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A 67-year-old man who had been pinned between a basket crane and a tree complained of severe pain in his lower back and a decreased appetite. Laparotomy after decompressing the gastrointestinal tract revealed incarceration of an ileal loop within a fractured third lumbar vertebra. The damaged bowel was resected, and an end-to-end anastomosis was performed. Once the patient’s condition had stabilised, posterior lumbar fixation was performed. There were no abdominal complications or lower limb neurological deficits during the follow-up period. Enhanced CT and MRI had been helpful in making the diagnoses. Histopathological examination revealed the aetiology of the traumatic incarceration: the intestine had been pinched as the disc space closed, and the body attempted to return to its original state by exerting countertraction.

Research into the prevention and treatment of age-related metabolic diseases are important in the present-day situation of the aging population. We propose that an elderly diabetic mouse model may be useful to such research as it exhibits deterioration of glucose and lipid metabolism. Although the KK mouse strain is commonly used as a model of moderate obesity and type 2 diabetes, the utility of this strain as an elderly obese and diabetic model mouse for research into aging remains unclear. The present study aimed to investigate age-related changes of glucose and lipid metabolism in male KK mice fed a standard chow diet. We demonstrate that 40 weeks KK mice exhibit age-related dysfunctions, such as development of insulin resistance associated with pancreatic islet hypertrophy and decreased lipolysis in white adipose tissue (WAT) compared with 15 weeks KK mice. However, aging does not appear to cause mitochondrial dysfunction of brown adipose tissue. Unexpectedly, hyperglycemia, potential glucose uptake in insulin-sensitive organs, hepatic lipid accumulation, hypertrophy of adipocytes, and inflammation in epididymal WAT did not worsen but rather compensated in 40 weeks KK mice. Our data indicate that the use of male KK mice as an elderly obese and diabetic mouse model has some limitations and in order to represent a useful elderly obese and diabetic animal model, it may be necessary to induce deterioration of glucose and lipid metabolism in KK mice through breeding with high-sucrose or high-fat diets.

Immediate appendectomy for acute appendicitis with abscess has a high frequency of ileocecal resection and postoperative complications compared with interval appendectomy after conservative treatment. The optimal approach to acute appendicitis with abscess remains controversial.A 69-year-old woman was referred to our hospital for abdominal pain. A computed tomography scan revealed an enlarged abscess around the cecum. The diagnosis was perforated appendicitis with abscess, and conservative treatment was performed. Percutaneous drainage was difficult because the abscess was near the intestinal tract. Because of the persistence of symptoms on the fourth day of hospitalization, laparotomy drainage was performed, and the patient's condition improved afterwards. Colonoscopy was performed on an outpatient follow-up to rule out malignant tumors of the colon. Interval laparoscopic appendectomy was performed 3 months after discharge to prevent appendicitis. The postoperative course was uneventful.For this case of acute appendicitis with abscess, conservative treatment such as antibiotic therapy and laparotomy drainage was performed. Laparotomy drainage enabled us to approach the abscess directly and minimized the risk of its spread into the abdominal cavity compared to the laparoscopic approach. Interval laparoscopic appendectomy was more effective and easier for this case of appendectomy, wherein adhesions to the abdominal wall were expected compared to laparotomy.Conservative treatment approaches, such as drainage and antibiotic therapy, can be first-line for appendicitis with abscesses. Interval laparoscopic appendectomy can be useful to resect the appendix and observe the abdominal cavity.

The elderly patients with type 2 diabetes suffer more adverse drug events than young adults due to pharmacokinetic and pharmacodynamic changes associated with aging. Reducing the risks of these medication-related problems are equally important for the clinical care of older type 2 diabetes patients. Pioglitazone is used for treating type 2 diabetes as an oral antidiabetic drug. Despite pioglitazone is used helpful insulin sensitizers, the accumulation of subcutaneous fat is considered a major adverse effect of pioglitazone therapy. We investigated to reduce the adverse effect of pioglitazone by combination with fish oil rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in aged diabetic KK mice. The accumulation of subcutaneous fat associated with high-dose pioglitazone is reduced by fish oil, suppressing lipogenesis and stimulating fatty acid β-oxidation in the liver. Our data suggest that adding fish oil to low-dose pioglitazone results in antidiabetic efficacy similar to that of the high-dose without concomitant body weight gain. Keywords: Beneficial effects, Combination, Fish oil, Pioglitazone, Type 2 diabetes

