Roles of FGF20 in dopaminergic neurons and Parkinson's disease.

The fibroblast growth factor (FGF) family comprises 22 members with diverse functions in development and metabolism. Fgf20 was originally identified as a new Fgf preferentially expressed in the substantia nigra pars compacta (SNpc). Fgf20, which acts on proximal cells, significantly enhanced the survival of cultured dopaminergic neurons by activating the mitogen-activated protein kinase (MAPK) pathway through Fgf receptor 1c. In the rat model of Parkinson's disease, Fgf20 afforded significant protection against the loss of dopaminergic neurons. The significant correlation of Parkinson's disease with single-nucleotide polymorphisms in FGF20 indicates that the genetic variability of FGF20 can be a Parkinson's disease risk. Neural and embryonic stem (ES) cells have been considered as cell resources for restorative transplantation strategies in Parkinson's disease. Fgf20 promoted the differentiation of these stem cells into dopaminergic neurons, which attenuated neurological symptoms in animal models of Parkinson's disease. These findings indicate the importance of FGF20 for the differentiation and survival of dopaminergic neurons and the etiology and therapy of Parkinson's disease

Roles of FGFs as Adipokines in Adipose Tissue Development, Remodeling, and Metabolism.

White and brown adipose tissues (BATs), which store and burn lipids, respectively, play critical roles in energy homeostasis. Fibroblast growth factors (FGFs) are signaling proteins with diverse functions in development, metabolism, and neural function. Among 22 FGFs, FGF1, FGF10, and FGF21 play roles as adipokines, adipocyte-secreted proteins, in the development and function of white and BATs. FGF1 is a critical transducer in white adipose tissue (WAT) remodeling. The peroxisome proliferator-activated receptor γ-FGF1 axis is critical for energy homeostasis. FGF10 is essential for embryonic white adipocyte development. FGF21 activates BAT in response to cold exposure. FGF21 also stimulates the accumulation of brown-like cells in WAT during cold exposure and is an upstream effector of adiponectin, which controls systemic energy metabolism. These findings provide new insights into the roles of FGF signaling in white and BATs and potential therapeutic strategies for metabolic disorders

Pressure-Induced Restoration of the Reversed Crystal-Field Splitting in α\alpha-Sr2_2CrO4_4

Motivated by an experimental finding that the successive phase transitions in $\alpha$-Sr$_2$CrO$_4$ observed at ambient pressure ceases to exist under high pressures, we carry out the density-functional-theory-based electronic structure calculations and demonstrate that the reversal of the crystal-field splitting reported previously is restored under high pressures, so that the orbital degrees of freedom disappears, resulting in the single phase transition that divides the system into high-temperature Mott insulating and low-temperature antiferromagnetic insulating phases.Comment: 5 pages, 1 figure, to appear in JPS Conf. Proc. (Proceedings for SCES2019

Early and Definitive Diagnosis of Toxic Shock Syndrome by Detection of Marked Expansion of T-Cell-Receptor Vβ2-Positive T Cells

We describe two cases of early toxic shock syndrome, caused by the superantigen produced from methicillin-resistant Staphylococcus aureus and diagnosed on the basis of an expansion of T-cell-receptor Vβ2-positive T cells. One case-patient showed atypical symptoms. Our results indicate that diagnostic systems incorporating laboratory techniques are essential for rapid, definitive diagnosis of toxic shock syndrome

フククウキョウカ テイイ ゼンポウ セツジョ ジュツゴ ニ ハッショウシタ well leg compartment syndrome ノ 1レイ

Well leg compartment syndrome(WLCS)は、砕石位での長時間の外科手術後に発生する重篤な合併症であるが、その発生は稀である。今回、直腸癌に対する腹腔鏡下低位前方切除術後にWLCSを発症した症例を経験したため報告する。症例は60歳代、男性、BMI 34.1。排便困難感と血便を認め、下部消化管内視鏡検査を受けたところ下部直腸癌と診断された。病変は肛門縁から5cmの後壁でSM以深への浸潤と左側方リンパ節転移が疑われたため、手術目的に当科紹介となった。砕石位、Trendelenburg体位で腹腔鏡下低位前方切除術、側方リンパ節郭清、回腸人工肛門造設術を施行した。肥満・狭骨盤・腫瘍位置から時間を要し、手術時間：10時間38分、出血量：370mlであった。手術終了直後から左下腿部の硬結と圧痛を認めていた。術翌日の検査にて、AST:130U/L, LDH 360U/L, CK 6548U/Lと筋由来酵素の上昇を認めた。深部静脈血栓症の所見はなく、WLCSと診断した。血流障害・神経障害はなかったことから、筋膜切開などの処置を施行せずに厳重な経過観察で改善した。WLCSは、発生頻度は低いが、発生した場合重篤な経過をたどる可能性があるため、早期診断と早期対応が必要である。術後の下肢痛を認めた場合は、WLCSの可能性を念頭におくとともに、術中体位による術後合併症に対して病態や発症リスクを理解した予防策を立てる必要性がある。Well leg compartment syndrome (WLCS) is a serious complication that occurs after prolonged surgery in the lithotomy position, but it is rare. We report a case of WLCS after laparoscopic lower anterior resection for rectal cancer. A 60s-year-old man with BMI 34.1 with a diagnosis of lower rectal cancer underwent laparoscopic lower anterior resection with lymph node D3 dissection (lateral lymph node dissection), and ileostomy in the lithotomy and Trendelenburg positions. The operation time was 10 hours and 38 minutes, and the amount of bleeding was 370 ml. Immediately after the operation, induration and tenderness of the left lower leg were observed. Examination the day after the operation revealed an increase in muscle-derived enzymes such as AST: 130U / L, LDH 360U / L, and CK 6548U / L, and diagnosed WLCS. There was no blood flow disorder or neuropathy, and the condition improved without any treatment such as fasciotomy. Although WLCS occurs infrequently, it may have a serious course and requires early diagnosis and early response. Preventive measures should be taken against complications due to intraoperative position, and if postoperative leg pain is present, the possibility of WLCS should be considered

