Improvement of the Anaerobic Digestion Performance for Fish Industry Waste Recycles

Poster Sessio

Utility of laparoscopic surgery for pelvic abscesses

骨盤内膿瘍に対する治療は，抗生剤による薬物療法が主体であるが，抗生剤無効例や，消化管から発生した膿瘍との鑑別を要する症例では外科的アプローチが必要となる。骨盤内膿瘍の場合，炎症による癒着が強いことが多く，手術は比較的難易度が高い。しかし，高度の炎症で疲弊した患者の負担を軽減するために，近年では腹腔鏡手術が積極的に導入されており，当院でも可能な限り腹腔鏡手術で対応している。抗生剤による治療が無効であった付属器膿瘍に対して腹腔鏡下手術を施行した4症例について報告する。4例とも輸血を要するような出血はなく，また他臓器損傷もなかった。術後は，速やかに炎症所見が改善し特に問題なく経過した。 骨盤内膿瘍に対する腹腔鏡手術は，ドレナージによりすみやかな炎症軽減が可能であり，かつ低侵襲であることから有用性は高い。一方で，（汎発性腹膜炎などで，）腸管麻痺を伴う症例では，腸管の膨隆のため腹腔鏡下の視野確保が困難であり，腹腔鏡手術の適応は慎重であるべきであると考える。Tubo-ovarian abscesses are classically treated with broad-spectrum antibiotics. Frequently, this approach fails, and surgical intervention becomes necessary. In recent years, laparoscopic surgery was positively introduced, and in our hospital, laparoscopic surgery, which is minimally invasive for patients, is selected as much as possible. We performed laparoscopy for four patients with tubo-ovarian abscess that did not improve with antibiotic treatment. No hemorrhage damage to other internal organs was noted in any of the patients. Inflammation was improved immediately, and postoperative progress was good. Usually, surgery for tubo-ovarian abscess is often technically difficult and associated with complications. For peritonitis accompanied with intestinal tract paralysis, it is difficult to secure the field of vision with the laparoscope, and therefore, the indications for laparoscopic surgery should be carefully considered before conducting the surgery

Papillary hidradenoma of the vulva : A case report

外陰部に発生する比較的まれなpapillary hidradenoma（乳頭状汗腺腫）の１例について報告する。症例は73歳の女性で小陰唇外側に胡桃大の皮膚腫瘤を認め，腫瘤摘出術を施行した。腫瘤内部には充実分を伴っており，組織学的には乳頭状増殖を示す腺構造で構成され，その腺腔は２層に重層した立方上皮で囲まれていた。上皮細胞の核異型は軽度であり，周囲組織への浸潤も認めず，papillary hidradenomaと診断された。しかし肉眼的所見および組織学的所見より腺癌と誤認される可能性があり，診断には注意が必要である。Papillary hidradenoma is rare, benign, cystic, papillary apocrine gland tumor that occurs almost exclusively in women in the skin of the anogenital region. We report a case of a 73-year-old woman who presented with a progressively enlarging perianal nodule. The nodule appeared as walnut-sized skin tumor on the outside of the labium minus pudendi, and local excision was performed. Macroscopically, the inside portion of the tumor appeared solid. Microscopically, this region consisted of papillary adenomatous structures whose lumina were lined by 2 layers of cuboidal epithelial cells. Nuclear atypia and mitotic figures of these epithelial cells were rare and noninvasive. However, cells with this appearance may be mistaken for adenocarcinoma by both macroscopic and histologic views, and attention is necessary for an accurate diagnosis

Significant morphological change in osteoarthritic hips identified over 6-12 months using Statistical Shape Modelling

Acknowledgements We are grateful to all the study participants. We thank Lana Gibson and Jennifer Scott for their expertise with the iDXA scanner as well as iDXA precision data. Funding source This study was supported by an award (Ref: WHMSB_AU068/071) from the Translational Medicine Research Collaboration – a consortium made up of the Universities of Aberdeen, Dundee, Edinburgh and Glasgow, the four associated NHS Health Boards (Grampian, Tayside, Lothian and Greater Glasgow & Clyde), Scottish Enterprise and initially Wyeth, now Pfizer. The funder had no involvement in the collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. Dr J.S. Gregory was the holder of an MRC New Investigator award (Ref: G0901242).Peer reviewedPostprin

Reproducibility and Diagnostic Accuracy of Kellgren-Lawrence Grading for Osteoarthritis Using Radiographs and Dual-Energy X-ray Absorptiometry Images

Copyright © 2014 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved. The authors would like to thank all the study volunteers, radiographers Lana Gibson and Jennifer Scott as well as Carol McKerron for administrative support. The acquisition of scans was supported in part by an award (Ref: WHMSB_AU_068_071) from the Translational Medicine Research Initiative - a consortium made up of the Universities of Aberdeen, Dundee, Edinburgh and Glasgow, the four associated NHS Health Boards (Grampian, Tayside, Lothian and Greater Glasgow & Clyde), Scottish Enterprise and Pfizer. Kanako Yoshida is funded by the Grampian Osteoporosis Trust (GOT). Jennifer Gregory is supported by the Medical Research Council [G0901242].Peer reviewedPostprin

