キョウマク チュウヒシュ ノ ソシキ シンダン ニオケル モンダイテン

This minireview discusses diagnostic issues of mesothelioma by immunohistochemical markers．A large number of immunohistochemical markers for distinction between pleural mesothelioma and pulmonary adenocarcinoma has been reported to date．Ordóñez, N.G. described that calretinin, cytokeratin 5/6 and WT-1 are the best positive markers, and carcinoembryonic antigen （CEA）, MOC-31 and Ber-EP 4 are the best negative markers for mesothelioma, and recommended the selection of two positive and two negative markers．We evaluated the significance of calretinin, cytokeratin 5/6, mesothelin，CEA, MOC-31 and new marker D 2-40 in 19 mesotheliomas and 19 lung adenocarcinomas．We concluded that calretinin, cytokeratin 5/6，D 2-40 and CEA are the most stable immunohistochemical markers for diagnosis of mesothelioma

キョウマク チュウヒシュ ノ ソシキ シンダン ニオケル モンダイテン

This minireview discusses diagnostic issues of mesothelioma by immunohistochemical markers．A large number of immunohistochemical markers for distinction between pleural mesothelioma and pulmonary adenocarcinoma has been reported to date．Ordóñez, N.G. described that calretinin, cytokeratin 5/6 and WT-1 are the best positive markers, and carcinoembryonic antigen （CEA）, MOC-31 and Ber-EP 4 are the best negative markers for mesothelioma, and recommended the selection of two positive and two negative markers．We evaluated the significance of calretinin, cytokeratin 5/6, mesothelin，CEA, MOC-31 and new marker D 2-40 in 19 mesotheliomas and 19 lung adenocarcinomas．We concluded that calretinin, cytokeratin 5/6，D 2-40 and CEA are the most stable immunohistochemical markers for diagnosis of mesothelioma

Inhibition of EP2/EP4 signaling abrogates IGF-1R-mediated cancer cell growth : Involvement of protein kinase C-θ activation

Associations between growth factor receptor-mediated cell signaling and cancer cell growth have been previously characterized. Receptors for prostaglandin E2, such as EP2, and EP4, play roles in cancer growth, progression and invasion. Thus, we examined the interactions between EP2/EP4- and IGF-1R-mediated cellular signaling in human pancreatic cancer cells. Selective antagonists against EP2 and EP4 abrogated IGF-1-stimulated cell growth and suppressed MEK/ERK phosphorylation. In subsequent experiments, phospho-antibody arrays indicated increased phosphorylation levels of protein kinase C-θ (PKC-θ) at the Thr538 position following the inhibition of EP2/EP4-mediated signaling. Inhibition of PKC-θ activity impaired cell viability compared with EP2/EP4-antagonized IGF-1-stimulated cells. PKC-θ kinase MAP4K3, which plays a pivotal role in PKC-θ activation, also affected growth signaling in the presence of EP2/EP4 antagonists. Administration of EP2 and EP4 antagonists significantly inhibited the growth of an orthotopic xenograft of IGF-1-secreting pancreatic cancer cells, with increased phospho-PKC-θ and decreased phospho-ERK. Clinico-pathological analyses showed that 17.4% of surgical pancreatic cancer specimens were quadruple-positive for IGF-1R, EP2 (or EP4), MAP4K3, and PKC-θ. These results indicate a novel signaling crosstalk between EP2/EP4 and IGF-1R in cancer cells, and suggest that the MAP4K3-PKC-θ axis is central and could be exploited as a molecular target for cancer therapy

Recurrent TMJ open lock

Patient: This report describes the case of a 51-year-old male patient who initially presented at age 23 with a habitual intermittent open lock (at > 35 mm) in the left temporomandibular joint (TMJ). The patient was able to manage this affliction through rapid-repetition jaw opening and closing. Tomography of the joint showed no irregular morphology, but intraoral examination revealed an occlusal interference at the mandibular left third molar during leftwards excursion. For this patient, alteration of lateral guidance using a palatal plate attached to the maxillary left canine precluded this intermittent open lock, but at 22 years of age, the open lock recurred and could not be relieved by the patient, who was unable to assume an occlusal position. Because conservative treatment was ineffective, a pumping manipulation technique was applied to reduce the open lock, after which the patient has maintained good jaw function. MRI taken before and after repositioning indicated that abrupt reduction of a displaced articular disk was the cause of the open lock, and that this articular disk was restored to its proper position during the manipulation. Discussion: Most TMJ open locks occur as anterior dislocation, where the mandibular head becomes trapped anterior to the articular eminences, causing excessive opening and difficulty closing. Our clinical findings from this patient indicate that open lock can occur through abrupt reduction of a displaced articular disk, particularly in patients with chronic internal derangement of the TMJ. Conclusion: TMJ open lock can occur following abrupt reduction of a displaced articular disk

Profile of Blood Glucose in Diabetic Patient Suffered from Diabetic Foot Osteomyelitis with Effective Low Carbohydrate Diet

The case was 52-year-old female with type 2 diabetes mellitus (T2DM) for 10-years. She complained of the decreased sensation of right lower foot, and revealed diabetic foot infection (DFI) and/or diabetic foot osteomyelitis (DFO) at right 1st proximal phalanx. Various data included body mass index (BMI) 33.3 kg/m2, HbA1c 11.4%, blood glucose 430 mg/dL, WBC 12100 /μL, C-reactive Protein (CRP) 13.5 mg/dL. On admission (day 1), she was started by 4 times of injection (Aspart and Glargin) with glucose profile 200-500 mg/dL. Surgical amputation of the right toe was performed between 1st metatarsal and proximal phalanx (day 17). Then, blood glucose profile decreased moderately. After discharge of the hospital, super-Low Carbohydrate Diet (LCD) was started without Aspart (day 37). Consequently, glucose profile was normalized with HbA1c 6.3% on (day 77). Consequently, LCD was evaluated to be effective for glucose variability in this case and some related discussion was described