Preoperative biliary drainage for biliary tract and ampullary carcinomas

We posed six clinical questions (CQ) on preoperative biliary drainage and organized all pertinent evidence regarding these questions. CQ 1. Is preoperative biliary drainage necessary for patients with jaundice? The indications for preoperative drainage for jaundiced patients are changing greatly. Many reports state that, excluding conditions such as cholangitis and liver dysfunction, biliary drainage is not necessary before pancreatoduodenectomy or less invasive surgery. However, the morbidity and mortality of extended hepatectomy for biliary cancer is still high, and the most common cause of death is hepatic failure; therefore, preoperative biliary drainage is desirable in patients who are to undergo extended hepatectomy. CQ 2. What procedures are appropriate for preoperative biliary drainage? There are three methods of biliary drainage: percutaneous transhepatic biliary drainage (PTBD), endoscopic nasobiliary drainage (ENBD) or endoscopic retrograde biliary drainage (ERBD), and surgical drainage. ERBD is an internal drainage method, and PTBD and ENBD are external methods. However, there are no reports of comparisons of preoperative biliary drainage methods using randomized controlled trials (RCTs). Thus, at this point, a method should be used that can be safely performed with the equipment and techniques available at each facility. CQ 3. Which is better, unilateral or bilateral biliary drainage, in malignant hilar obstruction? Unilateral biliary drainage of the future remnant hepatic lobe is usually enough even when intrahepatic bile ducts are separated into multiple units due to hilar malignancy. Bilateral biliary drainage should be considered in the following cases: those in which the operative procedure is difficult to determine before biliary drainage; those in which cholangitis has developed after unilateral drainage; and those in which the decrease in serum bilirubin after unilateral drainage is very slow. CQ 4. What is the best treatment for postdrainage fever? The most likely cause of high fever in patients with biliary drainage is cholangitis due to problems with the existing drainage catheter or segmental cholangitis if an undrained segment is left. In the latter case, urgent drainage is required. CQ 5. Is bile culture necessary in patients with biliary drainage who are to undergo surgery? Monitoring of bile cultures is necessary for patients with biliary drainage to determine the appropriate use of antibiotics during the perioperative period. CQ 6. Is bile replacement useful for patients with external biliary drainage? Maintenance of the enterohepatic bile circulation is vitally important. Thus, preoperative bile replacement in patients with external biliary drainage is very likely to be effective when highly invasive surgery (e.g., extended hepatectomy for hilar cholangiocarcinoma) is planned

The ASTRO-H X-ray Observatory

The joint JAXA/NASA ASTRO-H mission is the sixth in a series of highly successful X-ray missions initiated by the Institute of Space and Astronautical Science (ISAS). ASTRO-H will investigate the physics of the high-energy universe via a suite of four instruments, covering a very wide energy range, from 0.3 keV to 600 keV. These instruments include a high-resolution, high-throughput spectrometer sensitive over 0.3-2 keV with high spectral resolution of Delta E < 7 eV, enabled by a micro-calorimeter array located in the focal plane of thin-foil X-ray optics; hard X-ray imaging spectrometers covering 5-80 keV, located in the focal plane of multilayer-coated, focusing hard X-ray mirrors; a wide-field imaging spectrometer sensitive over 0.4-12 keV, with an X-ray CCD camera in the focal plane of a soft X-ray telescope; and a non-focusing Compton-camera type soft gamma-ray detector, sensitive in the 40-600 keV band. The simultaneous broad bandpass, coupled with high spectral resolution, will enable the pursuit of a wide variety of important science themes.Comment: 22 pages, 17 figures, Proceedings of the SPIE Astronomical Instrumentation "Space Telescopes and Instrumentation 2012: Ultraviolet to Gamma Ray

The Elevation in Preoperative Procalcitonin Is Associated with a Poor Prognosis for Patients Undergoing Resection for Colorectal Cancer.

Background:Procalcitonin (PCT) is a well-known marker for bacterial infection; however, the clinical significance of PCT in the long-term prognosis after colorectal cancer (CRC) surgery remains unclear.Methods:This is a retrospective review of 277 patients that underwent CRC surgery to investigate the relationship between preoperative PCT, clinicopathological condition, cancer-specific overall survival (OS), and relapse-free survival (RFS).Results:Median follow-up interval was 5.0 years in all patients. Thirty-six patients developed recurrence, and 46 patients died due to recurrences or metastases of CRC. Preoperative PCT levels were highest in Stage IV patients. The cancer-specific OS in patients with Stage IV/PCT ≤0.05 ng/mL was significantly higher than those with Stage IV/PCT >0.05 ng/mL (3 years survival; 42.3 vs. 14.3%, p = 0.0413). On multivariate analysis, gender, TNM classification, and PCT were identified as significant risk factors for cancer-specific OS in patients with Stage I-III CRC. The cancer-specific OS rate of these patients with PCT ≥0.08 ng/mL, compared with PCT <0.08 ng/mL, was significantly decreased (5 years survival; 59.1 vs. 92.7%, p < 0.0001). TNM classification was finally identified as an independent risk factor for cancer-specific RFS in these patients by multivariate analysis.Conclusion:High preoperative PCT values in CRC patients appeared to be associated with poor OS but not RFS following surgical treatments