Search

1982年より1991年までの間に当科で行った冠動脈再建術961例のうち, 周術期に脳梗塞を発症した12例を対象に周術期の脳梗塞について検討した. 症例の平均年齢は65±4歳, 術前の冠動脈危険因子は高血圧9例, 糖尿病7例, 高脂血症5例であった. 頭蓋内病変は多発性梗塞3例, 中大脳動脈領域の梗塞6例, 後大脳動脈領域の梗塞1例, 橋梗塞1例, 眼底動脈塞栓症1例であった. 脳梗塞の強く疑われる原因は上行大動脈の粥状硬化病変によると思われるもの7例, 術中の脳低灌流によるもの1例, 上室性不整脈により形成された遊離血栓によるもの2例, 左室壁在血栓の遊離によるもの1例, 不明1例であった. 予後は重症例6例のうち2例が10か月, 21か月に病院死亡, 1例が8か月後に死亡した.

We report on a case of organized thrombus of the tricuspid valve mimicking a valve tumor. Preoperative transesophageal echocardiography showed the mass to have originated from the septal leaflet of the tricuspid valve. A pouch of the tricuspid valve and a ventricular septal defect were observed perioperatively, with the mass attached to the septal leaflet. Histologic examination revealed the mass to be an organized thrombus without tumor components.

心臓原発の悪性腫瘍は希で, そのなかでも平滑筋肉腫は少なく, 外科的切除例の報告は20例に満たない. 今回, 右房内に発生した平滑筋肉腫というきわめて希な症例を経験したので報告する. 症例は69歳女性. 胸部大動脈瘤に対しステントグラフト留置を行ったが, このときの術前胸部CTで, 右房を占拠する腫瘍を認めた. その後心不全症状が出現したため, 人工心肺下に摘出術を施行した. 術後病理組織検査で平滑筋肉腫と診断された. 術後2カ月に脳転移巣からの出血に対して, 放射線治療を行ったところ著効を示した. 右房腫瘍発見後12カ月経過した現在, それ以外の再発は認めていない.

The 17-propanamide derivatives of diastereomeric Δ(14)-17α- and 17β-estradiols, the potential candidates of a 17β-hydroxysteroid dehydrogenase (17β-HSD) inhibitor, were synthesized in 11 steps from estrone. The principal reactions employed involved in (1) conversion of estrone to the corresponding Δ(14)-estrone, (2) Grignard reaction of Δ(14)-estrone with allylmagnesium bromide followed by regioselective hydroboration of the resulting stereoisomeric 17ξ-allyl-Δ(14)-17ξ-ols with 9-borabicyclo[3.3.1]nonane (9-BBN), and (3) direct amidation of the 17ξ-O-/17ξ-C-spiro-γ-lactones with NH(3) under positive pressure of H(2).

We aimed to evaluate the feasibility of using streptavidin-biotin-based pretargeting for positron emission tomography (PET) imaging of hypoxia-inducible factor (HIF)-1-active tumors.We used POS, a genetically engineered form of streptavidin that selectively stabilizes in HIF-1-active cells, and (4-(18)F-fluorobenzoyl)norbiotinamide ((18)F-FBB), a radiolabeled biotin derivative, for performing a biodistribution study and for PET imaging. The tumoral (18)F-FBB accumulation was compared to the HIF-1-dependent luciferase bioluminescence and HIF-1α immunohistochemical signal.(18)F-FBB accumulation was observed in POS-pretargeted tumors in mice (2.85 ± 0.55% injected dose per gram at 3 h), and clear PET images were obtained at the same time point. The tumoral (18)F-FBB accumulation positively correlated with luciferase bioluminescence (R = 0.72, P 0.05), and most of the area showing (18)F-FBB accumulation corresponded to HIF-1α-positive areas.Pretargeting with POS and (18)F-FBB is an effective approach for PET imaging of HIF-1-active areas in tumors.

In cardiovascular surgery, blood transfusions have been associated with infections (hepatitis B, C, and HIV) and immunologic reactions. To prevent transfusion complications, we should organize a transfusion guideline which indicate the appropriate timing of blood transfusion and the total amount of blood volume because a resourse of the blood product is limited. It is also very important to induce blood conservation techniques. Drugs that decrease bleeding and increase blood volume, devices that preserve blood, and autologous blood donation are most effective. Reduction of the transfusion requirement in cardiovascular surgery leads to a decreased morbidity and mortality.

