Investigation of laparoscopic therapy in 56 cases of duodenal ulcer perforation

Background: Although conservative therapy has been acceptable as the first-line therapy for duodenal ulcer (DU) perforations, surgical therapies are known to have certain advantages. We investigated the indications for laparoscopic (LS) or open surgery (OS) or conservative therapy (CoT) among 56 DU perforation cases over 5 years. Methods: 31 LSs, 22 OSs and 5 CoTs were analyzed for patient's physical and surgical factors and clinical course. Results: Mean age was 51.6. Male/female ratio was 49/9. Survival ratio was 98%. Although the hospital stay (10.9 vs 19.5 days) and analgesic administrations (1.9 vs 4.6 days) were significantly shorter in LS than OS, almost all OS patients were in serious condition as evidenced by longer waiting time before treatment, stronger pain, bigger hole of perforation, more ascites accumulation and higher morbidity of complications. Two cases of multisurgery were experienced in both LS and OS groups due to leakage of seam, abscess formation, relapsed ulcer or idiopathic intestinal perforation. LS is a therapy more widely usable and more beneficial than the other two. Conclusion: LS, a minimally invasive surgery for DU perforation, should be considered as a first-line standard therapy because of significant advantages such as shorter hospital stay. OS or CoT may be selected when appropriate

Lap-Protector and Circular Stapler Are Useful in Cystogastrostomy for Large Pancreatic Pseudocyst with Severe Infection

Lap-Protector, which is an abdominal wall sealing device, is usually used for wound protection from implantation of malignant cells or pyogenic fluid. A circular stapler is a common easy-to-use device for anastomosis of the digestive tract. We report the case of an infected pancreatic pseudocyst which was treated by surgical procedure using these useful devices. A 69-year-old man was followed up in our hospital after severe acute pancreatitis. He had undergone drainage surgeries twice for intractable pancreatic abscess followed by severe acute pancreatitis. He was admitted to our hospital complaining of loss of appetite, hiccups, and high fever. Computed tomography of the abdomen revealed an infected pancreatic pseudocyst which compressed the gastric wall. Internal drainage into the stomach was performed using Lap-Protector and circular stapler. The patient recovered uneventfully. Recently many endoscopic or laparoscopic procedures in cystogastrostomy are reported; however, a conventional open surgical approach is also important. This easy method may be useful for operative cystogastrostomy

ステロイド チョウキ トウヨ カンジャ ニオケル シュウジュツキ ステロイド カバー

In patients receiving chronic corticosteroid therapy, the adrenocortical function has decreased because of suppression of the hypothalamic-pituitary-adrenal axis. Under such a condition, it is easy to fall into a serious acute adrenocortical insufficiency during surgical stress. Corticosteroid supplementation is done as prevention of adrenocortical insufficiency. It is changing from corticosteroid supplementation of high dose into that of low dose that based on extrapolation from what constitutes a normal cortisol response to stress in recent years. On the other hand, some authors reported that patients receiving therapeutic doses of corticosteroids who undergo a surgical procedure do not routinely require corticosteroid supplementation so long as they continue to receive their usual daily dose of corticosteroid. Therefore, furthermore investigation should be necessary

Construction of Chiral Nano-Space toward Chiral Recognition and Asymmetric Reaction

Synthesis of axially chiral dicarboxylic acids with a rigid and straight structurewas studied. The preparation of copper salt of this type of dicarboxylic acid was alsostudied. Optically active 2,2\u27-dihydroxy-1,1\u27-binaphthalene-4,4\u27-dicarboxylic acid 2a wasprepared from the corresponding bromide 3 via cyanation followed by hydrolysis althoughthe reaction proceeded in very low yield. We found that 2a could be effectively preparedfrom 3 via palladium complex-catalyzed vinylation followed by KMnO4 oxidation. Directcarboxylation of 3 via lithiation followed by the reaction with CO2 was unsuccessful becauseof the instability of the monolithiated intermediate. The synthesis of optically activeallene-1,3-dicarboxylic acid 9 was investigated. The optical resolution of racemic 9 via thequinine salt was unsuccessful due to slow decomposition, therefore, diasteromericresolution of (-)-menthyl ester was investigated. A copper (II) salt of racemic2,2\u27-dihydroxy-1,1\u27-binaphthalene-3,3\u27-dicarboxylic acid 15 was prepared. X-raycrystallographic analysis of the single crystal of 15-Cu (II) showed a 2D infinite sheetstructure, where each sheet was composed of only one of the enantiomers of 15. Thecrystal had micropores of 4.15 Å diameter, which well corresponded to the value obtainedfrom the micropore size distribution measurement. Because of the micropore structure,the crystal showed a large surface area (BET: 642 m2g-1, Langmuire: 919 m2g-1).■原 著■ 2007 年度神奈川大学総合理学研究所共同研究助成論

