bluuebunny/crossref_metadata_2025_split huggingface dataset:
A case of retroperitoneal dedifferentiated liposarcoma successfully treated by neoadjuvant chemotherapy and subsequent surgery
Authors: Yokoyama Yukihiro , Nishida Yoshihiro , Ikuta Kunihiro , Nagino Masato 
Published: May 2020

Abstract
Background
Retroperitoneal liposarcoma (RPLS) is the most commonly observed soft tissue sarcoma in the retroperitoneal space. Although the beneficial effect of chemotherapy for RPLS is controversial, there are some reports that have shown a considerable tumor-suppressive effect of chemotherapy in RPLS. We demonstrate a case of dedifferentiated RPLS, which was initially considered inoperable but was successfully treated by neoadjuvant chemotherapy and subsequent curative resection.

Case presentation
A 59-year-old female was referred to our hospital with a chief complaint of right lower quadrant abdominal pain. Abdominal computed tomography revealed a large retroperitoneal tumor with a maximum diameter of 11 cm. The tumor involved retroperitoneal major vasculatures, such as the right common iliac vein and artery, as well as the right psoas muscle and femoral nerve. The right ureter was also involved and obstructed by the tumor. A biopsy was performed through the retroperitoneal route, and the tumor was diagnosed as a dedifferentiated liposarcoma with the Fédération Nationale des Centres de Lutte Contre le Cancer grade 3. Because the tumor was highly invasive and complete resection was not feasible, we decided to administer neoadjuvant chemotherapy with doxorubicin and ifosfamide (AI). After completing 6 courses of AI, the tumor size was considerably reduced, and we decided to perform surgery with curative intent. Before laparotomy, femoro-femoral arterial bypass was performed to prepare for the right common iliac artery resection. Thereafter, the patient underwent laparotomy and tumor resection combined with right nephrectomy, resection of the right common iliac artery and vein, and resection of the right psoas muscle and femoral nerve. The postoperative course was uneventful, although the patient needed a walking brace to support her gait. The pathological findings indicated a 99% disappearance of tumor cells. The patient was healthy without any complaints after 1 year of surgery, and a follow-up CT scan revealed no tumor recurrence.

Conclusions
To the best of our knowledge, this is the first report that showed a nearly complete pathological response to AI in dedifferentiated RPLS, which was subsequently completely resected.
Resected case of stage IV pleomorphic carcinoma of the lung with long-term survival
Authors: Choshi Haruki , Watanabe Mototsugu , Ujike Hiroyuki , Sato Yumiko , Morito Toshiaki , Sugimoto Ryujiro , Kataoka Kazuhiko 
Published: May 2020

Abstract
Background
No established treatments for pulmonary pleomorphic carcinoma exist because of its rarity, and the prognosis is poorer than that of other non-small cell lung cancers.

Case report
We present a case of stage IV pleomorphic carcinoma; the patient was a 66-year-old male. He was referred to our hospital because of a right adrenal hemorrhage and a lung tumor. A systemic examination revealed that the lung tumor was a primary lung cancer and that the adrenal hemorrhage was due to a metastatic cancer. We performed an adrenalectomy and resection of the lung tumor and obtained a diagnosis of pleomorphic carcinoma with adrenal metastasis. The patient has remained recurrence-free for 6 years since the surgery.

Conclusions
We report a patient with stage IV pleomorphic carcinoma of the lung and an oligometastasis in whom a complete resection enabled a good outcome. Additional reports are needed to clarify definite prognostic factors and the optimal treatment for pleomorphic carcinoma.
A typical case of resected pancreatic hamartoma: a case report and literature review on imaging and pathology
Authors: Katayama Hokahiro , Azuma Kyohei , Koneri Kenji , Murakami Makoto , Hirono Yasuo , Hatta Satomi , Imamura Yoshiaki , Goi Takanori 
Published: May 2020

Abstract
Background
Pancreatic hamartomas are rare entities and difficult to diagnose before resection. We report a case of resected pancreatic hamartoma and literature review of typical characteristics of the lesion.

Case presentation
A 78-year-old man presented with a mass in his pancreas, which was incidentally identified when he experienced pneumonia. No remarkable symptoms were observed, and laboratory tests showed no abnormalities, except a slight carcinoembryonic antigen elevation. Enhanced computed tomography and magnetic resonance imaging showed a well-demarcated solid mass with heterogeneous contrast that was 2 cm in size. A gradual enhancement pattern was also observed. The biopsy revealed no specific findings; therefore, surgical resection was necessitated to confirm the diagnosis. Histopathologically, ducts, acinar cells, and adipose cells without atypia were observed among abundant fibrous stroma, but islets of Langerhans and peripheral nerves were absent. An immunohistochemical examination demonstrated CD34 and c-kit positive staining in the stromal cells, S-100 positivity in the adipose cells, and a lack of elastic fibers in the duct walls. The lesion was diagnosed as a pancreatic hamartoma.