To clarify the whole picture of epidermal growth factor (EGF) signaling pathway, we identified proteins from the EGF-stimulated A431 cells by anti-phospho-tyrosine antibody column chromatography. Over 150 proteins were detected including previously unidentified proteins as well as well-studied proteins. Among these proteins, we picked up four proteins that had not been known in EGF signaling pathway and analyzed their functions. We report the functions of these proteins in this article. 1) CFBP interacts with CD2AP family proteins and functions as a key component in downregulation of EGF receptor protein level following EGF stimulation. 2) Ymer is found to be phosphorylated and ubiquitinated upon EGF stimulation, and functions as a regulator for the downregulation and endocytosis of EGF receptor. 3) CLPABP binds to mitochondria-specific phospholipids, cardiolipin, through its PH domain, and its complex includes various proteins related to mRNA metabolism. 4) GAREM is associated with Grb2 and Shp2. Each association affects the ERK activity. Finally, we discuss the possibilities that these proteins can be used as a novel biomarker protein for cancer and other diseases.

To clarify the whole picture of epidermal growth factor (EGF) signaling pathway, we identified proteins from the EGF-stimulated A431 cells by anti-phospho-tyrosine antibody column chromatography. Over 150 proteins were detected including previously unidentified proteins as well as well-studied proteins. Among these proteins, we picked up four proteins that had not been known in EGF signaling pathway and analyzed their functions. We report the functions of these proteins in this article. 1) CFBP interacts with CD2AP family proteins and functions as a key component in downregulation of EGF receptor protein level following EGF stimulation. 2) Ymer is found to be phosphorylated and ubiquitinated upon EGF stimulation, and functions as a regulator for the downregulation and endocytosis of EGF receptor. 3) CLPABP binds to mitochondria-specific phospholipids, cardiolipin, through its PH domain, and its complex includes various proteins related to mRNA metabolism. 4) GAREM is associated with Grb2 and Shp2. Each association affects the ERK activity. Finally, we discuss the possibilities that these proteins can be used as a novel biomarker protein for cancer and other diseases.

Anterior spinal fusion is a useful method for lumbar spinal disorders even though the fusion rate is not particularly high. However it has been demonstrated that the fusion rate is greater than 98% when using the A-O screw and wiring method. We used this method for 12 cases. In our seres there were 4 cases with wire-loosening (28.6%), which can be dangerous for vessels as the wire edge is sharp. We Therefore investigated the possibility of using Tekimron thread as a substitute for the wire. In vitro, the inter-column pressure measured by pressure gauge showed that Tekmiron thread was as useful as the wire.

72歳男性. 特発性間質性肺炎 (IIP) を伴う不安定狭心症の診断のもと冠動脈造影 (CAG) を施行し, LMTに90%の狭窄病変を認め, PTCAを施行したが約2か月後再び不安定狭心症となり, CAGでLMT 90%の再狭窄を認めたため, 冠動脈再建術 (CABG) を施行した. 術前, 胸部X線像では両側下肺野にびまん性細粒状影を認め, 聴診上も Velcro ラ音を聴取した. 手術は高齢者かつ肺機能低下例でもあることを考慮し, 短時間での血行再建を目標に伏在静脈を用いた2枝バイパスを行った. 体外循環終了後に一時的なPaO2の低下をみたが, 周術期は血行動態, 呼吸状態ともに安定しており, 第1病日に抜管した. 術後は特発性間質性肺炎の急性増悪もみられず29病日に退院した.

