Laparoscopic cholecystectomy has become the gold standard for the treatment of cholelithiasis, and many reports of single-incision laparoscopic cholecystectomy have been published in the past few years. Situs inversus totalis is a very rare condition, but the variant anatomy should not preclude a minimally invasive approach to surgery. We report a case of successful single-port laparoscopic cholecystectomy in a patient with situs inversus totalis, describe the technical advantages, and review the literature.

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Aims Hepatitis C virus (HCV) infection is monitored by the host innate immunity that includes the endogenous interferon (IFN), which up‐regulates IFN‐stimulated genes (ISGs). HCV is both hepatotropic and lymphotropic, but HCV replication in lymphoid cells is a controversial issue. Here, we analyzed the mRNA levels of the ISGs in B cells of HCV‐infected patients during antiviral therapy and investigated the effects of viral eradication. Methods One hundred and eighty‐one patients with chronic hepatitis C and 26 healthy volunteers were enrolled in this study. Levels of HCV RNA and mRNA of ISGs in B cells isolated from the patients were monitored before, during, and after antiviral therapy. Results HCV RNA was detected in B cells of 133/175 (76.0%) patients who achieved sustained virologic response (SVR) before therapy was started. The positive ratio of HCV RNA in B cells was higher in patients with genotype 1 and the non‐major genotype of interleukin 28B. HCV RNA in B cells of most patients disappeared 1 week after antiviral therapy was started. The baseline expression of ISG mRNA was significantly higher in the patients than in the healthy volunteers. Levels of ISG mRNA were increased and remained high throughout the IFN‐based therapy. In contrast, levels of ISG mRNA in patients who achieved SVR were significantly decreased 1 week after the IFN‐free therapy was started and remained low during the therapy. Conclusions These results suggested that IFN‐free therapy potentially eradicated HCV in the B cells, leading to the down‐regulation of endogenous ISGs. The level of ISG mRNA could be used as a marker for viral eradication in B cells.

This study examined classification of formative feedback (FB) for teachers in the Period for Integrated Studies. Objectives of the Period for Integrated Studies are to enable pupils to have independent thinking about life through cross-synthetic and inquiry studies while fostering qualities and abilities necessary to seek their own tasks, to learn and think independently, to make proactive decisions, and to solve problems better. For this study, we conducted utterance analysis of teacher-student interactions based on two assumptions: 1) types and modes of providing formative FB might differ among teachers with different skills, and 2) a relation might exist between student attitudes toward learning and formative FB. Utterance analyses assessed interactions between teachers and Grade 5 elementary students. We used a self-made rubric to apply quantitative analysis to evaluation data. Results demonstrated that an expertlevel teacher used formative FB of 35 types depending on student attitudes. Expert-level teachers used different formative FB depending on the student's approach type more than competent-level teachers did. However, competent-level teachers used formative FB of similar kinds, irrespective of a student's learning status. An expert teacher uses certain forms of formative FB for problem consciousness in learning to elicit solutions from students, and to improve students' learning quality.

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