Vaginoplasty with a Pudendal-Thigh Flap in Intersexuals

We treated 2 different types of intersexual patients who underwent a vaginoplasty with the pudendal-thigh flap. One was a female with testicular feminization syndrome for whom we reconstructed the total vagina with a pudendal-thigh flap, and the other was a female with an adrenogenital syndrome for whom we enlarged the introitus of the vagina with the same approach. There were no complications such as a flap necrosis. In addition, there was no stricture of the neo-vagina and no urinary problem.</p

Phantom erectile penis after sex reassignment surgery

Between January 2001 and December 2007, we performed vaginoplasty as sex reassignment surgery in a total of 14 male-to-female transsexual (MTFTS) patients [1]. Several complications occurred such as partial flap necrosis, rectovaginal fistula formation and hypersensitivity of the neoclitoris. Just after the operation, some patients feel that their penises still exist, but by several weeks postoperatively, this sensation has disappeared. Herein we report a case of MTFTS in whom the sensation of a phantom erectile penis persisted for much longer.</p

Sweet taste disorder and vascular complications in patients with abnormal glucose tolerance

AbstractBackgroundIt remains unknown whether taste disorders can be a risk factor for micro- and macro-vascular diseases in patients with abnormal glucose tolerance.MethodsA cross-sectional study in a nationally representative samples of 848 and 849 US adults (aged ≥40years) with diabetes or prediabetes who had sweet and salt taste disorders, respectively, from the National Health and Nutrition Examination Survey 2011–2012.ResultsAmong the study population, 5.7% had sweet taste disorder and 8.6% had salt taste disorder. These data correspond to approximately 1.5 million and 1.8 million individuals with abnormal glucose tolerance aged 40years or older in the US population, respectively. In the adjusted model, sweet taste disorder was significantly associated with complication of ischemic heart disease (adjusted odds ratio [OR], 2.45; 95% confidence interval [CI], 1.03–5.81; P=0.04). Moreover, sweet taste disorder in patients with diabetes was significantly associated with diabetic retinopathy (adjusted OR, 2.89; 95% CI, 1.09–7.69; P=0.03) and diabetic nephropathy (adjusted OR, 3.17; 95% CI, 1.07–9.36; P=0.03). Meanwhile, salt taste disorder was not significantly associated with diabetic retinopathy, diabetic nephropathy, ischemic heart disease, or stroke. Total sugar intake was significantly higher in patients with sweet taste disorder than in those without it, whereas total daily intake of carbohydrate did not differ significantly. No significant association was observed between salt taste disorder and daily intake of sodium after multivariate analysis.ConclusionsSweet taste disorder in patients with abnormal glucose tolerance was associated with increased sugar intake and vascular complications

Vaginoplasty with an M-Shaped Perineo- Scrotal Flap in a Male-to-female Transsexual

To date, many techniques have been reported for vaginoplasty in male-to-female trans-sexual (MTFTS) patients, such as the use of a rectum transfer, a penile-scrotal flap and a reversed penile flap. However, none of these procedures is without its disadvantages. We developed a newly kind of flap for vaginoplasty, the M-shaped perineo-scrotal flap (M-shaped flap), using skin from both sides of the scrotum, shorn of hair by preoperative laser treatment. We applied this new type of flap in 7 MTFTS patients between January 2006 and January 2007. None of the flaps developed necrosis, and the patients could engage in sexual activity within 3 months of the operation. The M-shaped flap has numerous advantages: it can be elevated safely while retaining good vascularity, it provides for the construction of a sufficient deep vagina without a skin graft, the size of the flap is not influenced entirely by the length of the penis, and it utilizes skin from both sides of the scrotal area, which is usually excised.</p

筑豊石炭一括販売所について(明治の企業家 杉山徳三郎の研究)

明治14年に目尾坑主杉山徳三郎が蒸気機関による汽力採炭に成功して以来,筑豊炭田の石炭産業は目覚ましい発展を遂げ,明治18年11月には政府・県の要請もあり,筑豊石炭坑業組合が設立された。しかし,筑豊の坑主達がこの組合を設立した目的の一つに当時支配力を強めつつあった石炭問屋から市場の主導権を取り戻す意図があり,そのために彼らは組合の一機関として石炭一括販売所を設け,杉山徳三郎を一括販売人に任命した。この販売所により,彼らは団結して炭価を維持し,坑主間金融により運転資金の確保を図ろうとしたのである。この試みは幕末以来幾度か行われてきた坑主による市場支配への最後で,最大の挑戦であったが,「19年恐慌」と後世に呼ばれた激しい炭価の下落の前に約半年しか命を保つことが出来なかった。この一括販売所については石炭産業の研究者の間で古くから知られていたが,史料の不足からその内部にまで立ち入った研究は現在まで発表されてこなかった。そこで本論では蒐集した文献と,デジタル処理により復元された杉山徳三郎の「明治19年日記」の断片を基に,その内容と機能を調査し,この挑戦が不可避的に失敗に至らざるを得なかった理由を明らかにするよう試みた。結果として,改めて生産者による市場支配の困難さと技術系企業家の限界が見えてくるようである

