day phalloidin pretreated groups. The contraction process itself was not normal in the experimental groups, the contraction phase being slow and sustained. The altered canalicular motility depended on the dose of phalloidin administered. These results suggest that the integrity of actin filaments is necessary for normal bile canalicular motility. Further, dysfunction of actin microfilaments with altered canalicular motility may be involved in the pathogenesis of canalicular cholestasis.

Living hepatocytes observed under standard methods of cell isolation and culture show frequent active contractions of bile canaliculi when viewed by time-lapse cinephotomicrography. This report gives details of the methods used to show the contractions. In addition, the characteristics of the contraction pattern are defined and analyzed. The contractions are regular, canalicular contraction time (systole) lasts 60 sec, and the most probably interval between contractions is 5 1/2 min. The finding of a regular pattern of contraction suggests an ordered, programmed, and integrated mechanism which entails a high degree of communication and functional coordination between neighboring hepatocytes.

A backward flow signal in the left atrium masquerading as mitral regurgitation was studied by a pulsed Doppler method. The subjects consisted of 20 normal volunteers, 12 cases with mitral valve prolapse syndrome, five cases with rheumatic mitral regurgitation, five cases with lone atrial fibrillation, four cases with asymmetric septal hypertrophy and three cases with the Björk-Shiley tilting disc valve in the mitral position. In two-dimensional echocardiography combined with pulsed Doppler method, a Doppler signal was recorded by locating a sample volume in the left atrium. In all of the cases with mitral valve prolapse syndrome and the cases with the prosthetic valve as well as in all of the normal subjects, the backward flow signal was observed in the left atrium. In three cases with mitral valve prolapse syndrome, it was differentiated from a transvalvular regurgitant flow signal. In all cases with rheumatic mitral regurgitation, the backward flow signal was masked by a turbulent flow signal representing regurgitation. In cases with mitral stenosis, the backward flow signal was scarcely recognized. The duration of the backward flow signal had no relationship with heart rate. The histogram of incidence on the scale of R-R interval revealed normal distribution with a mean value of 0.24 sec (+/- 0.09 sec). Therefore, in cases with tachycardia, the backward flow signal was seen throughout systole. The peak backward flow velocity of Doppler signals was correlated (r = 0.71, p less than 0.01) with the peak forward flow velocity in diastole. The faint backward flow signal seen in cases with mitral stenosis and post-extrasystolic potentiation of the backward flow signal were suggestive of the foregoing relationship. The mechanism producing the backward flow was postulated as a water hammer phenomenon caused by closure of the mitral valve.

A rich network of actin-containing microfilaments are associated with the plasma membrane of the liver cells. These filaments are especially numerous in the pericanalicular region. Recently, active contractions of bile canaliculi have been observed in normal coupled isolated hepatocytes. In this report, we document that this motility behavior is abolished by cytochalasins B and D. Other cytoplasmic contractile movements are also reduced or lost after a brief initial period of enhanced surface activity with the formation of zeiotic blebs. The lack of contractile activity of bile canaliculi is accompanied by the gradual dilation of canalicular lumina. Since there is overwhelming evidence that the functional effects of the cytochalasins on cell motility are due to their effects on actin filaments, we propose that the altered canalicular contractility observed is due to the effects of cytochalasin on pericanalicular actin filaments. If bile canalicular contractility is a requirement for normal bile flow, then interference with this mechanism may be a factor in the pathogenesis of some types of intrahepatic cholestasis.