This study investigates effects of dipeptide balenine, as a major component of whale meat extract (hereafter, WME), supplementation on senescence-accelerated mouse prone 8 (SAMP8), an Alzheimer's disease (AD) model at level of learning and memory formation and brain expression profiles genome-wide in brain. Mice fed experimental balenine (+ WME) supplemented diet for 26 weeks were subjected to four behavioral tests – open field, Y-maze, novel object recognition, and water-filled multiple T-maze – to examine effects on learning and memory. Brain transcriptome of SAMP8 mice-fed the WME diet over control low-safflower oil (LSO) diet-fed mice was delineated on a 4 × 44 K mouse whole genome DNA microarray chip. Results revealed the WME diet not only induced improvements in the learning and memory formation but also positively modulated changes in the brain of the SAMP8 mouse; the gene inventories are publically available for analysis by the scientific community. Interestingly, the SAMP8 mouse model presented many genetic characteristics of AD, and numerous novel molecules ( Slc2a5 , Treh , Fbp1 , Aldob , Ppp1r1a , DNase1 , Agxt2l1 , Cyp2e1 , Acsm1 , Acsm2 , and Pah ) were revealed over the SAMR1 (senescence-accelerated mouse resistant 1) mouse, to be oppositely regulated/recovered under the balenine (+ WME) supplemented diet regime by DNA microarray and bioinformatics analyses. Our present study demonstrates an experimental strategy to understand the effects of dipeptide balenine, prominetly contained in meat diet, on SAMP8, providing new insight into whole brain transcriptome changes genome-wide. The gene expression data has been deposited into the Gene Expression Omnibus (GEO): GSE76459 . The data will be a valuable resource in examining the effects of natural products, and which could also serve as a human model for further functional analysis and investigation.

Pioglitazone is one of the thiazolidinediones (TZDs) and an insulin-sensitive drug for type 2 diabetes. In our previous study, a combination of pioglitazone andfish oil rich in n-3 polyunsaturated fatty acids (PUFAs) was shown to inhibit pioglitazone-induced side effects, such as accumulation of subcutaneous fat andbody weight gain. However, the effects of the discontinuation of fish oil after combination treatment with TZD and fish oil are not clear. In this study,discontinuation of fish oil for 4 weeks showed several unfavorable effects: (1) return of plasma adiponectin level, (2) reversal of the inhibition of lipogenesis andactivation of fatty acidβ-oxidation in liver, (3) increase in hypertrophic adipocytes in epidydimal white adipose tissue (WAT) and (4) accumulation of lipids inbrown adipose tissue (BAT). However, insulin resistance was ameliorated by pioglitazone with or without fish oil treatment and the discontinuation of fish oil.These findings indicate that discontinuation of n-3 PUFA after combination therapy with TZDs adversely affects lipid metabolism and energy homeostasis in liver,epididymal WAT and BAT., Article 108265

Background The gold standard of rectal surgery is TME and DST anastomosis.1 - 6 The division of mesorectum in tumor-specific mesorectal and total mesorectal excisions is one of the most difficult procedures of anterior dissection. We have developed a laparoscopic-assisted anterior dissection technique using the simple Rectum Catcher device (RC) with an intraoperative colonoscopy (CF).7 , 8 METHODS: Surgical and oncological outcomes were compared between 99 patients undergoing a laparoscopic approach with the RC and a CF (RCF) and 104 patients undergoing the laparoscopic approach without the RC and without a CF (NRCF). Our standardized procedure for RCF is shown in the video. Results BMI (p = .025) and tumor diameter (p = .002) were significantly higher in the RCF group. However, operation times (p = .005) and time to tolerate diet (p = .009) were significantly shorter. Estimated blood loss was significantly decreased (p = .005) and quality of TME or TSME was significantly better (p = .017) in the RCF group. When we further analyzed surgical and oncological outcomes by dividing 3 parts of the rectum, patients with rectosigmoid (Rs) cancer and patients with cancer in the rectum below the peritoneal reflection (Rb) had comparable results. Particularly, statistically significant differences in length of operation time (p = .018), estimated blood loss (p = .050), quality of TME or TSME (p = .017), time to tolerate diet (p = .010), and R0 resections (p = .050) were observed in the patients with cancer below the peritoneal reflection. Conclusions Laparoscopic lower rectal surgery using the RC with a CF is feasible and provides acceptable surgical and oncological outcomes.

