"In vivo cryotechnique" for paradigm shift to "living morphology" of animal organs

The morphological study has been one of the major approaches in medical and biological fields. For the last century, the conventional chemical fixation and alcohol dehydration were commonly used as an easy preparation method, but it was frequently pointed out that they usually yield many structural artifacts during their preparation processes. Although both conventional quick-freezing and high-pressure freezing methods, by which animal tissues are resected and frozen for physical fixation,can reduce such structural artifacts, the tissues have to be removed from living animal organs for the freezing. Therefore, such specimens are inevitably exposed to noxious stresses of anoxia and ischemia, exhibiting only dead morphological states of animal tissues without blood circulation. To the contrary, our "in vivo cryotechnique", by which all cells and tissues in animal bodies are cryofixed in vivo, can prevent such artifacts of resected specimens. By means of the cryotechnique, it is now possible to reveal the in vivo morphology of cells and tissues in living animal organs. Actually, it has been already applied to several animal organs, such as kidney, liver, intestine, cerebellum, eye ball, blood vessel, and joint cartilage, and brought new morphological findings, reflecting their physiological significance, which had been difficult to demonstrate by the conventional preparation methods. Moreover, its application to immunohistochemistry has also revealed more precise immunolocalizations of dynamically changing molecules in living animal organs, easily translocated by ischemic stresses and anoxia caused during the tissue resection. The "in vivo cryotechnique" allows us to perform novel morphological investigations of "living" morphological states, and develops new medical and biological fields with "living morphology" during this 21st century.Biomedical Reviews 2004; 15: 1-19

Volatilization of alkali metals from the heated Murchison (CM2) meteorite

In order to examine volatilization processes of alkali metals at high temperature, heating experiments were carried out using a starting material prepared from Murchison (CM2) (grain-size : ∿10μm) at temperatures of 1200-1400℃ under a constant pressure of 8×10^ Torr, and heating duration up to 80min. Analyses of alkalis (Na, K, Rb), major and minor elements and petrographic examinations were performed for run products. Results show that fractional volatilization of alkali metals occurred during heating. It is suggested that the volatilization rates of alkali metals are influenced by the chemical composition of partial melt

LL55: Selective Early Lymphoid Expression of a Murine cDNA Clone Which Encodes a Putative RNA-Binding Protein

Specific expression of various RNA-binding protein (RNP) molecules is one of the critical factors that determine the development in Drosophila melanogaster and Caenorhabditis elegans. In the present study, we found a complementary DNA clone, LL55 encoding a putative RNP. Structural comparison of nucleotide and amino acid sequences demonstrate that LL55 encoding a nuclear protein with two RNA-binding consensus motifs and the common arginine-serine repeats, is similar to the sex-determining transformer-2 (tra-2) gene of Drosophila melanogaster. The expression of 2.3 kilobase (kb) and 1.5 kb LL55 messenger RNA (mRNA) is ubiquitous in murine organs and tissues, but it is selective in the early development of fetal life. It appears as early as day 10.5 and increases until day 15 of gestation in accordance with the expression of λ5 mRNA which is involved in murine pre-B cell generation. Taking account of the selective expression and the specific regulation of RNP molecules, the finding of LL55 RNP provides a new outlook for the generation and function of the immune system

<原著>副腎腫瘤の臨床的検討

We reviewed the records of 13 patients with adrenal masses operated on over a ten-year period to clarify clinical characteristics of adrenal tumors. Tumors were found incidentally in seven of nine patients with primary adrenal tumors (78%); however, three of these seven patients (43%) proved to have shown symptoms related to adrenal hyperfunction when re-e、raluated. Other adrenal tumors (metastatic in three patients and inflammatory in one) were found without any symptoms referable to the tumors. In nine of 13 patients (69%), tumors were discovered by computerized tomography (CT). All patients with primary tumors have been gotten free of disease postoperatively. In contrast, although all three patients with metastatic adrenal tumors underwent resection of all known disease tissue, they died of the recurrence of malignancies within 10 months. This study suggests that a number of functional adrenal tumors are possibly left undiagnosed until found incidentally, and that CT is the most powerful tool to detect adrenal tumors. Our data did not support surgical intervention in cases of metastatic adrenal tumors.副腎腫瘤の臨床的特徴を明らかにするために過去10年間に当科で手術された13例を検討した. 原発性腫瘍9例中2例は臨床症状より原発性アルドステロン症を疑われ副腎腫瘍を発見されているが, 残りの7例(78%)は偶然腫瘍が発見された, いわゆる incidentaloma であった. しかしながら, retrospective にみるとこの7例中3例(43%)で副腎機能亢進によると考えられる症状を呈していた. 転移性腫瘍3例, histoplasma による肉芽腫1例は全て無症状であった. 13例中9例(69%)はCTにより, 2例は超音波, 1例は血管造影, 1例は scintigraphy によりそれぞれ病変を発見され, CT で副腎腫瘤を指摘できなかったのは1例のみであった. 13例中11例は経腹的に, 2例 は開胸開腹で手術されたが, 術後合併症は1例に創感染を認めたのみであった. 原発性腫瘍例は全例術後再発を認めていないが, 転移性腫瘍の3例は全例, 術後10ヶ月以内に再発死した. 以上の結果は機能性副腎腫瘍でも偶然発見されるまで診断されない場合が多いことを示唆しており, 臨床症状を注意深く検討し常に副腎腫瘍の可能性を考慮にいれることが肝要であると考えられる. また, 今回の結果より CT が副腎腫瘤の診断において重要な位置を占めるものと考えられた. なお, 転移性副腎腫瘍に対する手術療法は今回の検討ではそれを積極的に支持する結果は得られず, 今後さらに検討を要する問題と思われる

