大腿骨頭靭帯の組織学的および分子学的特性に関する研究

The ligamentum capitis femoris (LCF) has increased in clinical significance through the development of hip arthroscopy. The histological pathologies and molecular composition of the femoral attachment of the LCF and the degeneration caused by LCF disruption were investigated in the human hip joint. Twenty-four LCFs were retrieved at surgery for femoral neck fracture (age range: 63–87 years). In the “intact” (i.e., intact throughout its length, n = 12) group, the attachment consisted of rich fibrocartilage. Fibrocartilage cells were present in the midsubstance. In contrast, the construction of the attachment in the “disrupted” (i.e., ligament no longer attached to the femoral head, n = 12) group had disappeared. The attachment in the disrupted group was not labeled for type II collagen or aggrecan, while that in the intact group was labeled for types I, II and III collagen, chondroitin 4-sulfate, chondroitin 6-sulfate, aggrecan, and versican. The percentage of single-stranded DNA-positive chondrocytes was significantly higher in the disrupted group than in the intact group. We conclude that the femoral attachment of the LCF has a characteristic fibrocartilaginous structure that is likely to adjust to the mechanical load, and suggest that its degeneration is advanced by disruption and should be regarded as a clinical pathology.博士（医学）・乙第1353号・平成27年3月16日© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Comparative survey of go/no-go results to identify the inhibitory control ability change of Japanese children

This research, conducted in 1998 and 2008, uses go/no-go data to investigate the fundamentals of cognitive functioning in the inhibitory control ability of Japanese children. 844 subjects from kindergarten to junior high school participated in go/no-go task experiments. Performance of go/no-go tasks, which are frequently used to investigate response inhibition, measures a variety of cognitive components besides response inhibition. With normal brain development, the ability to inhibit responses improves substantially in adolescence. An increase over time in the error rate during the go/no-go tasks of subjects of the same age indicates that these processes are not functioning properly. Comparisons between the 1998 and 2008 data revealed several differences in error rates. In 2008, there were increases in the number of errors in groups from each age range. The comparison also revealed that overall error rates peaked at later ages in the 2008 subjects. Taken together, these results show changing conditions in the inhibitory function of the prefrontal cortex. However, the reason for these changing conditions remains unclear. While a lifestyle questionnaire revealed several differences in factors such as bedtimes and hours spent watching TV, analysis did not reveal a significant correlation.ArticleBioPsychoSocial Medicine.8(1):14(2014)journal articl

Comparison of cortical activation during Mahjong game play in a video game setting and a real-life setting

The purpose of this study was to compare the hemodynamic changes that occur during Mahjong game play in virtual and real-life settings. Fourteen healthy right-handed men (average age ± standard deviation; 36.7 ± 14.9 years) played: 1) a Mahjong solitaire game on a video console against virtual rivals; 2) a Mahjong game against human opponents without conversation; and 3) a Mahjong game against human opponents with conversation. We measured oxygenated hemoglobin concentration at 44 locations over both hemispheres during Mahjong game play in each setting using near-infrared spectroscopy. The increase in oxygenated hemoglobin concentration at several locations, including Broca’s area, the somatosensory cortex, the somatosensory association cortex, the supramarginal gyrus part of Wernicke’s area, the primary and auditory association cortex, the angular gyrus part of Wernicke’s area, and the associative visual cortex was greater during game play in the real-life settings than during game play in the video game setting. There were no significant differences during game play in real-life settings without and with conversation. Each cortical area correlated with broad or specific areas. The common correlation areas were found at Angular gyrus part of Wernicke’s area of left hemisphere during real-life settings without and with conversation, but not during game play in a video game setting. These results suggest that the brain responds differently to game play in real world and virtual world settings, and indicate that comparison of games played in the virtual world and the real world may be an effective model to enhance understanding of the effects of video game on the brain.ArticleBiochemistry & Analytical Biochemistry.4(2):164(2015)journal articl

Sorafenib Prevents Escape from Host Immunity in Liver Cirrhosis Patients with Advanced Hepatocellular Carcinoma

