二分亀頭を伴った陰茎海綿体異物の1例

We had an opportunity to treat a rare case of foreign body in the corpus cavernosum in a patient with cleft glans penis. The foreign body was a 13 cm wire, which was inserted by the patient himself for masturbation, and was removed surgically. To our knowledge, such a case has never been reported in the literature

Simultaneous staining of Ki-67 and chromosome 8 in invasive ductal carcinoma: association with prognosis

Introduction: This study aimed to evaluate an approach that uses simultaneous staining to estimate malignant potential. This approach combines immunofluorescence (IF) staining for Ki-67 expression with fluorescence in situ hybridization (FISH) for copy number aberrations (CNA) of chromosome 8 in breast cancer cells.Methods: In 50 specimens of invasive ductal carcinoma (IDC), we examined a method that simultaneously combined immunostaining (Ki-67) and FISH with a chromosome 8 centromere-specific probe. Breast cancer cells were classified into Group 1, Ki-67 positive and chromosomal aberrant; Group 2, Ki-67 negative and chromosomal aberrant; Group 3, Ki-67 positive and chromosomal wild; Group 4, Ki-67 negative and chromosomal wild.Results: The frequency of Group 1 was significantly associated with nodal metastasis (p<0.05) and patient prognosis (p<0.05); however, it was not associated with age, tumor size, estrogen receptor status, progesterone receptor status, or histological type. Furthermore, Group 1-positive cases showed a significantly worse prognosis, as shown by the Kaplan-Meier method.Conclusions: We successfully stained for Ki-67 expression and CNA of chromosome 8 in breast tumor sections (n=50). This approach indicated that Ki-67-positive cells with aberrant chromosome 8 were associated with malignant potential in IDC

Clinical Significance of Telomerase Activity and Telomere Length in Various Liver Diseases

We investigated the clinical significance of telomerase activity and telomere length in hepatocellular carcinomas (HCCs) and chronic liver diseases. Telomerase activity was assessed quantitatively using \u27Stretch PCR\u27 assay and telomere length by Southern blotting in 24 HCCs, 2 focal nodular hyperplasia, 8 liver cirrhosis, 10 chronic hepatitis and 8 histologically normal livers. The latter were obtained from normal sections of resected specimens of cholangiocellular carcinoma, metastatic liver tumor or hemangioma. The relative titers of telomerase activity (RTA) were significantly higher in HCCs (average, 54 units) than in chronic liver diseases (average, 0.6 units) (P<0.001). In comparison, RTA was less than 2 units in non-malignant liver tissues. Telomere length in cirrhotic liver tissues was significantly shorter than in normal livers and tended to be shorter than those in chronic hepatitis. Telomere length and RTA correlated with the grading of tissue derangement in chronic liver diseases. Our results suggest that RTA estimated by Stretch PCR assay might be clinically useful for accurate diagnosis of liver diseases, particularly HCCs. In addition, telomere length seems to having a possibility as a useful predictor for risk of hepatocarcinogenesis

Underlying Histological Activity of Hepatitis Plays an Important Role for Tumor Recurrence After Curative Resection of Hepatocellular Carcinoma

Background: Hepatocellular carcinoma (HCC) commonly develops in patients with chronic hepatitis. This situation is one of the reasons why intrahepatic recurrence frequently occurs even after curative resection. There are two different components of such recurrences, which occurs within 12 months (the early recurrence group) and at more than 12 months after resection (the late recurrence group). The present study was conducted to clarify the factors contributing to these different types of HCC recurrence. Methods: Ninety seven patients who underwent curative resection for HCCs were followed for initial recurrence, and predictive factors of recurrence were examined. Results: Early and late intrahepatic recurrences developed in 30 and 42 patients, respectively. In the former group, univariate analyses showed the serum AFP level (>100ng/ml, P=0.045), higher inflammatory activity (Grading) (p=0.048) and status of fibrosis (Staging) (p=0.027) in non-cancerous liver tissues to be significant risk factors, while the serum AFP level (>100ng/ml) was the only independent risk factor based on a multivariate analysis (RR: 2.78). In the latter group, only the presence of hyperplastic foci (HPF) was found to be a significant risk factor (p=0.005). Higher Grading tended to be linked to shorter disease-free survival time, although not significant. In the non-cancerous liver tissues with HPF, the level of Grading, Staging, and PCNA labeling index was significantly higher (p=0.033, 0.003, 0.040, respectively).Conclusion: Not only the tumor factors but also the underlying hepatic status including HPF, Grading, and Staging were significant risk factors for intrahepatic recurrence after curative resection for HCC

Results of elective laparoscopic cholecystectomy for acute cholecystitis following percutaneous transhepatic gallbladder drainage

