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Soluble epoxide hydrolase (EC 3.3.2.10) is a key enzyme in the regulation of inflammation and metabolism, whereas, the role of its N-terminal phosphatase activity (N-phos) has been poorly understood because of a lack of selective inhibitors. Here we report 4-aminobenzoic (Ki 15.3 µm) and 3-amino-4-hydroxy benzoic acid (Ki 11.7 µm) as selective competitive inhibitors of N-phos.

Background This study evaluated the changes in basal insulin secretion capacity (BISC) after pancreatectomy across two surgical procedures. We also investigated the association between decreased BISC and the introduction of postoperative insulin therapy. Methods The data on 110 patients who underwent pancreatectomy during October 2018–February 2022 at our hospital were retrospectively registered and analyzed. We focused on the C-peptide index (CPI) as an index for BISC. A decreased postoperative BISC was defined as a postoperative CPI (post-CPI)

This study evaluated the changes in basal insulin secretion capacity (BISC) after pancreatectomy across two surgical procedures. We also investigated the association between decreased BISC and the introduction of postoperative insulin therapy. The data on 110 patients who underwent pancreatectomy during October 2018–February 2022 at our hospital were analyzed retrospectively. We focused on the C-peptide index (CPI) as an index for BISC. A decreased postoperative BISC was defined as a postoperative CPI (post-CPI)

Background: Postoperative cholangitis is a late complication of pancreaticoduodenectomy (PD). This study aimed to elucidate the pathogenesis of post-PD cholangitis (PPDC) and explore its optimal treatment.Methods: We retrospectively analyzed 210 patients who underwent PD at our institute between 2009 and 2018. Patients who underwent follow-up for less than one year or had cholangitis caused by cancer recurrence, were excluded from the analysis. Diagnostic criteria for cholangitis and its severity were determined based on the classification of acute cholangitis provided by the 2018 Tokyo Guidelines (TG18).Results: PPDC occurred in 19 (11%) of the 176 included patients. Of these 19 patients, nine experienced more than one episode of cholangitis (total episodes, 36). For 14 patients (74%), the first episode of PPDC occurred within two years after surgery. Based on the TG18, 21 episodes were mild and 15 episodes were moderate; none were severe. Blood culture test results were positive for 16 of 24 episodes. Most patients were hospitalized and treated with intravenous antibiotics (median, seven days). The blood test values improved promptly after treatment was started. Four patients with recurrent cholangitis underwent endoscopic examination, and three of them had anastomotic stenosis of the hepaticojejunostomy. The univariate and multivariate analyses did not indicate any significant predictive factors for PPDC development.Conclusion: Mild and moderate PPDC occurred and improved with short-term antimicrobial treatment. Temporary reflux into the intrahepatic bile ducts may have been the cause of PPDC while anastomotic stenosis may be involved in recurrent cases.

症例は65歳の女性で，左上腹部痛を主訴に近医を受診．諸検査にて異常は認められないとされたが症状改善はなく，1カ月後よりspike feverが出現，精査加療目的に当院紹介となった．US，CT，MRIにて膵尾部に接する脾嚢胞性病変様の所見を認めた．膵癌，もしくは膵炎に起因したもの，あるいは脾原発の悪性リンパ腫などが鑑別にあげられた．開腹所見では膵尾部に脾臓，腎臓，結腸間膜に浸潤している腫瘤を認め，膵癌と診断し左腎臓，左副腎の合併切除を伴う膵体尾部切除術を施行した．術後病理組織学的診断では膵尾部癌の脾臓浸潤と脾臓の膵酵素暴露による好塩基性変化を認めた．膵疾患による脾合併症は比較的まれであり，膵尾部癌の脾浸潤による脾臓の凝固壊死は検索した限りでは報告例がなく，極めてまれであると考えられる．脾臓の部分的凝固壊死を契機に発見された膵尾部癌について文献的考察を加え報告する．

