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The neoplastic environment is generally regarded as an immunosuppressive milieu. However, a group of cancers are characterized by the abundance of tumour-infiltrating lymphocytes (TILs). Here we examined the possible roles of chemokines in the formation of lymphoid stroma in lymphocyte-rich gastric carcinomas (GCs), including EBV+ cases and conventional GCs. Regardless of EBV positivity, TILs in lymphocyte-rich GCs predominantly expressed CXCR3, while its ligand CXCL9 was abundantly expressed by stromal cells and a portion of cancer cells. CXCL9+ stromal cells were judged to include dendritic cells, because they partly co-expressed fascin, DC-sign, CD83, DC-lamp or HLA-DR. T cells in close contact with CXCL9+ cells showed frequent labelling of Ki-67 (approximately 10%), suggesting the immunostimulatory activity of CXCL9+ stromal cells. The T-cell zone of the regional lymph nodes of lymphocyte-rich GCs also abounded with CXCR3+ T cells and CXCL9+ stromal cells. This indicated a close similarity between cancer stroma and regional lymph nodes of lymphocyte-rich GCs. Quantitative RT-PCR also confirmed the strong expression of CXCR3, CXCL9 and IFNγ in lymphocyte-rich GCs. In contrast, conventional GCs contained less abundant CXCR3+ T cells and few CXCL9+ stromal cells. Collectively, the CXCL9-CXCR3 axis plays a pivotal role in the formation of lymphoid stroma in lymphocyte-rich GCs. Given similar findings in the regional lymph nodes, the lymphoid stroma of lymphocyte-rich GCs may represent a tertiary lymphoid tissue with predominantly Th1-shifted immune responses. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A 47-year-old woman presented with right lower quadrant pain, diarrhea, and anorexia. Abdominal ultrasonography revealed a tumor with 'target-like sign'. Computed tomography demonstrated a tumor consisting of abundant fat and ileocolic intussusception. A barium enema revealed a polypoid filling defect in the ascending colon with a 'coiled-spring' appearance and a 2 × 2 cm well-circumscribed mass at the leading edge of the intussusception. Colonoscopy showed a large, round, smooth, yellow lesion on a large stalk in the proximal ascending colon causing partial obstruction. The tumor was positive for 'cushion signs', and biopsy specimens did not show any neoplastic cells. Ileocolic intussusception caused by ileal lipoma was confirmed by laparoscopic surgery. The terminal ileum, including the tumor, was partially resected. Histopathology revealed a lipoma derived from the muscular layer of the terminal ileum. Our case is only the 8th reported case of a lipoma derived from the muscular layer. Copyright © 2004 S. Karger GmbH, Freiburg [ABSTRACT FROM AUTHOR]

A 53-year-old man was found to have a gallbladder tumor during a routine follow-up more than 10 years after nephrectomy for renal cell carcinoma in 1991. Computed tomography demonstrated a 2.5 × 2.5 cm pedunculated mass with strong contrast enhancement that was hypervascular on celiac angiography. Laparoscopic cholecystectomy was performed. The grossly resected surgical specimen contained two pedunculated polypoid tumors originating from muscular layer. The histopathology showed clear cell carcinomas that were predominantly below the mucosal layer. The cancer cells stained positive for glycogen and epithelial membrane antigen, but not for carcinoembryonic antigen, vimentin, or cytokeratin 7. The final pathologic diagnosis was gallbladder metastasis from renal cell carcinoma. Our case is only the 8th reported case of a solitary metastasis within the gallbladder from renal cell carcinoma. Copyright © 2004 S. Karger GmbH, Freiburg [ABSTRACT FROM AUTHOR]

Two-dimensional (2D) nanostructured liquid crystals containing fluorinated cyclohexylphenyl and cyclic carbonate moieties have been developed as quasi-solid-state self-organized electrolytes for safe lithium-ion batteries. We have designed lithium ion-conductive liquid-crystalline (LC) materials with fluorine substituents on mesogens for improved oxidation stability. Computational studies suggest that the fluorination of mesogens lowers the highest occupied molecular orbital (HOMO) level of LC molecules and improves their oxidation resistance as electrolytes. The LC molecule complexed with lithium bis(trifluoromethanesulfonyl)imide exhibits smectic A LC phases with 2D ion transport pathways over wide temperature ranges. Cyclic voltammetry measurements of the fluorinated mesogen-based LC electrolytes indicate that they are electrochemically stable above 4.0 V vs. Li/Li + . Lithium half-cells composed of fluorinated LC electrolytes show higher discharge capacity and coulombic efficiency than those containing non-fluorinated analogous LC molecules. Combining molecular dynamics simulations with the experimental results, it is revealed that the fluorination of the mesogen effectively enhances the electrochemical stability of the LC electrolytes without significantly disrupting ionic conductivities and the LC order.