We investigated the distribution of spinal motoneurons corresponding to cervical nerve roots using the HRP (horseradish peroxidase) method as well as assessing the anatomical levels of anterior and posterior filaments, and discs. Eighteen forelimbs of Wistar rats were used, and 250I. U. (3μl) HRP solusion was injected into their cervical nerve roots. The levels of anterior and posterior filaments and discs on the corsd were noted microscopically, and motoneurons in the anterior horn at each levels were labelled, then compared to the levels of anterior and posterior filaments and discs.Motoneurons corresponding to the C5 nerve root were distributed from the middle of the C4 segment to upper part of the C6 segment with 92.3% of motoneuros located in the C5 segment.Motoneurons corresponding to the C6 nerve root were distributed from the middle of the C5 segment to the upper part of the C7 segment with 95.8% of motoneurons located in the C6 segment.Motoneurons corresponding to the C7 nerve root were distributed from the upper part of the C7 segment to the middle of the C8 segment with 95.5% of motoneurons located in the C7 segment.Anterior and posterior filament levels were almost the same from C5 to C7 and C4/5, C5/6, C6/7 disc levels were almost the same C5/6, C6/7, C7/8 spinal segments.

水酸化物型強塩基性陰イオン交換樹脂を用いるイオン排除クロマトグラフィーによるモノ,ジ及びトリエタノールアミンなどの弱塩基性アルカノールアミン類の簡便な分離定量法を開発し,化粧品中のトリエタノールアミンの分離定量に対して応用した.アルカノールアミン類は,水溶離液により主としてそれらの解離定数(pKb)の差に基づいて分離可能であったが,比較的疎水性の大きいトリエタノールアミンは吸着作用の関与を示すテイリングと再現性の乏しいクロマトグラムを示した.そこで,このイオン交換樹脂マトリックスへの吸着作用を抑制するために,溶離液として親水基(OH基)を有する多価アルコールを含む水系溶離液について検討しタところ,2%グリセリン溶離液によりアルカノールアミン類の再現性があり,しかも分離能の高いクロマトグラム(相対標準偏差1%以下)と良好な直線性(1～5mM)を有する検量線を得ることができた.本法は,種々の化粧品に対して良好に適用可能であった.

We analyzed the relations hip between the upper cervical spine and vertebral artery by angiography. The subjects of this study were 50 patients, whose ages ranged from 19 to 77 years. We measured; 1) the distance between the vertebral artery and midline at the level of C1 and C2; 2) the distance between the vertebral artery and midline at the level of the atlantoaxial joint; 3) the distance between the vertebral artery and C2 pedicle. The point of screw placement for C1-2 transarticular fixation was found to be 40% from the medial side of the atlantoaxial joint from the A-P view and 5% from the C2 pedicle from the lateral view.

修正大血管転位症に動脈側房室弁閉鎖不全(TR)を合併することはよく知られ,外科的処置の報告も多いが,今回われわれは,腱索断裂によるTRと静脈側房室弁閉鎖不全(MR)を合併した心不全の症例に対し,2弁置換術を施行した.本邦での腱索断裂の報告は1例だけであり,またMRの外科的処置の報告は3例にすぎない,今回は両心不全のため早期に確実に循環動態を改善すべく2弁置換術を選択,良好な結果を得たので報告する.

A 64-year-old man was admitted to Nagasaki Rosai Hospital on December 29th, 1989. His complaints were paralysis of bilateral lower extremities and urinary disorder. He felt spinal ache on Dec. 10th with no cause and paresthesia of bilateral lower extremities on Dec. 26th. In physical examination we found anesthesia under Th7 neurological level and diminishing of reflexes under the level. Laboratory data showed inflammation and with spinal puncture we suspected existence of obstructive lesion in Th level. With MR imaging we found space occupying lesion just behind of the spinal cord at Th4.5 level. The lesion showed low intensity in T1, high intensity in T2, and the margin of the lesion showed high in T1, low in T2.We suspected the lesion as spinal epidural abscess and did emergent operation on December 29th, 1989. At operation the lesion was proved to be spinal epidural abscess and we did Th345 laminectomy and rejection of the abscess.

