Leiomyomas are the most common benign tumors of the esophagus. They usually occur as a single lesion or as two or three nodules. Only two cases of esophageal multiple leiomyomas comprising more than 10 nodules have be...Leiomyomas are the most common benign tumors of the esophagus. They usually occur as a single lesion or as two or three nodules. Only two cases of esophageal multiple leiomyomas comprising more than 10 nodules have been reported previously. Moreover, there have been few reports of esophageal squamous cell carcinoma overlying submucosal tumors. We describe a 71-yearold man who was diagnosed as having a superficial esophageal cancer coexisting with two or three leiomyoma nodules. During surgery, 10 or more nodules that had not been evident preoperatively were palpable in the submucosal and muscular layers throughout the esophagus. As intramural metastasis of the esophageal cancer was suspected, we considered additional lymphadenectomy, but had to rule out this option because of the patient＇s severe anoxemia. Microscopic examination revealed that all the nodules were leiomyomas （20 lesions, up to 3 cm in diameter）, and that invasion of the carcinoma cells was limited to the submucosal layer overlying a relatively large leiomyoma. This is the first report of superficial esophageal cancer coexisting with numerous solitary leiomyomas. Multiple minute leiomyomas are often misdiagnosed as intramural metastasis, and a leiomyoma at the base of a carcinoma lesion can also be rnisdiagnosed as tumor invasion. The present case shows that accurate diagnosis is required for the management of patients with coexisting superficial esophageal cancer and multiple leiomyomas.展开更多
A 73-year old man presented with abdominal pain. A tumor with central ulceration was observed in the ileum using double-balloon enteroscopy. Histological findings of the biopsy specimens were consistent with malignant...A 73-year old man presented with abdominal pain. A tumor with central ulceration was observed in the ileum using double-balloon enteroscopy. Histological findings of the biopsy specimens were consistent with malignant lymphoma. Double-balloon enteroscopy confirmed the diagnosis of a malignant lymphoma tumor which was surgically resected. The patient is still in complete remission now.展开更多
Background: Long-term care facilities for older people play an important role as alternatives to family care in an aging society. This study aimed to assess staffing problems linked to emergency healthcare for residen...Background: Long-term care facilities for older people play an important role as alternatives to family care in an aging society. This study aimed to assess staffing problems linked to emergency healthcare for residents of these facilities, and to investigate the relationship between these problems and the characteristics of the facilities. Methods: The study surveyed managers of long-term care facilities for older people in a Japanese urban area between September and December 2014. The type of care facility, the number of staff and any problems providing or accessing emergency healthcare for the residents were evaluated. Multiple logistic regression analysis was used to explore the factors common to facilities reporting staffing problems linked to emergency healthcare of residents. Results: In total, 321 long-term care facilities were eligible for this study and 226 (70%) returned the questionnaire. We compared the characteristics of facilities reporting and not reporting staffing problems in emergency healthcare of residents. The type of care facility was significantly associated with staffing problems in emergency healthcare of residents both during the day (p < 0.01) and at night (p = 0.04). The facilities most likely to report problems were group homes for older people with dementia, because of staffing shortages. Conclusions: Problems in emergency healthcare systems in Japanese long-term care facilities for older people varied by type of care facility. Our data underscore the need for telemedicine and consideration of mergers between smaller facilities such as group homes for older people with dementia.展开更多
The hospital environment in Japan has changed drastically lately. Its unpredictability has increased the need for hospitals to select management strategies to clarify their course. However, research on Japanese hospit...The hospital environment in Japan has changed drastically lately. Its unpredictability has increased the need for hospitals to select management strategies to clarify their course. However, research on Japanese hospitals’ management strategies has only recently begun with too few studies in this area. Hence, this study clarifies the management strategies of Japanese private hospitals. It explores the hospital characteristics that affect strategy selection. A questionnaire was mailed to 5682 private medical institutions in 2013, and 459 responses with no missing data were used for analysis. Factor analysis yielded four factors: “bed conversion and downsizing (Factor 1),” “diversification of medical and nursing care (Factor 2),” “expansion in business scale (Factor 3),” and “expansion of income from non-insured medical care (Factor 4)”. Logistic regression analysis revealed that Year Founded (before 1965), Hospital Location (municipalities with populations smaller than 100,000), Hospital Type (psychiatric hospitals and mixed-care hospital), and Hospital Income and Expenditure (deficit) had significant positive impacts on the choice of Factor 1. For Factor 2, Hospital Type (sanatorium ward and mixed-care hospitals) and Hospital Income and Expenditure (constant surplus) had positive impacts. For Factor 3, Hospital Type (general hospital) and Bed Counts (more than 200) had positive impacts. For Factor4, Hospital Type (general hospital) had positive impacts. In other words, older hospitals, hospitals in rural areas, psychiatric hospitals, mixed-care hospitals, and hospitals with deficits tended to choose bed conversion and downsizing. Sanatorium ward hospitals, mixed-care hospitals, and hospitals with a constant surplus tended to choose diversification of medical and nursing care. General hospitals and large hospitals tended to choose expansion in scale, and general hospitals tended to choose expansion into non-insured medical care. The planning of mid- to long-term management strategies suitable for each hospital and their steady execution are required.展开更多