Purpose. It has been reported that Th2 cytokines downregulate antitumor immunity, while activation of type T cells promotes antitumor immunity. The aim of this paper was to evaluate host immunity in liver cirrhosis (LC) patients with advanced hepatocellular carcinoma (aHCC) receiving sorafenib therapy. Methods. Forty-five adult Japanese LC patients received sorafenib for aHCC between 2009 and 2011 at our hospital. Sorafenib was administered at a dose of 200–800 mg/day for 4 weeks. Blood samples were collected before and after treatment. Results. Eleven patients were treated with sorafenib at 200 mg/day (200 group), 27 patients received sorafenib at 400 mg/day (400 group), and 7 patients were given sorafenib at 800 mg/day (800 group). There was no significant change in the percentage of Th1 cells after treatment in any group. However, the percentages of Th2 cells and regulatory T cells were significantly decreased after treatment in the 400 group and 800 group compared with before treatment, although there was no significant change after treatment in the 200 group. Conclusions. These results indicate that treatment with sorafenib might induce Th1 dominance and prevent the escape of tumor cells from the host immune system in LC patients with aHCC

Phase II clinical trial of sorafenib plus interferon-alpha treatment for patients with metastatic renal cell carcinoma in Japan

Comparison of the current study with other sorafenib-interferon combination studies and with single-agent sorafenib studies [25]. (XLSX 12 kb

Carcinoma Arising from Brunner's Gland in the Duodenum after 17 Years of Observation – A Case Report and Literature Review

A 60-year-old man presented with melena and hematemesis in 1984. Esophagogastroduodenoscopy (EGD) detected a small protruding lesion in the duodenal bulb, which was diagnosed as Brunner's adenoma. No significant change was detected in subsequent annual EGD and biopsies for 10 years, after which the patient was not observed for 7 years. The patient presented with melena again in 2001. The lesion had changed shape to become a 10 mm sessile tumor with a central depression, and following a biopsy was diagnosed as an adenocarcinoma. The patient underwent partial resection of the duodenum. Histopathological assessment showed acidophilic cells with swollen nuclei, and clear cells forming a tubular or papillary tubule in the mucosal lamina propria and submucosal layer. The tumor cells stained positive for lysozyme, indicating that they arose from Brunner's gland. The patient showed no sign of recurrence and was disease-free for more than 34 months after surgery. The patient died of pneumonia. This is an extremely rare case of primary duodenal carcinoma arising from Brunner's gland in a patient observed for 17 years

Airway management in a patient with nuchal, interspinous, and flavum ligament rupture by a sickle: a case report

Background: Penetrating neck injury is an important trauma subset but is relatively rare, especially when involving the posterior cervical column. Rupture of the neck restraints, including the interspinous and flavum ligaments, can create serious cervical instability that requires special consideration when managing the airway. However, no detailed information regarding airway management in patients with profound posterior neck muscle laceration and direct cervical ligament disruption by an edged weapon is yet available in the literature. Case presentation: A 63-year-old Japanese man attempted to cut off his head using a sickle after drinking a copious amount of alcohol. On admission, his posterior vertebral column was grossly exposed and the lacerated tissues were actively bleeding, resulting in severe hypovolemic shock. We used a rapid-sequence intubation technique with direct laryngoscopy while manual in-line stabilization of his head and neck was maintained by several people. Surgical exploration revealed nuchal, interspinous, and flavum ligament rupture between his fourth and fifth cervical vertebrae, but no injury to the great vessels was present. The major source of bleeding was a site of oozing from his trapezius and splenius muscles. After surgical hemostasis, wound repair, and subsequent intensive care, our patient was discharged home without any neurological sequelae. Conclusions: Deficits of the neck restraints can cause cervical spine subluxation and dislocation secondary to neck movement. Thus, the key to successful airway management in such a scenario is minimization of neck movement to prevent further neurological impairment. We successfully managed an airway using a conventional but trusted endotracheal intubation strategy in a patient with multiple traumas and a suspected spinal cord injury. This case also illustrates that, even when great vessel injury is absent, severe hypovolemic shock may occur after profound neck muscle laceration, requiring immediate surgical intervention