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Background Dendritic cells (DCs) are potent antigenpresenting cells that are central to the regulation, maturation, and maintenance of the cellular immune response against cancer. In contrast, CD4? CD25 ? regulatory T cells (Tregs) play a central role in self-tolerance and suppress antitumor immunity. In this study, we investigated the clinical significance of mature CD83? DCs and Foxp3 ?Tregs in the primary tumor and regional lymph nodes from the viewpoint of the two opposing players in the immune responses.Methods We investigated, immunohistochemically, the density of CD83 ? DCs and Foxp3 ? Tregs in primary lesions of gastric cancer (n = 123), as well as in regional lymph nodes with (n = 40) or without metastasis (n = 40). Results Decreased density of CD83? DCs and increased density of Foxp3? Tregs were observed in the primary tumor and metastatic lymph nodes. Density was significantly correlated with certain clinicopathological features. Poor prognosis was observed in patients with a low density of CD83? DCs and a high density of Foxp3 ? Tregs in primary lesions. For patients with metastatic lymph nodes, the density of CD83? DCs in negative lymph nodes was found to be an independent prognostic factor by multivariate analysis. Conclusion The density of CD83? DCs and Foxp3 ?Tregs was inversely correlated with tumor progression and reflected the prognosis of gastric cancer.

To develop a rapid and quantitative diagnostic technique for the detection and identification of a wide range of fungi, an improved molecular method based on real-time PCR and the analysis of its products that targets the internal transcribed spacer (ITS) 2 region was established. The real-time PCR could quantitatively and specifically detect the ITS2 region from all 24 tested pathogenic fungal species at between 10 1 and 10 7 copies per test without amplification of bacterial or human DNA. The sequences of the primer-binding sites are conserved in the registered sequences of 34 other pathogenic fungal species, suggesting that the PCR would also detect these species. The hyperpolymorphic nature of the ITS2 region between fungal species in terms of length and nucleotide sequence provided valuable information for the determination of species. By labelling the 59 end of the reverse primer with NED fluorescent dye, the fragment lengths of the real-time PCR products and their 39-terminal fragments, derived using restriction enzyme ScrFI digestion, were easily evaluated by capillary electrophoresis. Using this analysis, the number and species of fungi present in samples could be estimated. Moreover, sequence analysis of the real-time PCR products could accurately determine species in samples containing a single species. This diagnostic technique can estimate a wide range of fungi from various clinical samples within 1 day and accurately identify them in 2 days. Quantitative results for fungal titre in samples can also provide useful information for understanding the progression of disease and the efficacy of antifungal chemotherapy.

BackgroundWe offer the first report of laparoscopic repair of an irreducible femoral hernia containing the fallopian tube alone.Case presentationAn 84-year-old woman presented with a 2-week history of a right groin mass with no abdominal symptoms. The mass was located below the inguinal ligament but showed no redness or tenderness. Abdominal computed tomography demonstrated a 4 × 3-cm cystic mass and enhanced cord-like structure in the right groin area. Hernia contents were considered potentially associated with the appendix, and right femoral hernia incarceration was diagnosed. We performed emergency surgery using a laparoscopic approach, revealing an irreducible femoral hernia containing the right fallopian tube, which was reduced laparoscopically. The reduced fallopian tube showed no ischemic changes, obviating the need for resection. No other abdominal organs such as the ovary, fimbriae of the fallopian tube, or appendix were incarcerated. We repaired the femoral hernia laparoscopically using a transabdominal preperitoneal approach with a mesh.ConclusionsA laparoscopic approach offers ready and accurate confirmation of incarcerated or irreducible organs, rapid recovery, and favorable cosmesis and should therefore be considered for the treatment of incarcerated or irreducible femoral hernia.

Gastric neuroendocrine tumors (GNETs) are rare lesions characterized by enterochromaffin-like cells of the stomach. Optimal management of GNETs has not yet been definitively determined. Endoscopic resection is approximately recommended for small GNETs associated with hypergastrinemia. However, endoscopic resection might present risk of perforation or positive vertical margin because neuroendocrine tumors occur in the deep mucosa, with some invading the submucosa. In this case, a patient with type A chronic atrophic gastritis had a small subepithelial lesion in a deep submucosal layer, and we diagnosed it as GNET using endoscopic ultrasound-guided fine-needle aspiration biopsy using a forward-viewing and curved linear-array echoendoscope. Moreover, our results show that laparoscopic and endoscopic cooperative surgery with regional lymph node dissection is a safe and feasible procedure for GNETs, especially those that cross to the muscularis propria. We suggest this approach as one therapeutic option for GNETs because it safely minimizes resection and is less invasive.