Effect of Paraquat-Induced Oxidative Stress on Insulin Regulation of Insulin-Like Growth Factor-Binding Protein-1 Gene Expression

Oxidative stress is thought to play a role in the development of insulin resistance. In order to elucidate the molecular effect of oxidative stress on liver insulin signaling, we analyzed the effect of paraquat (1,1-dimethyl-4,4-dipyridynium; PQ)-derived oxidative stress on the expression of insulin-dependent genes and activation of liver insulin signaling pathway. Incubation of primary cultured rat hepatocytes with 2 mM PQ for 6 h impaired the suppressive effect of insulin on insulin-like growth factor-binding protein-1 (IGFBP-1) gene expression, but did not influence glucose-6-phosphatase gene expression. Insulin-dependent phosphorylation or activation of insulin receptor, insulin receptor substrate-1 and -2, phosphatidylinositol 3-kinase, Akt and forkhead in rhabdomyosarcoma were not affected by PQ pre-treatment. In contrast, PQ treatment impaired insulin-dependent phosphorylation of mammalian target of rapamycin (mTOR). These results indicate that PQ-induced oxidative stress impairs insulin-dependent mTOR activation and that this impairment probably causes inhibition of insulin-dependent repression of IGFBP-1 expression

Infected aortic aneurysm and inflammatory aortic aneurysm—In search of an optimal differential diagnosis

SummaryInfected aortic aneurysm and inflammatory aortic aneurysm each account for a minor fraction of the total incidence of aortic aneurysm and are associated with periaortic inflammation. Despite the similarity, infected aortic aneurysm generally shows a more rapid change in clinical condition, leading to a fatal outcome; in addition, delayed diagnosis and misuse of corticosteroid or immunosuppressing drugs may lead to uncontrolled growth of microorganisms. Therefore, it is mandatory that detection of aortic aneurysm is followed by accurate differential diagnosis. In general, infected aortic aneurysm appears usually as a saccular form aneurysm with nodularity, irregular configuration; however, the differential diagnosis may not be easy sometimes for the following reasons: (1) symptoms, such as abdominal and/or back pain and fever, and blood test abnormalities, such as elevated C-reactive protein and enhanced erythrocyte sedimentation rate, are common in infected aortic aneurysm, but they are not found infrequently in inflammatory aortic aneurysm; (2) some inflammatory aortic aneurysms are immunoglobulin (Ig) G4-related, but not all of them; (3) the prevalence of IgG4 positivity in infected aortic aneurysm has not been well investigated; (4) enhanced uptake of 18F-fluorodeoxyglucose (FDG) by 18F-FDG-positron emission tomography may not distinguish between inflammation mediated by autoimmunity and that mediated by microorganism infection. Here we discuss the characteristics of these two forms of aortic aneurysm and the points of which we have to be aware before reaching a final diagnosis

豊田市総合型地域スポーツクラブの実践 : 豊田市スポーツ会議の試み「60歳からの体力再生教室」についての一考察

1995 begann das Kultusministerium einen Modellversuch zum Aufbau von Sportvereinen in Japan und beauftragte den Japanischen Sportbund, die Forderungsma〓nahmen fur die Sportvereine zu erarbeiten. Das Ziel dieses Modelversuches liegt darin, Voraussetzungen fur den Aufbau von Sportvereinen zu schaffen, die gemeinnutzig und fur alle Japaner leicht zuganglich sind. Im Gegensatz zu Europa, beispielsweise zu Deutschland, wird die Sportforderung in Japan in erster Linie von der offentlichen Sportverwaltung getragen. Im Jahre 2000 verabschiedete das japanische Kultusministerium den Leitplan zur Sportforderung, vor allem zur Forderung des Breitensports. Dieser Leitplan soll es ermoglichen, dass jeder zweite Japaner bis 2010 mindestens einmal pro Woche Sport treibt. Eine wesentliche Voraussetzung dafur ist der Aufbau und die Einfuhrung von Sportvereinen neuer Art in Japan, die moglichst umfangreiche Sportprogramme anbieten und von den Burgern selbst verwaltet werden. 2004 schlossen sich der Sportbund Toyota, der Bildungs- und Sportausschuss der Stadt Toyota, das Toyota Stadium e. V. und der Fachbereich Sport der Chukyo Universitat zusammen und grundeten "den Sportkongress der Stadt Toyota" mit dem Ziel bis 2010 in allen 20 Schulbezirken der Stadt Toyota mindestens einen Sportverein zu grunden. Die vorliegende Arbeit untersucht die neu gegrundeten Sportvereine in Toyota und deren Aktivitaten. Im Rahmen der vom Sportkongress Toyota angebotenen Sportforderungsprogramme startete im September 2004 ein Seniorensportkurs "Fitness ab 60" in Zusammenarbeit mit der Chukyo Universitat. Die Untersuchung umfasst auch die Reflexion und die Analyse des Sportkurses "Fitness ab 60". 2003 sind zwei Sportvereine mit 451 bzw. 70 Mitgliedern und 2005 ein Sportverein mit 200 Mitgliedern neu gegrundet worden. 2005 sind weitere 4 neue Sportvereine vorgesehen. "Fitness ab 60" fand vom 2.0ktober bis 25.Dezember 2004 einmal wochentlich (insgesamt 10 Kurse) im Leichtathletikstadion der Chukyo Universitat statt. Eine Trainingseinheit dauerte 90 Minuten. Die Teilnehmer waren 50 Senioren ab 60 aus der Stadt Toyota, sie wurden von den Lehrkraften des Fachbereichs Sport betreut. Aus der Analyse der Trainingsprotokolle und der Befragung der Teilnehmer ergaben sich folgende Erkenntnisse : 1. Der theoretische Teil des Kurses (allgemeine Informationen uber Fitness und Gesundheit im Seniorenalter, richtige Einstellung zu Sport und Fitness) ist sehr wichtig. 2. Die verstandliche Erklarung der Ubungen u. a. ist vor allem bei alteren Teilnehmern sehr wichtig. 3. Die Trainings- und Ubungsinhalte sollen im Zusammenhang mit "Freude an der Bewegung "ausgewahlt werden. Dabei spielt die Qualitat der Ubungsleiter eine wesentliche Rolle. 4. Die Teilnehmer legen gro〓en Wert auf die Geselligkeit und die Kommunikation untereinander. Sie wollen "gemeinsam" etwas tun. 5. Zusammenfassend wurde festgestellt, dass die Aufklarungsarbeit, die Ubungsleiterausbildung und das Programm-Angebot drei wesentliche Punkte fur den zukunftigen Vereinsbetrieb sind. Dabei ist es besonders wichtig, den Burgern Gelegenheit zu geben, ohne Hemmung mit Freunden und Bekannten am Sport teilzunehmen und die Sportstatten, die normalerweise nicht einfach zuganglich sind (z. B. die Sportanlagen der Universitaten oder Privatunternehmen) zu benutzen

