A case of gastric aberrant pancreas with bleeding and diagnosed by endoscopic ultrasonography

Aberrant pancreas is used to describe ectopic pancreatic tissue lying outside its normal location with no anatomic or vascular connection to the pancreas proper. Patients with aberrant pancreas are usually asymptomatic, so aberrant pancreas are typically discovered incidentally during endoscopy, surgery, or autopsy. This time, we report a case of gastric aberrant pancreas bleeding was repeated and endoscopic hemostasis was difficult. A 22-year-old man was admitted to a hospital with a complaint of epigastric pain and melena. Upper gastrointestinal endoscopy and endoscopic ultrasonography (EUS) revealed a submucosal tumor with a bleeding ulcer at the anterior wall of the antrum in the stomach, and diagnosed it as an aberrant pancreas. It was hard to stop bleeding by in total 7 times endoscopic hemostasis and anemia was gradually progressed, so partial gastrectomy was performed. This gastric tumor measured 40 mm × 30 mm × 20 mm and had a severe ulcerative change. The pathological diagnosis was aberrant pancreas with Langerhans islet, acinous cells and excretory duct. (Heinrich type) Until December 2013 in Japan, 13 cases of gastric aberrant pancreas with bleeding have been reported and in these, a surgery was done in 11 cases. In gastric aberrant pancreas cases with ulcer formation like this case, endoscopic hemostasis is expected to be difficult, and surgery is necessary. Hence, early accurate diagnosis by EUS is a very important to decide better treatment plan.

The observation indicator induced from gastrointestinal stromal tumor under long-term monitoring by endoscopic ultrasonography

INTRODUCTION

We report a case of low-risk stomach gastrointestinal stromal tumor (GIST) which has been under a long-term observation, obtaining from this experience knowledge useful in determining the treatment formula for this disease.

RESULTS

During the observation for 6 years, no such change as ulcer formation was observed in the appearance of the tumor. The measurement of tumor diameter, however, showed gradual growth of maximum tumor diameter from 2.7 to 5.0 cm. When the changes in the diameter of tumor during this period is plotted, taking the timeon the horizontal axis and the tumor diameter on the vertical axis, the growth of the tumor can be approximated with a secondary function, making it possible to estimate the developmental period of the GIST concerned from the approximated secondary function. Thus, the developmental period in this case was estimated to go back 19 years before the time when it was discovered for the 1(st) time. Further, it was considered that the coefficient of the secondary function represents the rate of tumor growth, and that comparison with this coefficient contributed to the evaluation of malignancy stage of the GIST concerned.

CONCLUSION

The growth curve predicting the growth of tumor could be depicted by measuring the diameter of the tumor in GIST twice or more at an interval of 6-12 months with EUS, and it was thought that this was utilizable for determining treatment formula for GISTs.

Optical designs of reflection and refraction collection optics for a JT-60SA core Thomson scattering system

Collection optics for core measurements in a JT-60SA Thomson scattering system were designed. The collection optics will be installed in a limited space and have a wide field of view and wide wavelength range. Two types of the optics are therefore suggested: refraction and reflection types. The reflection system, with a large primary mirror, avoids large chromatic aberrations. Because the size limit of the primary mirror and vignetting due to the secondary mirror affect the total collection throughput, conditions that provide the high throughput are found through an optimization. A refraction system with four lenses forming an Ernostar system is also employed. The use of high-refractive-index glass materials enhances the freedom of the lens curvatures, resulting in suppression of the spherical and coma aberration. Moreover, sufficient throughput can be achieved, even with smaller lenses than that of a previous design given in [H. Tojo, T. Hatae, T. Sakuma, T. Hamano, K. Itami, Y. Aida, S. Suitoh, and D. Fujie, Rev. Sci. Instrum. 81, 10D539 (2010)]. The optical resolutions of the reflection and refraction systems are both sufficient for understanding the spatial structures in plasma. In particular, the spot sizes at the image of the optics are evaluated as ~0.3 mm and ~0.4 mm, respectively. The throughput for the two systems, including the pupil size and transmissivity, are also compared. The results show that good measurement accuracy (<10%) even at high electron temperatures (<30 keV) can be expected in the refraction system.

Is location associated with high risk of hypertension? Shimane COHRE Study

BACKGROUND

There is growing evidence that residential environment is associated with hypertension. Recently, interest has also turned toward examining the possible influence of remoteness on hypertension. The aim of this study is to explore the effect of remoteness, the shortest path between the subject location and the population center, on hypertension prevalence in a rural region in Japan.

METHODS

We analyzed data from the Shimane COHRE Study conducted from 2006 to 2009 in rural mountainous regions of Japan. After excluding the missing data, we conducted a logistic regression analysis of the data for 1,348 individuals. Geographic information systems (GIS) were used in the network analysis. Network analysis determined the distance between subject's location and population center on road networks, and the distance was divided into tertiles: 0-26,685.8 m = close distance, 26,685.9 m-38,350.6 m = moderate distance, 38,350.7 m-68,070.1 m = far distance.

RESULTS

According to self-reported hypertension, the odds ratios for hypertension (taking antihypertensive medication or under treatment for hypertension without medication) were 1.44 (95% confidence interval (CI): 1.04-1.99) and 1.78 (95% CI: 1.29-2.46) in moderate and far distances, respectively, after adjustment for potential confounders. The odds ratios no longer remained significant after considering the measurement of blood pressure (BP) to define hypertension (taking antihypertensive medication or under treatment for hypertension without medication or BP ≥ 140/90 mm Hg for systolic BP (SBP)/diastolic BP (DBP)).

CONCLUSIONS

Our findings show that residential remoteness might be associated with a higher risk of hypertension in a rural region in Japan.

Status of ion sources at National Institute of Radiological Sciences

The National Institute of Radiological Sciences (NIRS) maintains various ion accelerators in order to study the effects of radiation of the human body and medical uses of radiation. Two electrostatic tandem accelerators and three cyclotrons delivered by commercial companies have offered various life science tools; these include proton-induced x-ray emission analysis (PIXE), micro beam irradiation, neutron exposure, and radioisotope tracers and probes. A duoplasmatron, a multicusp ion source, a penning ion source (PIG), and an electron cyclotron resonance ion source (ECRIS) are in operation for these purposes. The Heavy-Ion Medical Accelerator in Chiba (HIMAC) is an accelerator complex for heavy-ion radiotherapy, fully developed by NIRS. HIMAC is utilized not only for daily treatment with the carbon beam but also for fundamental experiments. Several ECRISs and a PIG at HIMAC satisfy various research and clinical requirements.

DIAGNOSIS OF SPATIAL RESOLUTION FOR MICROBEAM SCANNING PIXE USING STIM METHOD AND CR-39 TRACK DETECTOR IN PASTA

In PIXE analysis system and Tandem Accelerator facility (PASTA) of NIRS, we are using Scanning Transmission Ion Microscopy (STIM) method and solid track detector to diagnose the spatial resolution of scanning microbeam PIXE analysis system. These methods are widely used by many microbeam facilities.