We report a case of a 37-year-old Japanese female. She had a Tessier no. 8 craniofacial cleft and an orbital lipoma in the lateral canthal region. Excisional surgery and pathological examination revealed a genuine lip...We report a case of a 37-year-old Japanese female. She had a Tessier no. 8 craniofacial cleft and an orbital lipoma in the lateral canthal region. Excisional surgery and pathological examination revealed a genuine lipoma. No other case has been reported in the literature. Here, we present our case of a rare genuine lipoma located in lateral canthal region of the Tessier no. 8 cleft.展开更多
Purpose: Haemangiomas and vascular malformations are not easy to differentiate clinically. We describe a patient who was initially thought to have a scrotal venous malformation (VM) but after pathological examination ...Purpose: Haemangiomas and vascular malformations are not easy to differentiate clinically. We describe a patient who was initially thought to have a scrotal venous malformation (VM) but after pathological examination was diagnosed to be afflicted with an arteriovenous malformation (AVM) with a micro-fistula in pathorogical photo. We think that even if there are suspicions of VM before the operation, the importance of resection with an ample margin of safety is indicated. Material and Method: A 38-year-old man who noticed a mass in his scrotum. The patient was seen at our hospital in May 2009 with concern for progression of the scrotal mass. That mass appeared to indicate a simple case of VM of the scrotum. Result and Conclusion: A biopsy of the mass was performed and was diagnosed to be a micro-fistula AVM, with no tumour growth in the vascular endothelial cells. Resection was performed in September 2009. And there is no recurrence. Even if there are suspicions of VM before the operation, the importance of resection with an ample margin of safety is indicated.展开更多
Microporous molecular crystals are promising materials because of their designable porosity as well as their resistance to chemical and other stimuli.Here,we developed microporous molecular cocrystals by taking advant...Microporous molecular crystals are promising materials because of their designable porosity as well as their resistance to chemical and other stimuli.Here,we developed microporous molecular cocrystals by taking advantage of the specific interactions between porphyrins and fullerene molecules.Single-crystal X-ray diffraction analysis revealed that one nickel(Ⅱ)porphyrin interacts with two fullerene molecules to form a two-dimensional honeycomb network with an eclipsed stacking mode,providing onedimensional void channels.After the pores were activated by heat treatment or mechanical grinding,the prepared cocrystal can incorporate gas and solvent molecules reversibly while maintaining its single-crystallinity.Also,it retained its single-crystallinity in the presence of water,acid−base,or high pressure.These findings in this study expand the availability of molecular crystals based on intermolecular interactions as porous materials,which are expected to work under conditions that have not been applicable to other molecule-based porous materials.展开更多
Multiple primary malignant neoplasms （MPMNs） are rarely reported and it is important to give early diagnosis and proper therapy for these patients. Here reported a case of 62-year-old man with concomitant three earl...Multiple primary malignant neoplasms （MPMNs） are rarely reported and it is important to give early diagnosis and proper therapy for these patients. Here reported a case of 62-year-old man with concomitant three early stage cancer lesions in upper gastrointestinal tract, all of which were detected by endoscopy. The first one was an llc-type lesion at angular part of stomach under endoscopy, which was histologically confirmed to be a mucosal well-differentiated adenocarcinoma.The patient underwent a standard radical gastrectomy for the lesion after the failure of endoscopic treatment. The other two neoplasms were observed during follow-up and were indicated as early stage lesions by synthesizing information from endoscopy, endoscopic ultrasonography, computed tomography and biopsy. One displayed as a hyperemic patch （3cm×4 cm in size） located at the part of esophagus 27 cm away from the incisor teeth and was proved to be moderately differentiated squamous cancer by histopathological examination. The other was an llc-type lesion （3.0 cm×3.5 cm in size） located at the part of esophagus 36 cm away from the incisor teeth, and the biopsy result showed a poorly differentiated squamous carcinoma. Both the two lesions were treated with radical radiation because the patient refused surgery management. No recurrence of former lesions or occurrence of novel lesions were observed during post-treatment follow-up, suggesting radical radiation might be effective for this patient.展开更多
