Epigallocatechin gallate suppresses peritoneal fibrosis in mice.

Long-term peritoneal dialysis (PD) leads to histological changes in the peritoneal membrane. Angiogenesis and inflammation caused by glucose degradation products (GDPs) play crucial roles in peritoneal fibrosis. One such GDP is methylglyoxal (MGO), which enhances the formation of advanced glycation end products (AGEs). AGEs bind to their receptor (RAGE) and activate nuclear factor-κB (NF-κB), which is a key regulator of angiogenesis and inflammation. Recent studies have indicated that (-)-epigallocatechin gallate (EGCG), a tea polyphenol, inhibits angiogenesis and inflammation. Here, we examined whether EGCG suppresses peritoneal fibrosis in mice. Based on preliminary examination, 2mL of 40mM MGO or PD fluid was injected intraperitoneally and EGCG (50mg/kg) or saline was injected subcutaneously for 3weeks. In comparison to PD fluid+saline-treated mice, the peritoneal tissues of MGO+saline-treated mice showed marked thickening of the submesothelial compact zone. In the submesothelial compact zone of the MGO+saline-treated mice, CD31-positive vessels and vascular endothelial growth factor-positive cells were significantly increased, as were inflammation, F4/80-positive macrophages, and monocyte chemotactic protein-1. Moreover, 8-hydroxydeoxyguanosine, a marker of reactive oxygen species, and NF-κB, determined by Southwestern histochemistry, in the submesothelial compact zone were also increased in MGO+saline-treated mice. These changes were attenuated in MGO+EGCG-treated mice. We demonstrated that EGCG treatment suppresses peritoneal fibrosis via inhibition of NF-κB. Furthermore, EGCG inhibits reactive oxygen species production. The results of this study indicate that EGCG is a potentially novel candidate for the treatment of peritoneal fibrosis

ジョセイ コツバン ゾウキ ダツ カンジャ ニ タイスル Tension-free Vaginal Mesh シュジュツ ノ ハイニョウ キノウ ト Quality of Life ニ アタエル カイゼン コウカ ノ ケントウ

骨盤臓器脱にTVM 手術を施行した51 症例を対象としてUFM, 残尿量,P-QOL,ICIQ-SF 及びIPSSを調査することによりTVM 手術の下部尿路症状,排尿機能とQOL に与える改善効果を評価した.周術期成績と解剖学的改善度は良好であり,IPSS による下部尿路症状の評価では夜間頻尿以外のすべての項目で有意に改善した.またP-QOL を用いたQOL 評価でも有意な改善を示した.本研究では骨盤臓器脱に対してTVM 手術が下部尿路症状,排尿機能,QOL を短期間の評価ながら改善する事を示した.今後は解剖学的治療効果のみでなく,排尿や性機能を含めて長期間評価することが必要と考えられた.The aim of this paper is to describe the perioperativemedical outcome, complications and the improvement ofvoiding function and their quality of life( QOL) in 51 casesof tension-free vaginal mesh (TVM) for the treatment ofpelvic organ prolapse( POP) at our institute. Perioperativemedical outcome and anatomical restoration were good atsix months after the operation. Lower urinary tract symptomand QOL of the patients were statistically much improvedbased on the results of IPSS and prolapse quality oflife questionnaire( P-QOL), except for nocturia. This studyshowed improvement of voiding function and QOL for thefemale POP.Further studies will be needed for a long period not onlythe anatomical restoration but also the voiding and sexualfunction

フククウキョウカ シュジュツ ショケン カラ ノ ジンウ ニョウカン イコウ ブ キョウサクショウ ノ ケイタイ ブンルイ ト ジュツゴ ケイカ

【目的】水腎症の原因である腎盂尿管移行部閉塞(Uretero-Pelvic Junction Obstruction;UPJO)の病因を形態的に分類し,患者背景,術後の経過との関連性について検討した.【方法】2009年3月から2013年4月までに獨協医科大学越谷病院で施行した腹腔鏡下腎盂形成術(Laparoscopic Pyeloplasty;LPP)38症例について検討した.術中所見とビデオの見直しから以下のように3つの病因に分類した.Type 1:血管による閉塞を有するもの.Type 2:肥厚した被膜が腎盂尿管を包み込むもの.Type 3:硬い被膜に包まれ尿管の屈曲,狭窄を認めるもの.上記病因と術前後における症状,腹部超音波所見および利尿レノグラムを用いて評価した手術成績について比較検討した.【結果】38症例を手術ビデオで見直した結果,Type 1は14例,Type 2は13例,Type 3は11例であった.小児症例はType 1の症例が少なく,Type 2およびType 3が多かった.各Typeでの術後の症状,腹部超音波所見,利尿レノグラムの改善率に有意差はなかった.【結語】UPJOの形態と年齢には関連を認めたが,術後成績には明らかな違いは認めなかった.Background:To analyze the relationship between the etiology of ureteropelvic junction obstruction (UPJO) and surgical outcomes using laparoscopic clear view during pyeloplasty. Method:Total 38 patients who underwent laparoscopic pyeloplasty by Anderson-Hynes technique from 2009 March to 2013 April at Dokkyo Medical University Koshigaya Hospital, were enrolled into the study. According to the structure of the ureteropelvic junction under the laparoscopic view UPJO was divided to 3 types, type 1 (n= 14):vascular causes of ureteral obstruction, type 2 (n= 14):the presence of adhesion around UPJ, type 3 (n= 11):the presence of angulation due to ureteral kinks or adhesion. The relationships between types of UPJO and surgical outcomes were analyzed.Results:Many of pediatric patient were included in type 2 and 3. Types of UPJO were not related to operation time, symptom, abdominal ultrasonography, and results of diuretic renogram.Conclusion:Most of pediatric patients with hydronephrosis had no vascular cause. There are no significant differences between each types and surgical success rate in patients underwent laparoscopic pyeloplasty