Conventional open lateral lymph node (LLN) dissection performed along the internal iliac vessels frequently results in increased bleeding and postoperative complications [1, 2]. However, laparoscopic LLN dissection is a feasible, oncologically acceptable alternative [3-6]. We have developed a laparoscopic autonomic nerve-preserving technique for LLN dissection based on the vesicohypogastric fascia (VF) and ureterohypogastric nerve fascia (UNF) [7].Surgical and oncological outcomes were compared between 12 patients undergoing laparoscopic hemi-LLN dissection and 13 patients undergoing conventional open hemi-LLN dissection. Our standardized procedure for LLN dissection is shown in the video.The number of harvested LLNs and the postoperative hospital stay was similar in both groups. In the open dissection (OD) and laparoscopic dissection (LD) groups, the median operation times were 373.3 and 443.1 min, respectively. However, the median (range) blood loss was 38.8 (20-75) ml in the LD group versus 836.9 (365-2060) ml in the OD group. One LD patient had anastomotic leakage and one had hydronephrosis. One OD patient had anastomotic leakage, four had small bowel obstruction, three had wound infection and one had lymphatic leakage. Postoperative recovery was faster in the LD group: The median time to resumption of oral intake was 3.3 (2-6) days, versus 8.7 (3-34) days in the OD group. There was one case of grade 2 urinary retention in the LD group, but there were five cases of grade 2 or 3 urinary retention in the OD group. Surgical curability was R0 in all LD patients, whereas 7 of 13 patients were R0 in the OD group. After a mean follow-up of 24.4 (16.2-45.3) months, all LD patients were alive without recurrence. After 31.5 (6-63) months, three OD patients had local recurrence and two had distant metastasis.Laparoscopic LLN dissection based on VF and UNF is feasible, with acceptable surgical and oncological outcomes.

Whale oil (WO) contains n-3 polyunsaturated fatty acids (PUFAs), but the effects of whale oil intake on lipid metabolism have remained unclear. We examined the influence of WO on lipid metabolism in obese KK mice. Male KK mice were fed a high-fat diet for 12 weeks to induce obesity. The mice were then given free access to a different diet for 10 weeks: the lard/safflower oil (LSO) diet consisted of 25 energy% (en%) LSO (6:4), the WO diet consisted of 25 en% WO, and the fish oil (FO) diet consisted of 11 en% FO plus 14 en% LSO. The n-3 PUFA content of the FO diet was the same as that in the WO diet. In the WO and FO groups, the total plasma cholesterol level was significantly decreased compared with that in the LSO group. The number of lipid droplets in liver specimens was also lower in the WO and FO groups, and the hepatic triglyceride and total cholesterol levels were decreased in these groups compared with the LSO group. Hepatic mRNA levels of fatty acid synthase, and stearoyl-CoA desaturase 1, which are fatty acid synthesis-related genes, were decreased in the WO and FO groups. No significant differences were observed between the WO and FO groups. Taken together, these results indicate that WO intake inhibits lipid accumulation in the liver by reducing fatty acid biosynthesis.