文摘Leiomyomas are the most common benign tumors of the esophagus. They usually occur as a single lesion or as two or three nodules. Only two cases of esophageal multiple leiomyomas comprising more than 10 nodules have been reported previously. Moreover, there have been few reports of esophageal squamous cell carcinoma overlying submucosal tumors. We describe a 71-yearold man who was diagnosed as having a superficial esophageal cancer coexisting with two or three leiomyoma nodules. During surgery, 10 or more nodules that had not been evident preoperatively were palpable in the submucosal and muscular layers throughout the esophagus. As intramural metastasis of the esophageal cancer was suspected, we considered additional lymphadenectomy, but had to rule out this option because of the patient＇s severe anoxemia. Microscopic examination revealed that all the nodules were leiomyomas （20 lesions, up to 3 cm in diameter）, and that invasion of the carcinoma cells was limited to the submucosal layer overlying a relatively large leiomyoma. This is the first report of superficial esophageal cancer coexisting with numerous solitary leiomyomas. Multiple minute leiomyomas are often misdiagnosed as intramural metastasis, and a leiomyoma at the base of a carcinoma lesion can also be rnisdiagnosed as tumor invasion. The present case shows that accurate diagnosis is required for the management of patients with coexisting superficial esophageal cancer and multiple leiomyomas.
文摘A 73-year old man presented with abdominal pain. A tumor with central ulceration was observed in the ileum using double-balloon enteroscopy. Histological findings of the biopsy specimens were consistent with malignant lymphoma. Double-balloon enteroscopy confirmed the diagnosis of a malignant lymphoma tumor which was surgically resected. The patient is still in complete remission now.
文摘Background: Long-term care facilities for older people play an important role as alternatives to family care in an aging society. This study aimed to assess staffing problems linked to emergency healthcare for residents of these facilities, and to investigate the relationship between these problems and the characteristics of the facilities. Methods: The study surveyed managers of long-term care facilities for older people in a Japanese urban area between September and December 2014. The type of care facility, the number of staff and any problems providing or accessing emergency healthcare for the residents were evaluated. Multiple logistic regression analysis was used to explore the factors common to facilities reporting staffing problems linked to emergency healthcare of residents. Results: In total, 321 long-term care facilities were eligible for this study and 226 (70%) returned the questionnaire. We compared the characteristics of facilities reporting and not reporting staffing problems in emergency healthcare of residents. The type of care facility was significantly associated with staffing problems in emergency healthcare of residents both during the day (p < 0.01) and at night (p = 0.04). The facilities most likely to report problems were group homes for older people with dementia, because of staffing shortages. Conclusions: Problems in emergency healthcare systems in Japanese long-term care facilities for older people varied by type of care facility. Our data underscore the need for telemedicine and consideration of mergers between smaller facilities such as group homes for older people with dementia.
文摘The hospital environment in Japan has changed drastically lately. Its unpredictability has increased the need for hospitals to select management strategies to clarify their course. However, research on Japanese hospitals’ management strategies has only recently begun with too few studies in this area. Hence, this study clarifies the management strategies of Japanese private hospitals. It explores the hospital characteristics that affect strategy selection. A questionnaire was mailed to 5682 private medical institutions in 2013, and 459 responses with no missing data were used for analysis. Factor analysis yielded four factors: “bed conversion and downsizing (Factor 1),” “diversification of medical and nursing care (Factor 2),” “expansion in business scale (Factor 3),” and “expansion of income from non-insured medical care (Factor 4)”. Logistic regression analysis revealed that Year Founded (before 1965), Hospital Location (municipalities with populations smaller than 100,000), Hospital Type (psychiatric hospitals and mixed-care hospital), and Hospital Income and Expenditure (deficit) had significant positive impacts on the choice of Factor 1. For Factor 2, Hospital Type (sanatorium ward and mixed-care hospitals) and Hospital Income and Expenditure (constant surplus) had positive impacts. For Factor 3, Hospital Type (general hospital) and Bed Counts (more than 200) had positive impacts. For Factor4, Hospital Type (general hospital) had positive impacts. In other words, older hospitals, hospitals in rural areas, psychiatric hospitals, mixed-care hospitals, and hospitals with deficits tended to choose bed conversion and downsizing. Sanatorium ward hospitals, mixed-care hospitals, and hospitals with a constant surplus tended to choose diversification of medical and nursing care. General hospitals and large hospitals tended to choose expansion in scale, and general hospitals tended to choose expansion into non-insured medical care. The planning of mid- to long-term management strategies suitable for each hospital and their steady execution are required.