Predicting Blood Flow from the Superior Mesenteric Artery to the Celiac Arterial Region on CT Angiography in Patients with Median Arcuate Ligament Syndrome

Purpose: This study aimed to assess whether computed tomography (CT) findings can be used to predict blood flow from the superior mesenteric artery (SMA) to the celiac artery (CA) region in patients with median arcuate ligament syndrome (MALS). Materials and methods: Two radiologists who reviewed 1,290 conventional SMA angiograms and CT scans identified 36 patients with MALS. MALS was classified by their blood flow angiography findings as type A (CA region not or barely visualized) and type B (CA region clearly visualized). The association between patient age, sex, post-stenotic dilatation ratio of the celiac axis, maximum diameter of the pancreaticoduodenal arcade (PDA), and MALS classification based on SMA angiography was assessed. Results: Of 36 MALS patients, 17 had MALS type A and 19 had MALS type B. The mean of the maximum diameter of the PDA in MALS type A was 1.6 ± 0.9 mm (SD) and 4.3 ± 1.3 mm in MALS type B. The poststenotic dilatation ratio of the celiac axis was 2.4 ± 1.2 in MALS type A and 2.2 ± 1.4 in MALS type B. Only maximum diameter of the PDA was a predictor of MALS type B (odds ratio, 15.7; 95% confidence interval, 2.3–108.1). Conclusion: The maximum diameter of the PDA on CT angiography can be used to predict the blood flow from the SMA to the CA region in patients with MALS

<症例>胃癌手術 (脾摘術合併胃全摘術) 後の門脈血栓症の1例

A 48-year-old woman underwent total gastrectomy, splenectomy, and distal pancreatectomy with en bloc regional lymph node dissection for gastric carcinoma. Dull pain in the right upper quadrant and the back developed postoperatively. Contrast-enhanced computed tomography and ultrasonography disclosed portal vein thrombosis (PVT). Heparin and urokinase were given in conjunction with antbiotics. This treatment resulted in clinical improvement, but failed to achieve complete thrombolysis. Cavernous transformation of the portal system was confirmed. Although PVT after splenectomy has been reported mainly in patients with hematological disorders, our case suggests that splenectomy for en bloc node dissection in gastric carcinoma is a possible cause of PVT.門脈血栓症は肝硬変や肝癌の患者で時に認められる病態であるが, 術後の門脈血栓症は稀であり, そのほとんどが脾腫に対する脾摘術後に発生している. 我々は胃癌根治術に伴う脾摘術後に門脈血栓をきたした症例を経験したので報告する. 症例は48才の女性で, 胃体上部後壁を中心とする5型胃癌に対し, 胃全摘術, 脾摘術, 膵尾側切除術を行なった. 病変は組織学的には低分化腺癌, 深達度ss, No, Po, Ho の stage I b で, 摘出した脾重量は 150g であった. なお, 術前の出血凝固系検査には異常を認めなかった. 術後18日目より右上腹部から背部の鈍痛が出現し, 白血球数, CRP, 血清アルカリフォスファターゼ値も上昇してきた. 術後19日目の造影CTで, 門脈, 上腸間膜静脈がほとんど造影されず, 門脈から上腸間膜静脈におよぶ血栓形成が考えられた. 抗生剤の投与とともにただちにへパリンの持続静注とウロキナーゼ投与を併用したところ, 臨床症状や検査所見は軽快した. ただし, 血栓は完全に消失せず, その後の腹部血管造影では側副血行路としての肝十二指腸間膜内の静脈拡張, いわゆるcavernous transformation が認められた. へパリン, ウロキナーゼの投与からワーファリン内服に切り替え, 患者は術後66日目に退院した. 現在, 術後2年経過したが, 食道静脈瘤の出現や消化管出血などの門脈血栓, 門脈圧充亢進に起因すると思われる症状は認めていない. 我々の症例は, 進行胃癌根治術の際にしばしは合わせ行われる脾摘術後にも門脈血栓症の出現する可能性があることを示唆しており, そのような手術を受けた患者が術後原因不明の腹部症状や白血球増加を来たした時には門脈血栓症も疑い精査を進める必要があると考えられる

日本におけるアスレティックトレーナー界の発展に関する提案 : 特に資格認定団体と業界団体の区別を意識して

The purpose of this paper is to suggest how to develop an athletic trainer\u27s society in Japan. This paper is mainly considered the difference an association that qualify as an athletic trainer and a trade association. Especially, we propose following four point, "increase members", "build a trade association of Athletic trainer", "realize blush-up education", " make a system which profits by stakeholders". Moreover, we propose the evaluation index that can find how develop an athletic trainers society in Japan