Elevation by Oxidative Stress and Aging of Hypothalamic-Pituitary-Adrenal Activity in Rats and Its Prevention by Vitamin E

The present study was conducted in order to determine whether oxidative stress during aging involves dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis in association with the emergence of cognitive deficits. When young rats were subjected to oxidative stress in the form of hyperoxia, thiobarbituric acid reactive substances, conjugated diene and lipid hydroperoxides increased markedly in the HPA axis. Vitamin E inhibited such increases in lipid peroxides in each organ. Levels of corticotrophin-releasing hormone in the hypothalamus and plasma levels of adrenocorticotrophic hormone and corticosterone were markedly elevated in young rats exposed to hyperoxia. However, young rats fed vitamin E-supplemented diets showed no abnormal hormone secretion, even after being subjected to hyperoxia. Furthermore, glucocorticosteroid receptors (GR) in pyramidal cells in the Cornus ammonis 1 region of the hippocampus in young rats were markedly decreased by oxidative stress. Similar phenomena were also observed in normal aged rats and young rats fed vitamin E-deficient diet kept in a normal atmosphere. Vitamin E supplementation prevented the decrease in GR in the hippocampus and the increase in corticosterone secretion caused by hyperoxia. These results suggest that oxidative stress induces oxidative damage in the hippocampus and the HPA axis during aging, resulting in a cognitive deficit in rats, and that negative-feedback inhibition on HPA activity was markedly dampened due to an increase in corticosterone levels caused by loss of GR

Peritoneal dissemination of prostate cancer due to laparoscopic radical prostatectomy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Peritoneal dissemination with no further metastases of prostate cancer is very rare, with only three cases reported in the available literature. We report the first case of iatrogenic peritoneal dissemination due to laparoscopic radical prostatectomy.</p> <p>Case Presentation</p> <p>A 59-year-old Japanese man underwent laparoscopic radical prostatectomy for clinical T2bN0M0 prostate cancer, and the pathological diagnosis was pT3aN0 Gleason 3+4 adenocarcinoma with a negative surgical margin. Salvage radiation therapy was performed since his serum prostate-specific antigen remained at a measurable value. After the radiation, he underwent castration, followed by combined androgen blockade with estramustine phosphate and dexamethasone as each treatment was effective for only a few months to a year. Nine years after the laparoscopic radical prostatectomy, computed tomography revealed a peritoneal tumor, although no other organ metastasis had been identified until then. He died six months after the appearance of peritoneal metastasis. An autopsy demonstrated peritoneal dissemination of the prostate cancer without any other metastasis.</p> <p>Conclusion</p> <p>Physicians should take into account metastasis to unexpected sites. Furthermore, we suggest that meticulous care be taken not to disseminate cancer cells to the peritoneum during laparoscopic radical prostatectomy.</p

Late Recurrence and Second Primary Malignancy among 139 Patients with Germ Cell Tumors: Long-term Outcome of the Disease in a Single-center Experience

doi:10.1093/jjco/hyp14

Correlation of Heat Shock Protein Expression to Gender Difference in Development of Stress-Induced Gastric Mucosal Injury in Rats

Recent studies have indicated that heat shock proteins (HSPs), which function as molecular chaperones, play important roles in cellular responses to stress-related events. However, the gender difference in the expression of HSP in the gastric mucosa remains unclear. In order to understand the mechanism of gender difference in the prevalence or severity of gastric mucosal lesions, the expression level of HSP and the correlation of estrogen to HSP induction in the gastric mucosa were evaluated in this study. The basal expression levels of HSP60 and HSP90 in the gastric mucosa were significantly higher in females than those in males. The gastric ulcer index was significantly higher in male rats compared to female rats observed after 12 h water immersion stress exposure. At this time point, the expression levels of HSP60 and HSP90 in the gastric mucosa were significantly higher in females than those in males. An estrogen-treatment significantly induced the expression of HSP60, HSP70 and HSP90 in the gastric mucosa. Inversely, an ovariectomy dramatically reduced the expression of HSP60, HSP70 and HSP90 in the gastric mucosa. Our results suggested that estrogen might play an important role in gastric mucosal protection with the induction of gastric mucosal HSPs

Differences in Trocar Positioning within the Vertebral Body Using Two Different Positioning Methods: Effect on Trainee Performance