Pioglitazone, a thiazolidinedione (TZD), is widely used as an insulin sensitizer in the treatment of type 2 diabetes. However, body weight gain is frequently observed in TZD-treated patients. Fish oil improves lipid metabolism dysfunction and obesity. In this study, we demonstrated suppression of body weight gain in response to pioglitazone administration by combination therapy of pioglitazone and fish oil in type 2 diabetic KK mice. Male KK mice were fed experimental diets for 8 weeks. In safflower oil (SO), safflower oil/low-dose pioglitazone (S/PL), and safflower oil/high-dose pioglitazone (S/PH) diets, 20% of calories were provided by safflower oil containing 0%, 0.006%, or 0.012% (wt/wt) pioglitazone, respectively. In fish oil (FO), fish oil/low-dose pioglitazone (F/PL), and fish oil/high-dose pioglitazone (F/PH) diets, 20% of calories were provided by a mixture of fish oil and safflower oil. Increased body weight and subcutaneous fat mass were observed in the S/PL and S/PH groups; however, diets containing fish oil were found to ameliorate these changes. Hepatic mRNA levels of lipogenic enzymes were significantly decreased in fish oil-fed groups. These findings demonstrate that the combination of pioglitazone and fish oil decreases subcutaneous fat accumulation, ameliorating pioglitazone-induced body weight gain, through fish oil-mediated inhibition of hepatic de novo lipogenesis., Open Access.

We report a combined experimental and theoretical x-ray magnetic circular dichroism (XMCD) spectroscopy study at the Ir-${L}_{2,3}$ edges on the ${\mathrm{Ir}}^{5+}$ ions of the layered hybrid solid state oxide ${\mathrm{Sr}}_{2}{\mathrm{Co}}_{0.5}{\mathrm{Ir}}_{0.5}{\mathrm{O}}_{4}$ with the ${\mathrm{K}}_{2}{\mathrm{NiF}}_{4}$ structure. From theoretical simulation of the experimental Ir-${L}_{2,3}$ XMCD spectrum, we found a deviation from a pure ${J}_{\mathrm{eff}}=0$ ground state with an anisotropic orbital-to-spin moment ratio (${L}_{x}/2{S}_{x}=0.43$ and ${L}_{z}/2{S}_{z}=0.78$). This deviation is mainly due to multiplet interactions being not small compared to the cubic crystal field and due to the presence of a large tetragonal crystal field associated with the crystal structure. Nevertheless, our calculations show that the energy gap between the singlet ground state and the triplet excited state is still large and that the magnetic properties of the ${\mathrm{Ir}}^{5+}$ ions can be well described in terms of singlet Van Vleck paramagnetism.

We report a case of a 42-year-old man who underwent 3 times surgical resection for lymph nodes recurrence and multidisciplinary therapy for Stage IV b Barrett's esophageal adenocarcinoma, and was well 6 years and 3 months after the first resection. The prognosis of the recurrence cases after radical recection of the esophageal cancer is extremely poor. Long-term prognosis may be obtained in few patients, but the cases are squamous cell carcinoma in most of the reported cases. The number of Barrett's esophageal adenocarcinoma patients is increasing, but it is not many. There is little reports, and there is no fixed treatment policy.

Introduction Splenic hilar lymph node dissection via a splenectomy for advanced proximal gastric cancer remains controversial. Recently, a laparoscopic spleen-preserving hilar lymph node dissection procedure was described in several publications. To assess the feasibility and safety of spleen-preserving laparoscopic total gastrectomy with D2 lymphadenectomy (LTG-D2), the present retrospective study compared the short-term surgical outcomes between spleen preservation and splenectomy during laparoscopic D2 total gastrectomy (LTG-D2S). Method This study included 59 patients who underwent LTG-D2 and 19 patients who underwent LTG-D2S. Results The mean operation time did not significantly differ between the LTG-D2 and LTG-D2S groups (339.4 ± 56.8 vs 356.8 ± 46.0 min). The mean blood loss tended to be smaller in the LTG-D2 group than in the LTG-D2S group (105.9 ± 89.7 vs 210.0 ± 149.5 mL). The mean number of retrieved lymph nodes did not significantly differ between the LTG-D2 and LTG-D2S groups (39.9 ± 17.0 vs 40.6 ± 14.9), and the mean number of retrieved lymph nodes at the splenic hilum also did not significantly differ between the LTG-D2 and LTG-D2S groups (1.3 ± 1.7 vs 2.4 ± 2.6). Mild pancreatic fistula occurred in three cases (5%) in the LTG-D2 group and in three cases (15.8%) in the LTG-D2S group. Conclusion A LTG-D2 is feasible in terms of the short-term outcomes. However, the indications for this complicated procedure should be considered carefully.

