Perforated appendiceal diverticulitis associated with appendiceal neurofibroma in neurofibromatosis type 1

An appendiceal neurofibroma(ANF) is a rare neoplasm associated with neurofibromatosis type 1(NF-1),an inheritable neurocutaneous disorder that involves multiple systems including the intraabdominal organs.Appendiceal diverticulitis occasionally ruptures in the absence of intense abdominal pain,which can lead to serious consequences.Recent reports highlight the association between appendiceal diverticulum and appendiceal neoplasms; however,there is still little information on the association between appendiceal diverticulitis and ANF in NF-1.A 51-year-old Japanese male with NF-1 was referred to the division of surgery for mild right lower quadrant pain.It was suspected he had perforated acute appendicitis with periappendiceal abscess based on clinical manifestations and findings of computed tomography.An emergency appendectomy was conducted.The pathological examination revealed diffusely proliferated tumor cells of a neurofibroma,coexistent with multiple appendiceal diverticulums,leading to the diagnosis ofperforated appendiceal diverticulitis associated with ANF.Although he developed a remnant abscess,he recovered with the conservative treatments of antibiotics and drainage.This case suggests that appendiceal diverticulitis might be a complication of appendiceal involvement of NF-1,and that it occasionally ruptures in the absence of intense abdominal pain.Clinicians should recognize that NF-1 can cause various abdominal manifestations.

Endoscopic diagnosis of cytomegalovirus gastritis after allogeneic hematopoietic stem cell transplantation

AIM:To clarify the endoscopic and clinical findings of cytomegalovirus(CMV) gastritis after allogeneic hematopoietic stem cell transplantation(allo-SCT).METHODS:Between 1999 and 2005,523 patients underwent allo-SCT at our hospital,and 115 of these patients with gastrointestinal symptoms underwent esophagogastroduodenoscopy.RESULTS:CMV gastritis was diagnosed pathologically in seven patients(1.3%) with the other 108 patients serving as controls.Six of the seven patients developed positive CMV antigenemia,and five complained of abdominal pain.Development of abdominal pain preceded CMV antigenemia in four of the f ive patients.Endoscopic examination showed oozing(n=2),erosion(n=6),and redness(n=5) in the seven patients with CMV gastritis,while the control patients showed oozing(n=3),erosion(n=24),and redness(n=100).Erosion and oozing were more frequently documented in patients with CMV gastritis compared with the controls,and the differences were statistically significant(P=0.0012 and 0.029,respectively).CMV inclusion bodies were documented in 12 of 14 biopsy specimens obtained from erosive lesions,while they were identif ied in 4 of 15 biopsy specimens obtained from lesions other than erosions(P=0.0025).CONCLUSION:This study suggests that erosion and oozing,as well as abdominal pain,are useful indicators in the diagnosis of CMV gastritis following allo-SCT.

How Do Weekly Magazines Provide Information on Urogenital Cancer to the Public in Aged Societies?

Little information on cancer coverage rather than newspaper and television is available. Japanese weekly magazines have a circulation of over 2,700,000 per week. To examine how they delivered urogenital cancer information to the public, cancer-related articles and advertisements in six major Japanese weekly magazines from 2009 to 2010 was analyzed. 1.8% of total articles and advertisements were cancer-related. Prostate cancer (n = 119) was the second-most common topic, following lung cancer (n = 145), whereas only three articles were published on kidney or bladder cancer. The 53 articles on therapies for prostate cancer comprised radiotherapy (n = 29), surgery (n = 16), chemotherapy (n = 4), and others (n = 4). All 42 comments or interviews were cited in the article on prostate cancer, while 26 of them were attributed to only two famous doctors. Although cancer coverage in weekly magazines could be useful to spread information on prostate cancer, we should recognize their considerable bias based on a disproportionate emphasis.

Allergic reaction to anisakis-contaminated fish after the first administration of BNT162b2 mRNA vaccine:a case report

Introduction SARS-CoV-2 vaccination is an effective means to prevent severe illness and death due to SARS-CoV-2 infection[1].Vaccine safety has been carefully monitored to be sure that the benefit outweighs the risk of adverse events(AEs).Common AEs of the BNT162b2 mRNA vaccine,for example,include fatigue(45%),headache(40%),and chills(28%)after the first administration in accordance with the adult phase Ⅲ clinical trial[1].