The introduction of the guidelines has resulted in an increase of laparoscopic surgeries performed, but the rate of early surgery was still low. Here, the initial effect of the introduction of the guideline was confirmed in single center, and factors disturbing early cholecystectomy were analyzed. This study included 141 patients who were treated for acute cholecystitis from January 2010 to October 2014 at Kanazawa Medical Center. Each patient was assigned into a group according to when they received treatment. Patients in Group A were treated before the Tokyo Guidelines were introduced (n = 48 cases), those in Group B were treated after the introduction of the guidelines (93 cases). After the introduction of the guidelines, early laparoscopic cholecystectomy was significantly increased (P < 0.001), however, the rate of early operations was still 38.7% only. There are many cases with cardiovascular disease in delayed group, the prevalence had reached 50% as compared with early group of 24% (P < 0.01). Approximately 25% of patients continued antiplatelet or anticoagulant therapy. In the early days of guidelines introduction, the factor which most disturbed early surgery was the coexistence of cardiovascular disease. These contents could be described in the next revision of the guidelines., (© 2022. The Author(s).)

Background: Peritoneal dissemination is a frequent pattern of recurrence and metastasis of small bowel malignancy (SBM). However, the survival of patients with peritoneal dissemination from SBM is not clear, and there is no consensus on the treatment for it., Patients and Methods: A total of 31 selected patients with peritoneal dissemination from SBM were treated by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) between January 2006 and January 2014. The major focus of this study was overall survival, as well as morbidity and mortality., Results: Twenty-five patients had small bowel adenocarcinoma (SBA), and six patients had non-adenocarcinoma SBM. HIPEC was performed on 21 patients, and 21 patients received complete cytoreduction. There was no treatment-related mortality, and eight (25.8 %) patients had grade 3-4 complications. Until the latest follow-up, the median survival of 31 patients after CRS and HIPEC was 36 months (range 5-95 months), and the median survival after diagnosis was 51 months (range 18-101 months). For 25 patients with peritoneal carcinomatosis from SBA, the median survival after CRS and HIPEC was 36 months (range 6-95 months), and the median survival after diagnosis was 50 months (range 18-101 months). Multivariate analysis revealed that peritoneal cancer index <15 (p = 0.009) and HIPEC (p < 0.001) were independent predictors of better survival in patients with peritoneal dissemination from SBM treated by CRS and HIPEC., Conclusions: Until more data become available, a reasonable strategy for the treatment of SBM is CRS and HIPEC. It can be applied with acceptable safety in selected patients with peritoneal dissemination from SBM.

Objectives: Physicians are uncertain about what medical services should be provided to older and/or disabled patients. Better understanding of health outcome prioritization among health care providers and recipients may help the process of decision- and policy-making. For this purpose, surveys were conducted on priorities of health care outcomes for the elderly., Design: Survey research., Setting: Four groups of health care providers and four groups of health care recipients., Participants: A total of 2512 health care providers and 4277 recipients., Measurements: Questionnaires were sent to more than 8000 health care providers and more than 9000 health care recipients: geriatricians, physicians who commonly see older patients or work in long term care facilities, staff members and participants in adult day care, patients in outpatient geriatric clinics, family members of patients with dementia, and community-dwelling older adults. The questionnaire asked the subjects to rank 12 measures of health care outcomes., Results: The mean response rate was 49%. All health care provider groups considered "improvement of quality of life" the most important. In contrast, in health care recipient groups, "effective treatment of illness," "improvement of physical function," and "reduction of carer burden" were given high priority, whereas "improvement of quality of life" was perceived as less important. All the groups, including health care providers and recipients, ranked "reduction of mortality" the least important, followed by "avoiding institutional care." Stratification analysis showed that the results did not differ by sex, nursing care level, or the existence of relatives who required nursing care, whereas age slightly influenced the order of high-ranked measures., Conclusion: Priorities of health care services and their differences between providers and recipients should be taken into account in the health care of older patients and the design of health care policies and research., (Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.)