Purpose. To evaluate the educational effect of the Japanese Society of Interventional Radiology 7th Academic Summer Seminar from a technical perspective. Materials and Methods. Nineteen trainees participated in the seminar. The seminar consisted of vertebroplasty trainings using swine with the single-plane landmark method and with the ISOcenter Puncture (ISOP) method. All trainees were advised by an instructor as they operated the instruments and punctured the vertebra. For each trainee, the accuracy in the final position of the needle tip of the initial puncture in each swine training was evaluated. Results. Error in the final position of the needle tip of ≥5 mm from the target puncture site occurred in the lateral direction in 42% (8/19) of trainees with the landmark method and 5% (1/19) with the ISOP method. No error ≥5 mm occurred in the vertical or anteroposterior directions. In terms of puncture accuracy, error in the lateral direction was significantly lower with the ISOP method than with the landmark method (2.2 ± 1.5 mm versus 5.6 ± 3.2 mm). Conclusion. This seminar was effective training for trocar placement for beginners. The puncture was more accurate with the ISOP method than with the landmark method

Direct exploration of the role of the ventral anterior temporal lobe in semantic memory:Cortical stimulation and local field potential evidence from subdural grid electrodes

Semantic memory is a crucial higher cortical function that codes the meaning of objects and words, and when impaired after neurological damage, patients are left with significant disability. Investigations of semantic dementia have implicated the anterior temporal lobe (ATL) region, in general, as crucial for multimodal semantic memory. The potentially crucial role of the ventral ATL subregion has been emphasized by recent functional neuroimaging studies, but the necessity of this precise area has not been selectively tested. The implantation of subdural electrode grids over this subregion, for the presurgical assessment of patients with partial epilepsy or brain tumor, offers the dual yet rare opportunities to record cortical local field potentials while participants complete semantic tasks and to stimulate the functionally identified regions in the same participants to evaluate the necessity of these areas in semantic processing. Across 6 patients, and utilizing a variety of semantic assessments, we evaluated and confirmed that the anterior fusiform/inferior temporal gyrus is crucial in multimodal, receptive, and expressive, semantic processing

Systematic analysis of mitochondrial genes associated with hearing loss in the Japanese population: dHPLC reveals a new candidate mutation

<p>Abstract</p> <p>Background</p> <p>Variants of mitochondrial DNA (mtDNA) have been evaluated for their association with hearing loss. Although ethnic background affects the spectrum of mtDNA variants, systematic mutational analysis of mtDNA in Japanese patients with hearing loss has not been reported.</p> <p>Methods</p> <p>Using denaturing high-performance liquid chromatography combined with direct sequencing and cloning-sequencing, Japanese patients with prelingual (N = 54) or postlingual (N = 80) sensorineural hearing loss not having pathogenic mutations of m.1555A > G and m.3243A > G nor <it>GJB2 </it>were subjected to mutational analysis of mtDNA genes (<it>12S rRNA</it>, <it>tRNA</it>^{<it>Leu(UUR)</it>}, <it>tRNA</it>^{<it>Ser(UCN)</it>}, <it>tRNA</it>^<it>Lys</it>, <it>tRNA</it>^<it>His</it>, <it>tRNA</it>^{<it>Ser(AGY)</it>}, and <it>tRNA</it>^<it>Glu</it>).</p> <p>Results</p> <p>We discovered 15 variants in <it>12S rRNA </it>and one homoplasmic m.7501A > G variant in <it>tRNA</it>^{<it>Ser(UCN)</it>}; no variants were detected in the other genes. Two criteria, namely the low frequency in the controls and the high conservation among animals, selected the m.904C > T and the m.1105T > C variants in <it>12S rRNA </it>as candidate pathogenic mutations. Alterations in the secondary structures of the two variant transcripts as well as that of m.7501A > G in <it>tRNA</it>^{<it>Ser(UCN) </it>}were predicted.</p> <p>Conclusions</p> <p>The m.904C > T variant was found to be a new candidate mutation associated with hearing loss. The m.1105T > C variant is unlikely to be pathogenic. The pathogenicity of the homoplasmic m.7501T > A variant awaits further study.</p

