Obstructive azoospermia as an unusual complication associated with herniorrhaphy of an omphalocele: a case report

<p>Abstract</p> <p>Introduction</p> <p>Iatrogenic damage to the seminal tract is one of the causes of obstructive azoospermia, which can be an indication for reconstruction surgery. We present a case of obstructive azoospermia as an unusual complication after neonatal herniorrhaphy of an omphalocele.</p> <p>Case presentation</p> <p>A 30-year-old Japanese man was diagnosed with obstructive azoospermia. He had undergone herniorrhaphy of an omphalocele immediately after birth. Reconstruction surgery of both seminal tracts was performed to pursue the possibility of naturally achieved pregnancy. Intra-operative findings demonstrated that both vasa deferentia were interrupted at the internal inguinal rings, although the abdominal end of the right vas leading to the seminal vesicle was found in the abdominal cavity. The discharge from the stump of the testicular end had no sperm, although the right epididymal tubules were dilated with motile sperm. Therefore, we performed right-sided vasovasostomy in the internal inguinal ring and ipsilateral epididymovasostomy simultaneously.</p> <p>Conclusion</p> <p>To the best of our knowledge, this is the first report describing obstructive azoospermia as an unusual complication of herniorrhaphy of an omphalocele. It is important to pay attention to the existence of seminal tracts in such surgery as well as in inguinal herniorrhaphy.</p

Incidence of multiple primary cancers in Nagasaki atomic bomb survivors: association with radiation exposure.

To assess the effects of atomic bomb radiation on the incidence of multiple primary cancers (MPC), we analyzed the association between the incidence of second primary cancers in survivors of the atomic bombing of Nagasaki, and exposure distance. The incidence rate (IR) of a second primary cancer was calculated and stratified by the distance from the hypocenter and age at the time of bombing for the years 1968 through 1999. The IR of the first primary cancer was also calculated and compared with the second primary cancer to determine whether atomic bomb radiation was associated with the multiplicity of tumors. There were 511 confirmed cases of MPC in the 7572 cancer-bearing survivors. The crude IR was 27.6 per 100,000 person-years. The IR of second primaries decreased significantly with increasing distance from the hypocenter: relative risk, 0.89 per 1.0 km; 95% confidence interval, 0.84-0.94. A significant decrease was also noted for those of older ages at the time of the bombing, based on the attained age of the second primary cancer: relative risk, 0.91 per 1 year; 95% confidence interval, 0.90-0.92. These findings suggest that the radiation has affected the incidence of MPC. Furthermore, when compared with the first primary cancer, a stronger distance effect was suggested on the occurrence of a second primary cancer in the survivors. The present study suggests the significance of atomic bomb radiation on MPC in the survivors. These results on the incidence of MPC in the tumor-bearing survivors and its correlations with the atomic bombing of 62 years ago are described for the first time in this report

A Research on the Effect of a Teacher Training Program for Freshmen,“The Visit to Their Old High School”

岡山大学は全学の教職課程を担う「教師教育開発センター」を平成22年度に創設し、学部の枠を超えた教員養成教育の質保証に取り組んでいる。教育実習事前事後指導や教育実習ならびに教職実践演習（平成25年度から実施）等を中心とする「全学教職コア・カリキュラム」の企画・運営だけではなく、これらの科目の教育成果とその課題を検証し、FD的視点に基づくカリキュラム開発と改善とを進めている。「母校訪問」とは、教育学部以外の学生（文学部、法学部、経済学部、理学部、工学部、環境理工学部、農学部、マッチングプログラムコース）のうち、改正後の教育職員免許法が適用される平成22 年度以降入学生（現１、２年生）を対象に、センターが独自に開発した１年次生対象のプログラムである。本稿ではその成果と課題の検証を通して、いわゆる「開放制」と「大学における教員養成」の原則に基づいた教員養成教育の可能性を検討する

Spontaneous remission of a non-small cell lung cancer possibly caused by anti-NY-ESO-1 immunity.

