A primary aorto-duodenal fistula associated with an inflammatory abdominal aortic aneurysm: a case report.

Primary aorto-enteric fistula (PAEF)is a serious complication of abdominal aortic aneurysm(AAA). We report a patient with PAEF associated with inflammatory AAA who underwent emergent surgery. A 52-year-old male presented with recurrent hematemesis. A computer tomography scan showed a sealed rupture of the AAA adjacent to the duodenum. At surgery, a coin-sized PAEF was noted. The aorta was replaced with a Dacron graft in situ . Histological examination revealed the characteristics of an inflammatory AAA. The postoperative course was uneventful, and there has been no evidence of infection during a follow-up period of 3 years. We discuss the etiologic and surgical considerations regarding this unusual entity.</p

Lap-Protector and Circular Stapler Are Useful in Cystogastrostomy for Large Pancreatic Pseudocyst with Severe Infection

Lap-Protector, which is an abdominal wall sealing device, is usually used for wound protection from implantation of malignant cells or pyogenic fluid. A circular stapler is a common easy-to-use device for anastomosis of the digestive tract. We report the case of an infected pancreatic pseudocyst which was treated by surgical procedure using these useful devices. A 69-year-old man was followed up in our hospital after severe acute pancreatitis. He had undergone drainage surgeries twice for intractable pancreatic abscess followed by severe acute pancreatitis. He was admitted to our hospital complaining of loss of appetite, hiccups, and high fever. Computed tomography of the abdomen revealed an infected pancreatic pseudocyst which compressed the gastric wall. Internal drainage into the stomach was performed using Lap-Protector and circular stapler. The patient recovered uneventfully. Recently many endoscopic or laparoscopic procedures in cystogastrostomy are reported; however, a conventional open surgical approach is also important. This easy method may be useful for operative cystogastrostomy

C. elegans PlexinA PLX-1 mediates a cell contact-dependent stop signal in vulval precursor cells

AbstractPLX-1 is a PlexinA transmembrane protein in Caenorhabditis elegans, and the transmembrane-type semaphorin, SMP-1, is a ligand for PLX-1. The SMP-1/PLX-1 system has been shown to be necessary for proper epidermal morphogenesis in the male tail and seam cells. Here, we show that the SMP-1/PLX-1 system also regulates vulval morphogenesis. In plx-1 and smp-1 mutants, hermaphrodites sometimes exhibit a protruding vulva or multiple vulva-like protrusions. Throughout the vulval development of plx-1 and smp-1 mutants, the arrangement of vulval cells is often disrupted. In the initial step of vulval morphogenesis, vulval precursor cells (VPCs) are generated normally but are subsequently arranged abnormally in mutants. Continuous observation revealed that plx-1 VPC fails to terminate longitudinal extension after making contact with neighbor VPCs. The arrangement defects of VPCs in plx-1 and smp-1 mutants are rescued by expressing the respective cDNA in VPCs. plx-1::egfp and smp-1::egfp transgenes are both expressed in all vulval cells, including VPCs, throughout vulval development. We propose that the SMP-1/PLX-1 system is responsible for a cell contact-mediated stop signal for VPC extension. Analyses using cell fate-specific markers showed that the arrangement defects of VPCs also affect cell fate specification and cell lineages, but in a relatively small fraction of plx-1 mutants

The binding specificity of Translocated in LipoSarcoma/FUsed in Sarcoma with lncRNA transcribed from the promoter region of cyclin D1

Background: Translocated in LipoSarcoma (TLS, also known as FUsed in Sarcoma) is an RNA/DNA binding protein whose mutation cause amyotrophic lateral sclerosis. In previous study, we demonstrated that TLS binds to long noncoding RNA, promoter-associated ncRNA-D (pncRNA-D), transcribed from the 5' upstream region of cyclin D1 (CCND1), and inhibits the expression of CCND1. Results: In order to elucidate the binding specificity between TLS and pncRNA-D, we divided pncRNA-D into seven fragments and examined the binding with full-length TLS, TLS-RGG2-zinc finger-RGG3, and TLS-RGG3 by RNA pull down assay. As a result, TLS was able to bind to all the seven fragments, but the fragments containing reported recognition motifs (GGUG and GGU) tend to bind more solidly. The full-length TLS and TLS-RGG2-zinc finger-RGG3 showed a similar interaction with pncRNA-D, but the binding specificity of TLS-RGG3 was lower compared to the full-length TLS and TLS-RGG2-zinc finger-RGG3. Mutation in GGUG and GGU motifs dramatically decreased the binding, and unexpectedly, we could only detect weak interaction with the RNA sequence with stem loop structure. Conclusion: The binding of TLS and pncRNA-D was affected by the presence of GGUG and GGU sequences, and the C terminal domains of TLS function in the interaction with pncRNA-D

Involvement of Propionibacterium acnes in the Augmentation of Lipogenesis in Hamster Sebaceous Glands In Vivo and In Vitro