明治の企業家 杉山徳三郎の研究 : 創成期の大津造船所と兵庫製鉄所について : 徳三郎史料による史談会資料の検証

企業家史を構築するに際して収集する史料は,既に一般的に受け入れられている経済史上,産業史上の概念やその基となる史料の検証に有効である。本小論は琵琶湖の湖上交通と兵庫の兵庫製鉄所(加州製鉄所)の濫觴に関する基礎的史料「後藤報告」(『史談会速記録』)の史料としての信頼性を徳三郎関係史料によって検証したものである。これによってこの二つの産業の創成について,ある程度の史実に沿った再構築が可能となったと信じるが,この作業は同時に明治の企業家杉山徳三郎自身が,長崎製鉄所所属の地役人から文明開化の新しい時代の担い手たる技術者として,独立した歩みを始める最初のステップについて光を当てる作業でもあった。本検証を通して黎明期の産業の成り立ちや維新期を迎えて高いアスピレーションによって動かされた人々の姿に接することが出来る

内輪式蒸気船「先登丸」について : 安政末・文久期徳川幕府の造船政策と関連して(明治の企業家 杉山徳三郎の研究)

幕末文久期に徳川幕府が造った蒸気船「先登丸」は幻の船である。その存在は勝海舟『海軍歴史』中の表「船譜」などごく少数の史料によって一部の研究者には知られていたが,この船の概要,建造の状況など一切が不明であり,従ってこの船を正面から取り上げた研究は現在までのところ発表されていない。ところで明治の企業家杉山徳三郎に関する伝記的史料『商海英傑伝』はこの船に触れて,「文久三年汽船先登丸始て君の手に成る,是を我邦汽船製造の嚆矢とす。奉行駿河守之を江戸に致して幕府に献ず。君自ら之が汽鑵師となりて以て航海の途に就く」,と短く記しており,日本の造船史上においてこの船が無視できない研究対象である可能性を暗示している。従って,この企業家の歴史を通して,幕末・明治の所謂我が国産業の黎明期について研究している筆者にとっては,この先登丸は避けて通れないテーマの1つとなっている。本小論はこの『商海英傑伝』を基礎に,これに新たに収集した史料を加えて可能な限りこの蒸気船の姿を再現し,それを手掛かりとしてこの船の建造の由来や背景を探ることを試みたものである。その結果この船は,安政期にわが国にもたらされた2つの造船技術,即ち豆州戸田においてロシヤ人から学んだ船体建造技術と,長崎において和蘭人から伝習した蒸気機関の製造技術が,文久期に接合されて誕生した君沢形内輪式蒸気船であり,その出現の背景には幕末の緊張した政治情勢の中で,揺らぎつつ実行された幕府の造船政策が存在したと見られることが明らかとなった。約2年半と極めて短い船齢で姿を消したこの船は,それでも幕府の蒸気船第1号であったし,後の軍艦千代田形を軽て明治期以降主流となる近代的スクリュー式蒸気船につながる流れの先駆け(船登)ともみなさるべき船であった

A Case of Pulmonary Sarcoma with Significant Extension into the Right Lung

A female patient in her 30s was referred to us with a mass approximately 8 centimeters in diameter in right lung segment 6. Bronchoscopy was done, and a tumorous lesion obstructing right B6 was found. Biopsy of this lesion supported suspicions of sarcoma or spindle cell carcinoma. Contrast-enhanced CT showed that the mass extended to and obstructed the right main pulmonary artery. A skip lesion was also suspected in the periphery of pulmonary artery trunk. The tumor was removed by right pneumonectomy accompanied by resection of the main and left pulmonary arteries under cardiopulmonary bypass. The pulmonary artery trunk and the left pulmonary artery were reconstructed with a vascular graft. Collectively, intimal sarcoma originating from the right main pulmonary artery with extension into the right lung was diagnosed. Significant extension of pulmonary artery sarcoma into the lung, as was observed in the present case, is considered to be rare, and to our knowledge this is the first report in which the primary lesion was biopsied by bronchoscopy

KaPPA-View4: a metabolic pathway database for representation and analysis of correlation networks of gene co-expression and metabolite co-accumulation and omics data

Correlations of gene-to-gene co-expression and metabolite-to-metabolite co-accumulation calculated from large amounts of transcriptome and metabolome data are useful for uncovering unknown functions of genes, functional diversities of gene family members and regulatory mechanisms of metabolic pathway flows. Many databases and tools are available to interpret quantitative transcriptome and metabolome data, but there are only limited ones that connect correlation data to biological knowledge and can be utilized to find biological significance of it. We report here a new metabolic pathway database, KaPPA-View4 (http://kpv.kazusa.or.jp/kpv4/), which is able to overlay gene-to-gene and/or metabolite-to-metabolite relationships as curves on a metabolic pathway map, or on a combination of up to four maps. This representation would help to discover, for example, novel functions of a transcription factor that regulates genes on a metabolic pathway. Pathway maps of the Kyoto Encyclopedia of Genes and Genomes (KEGG) and maps generated from their gene classifications are available at KaPPA-View4 KEGG version (http://kpv.kazusa.or.jp/kpv4-kegg/). At present, gene co-expression data from the databases ATTED-II, COXPRESdb, CoP and MiBASE for human, mouse, rat, Arabidopsis, rice, tomato and other plants are available