Spontaneous remission of malignant tumors is rare and the biological mechanism of such remission has not been addressed. We report the case of a 71-year-old Japanese patient with non-small cell lung cancer with a right hilar tumor and pleural dissemination that spontaneously regressed. NY-ESO-1 is a cancer/testis antigen that can elicit specific immune responses in patients with cancer. Strong anti-NY-ESO-1 immunity was detected in this patient. His tumor cells expressed NY-ESO-1 and MHC class I molecules. Anti-NY-ESO-1 immunity might have contributed to spontaneous remission in this patient

Memory Immune Responses against Pandemic (H1N1) 2009 Influenza Virus Induced by a Whole Particle Vaccine in Cynomolgus Monkeys Carrying Mafa-A1*052∶02

We made an H1N1 vaccine candidate from a virus library consisting of 144 ( = 16 HA×9 NA) non-pathogenic influenza A viruses and examined its protective effects against a pandemic (2009) H1N1 strain using immunologically naïve cynomolgus macaques to exclude preexisting immunity and to employ a preclinical study since preexisting immunity in humans previously vaccinated or infected with influenza virus might make comparison of vaccine efficacy difficult. Furthermore, macaques carrying a major histocompatibility complex class I molecule, Mafa-A1*052∶02, were used to analyze peptide-specific CD8+ T cell responses. Sera of macaques immunized with an inactivated whole particle formulation without addition of an adjuvant showed higher neutralization titers against the vaccine strain A/Hokkaido/2/1981 (H1N1) than did sera of macaques immunized with a split formulation. Neutralization activities against the pandemic strain A/Narita/1/2009 (H1N1) in sera of macaques immunized twice with the split vaccine reached levels similar to those in sera of macaques immunized once with the whole particle vaccine. After inoculation with the pandemic virus, the virus was detected in nasal samples of unvaccinated macaques for 6 days after infection and for 2.67 days and 5.33 days on average in macaques vaccinated with the whole particle vaccine and the split vaccine, respectively. After the challenge infection, recall neutralizing antibody responses against the pandemic virus and CD8+ T cell responses specific for nucleoprotein peptide NP262-270 bound to Mafa-A1*052∶02 in macaques vaccinated with the whole particle vaccine were observed more promptly or more vigorously than those in macaques vaccinated with the split vaccine. These findings demonstrated that the vaccine derived from our virus library was effective for pandemic virus infection in macaques and that the whole particle vaccine conferred more effective memory and broader cross-reactive immune responses to macaques against pandemic influenza virus infection than did the split vaccine

ヒフ キンエン ノ ハッショウ オ ケイキ ニ シンダン サレタ ショウサイボウ ハイガン ノ 1レイ

74 歳男性.顔面,四肢,体幹の紅斑に続き,構音障害および嚥下障害,四肢筋肉痛並び脱力が出現し,起立困難となり入院となった.CK, ALD, AST, LDH 等筋原性酵素の著明上昇及び臨床所見により皮膚筋炎と診断された.高用量ステロイド療法その後シクロスポリンの追加にて治療開始し,検査所見に続き,臨床所見も改善傾向にあった.同時にproGRP 高値並びに全身CT 画像上縦隔リンパ節腫大認め,気管支鏡下気管支粘膜生検にて小細胞肺癌の病理診断が得られ,CBDCA+CPT-11 にて化学療法を施行,腫瘍の縮小効果を見た.皮膚筋炎が腫瘍随伴症候として,小細胞癌とほぼ同時期に発病したことを示唆した症例であったA 74-year-old man was admitted because of erythemaon face, extremities and trunk, followed by dysarthria, dysphagia,extremity myalgia accompanied with weakness, andthen difficulty in upstanding. Dermatomyositis (DM) wasdiagnosed on the basis of a marked increase in serum levelof myogenic enzymes, such as creatinin kinase, aldolase, aspartateaminotransferase and lactate dehydrogenase, andthe clinical manifestations. Introduction of high-dose glucocorticoidtherapy, subsequently concurrent administrationof cyclosporin, made laboratory data gradually return tonormal and produced slight symptom improvement. Inscreening for malignancies, high level of proGRP detectedin peripheral blood, computed tomography scan showed mediastinallymphadenopathy, and histopathologial testing ofthe transbronchial biopsy specimens revealed small celllung cancer (SCLC). Chemotherapy (CBDCA+CPT-11)started, resulting in tumor reduction. The current case maysuggest that DM coincided with SCLC around at the sametime, as a mean of paraneoplastic syndrome

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

セイゴ ハッタツキ ダイノウ ヒシツ ダイ 1ソウ ニ オケル シンケイ ネットワーク ノ カイセキ

京都大学0048新制・課程博士博士(医学)甲第10420号医博第2643号新制||医||842(附属図書館)UT51-2003-N911京都大学大学院医学研究科外科系専攻(主査)教授 金子 武嗣, 教授 井出 千束, 教授 小川 修学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDA