<Study 2> Saccadic eye movements and regional cerebral blood flow in schizophrenic patients.

This study examined tracking eye movements on predetermined stationary targets inpatients with schizophrenia spectrum dis order.The targets were 8 black points or 8 arabics\u27 numbered points placed on the circumference of a circle.Self-paced eye movements during clockwise tracking of these points by 23 patients and 23 normal controls were recorded using an infrared eye-mark recorder.Eye movements were an alyzed at two settings : first, when "fixation point" was defined as a point at which a gaze was held for at least 200 msec, and second, when held for at least 100 msec.The results indicated that at the 200 msec setting schizophrenic patients track with significantly fewer correct scores and more deviant scores than controls under black-point conditions.At the 100-msec setting, however, the correct scores of the patients were not significantly different from those of the controls, although the patients displayed more aberrant paths than the controls.The superfluous fixations in the patients improved significantly under numbered-point conditions, but patients still achieved lower correct scores than the controls. Four of the 23 patients exhibited centering (aberrant path directed toward the center point), suggesting immature control of eye movements under black-point conditions but not numbered-point conditions.These results suggest that some schizophrenic patients viewed the targets too quickly and that they have impaired directed attention, which can be improved by cues, and may have impaired preprogramming of eye movements, which is not improved by external cues.This study examined saccadic eye movements using simple stationary targets, in schizophrenic patients.The targets were 8 black points or 8 arabic-numbered points placed in randomized order on the circumference of a circle.Self-paced eye movements during clockwise tracking of these points, by 23 patients and 23 controls, were recorded using an infrared eye-mark recorder.Then the relationship between the saccades and clinical syndromes was investigated. Finally, the relationship between the performance of the saccades and resting regional cerebral blood flow (rCBF) was examined using single photon emission computed tomography with 99mTc-hexamethyl propyleneamine oxime (HMPAO).The results indicate that patients track with significantly fewer correct scores and more deviant scores than controls, in agreement with our previous study.There were two groups of patients : an ordinary group who obtained a full target hitting score at a 200 ms setting and a fast group who obtained the full score at 100 ms but not at 200 ms.Some patients displayed significantly more hypermetria than controls.Significant correlations were found between alienation syndrome (auditory hallucination and disturbance of the self) and correct scores, or delusion syndrome and deviant score.With respect to relative rCBF, fast group patients showed significantly decreased rCBF in the left limbic and inferior parietal areas as compared with ordinary group patients.These findings suggest that some schizophrenic patients view the stationary targets too fast and this may be related to dysfunction in the limbic-parietal association area in the left hemisphere.富山医科薬科大学・博士(医学)・乙第283号・松井三枝・1995/6/28富山医科薬科大

A New Candidate Supporting Drug, Rikkunshito, for the QOL in Advanced Esophageal Cancer Patients with Chemotherapy Using Docetaxel/5-FU/CDDP

Purpose. Docetaxel/5-FU/CDDP (DFP) therapy is a useful treatment for advanced esophageal cancer. However, adverse reactions such as chemotherapy-induced nausea and vomiting (CINV) interfere often with continuation of the chemotherapy. We investigated the efficacy of rikkunshito (TJ-43) on CINV. Methods. Nineteen patients who were going to undergo DFP therapy were enrolled. They were assigned to the following two groups: a TJ-43-treated group and -nontreated group. The following parameters were compared between the 2 groups: (1) the frequency of symptoms occurred, (2) vomiting, nausea, and anorexia score, and (3) QOL score. Results. The incidence of symptoms was lower in the TJ-43-treated group than that in the control group. The nausea score of the TJ-43-treated group was significantly lower than that of the control group. In the QOL score, the mood score and the ADL score decreased significantly in the control group. Conclusion. We recommend TJ-43 administration in patients undergoing DFP chemotherapy

The effect of nutritional support on the immune function in the acute postoperative period after esophageal cancer surgery : total parenteral nutrition versus enteral nutrition

Background : Enteral nutrition (EN) is now used more frequently than total parenteral nutrition (TPN) for nutritional support after resection for esophageal cancer. But consensus regarding which type of nutrition should be used does not exist. We studied the effect of TPN and EN on patients’ nutritional status and immune function in the immediate postoperative period after esophageal cancer resection. Methods : We enrolled 30 patients (27 men and 3 women) who underwent subtotal esophagectomy. The patients were randomly assigned to TPN or EN group. Either TPN or EN was begun on postoperative day 1. On postoperative days 1, 3, and 7, three endpoints were measured : albumin, C-reactive protein, and Th1/Th2 balance. Results : All patients completed the study. Anastomotic leaks occurred in 6 patients in the TPN group and 7 patients in the EN group. Albumin, Th1/Th2 balance, and C-reactive protein did not differ between the groups. Th1/Th2 balance was not different regardless of the preoperative treatment or complications. Conclusions. No differences in immune function, nutritional state, or inflammatory response were seen between patients supported with TPN and those supported with EN. The results of our study suggest that perioperative nutritional support can be safely performed either with TPN or EN