In Vivo and In Vitro Studies Suggest a Possible Involvement of HPV Infection in the Early Stage of Breast Carcinogenesis via APOBEC3B Induction

High prevalence of infection with high-risk human papilloma virus (HPV) ranging from 25 to 100% (average 31%) was observed in breast cancer (BC) patients in Singapore using novel DNA chip technology. Early stage of BC demonstrated higher HPV positivity, and BC positive for estrogen receptor (ER) showed significantly higher HPV infection rate. This unique association of HPV with BC in vivo prompted us to investigate a possible involvement of HPV in early stages of breast carcinogenesis. Using normal breast epithelial cells stably transfected with HPV-18, we showed apparent upregulation of mRNA for the cytidine deaminase, APOBEC3B (A3B) which is reported to be a source of mutations in BC. HPV-induced A3B overexpression caused significant γH2AX focus formation, and DNA breaks which were cancelled by shRNA to HPV18 E6, E7 and A3B. These results strongly suggest an active involvement of HPV in the early stage of BC carcinogenesis via A3B induction

p53 変異型ヒト口腔がん細胞における高LET 放射線によるp53 非依存Akt 生存シグナルの抑制

Although mutations and deletions in the p53 tumor suppressor gene lead to resistance to low linear energy transfer (LET) radiation, high-LET radiation efficiently induces cell lethality and apoptosis regardless of the p53 gene status in cancer cells. Recently, it has been suggested that the induction of p53-independent apoptosis takes place through the activation of Caspase-9 which results in the cleavage of Caspase-3 and poly (ADP-ribose) polymerase (PARP). This study was designed to examine if high-LET radiation depresses serine/threonine protein kinase B (PKB, also known as Akt) and Akt-related proteins. Human gingival cancer cells (Ca9-22 cells) harboring a mutated p53 (mp53) gene were irradiated with 2 Gy of X-rays or Fe-ion beams. The cellular contents of Akt-related proteins participating in cell survival signaling were analyzed with Western Blotting 1, 2, 3 and 6h after irradiation. Cell cycle distributions after irradiation were assayed with flow cytometric analysis. Akt-related protein levels decreased when cells were irradiated with high-LET radiation. High-LET radiation increased G(2)/M phase arrests and suppressed the progression of the cell cycle much more efficiently when compared to low-LET radiation. These results suggest that high-LET radiation enhances apoptosis through the activation of Caspase-3 and Caspase-9, and suppresses cell growth by suppressing Akt-related signaling, even in mp53 bearing cancer cells.博士（医学）・甲第598号・平成25年3月15日Copyright © 2012 Elsevier Inc. All rights reserve

Extreme deformability of insect cell membranes is governed by phospholipid scrambling

昆虫の細胞は柔らかい！ --細胞膜を柔らかくするタンパク質を発見--. 京都大学プレスリリース. 2021-06-09.Organization of dynamic cellular structure is crucial for a variety of cellular functions. In this study, we report that Drosophila and Aedes have highly elastic cell membranes with extremely low membrane tension and high resistance to mechanical stress. In contrast to other eukaryotic cells, phospholipids are symmetrically distributed between the bilayer leaflets of the insect plasma membrane, where phospholipid scramblase (XKR) that disrupts the lipid asymmetry is constitutively active. We also demonstrate that XKR-facilitated phospholipid scrambling promotes the deformability of cell membranes by regulating both actin cortex dynamics and mechanical properties of the phospholipid bilayer. Moreover, XKR-mediated construction of elastic cell membranes is essential for hemocyte circulation in the Drosophila cardiovascular system. Deformation of mammalian cells is also enhanced by the expression of Aedes XKR, and thus phospholipid scrambling may contribute to formation of highly deformable cell membranes in a variety of living eukaryotic cells