回腸を利用した膀胱形成術後に回腸部分より発生した腺癌の1例

回腸を利用した膀胱形成術後に回腸部分より発生した腺癌の1例札幌医科大学泌尿器科学教室(主任:熊本悦明教授)高橋敦, 塚本泰司, 熊本悦明, 佐藤嘉一, 渋谷明彦札幌医科大学中央検査部病理部門(主任=森道夫教授)佐藤昌明22年間尿路として機能していなかった回腸膀胱の回腸部分より発生した腺癌の1例を報告した.この例では, 回腸を用いた膀胱形成術の3ヵ月後に回腸導管が行われたことから, 尿の暴露に加え膀胱の炎症あるいは以前の放射線照射が癌発生に関係しているのではないかと推測された.We report a case of adenocarcinoma arising in the ileal segment of an ileocystoplasty which had remained defunctionalized for 22 years, after conversion to the ileal conduit. In our case, inflammation or previous radiation as well as urine exposure are suggested to have participated in the development of the carcinoma in the augmented bladder

腎細胞癌における腎部分切除術の臨床的検討

著者らの施設において1992年から2001年までに腎細胞癌に対し, 腎部分切除術を施行した54症例(絶対的適応患者11名, 選択的適応患者43名, 観察期間・中央値44ヵ月)の臨床的検討を行った.根治的腎摘除術を施行した症例のうち, 臨床病期Tlaの51症例を比較対象として, 周術期合併症, 手術前後の腎機能, 再発率について調べた結果, 術中の出血量は部分切除群の方が多いものの, 同種血輸血の割合に関して差は認めなかった.両群には, 病理学的所見, 合併症に関して有意差はなかった.また部分切除術後, 2症例に尿瘻, 1症例に腎性高血圧を認めた.部分切除術後の局所再発は認められず, 5年非再発率に関しても両群に有意差を認なかった.術後の腎機能は両群とも安定していたが, 根治的腎摘除後では, 基礎疾患を有する2症例(糖尿病, 腹部動脈瘤術後)において徐々に腎機能低下を示していた.以上より, 小径腎細胞癌に対する腎部分切除術は, 根治的腎摘除術と比較しても, 安全で有用な治療法と示唆されたWe retrospectively reviewed the records of 54 patients with RCC who underwent partial nephrectomy for the primary lesion between 1992 and 2001. The indications for partial nephrectomy were elective in 43 and imperative in 11 patients. We selected 51 patients with clinical stage T1a who underwent open radical nephrectomy for localized RCC for comparison during the same period. We evaluated the peri- and postoperative complications, disease-free survival rates and changes of renal function in the partial nephrectomy (PN) group, compared to the radical nephrectomy (RN) group. There was no significant difference with regard to pathological findings and clinical outcomes between two groups, except for the amount of intraoperative bleeding. Three patients in the PN group developed postoperative complications, consisting of urine leakage in 2 patients and renal hypertension in 1 patient. The 5-year disease-free survival rates in the PN and RN groups were 90% and 97%, respectively. Local recurrence from the resected area of the renal parenchyma was not found in patients in the PN group. All patients in the PN group maintained satisfactory and stable renal function. In the RN group, renal function slowly deteriorated in 2 patients. Therefore, partial nephrectomy offers cancer control and an acceptable low mortality rate, comparable to those of radical nephrectomy

Abnormality of retinal arterial velocity profiles using Doppler Fourier-domain optical coherence tomography in a case of Takayasu's arteritis with aortic regurgitation

Purpose: To evaluate the retinal microcirculation using a segmental-scanning Doppler optical coherence tomography (DOCT) flowmeter in a patient with Takayasu's arteritis (TA) with aortic valve regurgitation (AR). Observations: We measured the retinal blood velocity (V), retinal blood flow (RBF), and retinal blood velocity profiles (RBVP) of the major retinal arterioles using a DOCT flowmeter. The arteries were measured at the straight portion 1 disc diameter from the optic disc. Horizontal velocity profiles were extracted to evaluate the RBVP during one cardiac cycle. A patient with TA with stage 2 Takayasu retinopathy (TR) and AR, had normal RBF and V, and the RBVP had a parabolic pattern in the systolic phase. However, the V was very slow and the RBVP had an abnormal pattern in the diastolic phase. Conclusions and importance: The current study showed for the first time that segmental-scanning DOCT flowmeter enables evaluation of an abnormal flow pattern of the RVBP in the retinal arterioles in a patient with TA and AR. Measurement of the retinal arterial blood flow may detect aortic valve dysfunction and shed light on the pathogenesis of TR