STUDIES ON VITRIOL SPRINGS (4) ON THE COPPER, ZINC, NICKEL, AND COBALT CONTENTS OF BLOOD AFTER THE INTERNAL USE OF A VITRIOL WATER

Sotozono proved that the administration of daily 20cc of Fujino Mineral Water (an acid vitriol water containing copper, zinc, nickel and cobalt) has a remarkably beneficial effect on several kinds of hypochromic anemia. It contains 9.56gms of iron, 0.007gm of zinc, 0.005gm of copper 0.001gm of nickel, and 0.006gm of cobalt in one liter. 20 - 40cc of Fujino water was diluted 5 - 10 fold with plain water and administered to the fasting patients perorally. Blood samples were taken from cubital vein before, 1, 2, 4, 6, 24, 48, and 72 hours after the intake of the vitriol water. Copper, zinc, nickel and cobalt contents of the blood samples were measured by Ashizawa' s dithizone- chromatographic method. It was shown that copper, nickel, and cobalt contents of blood rose unexpectedly high temporarily, in a manner that did not correspond to their amount in the given mineral water. So that the mobilization of copper, nickel, and cobalt in the body after the intake of the mineral IVrter was susrected. Zinc content of blood showed no constant tendency

精巣胚細胞腫瘍の臨床的検討

精巣胚細胞腫瘍65例68精巣を臨床的に検討した.36精巣(53.7%)はセミノーマで, 残りはnon-seminomatous germ cell testicular tumor(NSGCTT)であった.セミノーマ症例のうち31例(88.6%)はI期でそれ以外は受診時に転移巣を有していた.NSGCTTのうち22例(68.8%)はI期であった.セミノーマ及びNSGCTT症例の平均年齢は各々40.4, 29.2歳であった.39例(60.0%)は右側, 23例(35.4%)は左側, 3例(4.6%)は両側性であった.5例は停留精巣の既往を有していた.49例(73.1%)において主訴は無痛性精巣腫大であった.症状発現から受診迄の期間はNSGCTT症例よりセミノーマの方が長かった(平均10.9ヵ月と3.4ヵ月).Immunosuppressive acidic protein(IAP)はalpha-feto protein(AFP), beta-human chorionic gonadotropin(betahCG), lactic dehydrogenase(LDH)と共に腫瘍マーカーとして有用であったA clinical statistical analysis on 65 patients with 68 testicular germ cell tumors was performed. Thirty-six testes (53.7%) had seminomas and the remainder non-seminomatous germ cell testicular tumors (NSGCTTs). Of the seminomas, 31 (88.6%) were in stage I and the others showed distant metastases at presentation. Of the 32 NSGCTTs, 22 (68.8%) were in stage I. The average ages of the patients with seminomas and NSGCTTs were 40.4 and 29.9 years, respectively. Thirty-nine patients (60.0%) had tumors on the right side, 23 (35.4%) on the left and 3 (4.6%) in both testes. Five patients had a past history of cryptorchidism. Chief complaints in 49 patients (73.1%) were a painless scrotal mass. The interval from clinical onset to presentation was longer in seminoma patients than in NSGCTT patients (10.9 months on average versus 3.4 months). Immunosuppressive acidic protein (IAP) was a useful diagnostic tumor marker as well as alpha-feto protein (AFP), beta-human chorionic gonadotropin (beta-hCG) and lactic dehydrogenase (LDH). We adopted a surveillance policy in more than half of the stage I patients and obtained acceptable results. In the remaining cases, therapies including combination chemotherapy, radiation and salvage operation were performed after orchiectomy. The three-year survival rate was 98.0, 100.0 and 26.7%, for stage I, II and III patients respectively