We report here a case of hepatic focal nodular hyperplasia (FNH) associated with hepatic hemangioma and multiple hepatic cysts in a 71-year-old man. He was admitted to our hospital because of body weight loss. Ultrasonography detected multiple cysts, and two tumors in the liver one, 3.5 cm and one, 1.6 cm. Color Doppler ultrasonography showed arterial signals within the large tumor. On dynamic computed tomography, the large tumor was a hypodense lesion which was enhanced during the arterial phase and almost isodense during the delayed phase; the small tumor was also a hypodense lesion, and was enhanced during both the arterial and delayed phases. On magnetic resonance imaging using superparamagnetic iron oxides, the large tumor had decreased signal intensity on the T2-weighted image. On hepatic arteriography, the feeding artery of the large tumor showed a spoke-wheel appearance and that of the small tumor showed a cotton-wool appearance. Ultrasonographically guided fine-needle aspiration biopsy of the large tumor revealed hepatocellular hyperplasia. Finally, we diagnosed the two hepatic tumors as FNH and hemangioma. There was no intracranial lesion. The cause of the patient's emaciation was psychogenic anorexia. To our knowledge, this is the first case report that describes the simultaneous occurrence of these three kinds of hepatic lesions. The pathogene-sis of FNH still remains unclear, but this association suggests that FNH may arise because of a vascular anomaly.

Gastric mucin plays an important role in protecting mucosa from irritants such as acids and pepsin, and UDP-galactosyltransferase is a key enzyme in mucin synthesis. In order to study the synthesis of gastric mucin in patients with chronic liver disease, we developed a new assay using a peanut agglutinin lectin to measure this enzyme in human gastric mucosa obtained by endoscopic biopsy. Enzyme activity correlated well with that determined with a previous method using radiolabeled galactose. The enzyme activity in gastric mucosa of cirrhotic patients was significantly lower than in patients with chronic hepatitis or in normal controls and correlated with the amount of mucin in surface epithelial cells. Our findings suggest that the synthesis of gastric mucin is impaired in patients with liver cirrhosis.

SUMMARY The third component of complement (C3) is central to both the classical and alternative pathways in complement activation. In this study, involvement of C3 activation in the mucosal injury of UC was investigated. We examined the distribution of activated (C3b) and degraded fragments (iC3b/C3dg) of C3, terminal complement complex (TCC), and complement regulatory proteins in normal and diseased colonic mucosa including UC and other types of colitis using immunohistochemical techniques at the level of light and electron microscopy. While C3b and iC3b/C3dg staining was negligible in the normal mucosa, iC3b/C3dg and, to a lesser extent, C3b were deposited in UC mucosa along the epithelial basement membrane. The deposition was enhanced in relation to the severity of mucosal inflammation (C3b, P

The stereoselective synthesis of α-linked glucobiose derivatives using 6-O-acetyl- or 6-O-p-nitrobenzoyl-2,3,4-tri-O-benzyl-D-glucopyranose and a ternary mixture of p-nitrobenzenesulfonyl chloride, silver trifluorometh-anesulfonate, and triethylamine in dichloromethane is described.

A 69 year-old male, driving a car, swerved and collided into a tree. He was sent to our hospital because of dyspea with extension of the neck. Although he had no subcutaneous emphysema nor open wound, he showed bilateral pneumothorax. Thoracic drainage was performed and his dyspnea improved. One day after admission his dyspnea recurred without emphysema. We tried tracheostomy because of bilateral recurrent nerve paresis. The cervical trachea was completely separated between the cricoid cartilage and the 1st tracheal ring. Under general anesthesia, tracheostomy was performed at the level of 3 rings distal from the separated part and tracheoplasty was carried out. Ten days after the operation, progressive necrosis occurred in the anterior wall of the trachea between the anastomosis and the tracheostomy. A silicon T-tube was inserted to keep the tracheal lumen open 50 days after the operation. The proximal end of the T-tube did not pass the vocal cord because slight movement of vocal cord appeared. Granulation tissue gradually replaced the necrotic tissue. After the silicon T-tube was removed 78 days after the operation, the T-tube wound was closed, then he was discharged with horseness but without dyspnea.

Background Although neuroendocrine tumors are most commonly found in the digestive system, neuroendocrine tumors originating from the bile duct are rare, and neuroendocrine carcinomas derived from the perihilar bile duct are extremely rare. This report presents the clinical course and clinicopathological features of neuroendocrine carcinomas arising from the extrahepatic bile duct. Case presentation A 70-year-old Japanese woman was preoperatively diagnosed with perihilar cholangiocarcinoma, and a radical resection with an extended left hepatic lobectomy and a choledochojejunostomy was performed. From the histopathological findings, we diagnosed the tumor as a neuroendocrine carcinoma of the bile duct (small cell type) with lymph node metastasis. The patient was treated with the same adjuvant chemotherapy as that used for small cell carcinoma of the lung. At 10 months after surgery, there was no recurrence of the disease. Conclusion Neuroendocrine carcinoma of the extrahepatic biliary tracts is a very rare and highly malignant disease with a poor prognosis. A multidisciplinary approach could improve the prognosis for this neoplasm.