浸潤性子宮頸癌における血管内皮増殖因子の発現と微小血管密度の重要性について

To determine whether vascular endothelial growth factor (VEGF) expression and microvessel density are predictive of prognosis in cases of invasive cervical cancer, correlations among VEGF expression, microvessel density, and clinicopathological parameters were identified. VEGF expression was evaluated in 50 cervical cancer samples by immunohistochemical staining. Microvessel density was assessed by immunostaining for CD31-positive endothelial cells in the most vascularized areas of tumors. VEGF expression and microvessel density were significantly higher in adenocarcinomas than in squamous cell carcinomas. However, in cases of adenocarcinoma, no significant correlations were found among VEGF expression, microvessel density, and clinicopathological parameters. In contrast, for squamous cell carcinomas, microvessel density was significantly higher in cases at an advanced stage and in those with several other poor prognostic factors. The finding that cervical adenocarcinomas exhibited greater VEGF expression and microvessel density than squamous cell carcinomas may explain the poorer prognosis of adenocarcinoma compared with squamous cell carcinoma. Moreover, microvessel density in squamous cell carcinomas was significantly correlated with poor prognostic factors. Therefore, there is possibility that bevacizumab, a humanized monoclonal antibody against VEGF-A, may be useful in the initial treatment targeting angiogenesis for early-stage cervical cancer

A new therapeutic strategy with istradefylline for postural deformities in Parkinson’s disease

Aim of the study. Postural deformities are common in Parkinson’s disease (PD) patients. Several treatment options have been reported, but responses to these treatments appear unpredictable. Istradefylline is a novel drug for PD. Cases of PD patients whose postural deformities were improved after withdrawal of dopamine agonists and initiation of istradefylline are presented. Materials and Methods. Four consecutive patients with postural deformities including antecollis, Pisa syndrome, and camptocormia were recruited and treated with istradefylline in combination with withdrawal of dopamine agonists, which are possible causes of postural deformities. Results. The dopamine agonists were discontinued an average of 26 months after the development of the postural deformities, and istradefylline was initiated an average of 1.3 months after dopamine agonist withdrawal. Three patients with preserved paraspinal muscle volume showed good responses to the treatment regimen at least two months after dopamine agonist withdrawal. Conclusions and clinical Implications. Postural deformities caused by dopamine agonists generally improve less than two weeks after dopamine agonist withdrawal. Given the response time in the present study, the response was unlikely to be caused solely by dopamine agonist withdrawal. Istradefylline can be a potential therapeutic option; however, appropriate selection of patients for treatment with istradefylline is warranted

Lymphadenectomy for endometrial cancer

The objective of this study was to identify pathological indicators that could be used to identify a subgroup of patients with apparent stage I endometrial cancer who do require retroperitoneal lymphadenectomy. 188 T1 endometrial cancer patients underwent primary surgery at Tokushima University Hospital. We retrospectively evaluated their clinical records and histopathological factors. Systematic lymphadenectomy was performed for 149 patients, and 39 patients (grade 1 with < 5 mm of myometrial invasion) were treated without lymphadenectomy. Lymph node metastases were found in 19 (12.8%) of the lymphadenectomy cases. Twenty-four patients with a T1a endometrium-limited lesion did not exhibit lymph node metastasis. Three (3.1%) of the 95 patients with a T1a lesion exhibited lymph node metastasis, and these 3 cases exhibited approximately 50% myometrial invasion. The 39 low-risk patients who did not undergo systematic lymphadenectomy remain alive without recurrence. Systematic lymphadenectomy could be omitted for patients with a grade 1 tumor and minor myometrial invasion of less than 5mm

Gene gun-mediated skin transfection with FL gene suppresses the growth of murine fibrosarcoma

Aim : Particle-mediated transfection is known as an efficient method of nonviral gene transfer. Flt3 ligand (FL) is a growth factor for hematopoietic progenitors ; it promotes the growth of dendritic cells (DC). DCs are powerful antigen-presenting cells (APCs) and show a remarkable capacity to stimulate antigen-specific T-cell responses. In this study, we intended to investigate the suppressive effect on tumor growth by gene gun-mediated transfer of FL in a murine model. Methods : C57BL/6J mice were injected intradermally with MCA205 cells. DNA (pNGVL-hFLex)-coated gold particles were delivered to themouse skin surrounding the target tumor. The expression of FL was determined by RT-PCR. Analyses by immunohistochemistry and fluorescence-activated cell sorter (FACS) revealed an increase in the number of DC after treatment with FL. Results : Gene gun-mediated pNGVL-hFLex transfer significantly inhibited the growth of the MCA205 tumor. FL transfer markedly increased the number of CD11c+ DCs in the tumor tissue. Further, the FL-transfected mice exhibited a significantly higher number of CD80+ MHC-II cells. Conclusion : We successfully performed FL therapy using an in vivo gene gun in order to effectively mobilize DCs in situ and induce suppressive immunity

コロナ禍における医学教育への取り組み

The COVID-19 pandemic has profoundly changed medical student clinical practice and limited hospital clinical practice. In order to make student training more meaningful, we have introduced medical education using a laparoscopic simulator. We conducted a student questionnaire on the usefulness of this training and evaluated the degree of understanding. For students who were able to practice at the hospital, they practiced using a laparoscopic simulator（Lap Mentor™）. A questionnaire survey was conducted on the presence or absence of interest in surgery. Student understanding of laparoscopic surgery improved 100％. 91％ understood the surgical procedure, 91％ improved technique and 97％ understood pelvic anatomy. In the training at Lap Mentor™, medical students were able to experience surgery while viewing images of the inside of the pelvis, which served as a means to increase their interest in surgery and obstetrics and gynecology