Propionibacterium acnes is considered to be involved in the aggravation of acne vulgaris, but it remains unclear whether P. acnes directly influences lipogenesis in sebaceous glands. In this study, we showed that a culture medium of P. acnes (acnes-CM) and formalin-killed P. acnes (F-acnes) prepared from P. acnes strains, JCM6473 and JCM6425, intracellularly augmented lipid droplet formation and triacylglycerol (TG) synthesis in undifferentiated and insulin-differentiated hamster sebocytes. Acnes-CM and F-acnes prepared from four clinical P. acnes strains elicited the same lipogenesis augmentation. The augmented TG production resulted from an increase in the diacylglycerol acyltransferase activity. Topical application of acnes-CM to the skin of hamster auricles every day for 4 weeks revealed that sebum accumulation was augmented in sebaceous glands and ducts. Furthermore, both acnes-CM and F-acnes increased the production of 15-deoxy-Δ12,14-prostaglandin J2 (15d-PGJ2), a cytochrome P450 (CYP)-linked sebaceous lipogenic factor, in differentiated sebocytes. A CYP inhibitor, SKF-525A, decreased the acnes-CM- and F-acnes-augmented production of TG and 15d-PGJ2. Thus, to our knowledge these results provide previously unreported evidence that P. acnes directly participates in the augmentation of sebaceous lipogenesis through a proposed mechanism in which an increase of 15d-PGJ2 production through the CYP pathway is closely associated with the enhancement of TG production

Comparison of V̇O2 for buoyancy and propulsion during swimming between male and female

体脂肪は人体の水中体重を小さくするから, 水泳には体脂肪の多いことが有利な条件となる可能性がある。本研究は水泳の際に浮くために使われるV̇O2と推進のために使われるV̇O2を測定し, 水中体重の大小が実際の水泳にどれほどの影響を与えているかという点について検討したものである。 男女各3名, 計6名の泳者に, 泳速が0.6, 0.8及び1.0m/secのクロール泳を行わせ, V̇O2を測定した。その際腰に錘をつけて水中体重を増加させ, あるいは滑車を介した錘で腰を引き上げるようにして水中体重を減少させ, 各水中体重において上記の測定を行った。V̇O2値を水中体重に対してプロットすることによって得られる回帰直線の勾配から浮くためのV̇O2を, またY切片から安静時V̇O2を差し引くことによって推進のためのV̇O2を求めた。 1 浮くために必要なV̇O2は泳速とは無関係であり, その平均値は男子の方(352±140ml/min)が女子のそれ(186±83ml/min)より有意に大であった。この差は水中体重に大きく依存していて, 単位水中体重当りに換算すると男女の値は接近した(男子: 117±46ml/min, 女子: 91±36ml/min)。 2 推進のために用いられるV̇O2は, 泳速の増加に伴って指数関数的に増大した。その増加率は男子よりも女子の方が大であったが, それは女子の水泳能力が男子のそれより劣ることに関連していると考えられる。 3 総V̇O2に対する推進のためのV̇O2の割合は, 男子よりも女子において大きく, この点女子の水中体重の小さいことは水泳において有利な条件になっている。男子の世界記録に対する女子のそれの比率は, 競泳の場合には競走の場合より大きいが, この差は女子の体脂肪の多いことが水泳では有利に作用していることに由来するものと考えられる。Body fat lessens underwater body weight and may offer an advantage for swimming performance. The present study was undertaken to measure separately V̇O2 for buoyancy and that for propulsion during swimming in the swimming flume and to elucidate the advantage of lower underwater body weight in female. Three male swimmers and three female swimmers participated as the subjects. V̇O2 was measured during free style swimming at a constant speed of 0.6, 0.8 and l.0m/sec.Underwater weight was increased stepwisely by loading an extra-weight around the subject's waist or decreased by suspending a weight which pulls the waist upward via a wire and pulleies. V̇O2 at a given speed depended proportionally on the underwater weight. V̇O2 for propu1sion was estimated by subtracting resting V̇O2 from the intercept on the ordinate, and V̇O2 for buoyancy was calculated from the slope. 1) V̇O2 for buoyancy was independent of swimming speed and the average value for female swimmers was much smaller than that for male swimmers (352±140m1/min for male, 186±83m1/min for female). This difference in V̇O2 for buoyancy depended largely on the difference in underwater weight as the calculated values of V̇O2 for buoyancy per kg of underwater weight revealed much smaller difference between sexes (117±46m1/min for male, 91±36m1/min for female). 2) V̇O2 for propulsion increased exponentially with increasing speed. The increasing rate was larger in female than in male. This is probably because of relative inferiority of swimming ability in the female group in this study. 3) The rate of propulsion V̇O2 to total V̇O2 during swimming was larger in female than in male. This represents the advantage of lower underwater weight in female for swimming. This result offers the probable explanation for the discrepancy which exists in male-female ratio of the world records between swimming and running

Changes in anemia management and hemoglobin levels following revision of a bundling policy to incorporate recombinant human erythropoietin

In April 2006, Japan's health insurance system instituted a bundling policy that included recombinant human erythropoietin (rHuEPO) in outpatient hemodialysis therapy. To evaluate outcomes of this, we analyzed a prospective cohort of hemodialysis patients in the Japan Dialysis Outcomes and Practice Patterns Study, in 53 facilities using prevalent cross-sections of 1584 patients before and 1622 patients after the rHuEPO reimbursement change. Patient data included hemoglobin levels, iron management profiles, and anemia treatment with rHuEPO and intravenous iron. No significant differences were found in pre- or post-policy cross-sections for hemoglobin distributions or the percentage of patients prescribed rHuEPO. Among patients receiving rHuEPO, the mean dose significantly decreased by 11.8 percent. The percentage of patients prescribed intravenous iron over 4months significantly increased; however, the mean dose of iron did not significantly change. Thus, this bundling policy was associated with reduced rHuEPO doses, increased intravenous iron use, and stable hemoglobin levels in Japanese patients receiving hemodialysis