DBA/2FG-pcy and C57BL/6FG-pcy congenic strains were established by transferring the polycystic kidney disease gene, pcy, to DBA/2 and C57BL/6 mice. We carried out pathological and hematological examinations of these strains at 4, 8, 16 and 30 weeks of age. In DBA/2FG-pcy mice more than 8 weeks of age, macroscopic renal cysts were observed on the surface of both kidneys. Their kidneys weight was significantly greater than in DBA/2 mice at all ages examined. Microscopic renal cysts were evenly distributed at 4, 8 and 16 weeks of age. At 30 weeks of age, the kidneys were filled with numerous polycysts. In C57BL/6FG-pcy mice, no macroscopic renal cysts were found until the animals were 30 weeks old, and the weight of their kidneys was greater than in B6 mice of the same age. From 8 weeks of age on, a limited number of microscopic renal cysts was observed, and many renal cysts were found adjacent to the enlarged Bowman's capsules. With age, the red blood cell count and hematocrit level decreased while the platelet count increased in both strains, with greater changes occurring in DBA/2FG-pcy mice than in C57 BL/6FG-pcy mice. These findings demonstrate that polycystic kidney disease exhibits strain differences in animals with a DBA/2 and C57BL/6 background. Our results suggest that phenotypic expression of the pcy gene in the mouse depends on genetic background, and that variations in the severity of human polycystic kidney disease may be explained, at least in part, by individual differences in genetic background.

Six patients with posterior ring apophyseal separation were treated during 1983-1990. Four patients required surgery, and the others were treated by conservative treatment. However, the conservative cases recoverd siower than the surgical cases in SLR test.Our studies showed good resuits for each operative method. However, it was agreed that the operative methods which were not dangerous for nerve tissues were generally the methods which showed the best results.

The characteristic differences between skin and lip surface and the age associated alterations on lip surface were studied in this experiment.Transepidermal water loss (TWL) value of lip surface was significantly higher than that of skin surface, And parakeratotic cells of corneocytes obtained by tape-strip method were also significantly more numerous in lip than in skin. These results indicated that the barrier function of lip surface is lower than that of skin, The characteristics between inside and outside of lip corneocytes were remarkably difference on the number of melanin granules and the intensity of DACM (N-(7-dimethylamino-4-methyl-3-coumarinyl) maleimide) fluorescence. The melanin granules stained with Fontana, silver ammonium solution were hardly observed and almost corneocytes were not stained with DACM in inside of lip surface. These phenomena suggested that the lip is more affective regions against environmental stimulation factors; dryness, ultraviolet rays and so on.Age-associated alterations of lip were studied on 101 healthy women (20-58 years old). TWL value of lip was decreased accompany with aging. Parakeratotic cells were observed most numerous in third decade and after that those were decreased with age. The number and depth of sulcus cutis were decreased with age by analyzed with image analyzer from replica of lip surface. These findings were similar to the skin alterations associated with age.

24 patients operated by partial laminectomy and 22 patients operated by wide laminectomy, with out fusion, were compared. There were no difference between partial laminectomy and wide laminectomy about subjective symptom, ADL, return to the work and satisfaction. But in wide laminectomy, instability after operation increased as time goes on and as degrees of lumbago.

Pedicle screw fixation is now routinely employed. Implantation safety depends upon anatomic constraints from the pedicles. We measured directly the lumbar pedicles of cadavera of 20 patients and observed the isthmus shape of the pedicles in the pedicle models. We found that some transverse diameters are smaller than 6.0mm and that the pedicles are almost round or oval shaped with the exception of those of fifth lumbar vertebra.These informations on these variations might help to prevent failure of fixation and injury to vital structures.

STUDY DESIGN To report a new index, the K-line, for deciding the surgical approach for cervical ossification of the posterior longitudinal ligament (OPLL). OBJECTIVE To analyze the correlation between the K-line-based classification of cervical OPLL patients and their surgical outcome. SUMMARY OF BACKGROUND DATA Previous studies showed that kyphotic alignment of the cervical spine and a large OPLL are major factors causing poor surgical outcome after laminoplasty for cervical OPLL patients. However, no report has evaluated these 2 factors in 1 parameter. METHODS The K-line was defined as a line that connects the midpoints of the spinal canal at C2 and C7. Twenty-seven patients who had cervical OPLL and underwent posterior decompression surgery were classified into 2 groups according to their K-line classification. OPLL did not exceed the K-line in the K-line (+) group and did exceed it in the K-line (-) group. By intraoperative ultrasonography, we evaluated the posterior shift of the spinal cord after the posterior decompression procedure. The Japanese Orthopedic Association scores before surgery and 1 year after surgery were evaluated, and the recovery rate was calculated. RESULTS Eight patients were classified as K-line (-), and 19 patients were classified as K-line (+). The mean recovery rate was 13.9% in the K-line (-) group and 66.0% in the K-line (+) group (P < 0.01). Ultrasonography showed that the posterior shift of the spinal cord was insufficient in the K-line (-) group. CONCLUSION The present results demonstrate that a sufficient posterior shift of the spinal cord and neurologic improvement will not be obtained after posterior decompression surgery in the K-line (-) group. Our new index, the K-line, is a simple and practical tool for making decisions regarding the surgical approach for cervical OPLL patients.

