Livelihood Factors and Household Strategies for an Unexpected Climate Event in Upland Northern Laos

Climate events pose major challenges to food production and the livelihoods of rural inhabitants in northern Laos, where upland rice using swidden production is an important crop. The onset of the rainy season in this area is one such climate event, and it has occurred earlier and with less regularity in recent years. Not all households are able to cope with these changes. This study examines the ability of local farmers to cope with rice insufficiency. This investigation also clarifies household strategies in dealing with the climate event. We randomly interviewed 63 of 95 household heads, and performed a paired sample t test to examine the significance of differences in three household groups between the 2010 normal climate and the 2011 climate event. The groups were categorized according to rice selfsufficiency in 2011: groups I are households with rice self-sufficiency, group II are those facing a rice shortage of up to 3 months, and group III are those with insufficient rice for over 3 months. We also conducted a one-way ANOVA to examine the significance of differences in livelihood strategies among the three groups. We found that the household labor force was the most important factor in enhancing the villagers' ability to deal with the climate event and that the level of impact of that event shaped their coping strategies. Households with substantial labor force had more options for coping strategies than those with smaller ones. The villagers faced different levels of impact and adopted differentcoping strategies accordingly. Non-timber forest product collection was the principle livelihood strategy in response to non-climate factors such as education, access to health services, provision of equipment and clothing, and overcoming the impact of the climate event. Households heavily affected by the early rainy season onset tended to engage in intensive activities such as off-farm activity and outside work, rather than their major livelihood activities in the village(upland crop and livestock production).

Isolated liver metastasis detected 11 years after the curative resection of rectal cancer:A case report

BACKGROUND The duration of surveillance after curative resection of colorectal cancer(CRC)is generally 5 years.The overall incidence of recurrence more than 5 years after surgery for CRC in Japan has been reported to be 0.6%.Moreover,it is rare for CRC to have metachronous liver metastasis more than 10 years after surgery.Here,we present a case of liver metastasis detected 11 years after the curative resection of rectal cancer.CASE SUMMARY A 72-year-old man was referred to our hospital after a liver tumor was detected by abdominal ultrasonography at another hospital.He had undergone surgery for rectal cancer 11 years previously.Contrast-enhanced computed tomography(CT)showed a tumor with a diameter of approximately 8 cm in the posterior segment,which was weakly and gradually enhanced.18F-fluorodeoxyglucose-positron emission tomography/CT showed an abnormally high uptake on the tumorous lesion,which showed that the tumor appeared to spread convexly along the intrahepatic bile ducts.Intrahepatic cholangiocarcinoma was therefore diagnosed,and he had an extended right posterior sectionectomy and regional lymph node dissection.Histopathological examination showed that the tumor was a moderately differentiated adenocarcinoma and showed the same pathological characteristics as the rectal cancer.Immunohistological examination showed that the cancer cells of both the liver tumor and rectal cancer were positive for cytokeratin(CK)20 and weakly positive for CK 7.These findings were consistent with the liver metastasis from the rectal cancer.CONCLUSION It is possible that a liver tumor is metastatic in a patient with a previous history of CRC,even if it was more than 10 years earlier.

Atopic Dermatitis Deteriorates Dextran Sodium Sulfate-Induced Ulcerative Colitis via Thymic Stromal Lymphopoietin in Mice

It has been reported that atopic dermatitis (AD) and ulcerative colitis are related. However, the mechanism underlying this association has not been clarified. We therefore explored how AD induces ulcerative colitis. We developed an AD mouse model (NC/Nga mice) with ulcerative colitis by administering dextran sodium sulfate (DSS) for five days. DSS-induced ulcerative colitis was deteriorated in our conventional AD mouse model compared with specific-pathogen-free (SPF) mice. The plasma levels of thymic stromal lymphopoietin (TSLP) and tumor necrosis factor-α increased the most in DSS-treated conventional mice. Furthermore, the expression of dendritic cells (DC), retinoid-related orphan receptor (ROR)γt (marker of T helper 17 cells [Th17]), interleukin (IL)-17, GATA binding protein 3 (GATA3) (marker of Th2), and IL-4 increased the most in the colon of the DSS-treated conventional mice compared with DSS-treated SPF mice. In addition, TSLP inhibitor (TSLP neutralizing antibody) did not exacerbate ulcerative colitis in DSS-treated conventional mice. These results indicate that TSLP/DC/Th2 and Th17 play major roles in the exacerbation of ulcerative colitis by AD.

Pancreaticoduodenectomy following total gastrectomy:A case report and literature review

We present a case of afferent loop syndrome(ALS)occurring after pancreaticoduodenectomy(PD)in a patient who had previously undergone total gastrectomy(TG),and review the English-language literature concerning reconstruction procedures following PD in patients who had undergone TG.The patient was a69-year-old man who had undergone TG reconstruction by a Roux-en-Y method at age 58 years.The patient underwent PD for pancreas head adenocarcinoma.A jejunal limb previously made at the prior TG was used for pancreaticojejunostomy and hepaticojejunostomy.Despite normal patency of the hepaticojejunostomy,he suffered from repeated postoperative cholangitis which was brought on by ALS due to shortness of the jejunal limb(15 cm in length).We therefore performed receliotomy in which the hepaticojejunostomy was disconnected and reconstructed using a new Y limb 40-cm in length constructed in a double Roux-en-Y fashion.The refractory cholangitis resolved immediately after the receliotomy and did not recur.Review of the literature revealed the lack of any current consensus for a standard procedure for reconstruction following PD in patients who had previously undergone TG.This issue warrants further attention,particularly given the expected future increase in the number of PDs in patients with a history of gastric cancer.

Skin Hydrating Effects of <i>Corchorus olitorius</i>Extract in a Mouse Model of Atopic Dermatitis

Background: Corchorus olitorius leaf contains a significant amount of mucilaginous polysaccharide. It has been generally accepted that the polysaccharides derived from botanical extracts increase skin hydration. Since skin hydration improves skin barrier function, it is one of the most effective treatments for atopic dermatitis (AD). However, other components of botanical extracts other than polysaccharides may influence skin hydration and transepidermal water loss (TEWL). The aim of this study was to evaluate the hydration efficacy and skin barrier protection afforded to the skin after exposure to Corchorus olitorius extract without high-molecular-weight compounds (COEW), such as polysaccharides. Methods: NC/Nga mice possess disrupted skin barrier function, and were used as a model for AD. A stable base cream was supplemented with 0.2% COEW and applied to the dorsal skin of these mice. Skin hydration and TEWL were analyzed after a 14-d period of daily application. AD scores and plasma immunoglobulin E (IgE) concentrations were also investigated. Results: Compared to control mice, mice treated with the COEW cream showed significantly increased skin hydration and reduced TEWL. Plasma IgE concentrations were not affected by the COEW cream, whereas an increase in AD score in NC/Nga mice was prevented because of the application of the COEW cream. Conclusions: COEW has the ability to maintain hydration of the skin, and to prevent the disruption of skin barrier function, which leads to the aggravation of AD. COEW may be used as an adjunct treatment for AD.