Conclusion
Asymptomatic pancreatic hamartomas can avoid resection. A careful consideration of imaging and appropriate immunohistochemistry of biopsy specimen may facilitate accurate diagnosis before resection. Therefore, sufficient recognition of the characteristics of pancreatic hamartomas is desirable.
Fluoroscopic balloon dilation for early jejunojejunostomy obstruction after gastrectomy with roux-en-Y reconstruction: a case series of three patients
Authors: Kamada Teppei , Ohdaira Hironori , Hoshimoto Sojun , Narihiro Satoshi , Suzuki Norihiko , Marukuchi Rui , Takeuchi Hideyuki , Yoshida Masashi , Yamanouchi Eigoro , Suzuki Yutaka 
Published: May 2020

Abstract
Background
Small bowel obstruction after gastrectomy with Roux-en-Y reconstruction (R-Y reconstruction) is not a rare complication. However, patients who need re-operation for this complication have a high rate of postoperative complications.
We report a case series of three patients who underwent fluoroscopic balloon dilation (FBD) for early jejunojejunostomy obstruction (JJO) after gastrectomy with Roux-en-Y reconstruction (R-Y reconstruction).

Case presentation
Three patients were referred to our hospital for surgery for gastric cancer. Robot-assisted distal gastrectomy with D2 lymph node dissection and antecolic R-Y reconstruction were performed in two patients, and robot-assisted total gastrectomy with D1+ lymph node dissection and antecolic R-Y reconstruction was performed in one patient. The jejunojejunostomy was created as a side-to-side anastomosis using a linear 45-mm stapler. The entry hole was closed with a knotless barbed suture, and serosal-muscle layer suture reinforcement with an absorbable suture was performed at the jejunojejunostomy.
Subsequently, all the patients were diagnosed with JJO by computed tomography and upper gastrointestinal series. The average time to JJO from gastrectomy was 5 days (range 2–7); initial clinical symptoms were vomiting in all three cases, with simultaneous upper abdominal pain in one case. We successfully performed FBD in all three cases after unsuccessful conservative treatment using an ileus tube. The clinical symptoms improved soon after FBD, and all the patients were able to avoid re-operation. The average period to FBD from JJO was 10 days (range 4–14). The average procedure time was 46 min (range 29–68), and the average duration to oral intake from FBD was 4 days (range 2–5). The average duration of hospital stay after FBD was 12 days (range 9–15). There were no complications in any of the cases.

Conclusion
FBD might be a feasible procedure to avoid surgery for early small bowel obstruction after gastrectomy with R-Y reconstruction.
Spontaneous pneumothorax caused by an inflammatory myofibroblastic tumor-like lesion in a 14-year-old girl: a case report
Authors: Miyagi Hisayuki , Ishii Daisuke , Hirasawa Masatoshi , Yasuda Shunsuke , Toriumi Naohisa , Sarashina Takeo , Tanino Mishie , Tanaka Mio , Tanaka Yukichi , Miyamoto Kazutoshi 
Published: May 2020

Abstract
Background
Spontaneous pneumothorax occurs more often in younger, slim, and shallow-chested men. Although less common, differential diagnoses for secondary pneumothorax in children are asthma, emphysematous blebs, catamenial pneumothorax, and others. We report a patient who presented with pneumothorax and was found to have an inflammatory myofibroblastic tumor (IMT)-like lesion, and present a review of the related literature.

Case presentation
A 14-year-old girl visited her physician for chest pain that developed while exercising. Although chest drainage was performed, the symptoms associated with a collapsed lung did not improve, and she was referred to our hospital. Computed tomography revealed the presence of a 19 × 17-mm cyst with a thick wall in the apex of the right lung. She was tested for infectious diseases, namely tuberculosis, but the results were not definitive. Catamenial pneumothorax was also suspected because she was menstruating when she presented to our hospital. As a therapeutic diagnosis, we performed a thoracoscopic partial resection of the right upper lobe of the lung. Three small openings were identified inside the cyst, suggesting connection with the bronchiole. The lesion was pathologically diagnosed as an IMT-like lesion. Considering the progress so far, we considered that the final diagnosis to be an IMT. The patient was discharged on postoperative day 3, and we have followed her for the past 6 months with no local recurrence or metastasis.