Carbon tetrachloride (CCl4) is known to induce liver damage. Animal experiments with CCl4 injections have revealed many findings, especially mechanisms of liver damage and liver regeneration. Recently, proteomic approaches have been introduced in various studies to evaluate the quantitative and qualitative changes in the comprehensive proteome level. The aim of this research is to elucidate the key protein for liver damage, liver protection and liver regeneration by using proteomic techniques. 50 % (v/v) CCl4 in corn oil was administered intraperitoneally to adult male rats at a dose of 4ml/kg body weight. Approximately 24h after the injection, the liver was removed and extracted proteins were analyzed with cleavable isotope coded affinity tag (cICAT) reagents, two-dimensional gel electrophoresis (2-DE) and mass spectrometry (MS). A twelvefold increase in D-dopachrome tautomerase (DDT) was indicated. This enzyme has been reported to be involved in the biosynthesis of melanin, an antioxidant. According to the histological analysis, melanin levels were increased in un-damaged hepatocytes of CCl4-treated rats. These results suggest that the increase in DDT is a response to liver damage, accelerates melanin biosynthesis and protects the liver from oxidative stress induced by CCl4.

Inoculation tests of Staphylococcus aureus were performed to evaluate the risk of toxic hazard in cheese manufacturing processes. S. aureus was inoculated into pasteurized milk or cheese curd, and the survival and growth were examined. S. aureus grew only slightly or decreased in cell number under the manufacturing condition of semi-hard type cheese or soft-type cheese. Under the conditions of the fresh cheese making process, S. aureus slightly increased in cell number, though no enterotoxin was detected. In processed cheese, S. aureus did not grow at all. Growth inhibition of S. aureus by lactic acid produced from starter culture was suggested to be the cause of growth inhibition in the natural cheese.

Reaction mechanism, hydrogen transfer and consumption of asphaltene hydrogenation were examined at 723K and 10.1MPa of nitrogen or hyd-rogen with or without solvent and catalyst. The asphaltene was prepared by hyd-rogenating Akabira coal at 723K and 10.1MPa of hydrogen. The oil products, i.e. the hexane solubles, were fractionated by gas chromatography into four oil compo-nents, O1 to O4, having different boiling-point temperature ranges and aromatic ring numbers.On the basis of the time profiles of the asphaltene conversion and the yields of oil fractions and gas, it was shown that the rate for formation of oil components from the heavier ones was negligibly small so that they could be assumed to be formed indepen-dently each other from asphaltene. Asphaltene was easily hydrogenated to oil compo-nents by tetralin. In the presence of Co-Mo-Al2O3, only the rate for formation of the heaviest oil component, O4, was accelerated by hydrogen transfer from the gas phase. The hydrogen consumption per unit mass of asphaltene was found to increase in prop-ortion to the asphaltene conversion, implying that reactivity of asphaltene was almost invariable during initial stage of hydrogenation.

A case of concurrent diastematomyelia and syringomyelia in a 6-year-old girl was presented. She had hypertrichosis and dimple in the lumbosacral region. X-ray and CT myelography demonstrated spina bifida, low placed conus, tight filum terminale, and diastematomyelia. In addition to these abnormalities, MR imaging demonstrated syringomyelia that was not detected by other radiographic studies.Because embryopathologically, diastematomyelia and syringomyelia may occur simultaneously, the possibility of syringomyelia should be carefully evaluated in patients with diastematomyelia. And MR imaging will be an excellent tool to deliniate the presence of syringomyelia as well as other associated abnormalities.