Here we report a case of nasolacrimal obstruction resulting from rice grains ingested over many years that had formed an obstructive mass. This is a hitherto unreported cause of nasolacrimal obstruction. We exclusively treated the obstruction safely with repeated irrigation with physiological saline. Although there have been various reports on new techniques such as the blind insertion of a bougie and insertion of a silicon tube under endoscopic guidance, successful treatment of this condition is possible with an old-fashioned approach using the time-honored tools of a syringe and an irrigation needle, if utilized patiently and repeatedly. In Japan, we call this ‘learning new lessons from the past'. This implies that newer techniques may not necessarily be superior and traditional techniques can offer advantages of safety and simplicity in treating this condition.

Galanin-like peptide (GALP) is a neuropeptide involved in the regulation of food intake behavior, body weight and energy metabolism. In previous studies, we demonstrated that the intranasal administration of GALP has weight loss effects, although the mechanism of this action was not clarified. The aim of this study was to demonstrate the functional significance of GALP on lipid metabolism in the liver. Mice were fed a high fat diet to cause diet-induced obesity (DIO) and then administered GALP intranasally for 2 weeks (experimental), or vehicle (control). Body weights, along with lipid levels in the plasma and liver, and lipid metabolism-related gene expression in the liver were subsequently measured. Body weight gain was decreased by the GALP treatment compared to the control group. Lipid droplet levels in hepatocytes and hepatic triglyceride levels were decreased in the GALP group compared with the vehicle group, whereas hepatic fatty acid β-oxidation-related gene mRNA levels were increased in the GALP group. These results suggest that the intranasal administration of GALP has an inhibitory effect on lipid accumulation in the liver.

We herein report 2 cases of radical operation for synchronous double cancer of the thoracic esophagus and each side of the lung. Case 1:A 71-year-old woman with synchronous double cancer of the thoracic esophagus (Mt, T3N2M0, Stage III) and right lung (M, T2aN0M0, Stage I B) underwent esophagectomy concomitantly with right middle lobectomy through right thoracotomy (single-stage operation) after 2 courses of systemic chemotherapy with docetaxel, cisplatin and 5-fluorouracil( DCF regimen). Case 2:A 72-year-old man with synchronous double cancer of the thoracic esophagus( MtLt, T3N2M0, Stage III) and left lung( U, T1aN0M0, Stage I A) underwent 2-stage operation after 2 courses of the DCF therapy. Esophagectomy through right thoracotomy was performed followed by left upper lobectomy through left thoracotomy 3 months later. Treatment strategy for synchronous double cancer of the thoracic esophagus and lung is discussed based on our experiences and previous reports.

We have investigated the electronic structure of ${\mathrm{Sr}}_{2}{\mathrm{IrO}}_{4}$ using core-to-core resonant inelastic x-ray scattering. The experimental spectra can be well reproduced using ab initio density functional theory based multiplet ligand field theory calculations, thereby validating these calculations. We found that the low-energy, effective Ir ${\mathrm{t}}_{2\mathrm{g}}$ orbitals are practically degenerate in their crystal-field energy. We uncovered that ${\mathrm{Sr}}_{2}{\mathrm{IrO}}_{4}$ and iridates in general are negative charge transfer systems with large covalency and a substantial oxygen ligand hole character in the Ir ${\mathrm{t}}_{2\mathrm{g}}$ Wannier orbitals. This has far reaching consequences, as not only the on-site crystal-field energies are determined by the long-range crystal structure, but, more significantly, magnetic exchange interactions will have long-range distance dependent anisotropies in the spin direction. These findings set constraints and show pathways for the design of ${d}^{5}$ materials that can host compasslike magnetic interactions.

Background While esophageal fistula formation in the adjacent organs is associated with high rates of morbidity and mortality, the management of non-aortic arterio-esophageal fistula has not been frequently reported. Case presentation A 69-year-old Japanese man who had undergone definitive chemoradiotherapy for esophageal cancer was admitted to our hospital with hematemesis. He was diagnosed with mediastinal abscess caused by esophageal perforation, and esophageal bypass surgery was performed. After 3 days, he presented with fatal hemoptysis. As angiography revealed an intercostal artery pseudoaneurysm, transcatheter arterial embolization was performed. Conclusions When patients with esophageal cancer, especially those with a history of radiotherapy and/or mediastinitis, present with hematemesis and/or hemoptysis, the possibility of non-aortic arterio-esophageal fistula should be considered. Transcatheter arterial embolization is an effective treatment for non-aortic arterio-esophageal fistula.

The prognosis of patients with Stage IV gastric cancer is generally poor. The 5-year overall survival rate is less than 10%. The patient was a 73-year-old man with Stage IV gastric cancer. Before chemotherapy, peritoneal dissemination was observed using staging laparoscopy. The patient received first-line chemotherapy with TS-1 plus CDDP. Renal function worsened and consequently the therapy was stopped. He received 3 courses of chemotherapy with weekly PTX. The peritoneal dissemination had disappeared by the second staging laparoscopy and he underwent distal gastrectomy. The final diagnosis was pT4a, ly2, v1, pN2(4/16),M0, fStage III B. The patient received adjuvant chemotherapy of TS-1 for 4 years and 8months after gastrectomy. More than 5 year after gastrectomy, the patient is alive without recurrence.

Introduction Reduced port surgery and single-port surgery are currently in the spotlight as next-generation, minimally invasive surgical techniques. We performed a triple-incision laparoscopic distal gastrectomy (TIL-DG) for gastric cancer as a reduced port surgery. Method A total of 76 patients underwent a TIL-DG. A D1+ or D2 lymph node dissection was performed, and the Roux-en-Y method was used for reconstruction. The short-term patient outcomes of the TIL-DG group were compared with those of the conventional laparoscopy-assisted distal gastrectomy group (59 cases) to evaluate the feasibility of TIL-DG. Results No significant differences were observed between the TIL-DG group and the laparoscopy-assisted distal gastrectomy group in terms of mean operative time, blood loss, and the length of the postoperative hospital stay. The mean number of retrieved regional lymph nodes in the TIL-DG group was slightly higher than that in the laparoscopy-assisted distal gastrectomy group. Conclusion A triple-incision laparoscopic distal gastrectomy is a feasible and safe procedure.

In obese humans and animals, adiponectin production and release in adipose tissue are downregulated by feedback inhibition, resulting in decreased serum adiponectin. We investigated adiponectin production and release in ventromedial hypothalamic (VMH)-lesioned animals. VMH-lesioned mice showed significant increases in food intake and body weight gain, with hyperinsulinemia and hyperleptinemia at 1 and 4 weeks after VMH-lesioning. Serum adiponectin was elevated in VMH-lesioned mice at 1 and 4 weeks, despite adipocyte hypertrophy in subcutaneous and visceral adipose tissues and increased body fat. Adiponectin production and mRNA were also increased in both adipose tissues in VMH-lesioned mice at 1 week. These results were replicated in VMH-lesioned rats at 1 week. Daily atropine administration for 5 days or subdiaphragmatic vagotomy completely reversed the body weight gain and eliminated the increased adiponectin production and release in these rats, with reversal to a normal serum adiponectin level. Parasympathetic nerve activation by carbachol infusion for 5 days in rats increased serum adiponectin, with increased adiponectin production in visceral and subcutaneous adipose tissues without changes of body weight. These results demonstrate that activation of the parasympathetic nerve by VMH lesions stimulates production of adiponectin in visceral and subcutaneous adipose tissues and adiponectin release, resulting in elevated serum adiponectin.