文摘We report a case of a 37-year-old Japanese female. She had a Tessier no. 8 craniofacial cleft and an orbital lipoma in the lateral canthal region. Excisional surgery and pathological examination revealed a genuine lipoma. No other case has been reported in the literature. Here, we present our case of a rare genuine lipoma located in lateral canthal region of the Tessier no. 8 cleft.
文摘Purpose: Haemangiomas and vascular malformations are not easy to differentiate clinically. We describe a patient who was initially thought to have a scrotal venous malformation (VM) but after pathological examination was diagnosed to be afflicted with an arteriovenous malformation (AVM) with a micro-fistula in pathorogical photo. We think that even if there are suspicions of VM before the operation, the importance of resection with an ample margin of safety is indicated. Material and Method: A 38-year-old man who noticed a mass in his scrotum. The patient was seen at our hospital in May 2009 with concern for progression of the scrotal mass. That mass appeared to indicate a simple case of VM of the scrotum. Result and Conclusion: A biopsy of the mass was performed and was diagnosed to be a micro-fistula AVM, with no tumour growth in the vascular endothelial cells. Resection was performed in September 2009. And there is no recurrence. Even if there are suspicions of VM before the operation, the importance of resection with an ample margin of safety is indicated.
基金supported by JST-FOREST(JPMJFR203F)and JST-CREST(JPMJCR18R3)supported by JSPS KAKENHI Grant Nos.JP23H04612,JP20H02547,21K14490,22KJ0294,22H05142,and 22H05145+2 种基金Nippon Sheet Glass Foundation for Materials Science and Engineeringthe Asahi Glass Foundation for financial supportA part of SXRD measurements was performed at SPring-8 BL02B1 with the approval of the Japan Synchrotron Radiation Research Institute(JASRI)(Proposal Nos.2023B1680,2023B1853).
文摘Microporous molecular crystals are promising materials because of their designable porosity as well as their resistance to chemical and other stimuli.Here,we developed microporous molecular cocrystals by taking advantage of the specific interactions between porphyrins and fullerene molecules.Single-crystal X-ray diffraction analysis revealed that one nickel(Ⅱ)porphyrin interacts with two fullerene molecules to form a two-dimensional honeycomb network with an eclipsed stacking mode,providing onedimensional void channels.After the pores were activated by heat treatment or mechanical grinding,the prepared cocrystal can incorporate gas and solvent molecules reversibly while maintaining its single-crystallinity.Also,it retained its single-crystallinity in the presence of water,acid−base,or high pressure.These findings in this study expand the availability of molecular crystals based on intermolecular interactions as porous materials,which are expected to work under conditions that have not been applicable to other molecule-based porous materials.
文摘Multiple primary malignant neoplasms （MPMNs） are rarely reported and it is important to give early diagnosis and proper therapy for these patients. Here reported a case of 62-year-old man with concomitant three early stage cancer lesions in upper gastrointestinal tract, all of which were detected by endoscopy. The first one was an llc-type lesion at angular part of stomach under endoscopy, which was histologically confirmed to be a mucosal well-differentiated adenocarcinoma.The patient underwent a standard radical gastrectomy for the lesion after the failure of endoscopic treatment. The other two neoplasms were observed during follow-up and were indicated as early stage lesions by synthesizing information from endoscopy, endoscopic ultrasonography, computed tomography and biopsy. One displayed as a hyperemic patch （3cm×4 cm in size） located at the part of esophagus 27 cm away from the incisor teeth and was proved to be moderately differentiated squamous cancer by histopathological examination. The other was an llc-type lesion （3.0 cm×3.5 cm in size） located at the part of esophagus 36 cm away from the incisor teeth, and the biopsy result showed a poorly differentiated squamous carcinoma. Both the two lesions were treated with radical radiation because the patient refused surgery management. No recurrence of former lesions or occurrence of novel lesions were observed during post-treatment follow-up, suggesting radical radiation might be effective for this patient.