We report a case of congenital extradural arachnoid cyst. Computed tomographic myelography and magnetic resonance (MR) were complementary, and both correctly charactarized the cystic nature of the lesion. Surgical removal of the cyst and obliteration of the communication led to improvement in neurological symptoms.

We developed a new orthognathic surgical simulation system able to predict both occlusal correction and mandibular repositioning in three dimensions. This system uniquely integrates the real motion of the dental cast model with the virtual motion of the reconstructed cranio-facial model. The skeletal change of the mandibular osteotomy is simulated on the PC monitor while the occlusal change is confirmed by checking the cast model on the simulator. The simulation process is easily repeated and the operator can make several attempts to determine the final mandibular position. The occlusal relationship at the simulated mandibular posture is registered and the occlusal wafer splint, which ensures intermaxillary fixation, is fabricated on the simulator. This surgical simulation system appears to satisfy clinical demands well and is an important facilitator of communication between orthodontists and surgeons. Here, we outline the system and apply it to a demonstration case of orthognathic surgery.

Bacground We have previously reported mid-term results of a study, which ended in January 2000, on the Bicarbon valve. The study concluded that the valve showed excellent clinical results, associated with a low incidence of valve-related complications. In the present study, the same patients were prospectively followed for an additional 5 years. Methods Forty-four patients had aortic valve replacement (AVR), 48 had mitral valve replacement (MVR), and 13 had both aortic and mitral valve replacement (DVR). The mean age of the 105 patients was 61.2 ± 11.3 years. The mean follow-up was 6.1 ± 1.9 years with a cumulative follow-up of 616 patient-years. Results There were 5 early deaths (4.7%: 4 in the AVR group and 1 in the MVR group) and 21 late deaths (3.4%/patient-year: 5 valve related deaths and 16 valve unrelated deaths). Survival at 8 years was 75.2 ± 7.0% in the AVR group, 76.6 ± 6.2% in the MVR group, and 55.4 ± 16.1% in the DVR group. The linearized incidence of thrombo-embolic complications, hemorrhagic complications, and paravalvular leaks in all patients was 0.65 ± 1.48%, 0.81 ± 1.69%, and 0.16 ± 0.54%/patient-year respectively. No other complications were observed. Conclusion The Bicarbon prosthetic heart valve has shown excellent long-term clinical results, associated with a low incidence of valve-related complications.

Signet-ring cell carcinoma is one of the most malignant tumors, classified histologically as a poorly differentiated adenocarcinoma. The ErbB2/ErbB3 complex is often constitutively activated, which suggests that the ErbB2/ErbB3 signaling pathway may be important for malignancy of this tumor. However, the mechanism underlying this activation has not been understood. Here, we show that ErbB2 and Muc4 bind in signet ring carcinoma cells, which was not seen in highly differentiated adenocarcinoma cell lines. ErbB3 was suggested to be a substrate of ErbB2 because knockdown of ErbB2 resulted in less phosphorylation of ErbB3. Inhibition of expression of Muc4 at the cell surface by the treatment of the cells with benzyl-GalNac, an inhibitor of mucin secretion, blocked phosphorylation of ErbB3, suggesting that activity of ErbB2 depends on the expression of Muc4. These results supply the biochemical backgrounds in recent studies suggesting the contribution of Muc4 in the tumorigenesis.

Background . Dynamic cardiomyoplasty is an experimental operation for advanced heart failure. Current clinical results bring the possibility of its application to children. This study was designed to obtain information about the relationship between cardiomyoplasty and growth of the heart. Methods . Six beagles, 9 to 10 weeks old, underwent cardiomyoplasty without electric stimulation (cardiomyoplasty group), and another 5 beagles underwent median sternotomy and pericardiotomy (control group). Six months later, weights of hearts, wrapped latissimus dorsi muscles, and unwrapped right latissimus dorsi muscles and pressure–volume relationships were obtained. Results . Wrapped latissimus dorsi muscles weighed 33 ± 3 g (mean ± standard deviation), and unwrapped muscles weighed 68 ± 5 g. The heart weight was 82 ± 3 g in the cardiomyoplasty group and 89 ± 7 g in the control group. Left ventricular maximum elastance was 3.8 ± 0.8 mm Hg/mL in the cardiomyoplasty group and 3.9 ± 0.9 mm Hg/mL in the control group. End-diastolic pressure versus end-diastolic volume ratios were 0.52 ± 0.03 and 0.54 ± 0.05, respectively. Pathologic examination showed fat infiltration and muscle fiber atrophy in the cardiomyoplasty group. Conclusions . The wrapped latissimus dorsi muscle flaps were growing and the diastolic function was not impaired. This indicates a potentially safe clinical application of dynamic cardiomyoplasty for children.