Conclusions
IMT is not uncommon in children. Therefore, this lesion should be considered as a possible diagnosis if children and young adults develop spontaneous pneumothorax.
Argon plasma coagulation for successful treatment of bile leakage after subtotal cholecystectomy
Authors: Aritake Tsukasa , Takagi Kenji , Nagano Natsuki , Kobayashi Ryutaro , Maeda Takashi , Kawai Kiyotaka , Kawai Satoru , Kamiya Satoaki 
Published: May 2020

Abstract
Background
Subtotal cholecystectomy is an effective surgical method to decrease the risk of complications for gallbladders that are difficult to remove. However, there is a risk for postoperative refractory bile leakage through the gallbladder stump. Here, we report a new management technique involving the use of argon plasma coagulation (APC) to stop bile leakage after a subtotal cholecystectomy.

Case presentation
A 74-year-old man was referred to our hospital for abdominal pain and fever. Contrast-enhanced computed tomography of the abdomen showed fluid collection, such as an abscess, surrounding the gallbladder and hepatic flexure colon. The patient was diagnosed with colonic perforative peritonitis, and he underwent emergency surgery. On laparotomy, the abscess was observed outside of the hepatic flexure colon and gallbladder necrosis was detected. The neck of the gallbladder and the area close to the hepatoduodenal ligament was severely inflamed prohibiting dissection. The hepatic flexure colon was part of the abscess wall, and resection was needed. A subtotal cholecystectomy and right hemicolectomy confirmed peritonitis caused by cholecystic perforation. The mucous membrane of the gallbladder neck that remained was necrotic or detached. Therefore, the stump of the gallbladder was closed by primary sutures without cauterization of the mucosa. On postoperative day 6, bile leakage from the gallbladder stump was revealed. Percutaneous and endoscopic retrograde cholangiography drainage were performed. However, the liquid, which seemed to be secreted from the mucosa of the remnant gallbladder, was continuously obtained. We used APC to cauterize the gallbladder mucosa through the fistula of the abdominal drainage tube. Bile leakage and mucus discharge were improved after three rounds of APC cauterization.

Conclusions
APC effectively treated refractory bile leakage from a gallbladder stump after subtotal cholecystectomy for severe cholecystitis.
Laparoscopic gastrectomy with lymph node dissection for the treatment of remnant stomach gastrointestinal stromal tumors in incomplete-type Carney’s triad: a case report
Authors: Shimura Yuhi , Kanaji Shingo , Urakawa Naoki , Yamamoto Masashi , Utsumi Masako , Takiguchi Gousuke , Hasegawa Hiroshi , Matsuda Yoshiko , Yamashita Kimihiro , Matsuda Takeru , Oshikiri Taro , Nakamura Tetsu , Suzuki Satoshi , Kakeji Yoshihiro 
Published: May 2020

Abstract
Background
We report a rare case of gastrointestinal stromal tumors (GISTs) in Carney’s triad, successfully treated using laparoscopic gastrectomy with lymph node dissection after chemotherapy.

Case presentation
A 21-year-old woman presented to our hospital for treatment of recurrent GISTs. The patient had been admitted for treatment 11 years prior, with black stools being the chief presenting complaint at that time. On examination at that time, multiple submucosal tumors in the pyloric antrum and multiple pulmonary tumors had been observed. She underwent open partial gastrectomy, and the diagnosis of GISTs was confirmed. She was administered tyrosine kinase inhibitors to treat lung metastases from 2 months after surgery. Due to the increasing size of the lung tumors, a right upper lobectomy was performed 9 years after the index gastric surgery. Histopathological examination of the lung specimen, in combination with re-examination of the gastric specimens, was indicative of incomplete-type Carney’s triad. Eleven years after the index gastric surgery, multiple GISTs were observed in her entire stomach. Tumor biopsy revealed a succinate dehydrogenase deficiency, confirming the diagnosis of recurrent GISTs. For treatment, the patient underwent laparoscopic completion gastrectomy, with D1 plus lymph node dissection.