The Tokyo Guidelines 2013 (TG13) provides a simple criteria and management strategy for acute cholecystitis. The optimal interval between performing percutaneous transhepatic gallbladder drainage (PTGBD) and delayed elective laparoscopic cholecystectomey (LC) and the suitable period of PTGBD, is controversial. In this study, we evaluate the operative outcome of elective LC with PTGBD for the management of acute cholecystitis. We analyzed 21 patients who underwent elective LC following PTGBD. The diagnosis and severity grading for acute cholecystitis was based on TG13. All patients showed grade II/III acute cholecystitis by TG13. Median time interval from onset of acute cholecystitis to PTGBD was 1.5 days (range 0-6). In all patients, local inflammation of gallbladder was improved by PTGBD. Median time interval from PTGBD to elective LC was 46 days (range 12-74). Only one patient (5%) showed bile leakage, and median postoperative hospital stay was 5 days (range 4-15). In conclusion, delayed elective LC following emergent PTGBD is a safe and effective treatment strategy for patients withcomplicated acute cholecystitis

Impact of Anatomical Resection for Hepatocellular Carcinoma With Microportal Invasion (vp1): A Multi-institutional Study by the Kyushu Study Group of Liver Surgery

Objective: The aim of the present study was to evaluate the value of anatomical resectionfor HCC with micro-portal vascular invasion (vp1) between 2000 and 2010. Summaryof Background: Vascular invasion has been reported as a prognostic factor of liverresection for hepatocellular carcinoma (HCC). Anatomical resection for HCC has resulted in optimum outcomes of eradicating intrahepatic micrometastases through the portal vein, but opposite results have also been reported. Methods: A clinical chart review was performed for 546 HCC patients with vp1. We retrospectively evaluated the recurrence-free survival (RFS) between anatomical (AR)and non-anatomical resection (NAR). The site of recurrence was also compared between these groups. The influence of AR on the overall survival (OS) and RFS rates was analyzed in patients selected by propensity score matching, and the prognostic factors were identified.Results: A total of 546 patients were enrolled, including 422 in the AR group and 124 in the NAR group. There was no difference in the 5-year OS and RFS rates between the two groups. Local recurrence was significantly more frequent in the NAR group than in the AR group. In a multivariate analysis, hepatitis C (HCV), PIVKAII ?380 mAU/ml, tumor diameter ?5 cm and ?70 years of age were significant predictors of a poor RFS after liverresection. There were no significant differences in the OS or RFS between the AR and NAR groups by a propensity score-matched analysis. Conclusion: Although local recurrence around the resection site was suppressed by AR, AR for HCC with vp1 did not influence the RFS or OS rates after hepatectomy in the modern era

Activity-Guided Fractionation of Green Tea Extract with Antiproliferative Activity against Human Stomach Cancer Cells

Epidemiological studies have suggested that the consumption of green tea provides protection against stomach cancer. Fractionation of green tea extract, guided by antiproliferative activity against human stomach cancer (MK-1) cells, has resulted in the isolation of six active flavan-3-ols, epicatechin (EC), epigallocatechin (EGC), epigallocatechin gallate (EGCg), gallocatechin (GC), epicatechin gallate (ECg), gallocatechin gallate (GCg), together with inactive glycosides of kaempferol and quercetin. Among the six active flavan-3-ols, EGCg and GCg showed the highest activity, EGC, GC, ECg followed next, and the activity of EC was lowest. These data suggest that the presence of the three adjacent hydroxyl groups (pyrogallol or galloyl group) in the molecule would be a key factor for enhancing the activity. Since reactive oxygen species play an important role in cell death induction, radical scavenging activity was evaluated using the DPPH (1,1-diphenyl-2-picrylhydrazyl) radical. The order of scavenging activity was ECg?EGCg?EGC?GC?EC. The compounds having a galloyl moiety showed more potent activity. The contribution of the pyrogallol moiety in the B-ring to the scavenging activity seemed to be less than that of the galloyl moiety

Diverse Effects of FK506 on the Apoptosis of Hepatocytes and Infiltrating Lymphocytes in an Allografted Rat Liver.

BACKGROUND: The current study investigated whether FK506 (FK) regulates the apoptotic systems in allografted rat liver and the contribution of Fas/Fas-ligand system and Bcl-2 family during acute rejection. MATERIALS AND METHODS: The recipients were divided into three groups, the allo, the allo-FK, and the syn group. Rats were euthanized 1, 3, 5, and 7 d after OLT. Apoptotic activity was explored using terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. The expression of Fas/Fas-ligand and Bcl-2/Bax in the grafted livers was investigated by Western blotting and immunohistochemistry. RESULTS: The apoptotic index (AI) of hepatocytes in the allo-FK group was less than that in the allo group. Fas in the allo group was more intense than that in the allo-FK group in the periportal areas on day 1 and 3, while Bcl-2 in the allo group was less intense than that in the allo-FK group in the pericaval areas at all time-points after OLT. CONCLUSION: FK provides beneficial antiapoptotic effects on hepatocytes in the grafted rat livers through both the down-regulation of Fas expression in the periportal areas and the up-regulation of Bcl-2 expression in the pericaval areas