Recent studies suggest that serrated polyps, including hyperplastic polyps, traditional serrated adenomas, and sessile serrated adenomas, may be morphologically and genetically distinct and linked to microsatellite unstable colorectal cancers, and thus the concept of a hyperplastic polyp-serrate adenoma-carcinoma pathway has been suggested. Furthermore, it has been suggested that transformation from serrated polyps to invasive cancers can be rapid and occurs when the lesions are small; however, direct evidence for this issue is scant. We herein describe a case of a sessile serrated adenoma showing rapid transformation into a submucosal invasive carcinoma with remarkable morphological change in a short period of 8 months. This case is unique and suggestive, as it provided information about the natural history of a sessile serrated adenoma.
We examined prospectively 8,726 patients in outpatient eye clinics. A total of 225 (2.9%) patients had subconjunctival hemorrhage. No sexual or age predilection was found. The most common causes for the condition were minor local trauma, systemic hypertension, and acute conjunctivitis. Subconjunctival hemorrhages resulting from local trauma were frequent in the summer, and those associated with systemic hypertension were noted most often in older patients. Blood pressures should be examined in patients with subconjunctival hemorrhages, particularly in older patients.
Although we know that rainfall interception (the rain caught, stored, and evaporated from aboveground vegetative surfaces and ground litter) is affected by rain and throughfall drop size, what was unknown until now is the relative proportion of each throughfall type (free throughfall, splash throughfall, canopy drip) beneath coniferous and broadleaved trees. Based on a multinational data set of >120 million throughfall drops, we found that the type, number, and volume of throughfall drops are different between coniferous and broadleaved tree species, leaf states, and timing within rain events. Compared with leafed broadleaved trees, conifers had a lower percentage of canopy drip (51% vs. 69% with respect to total throughfall volume) and slightly smaller diameter splash throughfall and canopy drip. Canopy drip from leafless broadleaved trees consisted of fewer and smaller diameter drops (D50_DR, 50th cumulative drop volume percentile for canopy drip, of 2.24 mm) than leafed broadleaved trees (D50_DR of 4.32 mm). Canopy drip was much larger in diameter under woody drip points (D50_DR of 5.92 mm) than leafed broadleaved trees. Based on throughfall volume, the percentage of canopy drip was significantly different between conifers, leafed broadleaved trees, leafless broadleaved trees, and woody surface drip points (p ranged from <0.001 to 0.005). These findings are partly attributable to differences in canopy structure and plant surface characteristics between plant functional types and canopy state (leaf, leafless), among other factors. Hence, our results demonstrating the importance of drop‐size‐dependent partitioning between coniferous and broadleaved tree species could be useful to those requiring more detailed information on throughfall fluxes to the forest floor.
Background:Malignant pleural mesothelioma (MPM) is a rare but fatal tumour. Although most MPM patients show pleural effusion at even the early stage, it is hard to diagnose as MPM at the early stage because a sensitive and reliable diagnostic marker for MPM has not been found in plasma or pleural effusion.Methods:In this study, we investigated whether intelectin-1 was specifically contained in MPM cells and the pleural effusion of MPM patient by immunohistochemistry, western blotting, and enzyme-linked immunosorbent assay.Results:Malignant pleural mesothelioma cell lines, but not lung adenocarcinoma cell lines, secreted intelectin-1. In immunohistochemistry, epithelioid-type MPMs, but neither pleura-invading lung adenocarcinomas nor reactive mesothelial cells near the lung adenocarcinomas, were stained with anti-intelectin antibodies. Pleural effusion of MPM patients contained a higher concentration of intelectin-1 than that of lung cancer patients.Conclusion:These results suggest that detection of intelectin-1 may be useful for a differential diagnosis of epithelioid-type MPM in immunohistochemistry and that a high concentration of intelectin-1 in pleural effusion can be used as a new marker for clinical diagnosis of MPM.
We reviewed the clinical records, color photographs and fluorescein angiograms of 106 eyes of 53 patients (44 men and 9 women) with central serous chorioretinopathy who had been followed up for 1 year or more. Their ages ranged from 20 to 59 years. One eye in each patient was involved at the initial visit. According to fluorescein-angiographic findings, the lesions were divided into smokestack pattern (13 eyes), ink blot appearance (33 eyes) and minimally enlarging spot (7 eyes). Most patients complained of central scotoma, and most patients had moderately decreased visual acuities at the initial visit, which improved after recovery. In particular, all 7 eyes with a minimally enlarging spot had a visual acuity of 0.8 or more at the initial visit; of these 6 eyes had 1.0 or more several weeks later. On fluorescein angiography, 49 eyes demonstrated 1 leaking spot and 4 eyes showed 2 spots. Of 57 leaking spots, 10 were observed in the foveola, 31 were noted in the fovea and 16 were found in the para- or perifovea. Of 13 smokestack patterns, 5 were found in the inferonasal area. The ink blot appearance and minimally enlarging spots were frequently found in the superonasal and superotemporal areas.
OBJECTIVES A micropapillary (MIP) component is reported to be associated with a poor prognosis in patients with completely resected lung adenocarcinoma. The purpose of this study was to investigate the impact of an MIP component on the timing of postoperative recurrence using hazard curves. METHODS A total of 1289 patients with lung adenocarcinoma who underwent complete pulmonary resection from 2008 to 2015 were studied. Hazard curves representing the changes in hazard over time were evaluated. RESULTS The hazard curve displayed an initial wide, high peak within 1 year after surgery in patients with an MIP component, whereas some gentle peaks around the second year were noted in patients without an MIP component. The presence of an MIP component was associated with a worse recurrence-free survival and an early recurrence in stage I patients but not in advanced-stage patients. In multivariable Cox regression, the presence of an MIP component and lymph node metastasis, pleural invasion and gender were associated with a poor prognosis. CONCLUSIONS Patients with an MIP component retained a high risk of early recurrence after surgery, and the risk for recurrence persisted over the long term. Even after complete resection in stage I lung adenocarcinoma patients, an MIP component remains correlated with a poor prognosis.
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