Inverted ductal papilloma (IDP) is a type of ductal papilloma arising in ducts of minor salivary glands. Very few cases, and no cases in Japan, have been reported. Reported herein is a case of IDP with a review of the literature. The patient was a 49-year-old man presenting with a lump in the right buccal mucosa of the premolar area of the mandible. The tumor was excised en bloc after a biopsy diagnosis of IDP. On the surface of the covering epithelium, an opening was seen to be filled with mucinous material. On cut surface the opening led to the tumor cavity. The major portion of the tumor parenchyma was made up of papillary proliferation of basaloid squamous cells. Some crypts, microcysts, and mucous cells were seen. There were no findings suggestive of a malignant tumor. The patient's postoperative course was uneventful and there has been no recurrence after 1 year's follow up. Immunohistochemical analysis of the present case supports the hypothesis that IDP originates from squamous metaplasia and proliferation of minor salivary gland duct cells.

Objective: Recently, there has been an increase in case of repeated open-heart valve surgery and the clinical results of the second surgery are only slightly worse than those of the first surgery. However, clinical results of the third open-heart valve surgery at the same position are rarely reported. Clinical features of third open-heart valve surgery at the same position are discussed in this study.Methods: Between 1995 and 2004, 16 patients underwent third open-heart valve surgery at the same valve position under cardiopulmonary bypass. The average age of the 16 patients, 12 females and 4 males, was 56±15 years. Clinical features of the 16 cases were retrospectively analyzed.Results: Mechanical valve nonstructural dysfunction was the most common valve malady, followed by bioprosthetic valve dysfunction. The duration of surgery from skin incision to establishment of the cardiopulmonary bypass was 94±42 minutes. Myocardial ischemia time was 137±38 minutes and extracorporeal circulation time was 212±82 minutes. Early mortality was seen in 1 patient (6.25%) and late mortality was seen in 1 patient.Conclusion: Mechanical valve nonstructural valve dysfunction leads to repeated valve surgery. The clinical results of the third open-heart valve surgery at the same valve position are acceptable, and the mid-term survival is excellent.

Background: Accumulating evidence reveals effectiveness of histone deacetylase (HDAC) inhibition in various types of cancer, and resminostat is a novel and oral HDAC inhibitor. In this study, we investigated the preclinical activity of resminostat in human non-small-cell lung cancer (NSCLC) cells, especially in combination with docetaxel (DTX). Materials and Methods: Anti-proliferative activity of resminostat was evaluated in 9 human NSCLC cell lines in vitro. Monolayers of cultured cells were exposed to resminostat and cell viability was determined. The amount of p21, acetylated histone H3 and α-tublin were analyzed by Western blotting in NCI-H460 cells exposed to resminostat. In addition, caspase-3 activity was measured. In a drug combination study, cells were simultaneously exposed to resminostat and DTX, and the synergistic effects of this drug combination were analyzed using the Combination Index, calculated by the median-effect method. For in vivo studies, a suspension of NCI-H460 cells was subcutaneously inoculated into the flank of male nude mice. The antitumor efficacies of oral resminostat alone or in combination with intravenous DTX were evaluated in this NSCLC xenograft model. Results: Resminostat exhibited antiproliferative activity in all tested cell lines. Sensitivity to resminostat was not influenced by the genetic status of KRAS among the cell lines (IC50 from 9 cell lines: 0.4-8.7 μmol/L). The treatment of cells with resminostat alone increased the levels of total p21 protein and acetylated histone H3. α-tublin was also acetylated by resminostat treatment and the level of acetylation was enhanced by the combination treatment with DTX. The amount of polymerized α-tubulin was increased by DTX treatment and this effect was greater in the combination treatment with resminostat than with DTX alone. Caspase-3 was more significantly activated by the combination treatment than with each mono-treatment. The Combination Index showed synergistic or additive effects in the resminostat plus DTX combination. The antitumor activities of resminostat were demonstrated in NCI-H460 tumor-bearing mice, where an up-regulation of p21 was accompanied by acetylation of histone H3 in the tumor tissues. The tumor growth inhibition ratio (IR) in the combination treatment was 2.6 and 1.8 times higher than with DTX alone or with resminostat alone, respectively, following a tolerable drug application schedule. Conclusion: These results demonstrated the potent activity of resminostat in NSCLC. The combination of resminostat and DTX appears to be a promising regimen to be tested in clinical trials in NSCLC patients. Based on this study, we initiated a phase I/II study in NSCLC patients to examine the safety and efficacy of this combination. Citation Format: Akimitsu Takagi, Hiroaki Konishi, Momomi Tsugane, Keisuke Taniguchi, Hiroyuki Takahashi, Yu Inutake, Akinobu Watanabe, Hiroshi Kodaira, Takeshi Matsuzaki. A novel and oral histone deacetylase inhibitor, resminostat, effectively suppresses the growth of non-small cell lung cancer in a xenograft mouse model. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 5534. doi:10.1158/1538-7445.AM2014-5534