Current Status and Future Potential of Robotic Surgery for Gastrointestinal Cancer

　Robotic surgery has built on innovations in areas such as medical engineering and optical technology. Laparoscopic surgery has been successfully adapted for gastric, colon, and rectal cancer surgeries over the past two decades with numerous clinical trials showing oncological results comparable to those of open surgery. These trials have also shown that the laparoscopic approach shortens postoperative recovery time and decreases complication rates. Another advantage of minimally invasive techniques for the resection of gastric, colon, and rectal cancers is improved visualization of the surgical field. Despite the near absence of tactile feedback, robotic surgery has overcome many of the challenges inherent in laparoscopic surgery through features such as 3D vision, stable magnification, EndoWrist instruments, physiological tremor filtering, and motion scaling. Robotic surgery is not yet widely used in esophageal cancer surgery or in a pancreaticoduodenectomy for pancreatic cancer due to anatomical difficulties and the lack of a suitable approach.　Comparative studies of robotic and laparoscopic surgery have shown similar results in terms of perioperative management, oncologic evaluation, and functional outcomes. However, it is also true that the high cost and lack of tactile feedback in robotic surgery are major limitations in terms of current robotic technology becoming the worldwide standard for minimally invasive surgery. The future of robotic surgery will require cost reduction, the development of new platforms and technologies, the creation and validation of curricula and virtual simulators, and confirmation through appropriate randomized controlled clinical trials

A modified multi-patch technique for double-layered repair of ischemic posterior ventricular septal rupture

Abstract Background The rupture of the posterior ventricular septum after acute inferior myocardial infarction is more challenging to repair than ruptures in other sites since it is less accessible and anatomically restricted. We described a modification of Daggett’s original technique of multi-patch repair of ruptured posterior septum. Case presentation The technique was employed in the operation of a 67-year-old male who presented with severe heart failure at the 10th day after he developed inferior myocardial infarction. His ventricular septum had ruptured at the level between the posteromedial papillary muscle and the mitral annulus. A large endoventricular patch covered separately over the locally patched septal defect and the ventriculotomy defect which was going to be roofed eventually with an external patch. Both defects were then individually closed in double layers, holding a single continuous patch in common. The common use of a single patch expedited multilayered closure of the left ventricular defects and could minimize geometric remodeling of the covered area. The patches on both the endocardial and the epicardial sides avoided potentially fatal bleeding from the ventriculotomy site. The transmural mattress sutures incorporating ventriculotomy patches required minimal bites toward the posteromedial papillary muscle and mitral annulus, thereby preserving the mitral valve function. Conclusions Thus, the technique enhances the advantage of the left ventriculotomy in the repair of posterior septal rupture and avoids ventriculotomy-related morbidity

Repetitive complications after prosthetic graft for inflammatory aortic aneurysm

The presence of retroperitoneal fibrosis after an aortic graft replacement is a marker of poor prognosis following aortic graft replacement. Herein we report the case of a 39-year-old man with retroperitoneal fibrosis that had been causing ureteral obstruction. The man had undergone repeated aortic graft replacement due to bacteremia and aortic graft–small intestinal fistula that occurred 4 years after initial aortic grafting for an inflammatory aortic aneurysm. The patient was discharged after 4 weeks of intravenous antibiotic therapy following the latest aortic graft replacement