Utility of laparoscopic surgery for pelvic abscesses

骨盤内膿瘍に対する治療は，抗生剤による薬物療法が主体であるが，抗生剤無効例や，消化管から発生した膿瘍との鑑別を要する症例では外科的アプローチが必要となる。骨盤内膿瘍の場合，炎症による癒着が強いことが多く，手術は比較的難易度が高い。しかし，高度の炎症で疲弊した患者の負担を軽減するために，近年では腹腔鏡手術が積極的に導入されており，当院でも可能な限り腹腔鏡手術で対応している。抗生剤による治療が無効であった付属器膿瘍に対して腹腔鏡下手術を施行した4症例について報告する。4例とも輸血を要するような出血はなく，また他臓器損傷もなかった。術後は，速やかに炎症所見が改善し特に問題なく経過した。 骨盤内膿瘍に対する腹腔鏡手術は，ドレナージによりすみやかな炎症軽減が可能であり，かつ低侵襲であることから有用性は高い。一方で，（汎発性腹膜炎などで，）腸管麻痺を伴う症例では，腸管の膨隆のため腹腔鏡下の視野確保が困難であり，腹腔鏡手術の適応は慎重であるべきであると考える。Tubo-ovarian abscesses are classically treated with broad-spectrum antibiotics. Frequently, this approach fails, and surgical intervention becomes necessary. In recent years, laparoscopic surgery was positively introduced, and in our hospital, laparoscopic surgery, which is minimally invasive for patients, is selected as much as possible. We performed laparoscopy for four patients with tubo-ovarian abscess that did not improve with antibiotic treatment. No hemorrhage damage to other internal organs was noted in any of the patients. Inflammation was improved immediately, and postoperative progress was good. Usually, surgery for tubo-ovarian abscess is often technically difficult and associated with complications. For peritonitis accompanied with intestinal tract paralysis, it is difficult to secure the field of vision with the laparoscope, and therefore, the indications for laparoscopic surgery should be carefully considered before conducting the surgery

N-methyl-D-aspartate receptors play important roles in acquisition and expression of the eyeblink conditioned response in glutamate receptor subunit delta2 mutant mice.

Classical eyeblink conditioning has been known to depend critically on the cerebellum. Apparently consistent with this, glutamate receptor subunit delta2 null mutant mice, which have serious morphological and functional deficiencies in the cerebellar cortex, are severely impaired in delay paradigm. However, these mutant mice successfully learn in trace paradigm, even in \u270-trace paradigm,\u27 in which the unconditioned stimulus starts just after the conditioned stimulus terminates. Our previous studies revealed that the hippocampus and the muscarinic acetylcholine receptors play crucial roles in 0-trace paradigm in glutamate receptor subunit delta2 null mutant mice unlike in wild-type mice, suggesting a large contribution of the forebrain to 0-trace conditioning in this type of mutant mice. In the present study, we investigated the role of N-methyl-D-aspartate receptors in 0-trace eyeblink conditioning in glutamate receptor subunit delta2 null mutant mice. Mice were injected intraperitoneally with the noncompetitive N-methyl-d-aspartate receptor antagonist (+)MK-801 (0.1mg/kg) or saline, and conditioned with 350-ms tone conditioned stimulus followed by 100-ms periorbital shock unconditioned stimulus. Glutamate receptor subunit delta2 null mutant mice that received (+)MK-801 injection exhibited a severe impairment in acquisition of the conditioned response, compared with the saline-injected glutamate receptor subunit delta2 null mutant mice. In contrast, wild-type mice were not impaired in acquisition of 0-trace conditioned response by (+)MK-801 injection. After the injection solution was changed from (+)MK-801 to saline, glutamate receptor subunit delta2 null mutant mice showed a rapid and partial recovery of performance of the conditioned response. On the other hand, when the injection solution was changed from saline to (+)MK-801, glutamate receptor subunit delta2 null mutant mice showed a marked impairment in expression of the pre-acquired conditioned response, whereas impairment of the expression was small in wild-type mice. Injection of (+)MK-801 had no significant effects on spontaneous eyeblink frequency or startle eyeblink frequency to the tone conditioned stimulus in either glutamate receptor subunit delta2 null mutant mice or wild-type mice. These results suggest that N-methyl-D-aspartate receptors play critical roles both in acquisition and expression of the conditioned response in 0-trace eyeblink conditioning in glutamate receptor subunit delta2 null mutant mice