Conclusion
This is a first case report of completion gastrectomy performed laparoscopically for the treatment of GISTs associated with incomplete-type Carney’s triad. The recurrent GISTs developed over a protracted period of 11 years from the index gastric surgery to tumor recurrence.
Pancreatoduodenectomy co-morbid with celiac axis compression syndrome: a report of three cases
Authors: Miyazaki Katsuki , Morine Yuji , Saito Yu , Yamada Shinichiro , Tokuda Kazunori , Ikemoto Tetsuya , Imura Satoru , Shimada Mitsuo 
Published: May 2020

AbstractBackgroundCeliac axis compression syndrome (CACS) is a relatively rare disease. Because of the nature of the blood flow in the celiac region when a pancreatoduodenectomy (PD) is performed for CACS, the celiac region can become ischemic. The aim of this study is to report on the importance of pre-operative diagnosis of CACS in terms of the outcomes for patients post-operatively. In this study, three 3 cases of PD co-morbid with CACS are reported: one intra-operative diagnosis case and two pre-operative diagnosis cases.Case presentationThe one case, not diagnosed with CACS prior to the operation, had a hard post-operative course because of complication caused by ischemia of the celiac region compared with the two cases diagnosed prior to the operation, who had a good post-operative course because of pre-operative or intra-operative intervention.ConclusionsPost-operative complications due to CACS are preventable by pre-operative diagnosis and appropriate interventions.
The association between dietary consumption, anthropometric measures and body composition of rural and urban Ghanaian adults: a comparative cross-sectional study
Authors: Agyapong Nana Ama F. , Annan Reginald A. , Apprey Charles , Aduku Linda N. E. , Swart Elizabeth C. 
Published: May 2020

Abstract
Background
Overweight and obesity have become threats to public health in all regions across the globe including sub-Saharan Africa where prevalence used to be low. Policies to regulate the food environment and promote healthy food consumption look promising to reducing the prevalence of obesity but in Ghana there is not enough data to elicit a policy response. This study assessed the association between dietary consumption, anthropometric measures, body composition and physical activity among rural and urban Ghanaian adults.

Methods
This was a cross-sectional study involving 565 Ghanaian adults. Structured interviewer administered questionnaires were used to collect information on socio-demographics. Dietary consumption was assessed using household food frequency questionnaire and 24-h recall. Height, weight, BMI, waist circumference and body composition of all participants were determined. The World Health Organization’s Global Physical Activity Questionnaire (GPAQ) was used to assess physical activity levels. Mann-Whitney U test was used to analyze differences in anthropometric measures, body composition and consumption among rural and urban participants. Principal component analysis was used to analyze household food frequency data and nutrient analysis template was used to analyze 24-h recall. Chi-square was used to measure differences in obesity prevalence by community and gender. Multinomial logistic regression was used to model the risk factors associated with obesity.

Results
The prevalence of overweight and obesity using BMI were 29.9 and 22.9% respectively. Use of waist circumference measurement resulted in the highest overall obesity prevalence of 41.5%. Prevalence of obesity was higher among females compared to males across all measures with the exception of visceral fat that showed no significant difference. Four different patterns were derived from principal component analysis. Among urban participants, the staple pattern showed a significant negative correlation with visceral fat (r − 0.186, p-value 0.013) and BMI (r − 0.163, p-value 0.029). Multinomial logistic regression revealed that males (AOR 19.715, CI 9.723–39.978, p-value < 0.001) had higher odds of being of normal weight compared to females.

Conclusion
Prevalence of overweight and obesity continue to rise in Ghana, especially among females. Public education and screening as well as interventions that regulate the food environment and make affordable and available healthy food options are needed to control the rise in obesity prevalence.
Carbohydrate digestive enzymes are inhibited by Poincianella pluviosa stem bark extract: relevance on type 2 diabetes treatment
Authors: Kato-Schwartz Camila Gabriel , de Sá-Nakanishi Anacharis Babeto , Guidi Ana Carolina , Gonçalves Geferson de Almeida , Bueno Fernanda Giacomini , Zani Beatriz Petroncine Martins , de Mello João Carlos Palazzo , Bueno Paulo Sérgio Alves , Seixas Flavio Augusto Vicente , Bracht Adelar , Peralta Rosane Marina 
Published: May 2020

