精神疾患患者による朝顔栽培への参加継続要因の検討

精神科病院に入院中の精神疾患患者38名を対象に、フェイススケールを用いて園芸作業による気分の変化の調査、および参加観察を行った。園芸作業への参加継続群と非継続群を比較した結果、継続群は“園芸作業が気分の安定に効果的な群”、非継続群が“園芸作業が気分の安定に効果的でない群”であることが明らかとなった。継続群、非継続群の結果より、朝顔栽培への参加が継続できない要因は、精神症状が安定していないことが考えられた。また、参加継続要因は、精神症状が安定していること、朝顔の成長を予期できること、やりがいを見いだせること、他者との集団行動がとれること、前年度から継続して参加していることの5点であると考えられた

Alternative treatments for prophylaxis of colorectal cancer in familial adenomatous polyposis

Familial adenomatous polyposis (FAP) is a rare, hereditary disease characterized by the presence of 100 or more adenomas distributed throughout the colon and rectum. If untreated, colorectal cancer develops in almost 100% of FAP patients. As prophylactic treatment, proctocolectomy with ileal pouch-anal anastomosis remains the surgical treatment of choice. High rates of postoperative complications, however, have been reported with this procedure, including bowel dysfunction, incontinence, and reduced female fecundity. Some novel strategies for preventing hereditary colon cancers have been reported. This review summarizes alternative treatments, including the laparoscopic approach, chemoprevention, endoscopic management, and subtotal colectomy combined with endoscopic treatment, for prophylaxis of colorectal cancer in FAP patients

A case with mesenteric desmoid tumor after laparoscopic resection of stage I sigmoid colon cancer

Abstract Background Intra-abdominal desmoid tumors are rare and generally occur in some patients with familial adenomatous polyposis or secondary to an external stimulus such as surgical trauma. We report herein a case of intra-abdominal desmoid tumor in the jejunal mesentery after laparoscopic colectomy for sigmoid colon cancer. Case presentation A 74-year-old woman underwent laparoscopic sigmoid colectomy for colon cancer with pathological stage I. Follow-up computed tomography (CT) 18 months after primary surgery showed a nodular and enhanced soft tissue density mass, 20 mm in size, in the mesentery at the left side of the abdomen. Serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels were within the normal range. Fluorodeoxyglucose positron emission tomography did not suggest cancer recurrence. Another CT scan, done 1 month later, revealed that the tumor had enlarged to 25 mm in size. Although the pathological diagnosis was not obtained, we suspected recurrence of the sigmoid colon cancer and applied chemotherapy using capecitabine, oxaliplatin, and bevacizumab. After 3 cycles of chemotherapy, however, the tumor had enlarged further. Therefore, the surgical resection of the tumor was performed to determine the diagnosis and to achieve possible curative resection of the tumor. The tumor existed in the mesentery of the jejunum, 100 cm from the ligament of Treitz, and showed invasive growth. We resected 40 cm of the jejunal segment together with the tumor. Microscopically, the tumor was composed of fibroblast, myofibroblast, and infiltrating the inflammatory cell and diagnosed as desmoid tumor by immunostaining (desmin+/−, β-catenin+, CD117−, vimentin+). At 33 months after the resection of the desmoid tumor, neither the sigmoid colon cancer nor desmoid tumor has had a recurrence. Conclusions After surgery for gastrointestinal cancer, it is difficult to differentiate between intra-abdominal desmoid tumor and recurrence. The possibility of intra-abdominal desmoid should be considered along with tumor recurrence during postoperative surveillance after resection of gastrointestinal cancer, especially when the risk of recurrence is low

Elevated cyclooxygenase-2 expression is associated with histological grade in invasive ductal breast carcinoma

Purpose: The aim of this study was to evaluate the expression of cyclooxygenase-2 in human breast cancer using immunohistochemistry and to determine whether the expression of cyclooxygenase-2 is associated with clinicopathological factors in invasive ductal breast carcinoma. Methods: Cyclooxygenase-2 expression was investigated by immunohistochemistry in 30 invasive ductal breast carcinoma specimens and relationships between cyclooxygenase-2 expression and age, histological grade, histological type, nodal status, and hormone receptor status were evaluated. Results: Cyclooxygenase-2 expression was found in 56.7% of the tumor samples and was related to histological grade (P<0.01) and histological type (P<0.001). Conclusions: Our results suggest that cyclooxygenase-2 expression has an important role in tumor differentiation in invasive ductal breast carcinoma

Angiotensin II Receptor Blocker Ameliorates Stress-Induced Adipose Tissue Inflammation and Insulin Resistance

<div><p>A strong causal link exists between psychological stress and insulin resistance as well with hypertension. Meanwhile, stress-related responses play critical roles in glucose metabolism in hypertensive patients. As clinical trials suggest that angiotensin-receptor blocker delays the onset of diabetes in hypertensive patients, we investigated the effects of irbesartan on stress-induced adipose tissue inflammation and insulin resistance. C57BL/6J mice were subjected to 2-week intermittent restraint stress and orally treated with vehicle, 3 and 10 mg/kg/day irbesartan. The plasma concentrations of lipid and proinflammatory cytokines [Monocyte Chemoattractant Protein-1 (MCP-1), tumor necrosis factor-α, and interleukin-6] were assessed with enzyme-linked immunosorbent assay. Monocyte/macrophage accumulation in inguinal white adipose tissue (WAT) was observed with CD11b-positive cell counts and mRNA expressions of CD68 and F4/80 using immunohistochemistry and RT-PCR methods respectively. The mRNA levels of angiotensinogen, proinflammatory cytokines shown above, and adiponectin in WAT were also assessed with RT-PCR method. Glucose metabolism was assessed by glucose tolerance tests (GTTs) and insulin tolerance tests, and mRNA expression of insulin receptor substrate-1 (IRS-1) and glucose transporter 4 (GLUT4) in WAT. Restraint stress increased monocyte accumulation, plasma free fatty acids, expression of angiotensinogen and proinflammatory cytokines including MCP-1, and reduced adiponectin. Irbesartan reduced stress-induced monocyte accumulation in WAT in a dose dependent manner. Irbesartan treatment also suppressed induction of adipose angiotensinogen and proinflammatory cytokines in WAT and blood, and reversed changes in adiponectin expression. Notably, irbesartan suppressed stress-induced reduction in adipose tissue weight and free fatty acid release, and improved insulin tolerance with restoration of IRS-1 and GLUT4 mRNA expressions in WAT. The results indicate that irbesartan improves stress-induced adipose tissue inflammation and insulin resistance. Our results suggests that irbesartan treatment exerts additive benefits for glucose metabolism in hypertensive patients with mental stress.</p></div

Irbesartan rescued stress-induced decline in insulin sensitivity.

<p><b>A:</b> Glucose tolerance was comparable between the stressed mice treated with vehicle and irbesartan (10 mg/kg/day) after stress. Insulin tolerance showed significant recovery in the irbesartan-treated and stressed mice (lower panel). Data are mean ± SD of 10 mice per group. *<i>P<</i>0.05, and **<i>P<</i>0.02, compared with the vehicle-treated and stressed mice. <b>B:</b> Quantitative analysis of IRS-1 and GLUT4 expression in inguinal adipose tissue and skeletal muscle (adductor muscle) of the stressed mice treated with vehicle or irbesartan (10 mg/kg/day). Data are mean ± SD of 10 mice per group. *<i>P<</i>0.05, compared with the vehicle-treated and stressed mice.</p