Papillary hidradenoma of the vulva : A case report

外陰部に発生する比較的まれなpapillary hidradenoma（乳頭状汗腺腫）の１例について報告する。症例は73歳の女性で小陰唇外側に胡桃大の皮膚腫瘤を認め，腫瘤摘出術を施行した。腫瘤内部には充実分を伴っており，組織学的には乳頭状増殖を示す腺構造で構成され，その腺腔は２層に重層した立方上皮で囲まれていた。上皮細胞の核異型は軽度であり，周囲組織への浸潤も認めず，papillary hidradenomaと診断された。しかし肉眼的所見および組織学的所見より腺癌と誤認される可能性があり，診断には注意が必要である。Papillary hidradenoma is rare, benign, cystic, papillary apocrine gland tumor that occurs almost exclusively in women in the skin of the anogenital region. We report a case of a 73-year-old woman who presented with a progressively enlarging perianal nodule. The nodule appeared as walnut-sized skin tumor on the outside of the labium minus pudendi, and local excision was performed. Macroscopically, the inside portion of the tumor appeared solid. Microscopically, this region consisted of papillary adenomatous structures whose lumina were lined by 2 layers of cuboidal epithelial cells. Nuclear atypia and mitotic figures of these epithelial cells were rare and noninvasive. However, cells with this appearance may be mistaken for adenocarcinoma by both macroscopic and histologic views, and attention is necessary for an accurate diagnosis

Effects of oxytocin in postmenopausal rats

Recent studies have revealed that the administration of oxytocin has beneficial effects on the regulation of body weight, food intake, and metabolic functions, especially in obese individuals. Obesity is common in women after the menopause and drives many components of metabolic syndrome. Weight gain in menopausal women has been frequently reported. Although obesity and associated metabolic disorders are frequently observed in peri- and postmenopausal women, there are few medical interventions for these conditions. In this study, we evaluated the effects of chronic oxytocin administration on appetite, body weight, and fat mass in peri- and postmenopausal female rats. Sixteen naturally premenopausal or menopausal rats were intraperitoneally injected with oxytocin (1,000 μg/day) for 12 days. The daily changes in their body weight and food intake were measured at the same time as the oxytocin and vehicle injections. Intraperitoneally administering oxytocin for 12 days significantly reduced food intake, body weight, and visceral adipocyte size. In addition, oxytocin administration caused reductions in serum triglyceride and low-density lipoprotein-cholesterol levels, while it did not disturb hepatic or renal functions or locomotor activity. This is the first study to show the effects of oxytocin on the metabolic and feeding functions of peri- and postmenopausal female rats. Oxytocin might be a useful treatment for metabolic disorders caused by the menopause or aging

Split luciferase complementation assay to detect regulated protein-protein interactions in rice protoplasts in a large-scale format

© 2014 Fujikawa et al. Background: The rice interactome, in which a network of protein-protein interactions has been elucidated in rice, is a useful resource to identify functional modules of rice signal transduction pathways. Protein-protein interactions occur in cells in two ways, constitutive and regulative. While a yeast-based high-throughput method has been widely used to identify the constitutive interactions, a method to detect the regulated interactions is rarely developed for a large-scale analysis. Results: A split luciferase complementation assay was applied to detect the regulated interactions in rice. A transformation method of rice protoplasts in a 96-well plate was first established for a large-scale analysis. In addition, an antibody that specifically recognizes a carboxyl-terminal fragment of Renilla luciferase was newly developed. A pair of antibodies that recognize amino- and carboxyl- terminal fragments of Renilla luciferase, respectively, was then used to monitor quality and quantity of interacting recombinant-proteins accumulated in the cells. For a proof-of-concept, the method was applied to detect the gibberellin-dependent interaction between GIBBERELLIN INSENSITIVE DWARF1 and SLENDER RICE 1. Conclusions: A method to detect regulated protein-protein interactions was developed towards establishment of the rice interactome

Free fatty acid receptors, G protein-coupled receptor 120 and G protein-coupled receptor 40, are essential for oil-induced gastric inhibitory polypeptide secretion

