Habu snake venom (HSV) contains many matrix metalloproteinases and exhibits proteolytic activity against intestinal villi. In the present study, we examined whether bone marrow-derived cells (BMCs) could contribute to intestinal villous regeneration in a mouse model of HSV-induced intestinal injury. Intravenous administration of 2.1 mg/kg of HSV into C57BL/6 mice resulted in diffuse villus shedding with hemorrhage within 24 hours but the mice recovered completely by 14 days. To examine the role of BMCs in intestinal villous regeneration, bone marrow cells from GFP transgenic mice were transplanted into lethally irradiated C57BL/6 mice, after which intestinal injury was induced by HSV injection. Intestinal tissues were analyzed by immunohistochemistry for GFP and CD45 at days 3, 7 and 14 after HSV administration. The number of GFP-positive cells in the villous epithelia was increased significantly in mice treated with HSV compared with control mice at days 3 and 7. Most of the GFP-positive cells in the villous epithelia exhibited a spherical shape and expressed CD45, indicating that they were bone marrow-derived lymphocytes. The other GFP-positive cells in the villous epithelia exhibited a columnar shape and were CD45-negative, suggesting that they were bone marrow-derived epithelial cells. The proportion of GFP-positive CD45-negative cells in the villous epithelia was also increased at days 3 and 7, although the proportion was less than 1% in the regenerated epithelial cells. These results suggest that bone marrow-derived cells may contribute to epithelial regeneration after intestinal villous injury.
We determined the usefulness of evaluating nutrition at admission using the Mini-Nutritional Assessment-Short Form (MNA-SF), with the number of days spent in the hospital as a measure. The subjects were 236 patients aged 65 or older who were hospitalized in any department (excluding the Pediatric Department) of the Nihon University Nerima Hikarigaoka Hospital in May 2010 (31 days). Nutritional evaluation was performed both with the conventional assessment method (BMI, serum albumin [Alb], total cholesterol [TC], cholinesterase [ChE], and lymphocyte count) and the MNA-SF. The impact on the number of days spent in the hospital 14 (i.e., 14 days or more) was compared, and the relationships between values obtained by the MNA-SF and the evaluation items of the conventional assessment method were determined. Risk factors for the amount of time spent in the hospital being 14 days or longer were selected from the evaluation items of the MNA-SF. The possibility that the number of days spent in the hospital would be 14 or more was evaluated with the MNA-SF, as well as using the conventional assessment method. The evaluation items of the conventional assessment method were correlated with the values obtained using the MNA-SF. The most influential evaluation item of the MNA-SF on the number of days spent in the hospital was the walking status. The MNA-SF is useful for evaluating nutrition at admission using the number of days spent in the hospital as a measure, and it was suggested that the walking status at admission may influence the number of days spent in the hospital.
We report a case of giant incarcerated umbilical hernia with strangulation and necrosis of two loops of the small intestine. A 63-year-old woman was admitted to our hospital because of swelling and pain of the umbilical region. We diagnosed her with strangulated umbilical hernia, necrosis, perforation and diffuse peritonitis, and performed emergency surgery. We extirpated 150 centimeters of the small intestine and ileocecum that exhibited hemostasis and necrosis. Umbilical hernia is a rare hernia that can occur often in middle-aged-woman. This is a very rare case of strangulated multiple hernias. In cases of strangulated hernia that exist with chronic hernia it is easy to develop multiple impactions.
Cardiac surgery in nonagenarians has been rarely reported in Japan. According to international reports, post-surgical mortality or complications are comparatively high in this age group. In this paper, we report a successful case of aortic valve replacement in a 90-year-old man with severe aortic valve stenosis.
We report case of a patient who was diagnosed with congenital biliary dilatation (CBD) due to acute pancreatitis. An 8-year-old-girl was referred to our hospital for acute onset of upper abdominal pain. Acute pancreatitis was suggested due to her laboratory data, and CBD was also suggested by abdominal ultrasonography and abdominal computed tomography. Her symptoms improved markedly after several days of starving, intravenous fluid infusion, antibiotics and infusion of a protease inhibitor. We subsequently initiated administration of enteral nutrition via a nasojejunal feeding tube to reduce the recurrence of pancreatitis. Radical CBD operation was performed successfully 3 weeks later. Her postoperative course was uneventful. We conclude that it is essential to prevent the recurrence of acute pancreatitis in cases of CBD and to perform surgery as soon as possible.