The 3-D kinematics of water masers around the semiregular variable RT Virginis

We report observations of water masers around the semiregular variable RT Virginis (RT Vir), which have been made with the Very Long Baseline Array (VLBA) of the National Radio Astronomy Observatory (NRAO) at five epochs, each separated by three weeks of time. We detected about 60 maser features at each epoch. Overall, 61 features, detected at least twice, were tracked by their radial velocities and proper motions. The 3-D maser kinematics exhibited a circumstellar envelope that is expanding roughly spherically with a velocity of about 8 km/s. Asymmetries in both the spatial and velocity distributions of the maser features were found in the envelope, but less significant than that found in other semiregular variables. Systematic radial-velocity drifts of individual maser features were found with amplitudes of <= 2 km/s/yr. For one maser feature, we found a quadratic position shift with time along a straight line on the sky. This apparent motion indicates an acceleration with an amplitude of 33 km/s/yr, implying the passage of a shock wave driven by the stellar pulsation of RT Vir. The acceleration motion is likely seen only on the sky plane because of a large velocity gradient formed in the accelerating maser region. We estimated the distance to RT Vir to be about 220 pc on the basis of both the statistical parallax and model-fitting methods for the maser kinematics.Comment: 18 pages, 8 figures. Accepted to appear in the Astrophysical Journa

ゴウセイ キュウシュウセイ ユチャク ボウシザイ オ シヨウシタ イ ゼンテキ ジュツゴ ニ ハッショウシタ コウヤクセイ イレウス ノ イチレイ

The patient was a 50-year-old male. He underwent total gastrectomy with complication ablationof the greater omentum for gastric cancer. We used composition absorbent materials toprevent adhesion（seprafilm_）at closing of the abdominal wall. When he consulted our hospital forabdominal pain after 7 months later, we diagnosed the patient as having adhesive ileus. Severalhours later, he demonstrated abdominal swelling and fell into shock. Therefore, we performedurgent abdominal surgery. There were large quantities of cacosmia ascites and no adhesion exceptat only one point between the bottom of the previous wound and the small intestine. Weconfirmed strangulation ileus that had turned the small intestine with 360°dextroversion centeringon the adhesion point and the superior mesenteric artery root. Because most of small intestinehad become swollen and necrotized, we performed wide small intestinal resection with about 60cmsmall intestines survived. Currently we are following the patient with at-home intravenous hyperalimentationafter two further reoperations. At the time of the first operation, we had applied　seprafilm. This patient had a very late case of strangulation ileus, because there was almost noadhesion. This case represents a rare r side effect reports, involving shock, infection developingafter the use of seprafilm

ショウチョウカンマク デスモイド シュヨウ ノ 1レイ

A 51-year-old man was referred to our hospital in 2005, because of an abdominal mass in thehypogastrium. There was no tenderness, and the tumor moved to epigastric resion easily. Therewere no important findings in a physical examination, except the mass. Enhanced CT showed themass with clear boundaries of 8cm size that the inside was contrasted heterogeneously in pelviccavity, and the internal was able to confirm tessellated mass by a supersonic wave. We doubtedintestinal GIST and performed an operation. We showed mass of mesoileum origin, in 15cm oralside from terminal ileum, there was no adhesion and invasion to circumference, so we underwent apartial resection of the terminal ileum. It was diagnosed as desmoid of a mesoileum origin by apostoperative histopathology diagnosis. There has been no recurrence for postoperative threeyears. Intraabdominal desmoid is relatively rare, and often noted a history of the laparotomy orestrogenic intervention, and combined with Gardner’s syndrome. In addition, it is assumed that itusually grows infiltrative, and easy to develop local recurrence. We experienced a rare case fallingunder neither, so we report it

イ ジョウコウ ケッチョウ チョクチョウ ノ 3 チョウフクガン ニ タイシテ イッキテキ ニ フククウキョウカ シュジュツ オ シコウ シタ 1レイ

A ５１-years-old man was admitted with anemia. The upper gastrointestinal endoscopy revealed ０-IIa＋IIc lesion in the middle body of the stomach. The colonoscopy revealed type ３ lesion by Borrmann classification with advanced stenosis. Computed tomography of the abdomen revealed the tumor in the ascending colon. We diagnosed a synchronous gastric, ascending colon, and rectal cancer. After neoadjuvant chemotherapy, we performed the laparoscopic operation for the synchronous cancer. There were no remarkable complications due to the collaboration. Laparoscopic approach for synchronous triple cancer is feasible as safety and minimally invasive surgery

Trastuzumab/Capecitabine/Cisplatin HXP リョウホウ ニヨル 2ジ チリョウ ガ ユウコウ デアッタ シンコウ イガン ノ 1レイ