In this article, we identify and characterize p600, a unique 600-kDa retinoblastoma protein- and calmodulin-binding protein. In the nucleus, p600 and retinoblastoma protein seem to act as a chromatin scaffold. In the cytoplasm, p600 and clathrin form a meshwork structure, which could contribute to cytoskeletal organization and membrane morphogenesis. Reduced expression of p600 with interference RNA abrogates integrin-mediated ruffled membrane formation and, furthermore, prevents activation of integrin-mediated survival pathways. Consequently, knockdown of p600 sensitizes cells to apoptosis induced by cell detachment. These findings provide mechanistic insight into the regulation of membrane-proximal events in tumorigenesis.

A rotary blood pump inherently provides only one noninvasive "observable'" parameter (motor current) and allows for only one "controllable" parameter (pump speed). To maintain the systemic circulation properly, the pump speed must be controlled to sustain appropriate outlet Hows and perfusion pressure while preventing pulmonary damage caused by extremes in preload. Steady-state data were collected at repeated intervals during chronic trials of the Nimbus AxiPump (Nimbus, Inc., Rancho Cordova, California, U.S.A.) in sheep (n = 7) and calves (n = 12). For each data set, the pump speed was increased at increments of 500 rpm until left ventricular and left atrial emptying was observed by left atrial pressure diminishing to zero. The effect of decreasing preload was evaluated perioperatively by inferior vena cava occlusion at a constant pump speed. Fourier analysis established a relationship between changes in the pump preload and the power spectra of the pump current waveform. Based on these results, a control method was devised to avoid ventricular collapse and maintain the preload within a physiologic range. The objective of this controller is the minimization of the second and third harmonic of the periodic current waveform. This method is intended to provide a noninvasive regulation of the pump by eliminating the need for extraneous transducers.

A rare case of thoracic intradural extramedullary tumor with an apoplectic onset is reported. A 37-year-old female complained of sudden backache. The patient was treated surgically after which she showed improvement in symptoms.

We reviewed 10 cases of extraforaminal lumber disc herniation.In 5 cases of suspected herniation, we used oblique X-ray pictures of radiculography which were effective for accurately identifying and precisely locating extraforaminal lumber disc herniation. 3 cases were treated conservativery with root block and 7 cases were treated with a surgical procedure.

We reviewed 11 patients who required re-operations for cervical spondylotic myelopathy.These Subjects were separated into two groups according to their clinical conditions.Group 1 included patients who required re-operation because of conditions related to their initial condition or initial surgery.Group 2 included patients who required re-operation because of an added clinical condition. After secondary surgery, Group 2 achieved better clinical results than Group 1.We recommend that we teach patients about their expected clinical course after surgery and in patients with a narrow spinal canal we recommend the use of combined operations.