AbstractBackgroundThe stem bark aqueous alcohol extract ofPoincianella pluviosa(PPSB extract) is rich in bioactives including gallic acid, gallic acid methyl ester, pyrogallol, ellagic acid, corilagin, 1,4,6-tri-O-galloyl-glucose, 1,2,3,6-tetra-O-galloyl-glucose, 1,2,3,4,6-penta-O-galloyl-glucose, tellimagrandin I, tellimagrandin II, mallotinic acid, mallotusinic acid, and geraniin. The aim of the present study was to evaluate the antioxidant activity of the PPSB extract as well as its inhibitory action on carbohydrate digestive enzymes relevant to type 2 diabetes.ResultsThe PPSB extract was prepared using a mixture of 40% ethanol and 60% distilled water. The PPSB extract showed high antioxidant activities and inhibited several carbohydrate digestive enzymes. The IC50values for inhibiting in vitro salivary amylase, pancreatic amylase, intestinal β-galactosidase and intestinal invertase were, respectively, 250 ± 15, 750 ± 40, 25 ± 5, and 75 ± 8 μg/mL. In vivo inhibition of the intestinal starch absorption was confirmed by determination of blood glucose levels in rats before and after administration of starch by gavage with or without different amounts of PPSB extract. Docking simulations performed on three different programs to rank the extract compounds most likely to bind to porcine pancreatic α-amylase suggest that geraniin is likely to be theP. pluviosaextract compound that presents the greatest binding potential to the pancreatic alpha-amylase. However, the total inhibitory action of the PPSB extract is likely to result from a summation of effects of several molecules. Furthermore, the PPSB extract did not present acute toxicity nor did it present mutagenic effects.ConclusionIt can be concluded that the PPSB extract is potentially useful in controlling the postprandial glycaemic levels in diabetes. Further clinical studies with the extract are needed, however, to confirm its potential use in the management of type 2 diabetes.
Effects of the scid mutation on X-ray-induced deletions in the brain and spleen of gpt delta mice
Authors: Masumura Kenichi , Yatagai Fumio , Ochiai Masako , Nakagama Hitoshi , Nohmi Takehiko 
Published: May 2020

Abstract
Background
DNA-dependent protein kinase (DNA-PK), consisting of a Ku heterodimer (Ku70/80) and a large catalytic subunit (DNA-PKcs), plays an important role in the repair of DNA double-strand breaks via non-homologous end-joining (NHEJ) in mammalian cells. Severe combined immunodeficient (scid) mice carry a mutation in the gene encoding DNA-PKcs and are sensitive to ionizing radiation. To examine the roles of DNA-PKcs in the generation of deletion mutations in vivo, we crossed scid mice with gpt delta transgenic mice for detecting mutations.

Results
The scid and wild-type (WT) gpt delta transgenic mice were irradiated with a single X-ray dose of 10 Gy, and Spi− mutant frequencies (MFs) were determined in the brain and spleen 2 days after irradiation. Irradiation with X-rays significantly enhanced Spi− MF in both organs in the scid and WT mice. The MFs in the brain of irradiated scid mice were significantly lower than those in WT mice, i.e., 2.9 ± 1.0 × 10− 6 versus 5.0 ± 1.1 × 10− 6 (P < 0.001), respectively. In the spleen, however, both mouse strains exhibited similar MFs, i.e., 4.1 ± 1.8 × 10− 6 versus 4.8 ± 1.4 × 10− 6. Unirradiated scid and WT mice did not exhibit significant differences in MFs in either organ.

Conclusions
DNA-PKcs is unessential for the induction of deletion mutations in the spleen, while it plays a role in this in the brain. Therefore, the contribution of DNA-PKcs to NHEJ may be organ-specific.
Symmetry breaking during defect self-organization under irradiation
Authors: Zhang Yongfeng , Gao Yipeng , Sun Cheng , Schwen Daniel , Jiang Chao , Gan Jian 
Published: May 2020

AbstractOne of the most intriguing phenomena under radiation is the self-organization of defects, such as the void superlattices, which have been observed in a list of bcc and fcc metals and alloys when the irradiation conditions fall into certain windows defined by temperature and dose rate. A superlattice features a lattice parameter and a crystal structure. Previously, it has been shown that the superlattice parameter is given by the wavelength of vacancy concentration waves that develop when the uniform concentration field becomes unstable. This instability is driven thermodynamically by vacancy concentration supersaturation and affected by the irradiation condition. However, a theory that predicts the superlattice symmetry, i.e., the selection of superlattice structure, has remained missing decades after the first report of superlattices. By analyzing the nonlinear recombination between vacancies and self-interstitial-atoms (SIAs) in the discrete lattice space, this work establishes the physical connection between symmetry breaking and anisotropic SIA diffusion, allowing for predictions of void ordering during defect self-organization. The results suggest that while the instability is driven thermodynamically by vacancy supersaturation, the symmetry development is kinetically rather than thermodynamically driven. The significance of SIA diffusion anisotropy in affecting superlattice formation under irradiation is also indicated. Various superlattice structures can be predicted based on different SIA diffusion modes, and the predictions are in good agreement with atomistic simulations and previous experimental observations.