The case was a ６９-year-old man, and gastric cancer （papillary adenocarcinoma） was diagnosed by a close inspection of the abdominal pain in ２００８, and it was our department introduction. Show the type ０‐IIa＋IIc like advanced lesion of gastric middle body gastrointestinal endoscope, and CT showed no regional lymph node and distant metastases, and we diagnosed it as c-T２ （MP）, N０, M０, stageIB. We performed laparoscopic distal gastrectomy with D２ dissection, and in pathology, acknowledgment of severe lymph node metastases was obtained, and diagnosed it as T３ （SE）, N２, M０, stageIIIB. We gave adjuvant chemotherapy with S-１and Cisplatin for ５ cycles, and maintenance S-１alone up to ２４ months after surgery. There was no recurrence for ３９ months after surgery. But multiple metastases to lung recurrence was acknowledged and we performed S-１/Docetaxel therapy for ６ cycles, which lead to progressive disease. Then we performed Trastuzumab/Capecitabine/Cisplatin chemotherapy （HXP）, the anti-tumor effect was good, and after １４ months later, showed a liver metastasis, but the tolerability was good. Generally, it is said that the chemotherapy is poor at an effect after the second line treatment, but HXP may be useful even in the second line chemotherapy

Omentin Prevents Myocardial Ischemic Injury Through AMP-Activated Protein Kinase- and Akt-Dependent Mechanisms

ObjectivesThis study examined the impact of omentin on myocardial injury in a mouse model of ischemia/reperfusion (I/R) and explored its underlying mechanisms.BackgroundObesity is a major risk factor for ischemic heart disease. Omentin is a circulating adipokine that is down-regulated by obesity.MethodsIn patients who underwent successful reperfusion treatment after acute myocardial infarction, cardiac function and perfusion defect were assessed by using scintigraphic images. Mice were subjected to myocardial ischemia followed by reperfusion.ResultsThis study found that high levels of plasma omentin were associated with improvement of heart damage and function after reperfusion therapy in patients with acute myocardial infarction. Systemic administration of human omentin to mice led to a reduction in myocardial infarct size and apoptosis after I/R, which was accompanied by enhanced phosphorylation of AMP-activated protein kinase (AMPK) and Akt in the ischemic heart. Fat-specific overexpression of human omentin also resulted in reduction of infarct size after I/R. Blockade of AMPK or Akt activity reversed omentin-induced inhibition of myocardial ischemic damage and apoptosis in mice. In cultured cardiomyocytes, omentin suppressed hypoxia/reoxygenation-induced apoptosis, which was blocked by inactivation of AMPK or Akt.ConclusionsOur data indicate that omentin functions as an adipokine that ameliorates acute ischemic injury in the heart by suppressing myocyte apoptosis through both AMPK- and Akt-dependent mechanisms

The effects of the herbal medicine Daikenchuto (TJ-100) after esophageal cancer resection, open-label, randomized controlled trial

Background Daikenchuto (TJ-100), a traditional Japanese herbal medicine, is widely used in Japan. Its effects on gastrointestinal motility and microcirculation and its anti-inflammatory effect are known. The purpose of this prospective randomized controlled trial was to investigate the effect of TJ-100 after esophagectomy in esophageal cancer patients. Methods Forty patients for whom subtotal esophageal resection for esophageal cancer was planned at our institute from March 2011 to August 2013 were enrolled and divided into two groups at the point of determination of the operation schedule after informed consent was obtained: a TJ-100 (15 g/day)-treated group (n = 20) and a control group (n = 20). The primary efficacy end-points were maintenance of the nutrition condition and the recovery of gastrointestinal function. The secondary efficacy end-points were the serum C-reactive protein (CRP) level and adrenomedullin level during the postoperative course, the incidence of postoperative complications, and the length of hospital stay after surgery. Results We examined 39 patients because one patient in the TJ-100 group was judged as having unresectable cancer after surgery. The mean age of the TJ-100 group patients was significantly older than that of the control group patients.The rate of body weight decrease at postoperative day 21 was significantly suppressed in the TJ-100 group (3.6% vs. the control group: 7.0%, p = 0.014), but the serum albumin level was not significantly different between the groups. The recovery of gastrointestinal function regarding flatus, defecation, and oral intake showed no significant between-group differences, but postoperative bowel symptoms tended to be rare in the TJ-100 group. There was no significant between-group difference in the length of hospital stay after surgery. The serum CRP level at postoperative day 3 was 4.9 mg/dl in the TJ-100 group and 6.9 mg/dl in the control group, showing a tendency of a suppressed serum CRP level in the TJ-100 group (p = 0.126). The rate of increase in adrenomedullin tended to be high postoperatively, but there was no significant difference between the two groups. Conclusions TJ-100 treatment after esophageal cancer resection has the effects of prompting the recovery of gastrointestinal motility and minimizing body weight loss, and it might suppress the excess inflammatory reaction related to surgery