Development of monitoring tool by pharmacists

Purpose: Drug side effects often lead to serious outcomes. Administration of second-generation antipsychotics has resulted in diabetic ketoacidosis and diabetic coma leading to death. Therefore, pharmacists are required to collect information on clinical test values, determine the appropriate test timing, and coordinate with doctors for further clinical laboratory orders, all of which are labor- and time-intensive tasks. In this study, we developed a side effect-monitoring tool and aimed to clarify the influence and efficiency of monitoring side effects by using the tool in patients taking atypical antipsychotics in whom it is necessary to check clinical test values such as blood sugar levels. Methods: We extracted clinical test values for patients treated with second-generation antipsychotics from electronic medical records. The test values are automatically displayed in the side effect grade classification specified by CTCAE ver. 4.0. A database was constructed using scripts to provide alerts for the timing of clinical testing. The pharmacist used this tool to confirm clinical test values for patients taking medication and requested the physician to inspect orders based on the appropriate test timings. Results: The management tool reduced the pharmacists’ effort in collecting information on patients’ prescription status and test values. It enabled patients to undergo tests at the appropriate time according to the progression of glucose metabolism and allowed for easy monitoring of side effects. Conclusion: The results suggested that regardless of pharmacists’ experience or skill, the introduction of this tool enables centralization of side-effect monitoring and can contribute to proper drug use

Group Theory of Non-Abelian Vortices

We investigate the structure of the moduli space of multiple BPS non-Abelian vortices in U(N) gauge theory with N fundamental Higgs fields, focusing our attention on the action of the exact global (color-flavor diagonal) SU(N) symmetry on it. The moduli space of a single non-Abelian vortex, CP(N-1), is spanned by a vector in the fundamental representation of the global SU(N) symmetry. The moduli space of winding-number k vortices is instead spanned by vectors in the direct-product representation: they decompose into the sum of irreducible representations each of which is associated with a Young tableau made of k boxes, in a way somewhat similar to the standard group composition rule of SU(N) multiplets. The K\"ahler potential is exactly determined in each moduli subspace, corresponding to an irreducible SU(N) orbit of the highest-weight configuration.Comment: LaTeX 46 pages, 4 figure

スパイラル CT オ モチイタ ガクカンセツ ノ サンジゲン ヒョウカホウ

Three-dimensional (3-D) image reconstructed from Computed Tomography (CT) data is an ef>cient method to evaluate temporomandibular joint (TMJ) morphologically. Even the 3-D image reconstructed from spiral CT data has some distortion, typically along to the table feed direction, very few studies were reported about accuracy of reconstructed 3-D image size. The purpose of this research was to evaluate the distortion on 3-D image reconstructed with spiral CT (Somatom Plas4, Siemens Co, Germany) quantitatively. We used three imaging targets, eight ceramic balls placed at corners of cubic frame, a calibration cube that has the CT value nearly equal to cortex bone of human dried mandibular head. We evaluated relation between a threshold level of CT image processing and reconstructed 3-D image size with a custom-made computer program. CT data of ceramic balls clari>ed changes of the reconstructed image, -0.215mm for table feed direction and less than ±0.006mm for the other directions. The calibration cube was used for the arrangement of optimal scanning condition (reconstruction mode, collimation, reconstitution interval) and evaluation of reconstructed image size. The distortion of the image was +0.207mm for table feed direction and less than +0.029mm for the other directions. Changes of dried skull TMJ image reconstructed with the optimal scanning condition were -1.463mm for lateral direction of the condylar head, -0.956mm for back and forth direction and -0.580mm for table feed direction. Results of this research suggested that the level of the 3-D image distortion was mostly affected with the scanning condition. And the size of 3-D image was susceptible to the threshold level of CT image processing. Consequently, we think that the standardization of scanning condition should be concerned for the quantitative evaluation of 3-D TMJ image using CT data

Daptomycin-related Musculoskeletal Adverse Events and Statin Use

Background. There is a growing concern about the association between the combined use of daptomycin (DAP) and statins and the occurrence of musculoskeletal adverse events (MAEs), but this remains controversial. This study aimed to clarify the association between statin use and DAP-related MAEs. Methods. We used a mixed approach that combines 2 methodologies. First, we conducted a meta-analysis to examine the effects of statin use on DAP-related MAEs. Second, we conducted a disproportionality analysis using the US Food and Drug Administration Adverse Events Reporting System (FAERS) to further confirm the results of the meta-analysis and to examine the effect of each type of statin on DAP-related MAEs in a large population. Results. In the meta-analysis, statin use significantly increased the incidence of DAP-related rhabdomyolysis (odds ratio [OR]: 3.83; 95% confidence interval [CI]: 1.43–10.26) but not DAP-related myopathy (OR: 1.72; 95% CI: .95–3.12). In the disproportionality analysis using the FAERS, the use of statin significantly increased the reporting OR (ROR) for DAP-related myopathy (ROR: 5.69; 95% CI: 4.31–7.51) and rhabdomyolysis (ROR: 5.77; 95% CI: 4.33–7.68). Atorvastatin, rosuvastatin, and simvastatin all increased the incidence of DAP-related myopathy and rhabdomyolysis. Conclusion. The mixed approach combining a meta-analysis and disproportionality analysis showed that statin use was associated with the occurrence of DAP-related rhabdomyolysis. The appropriate use of statins and DAP should be performed with careful consideration of its safety