Aims/Introduction: Incretin hormone glucose‐dependent insulinotropic polypeptide/gastric inhibitory polypeptide (GIP) plays a key role in high‐fat diet‐induced obesity and insulin resistance. GIP is strongly secreted from enteroendocrine K cells by oil ingestion. G protein‐coupled receptor (GPR)120 and GPR40 are two major receptors for long chain fatty acids, and are expressed in enteroendocrine K cells. In the present study, we investigated the effect of the two receptors on oil‐induced GIP secretion using GPR120‐ and GPR40‐double knockout (DKO) mice. Materials and Methods: Global knockout mice of GPR120 and GPR40 were crossbred to generate DKO mice. Oral glucose tolerance test and oral corn oil tolerance test were carried out. For analysis of the number of K cells and gene expression in K cells, DKO mice were crossbred with GIP‐green fluorescent protein knock‐in mice in which visualization and isolation of K cells can be achieved. Results: Double knockout mice showed normal glucose‐induced GIP secretion, but no GIP secretion by oil. We then investigated the number of K cells and gene characteristics in K cells isolated from GIP‐green fluorescent protein knock‐in mice. Deficiency of both receptors did not affect the number of K cells in the small intestine or expression of GIP messenger ribonucleic acid in K cells. Furthermore, there was no significant difference in the expression of the genes associated with lipid absorption or GIP secretion in K cells between wild‐type and DKO mice. Conclusions: Oil‐induced GIP secretion is triggered by the two major fatty acid receptors, GPR120 and GPR40, without changing K‐cell number or K‐cell characteristics

Effect of Music on Emotions and Respiration

In the present study we investigated whether the emotional state induced by music can change respiratory rate (RR), tidal volume (VT), minute ventilation (VE), and end-tidal CO2concentration (ETCO2). In a pioneering study investigating the effect of music on respiration, the music of Stockhausen and Chopin was used. In the present study, we examined the effects of the same musical stimuli used in that study on respiration. Each stimulus (Stockhausen, Chopin, and silence) was delivered for 30 s and each stimulus was presented five times in random order. Subjects reported feeling uncomfortable listening to Stockhausen\u27s music, but comfortable during Chopin\u27s music and silence. The respiratory response during exposure to Stockhausen\u27s music was rapid and shallow breathing, resulting in an increase in RR. Although the RR was decreased during silence and Chopin\u27s music by Chopin compared with that during Stockhausen\u27s music, there was no significant difference in RR in response to Chopin\u27s music and Stockhausen\u27s music. Although subjects reported feeling comfortable while listening to Chopin\u27s music, the decrease in RR was not significant. The lack of a significant decrease in RR in response to Chopin\u27s music may be due to a mixture of various emotions that may be interconnected to physiological responses, and this higher processing may be peculiar to humans

Lymphadenectomy for endometrial cancer

The objective of this study was to identify pathological indicators that could be used to identify a subgroup of patients with apparent stage I endometrial cancer who do require retroperitoneal lymphadenectomy. 188 T1 endometrial cancer patients underwent primary surgery at Tokushima University Hospital. We retrospectively evaluated their clinical records and histopathological factors. Systematic lymphadenectomy was performed for 149 patients, and 39 patients (grade 1 with < 5 mm of myometrial invasion) were treated without lymphadenectomy. Lymph node metastases were found in 19 (12.8%) of the lymphadenectomy cases. Twenty-four patients with a T1a endometrium-limited lesion did not exhibit lymph node metastasis. Three (3.1%) of the 95 patients with a T1a lesion exhibited lymph node metastasis, and these 3 cases exhibited approximately 50% myometrial invasion. The 39 low-risk patients who did not undergo systematic lymphadenectomy remain alive without recurrence. Systematic lymphadenectomy could be omitted for patients with a grade 1 tumor and minor myometrial invasion of less than 5mm

Gene gun-mediated skin transfection with FL gene suppresses the growth of murine fibrosarcoma

Aim : Particle-mediated transfection is known as an efficient method of nonviral gene transfer. Flt3 ligand (FL) is a growth factor for hematopoietic progenitors ; it promotes the growth of dendritic cells (DC). DCs are powerful antigen-presenting cells (APCs) and show a remarkable capacity to stimulate antigen-specific T-cell responses. In this study, we intended to investigate the suppressive effect on tumor growth by gene gun-mediated transfer of FL in a murine model. Methods : C57BL/6J mice were injected intradermally with MCA205 cells. DNA (pNGVL-hFLex)-coated gold particles were delivered to themouse skin surrounding the target tumor. The expression of FL was determined by RT-PCR. Analyses by immunohistochemistry and fluorescence-activated cell sorter (FACS) revealed an increase in the number of DC after treatment with FL. Results : Gene gun-mediated pNGVL-hFLex transfer significantly inhibited the growth of the MCA205 tumor. FL transfer markedly increased the number of CD11c+ DCs in the tumor tissue. Further, the FL-transfected mice exhibited a significantly higher number of CD80+ MHC-II cells. Conclusion : We successfully performed FL therapy using an in vivo gene gun in order to effectively mobilize DCs in situ and induce suppressive immunity