We report the analysis of magnetic susceptibility $\chi$($T$) of Sr$_2$IrO$_4$ single crystal in the paramagnetic phase. We formulate the theoretical susceptibility based on isotropic Heisenberg antiferromagnetism incorporating the Dzyaloshinsky-Moriya interaction exactly, and include the interlayer couplings in a mean-field approximation. $\chi$($T$) above $T_{\rm N}$ was found to be well described by the model, indicating the predominant Heisenberg exchange consistent with the microscopic theory. The analysis points to a competition of nearest and next-nearest neighbor interlayer couplings, which results in the up-up-down-down configuration of the in-plane canting moments identified by the diffraction experiments.

The purpose of this study was to examine whether hesperidin inhibits bone loss in androgen-deficient male mice. Male ddY mice aged 7 weeks underwent either a sham operation or orchidectomy (ORX) and were divided into five groups: a sham-operated group fed a control diet (Sham) based on AIN-93G formulation with corn oil instead of soy bean oil, an ORX group fed the control diet (ORX), a group fed the control diet containing 0.5% hesperidin (ORX + H), a group fed the control diet containing 0.7% α-glucosylhesperidin (ORX + αG), and a group fed the control diet containing 0.013% simvastatin (ORX + St). Four weeks after intervention, ORX mice showed a striking decrease in seminal vesicle weight, which was not affected by the administration of hesperidin, α-glucosylhesperidin, or simvastatin. Femoral BMD was significantly reduced by ORX, and bone loss was inhibited by the administration of hesperidin, α-glucosylhesperidin or simvastatin. Histomorphometric analysis showed that the bone volume and trabecular thickness were significantly lower, and the osteoclast number was higher in the distal femoral cancellous bone in the ORX group than in the Sham group, and these were normalized in the ORX + H, ORX + αG and ORX + St groups. These results indicate that hesperidin inhibited bone resorption and hyperlipidemia, in ORX mice, and the preventive effect was stronger than that observed in ovariectomized mice in our previous study. Copyright © 2013 John Wiley & Sons, Ltd.

We examined the effects of fish oil (FO) on high-cholesterol diet-induced hepatic lipid accumulation and oxidative stress. Female C57BL/6J mice were fed diets consisting of safflower oil (SO), 1 en% FO (1FO), 2 en% FO (2FO), or 20 en% FO (20FO) with or without 2 weight% (wt%) cholesterol (SO/CH, 1FO/CH, 2FO/CH, and 20FO/CH groups, respectively) for 8 weeks. The hepatic triacylglyceride levels were significantly lower in the 2FO/CH and 20FO/CH groups than in the SO/CH group. The hepatic mRNAs of fatty acid oxidation-related genes were upregulated and the fatty acid synthesis-related genes were downregulated by the FO feeding. Adverse effects were not observed in the plasma levels of indicators of oxidative stress in response to the consumption of FO up to 20 en%. These results suggest that FO consumption in the range of 2–20 en% prevents hepatic lipid accumulation, thus improving lipid metabolism without causing oxidative stress.

We investigated the effects of dietary fat energy restriction and fish oil intake on glucose and lipid metabolism in female KK mice with high-fat (HF) diet-induced obesity. Mice were fed a lard/safflower oil (LSO50) diet consisting of 50 energy% (en%) lard/safflower oil as the fat source for 12 weeks. Then, the mice were fed various fat energy restriction (25 en% fat) diets - LSO, FO2.5, FO12.5 or FO25 - containing 0, 2.5, 12.5, or 25 en% fish oil, respectively, for 9 weeks. Conversion from a HF diet to each fat energy restriction diet significantly decreased final body weights and visceral and subcutaneous fat mass in all fat energy restriction groups, regardless of fish oil contents. Hepatic triglyceride and cholesterol levels markedly decreased in the FO12.5 and FO25 groups, but not in the LSO group. Although plasma insulin levels did not differ among groups, the blood glucose areas under the curve in the oral glucose tolerance test were significantly lower in the FO12.5 and FO25 groups. Real-time polymerase chain reaction analysis showed fatty acid synthase mRNA levels significantly decreased in the FO25 group, and stearoyl-CoA desaturase 1 mRNA levels markedly decreased in the FO12.5 and FO25 groups. These results demonstrate that body weight gains were suppressed by dietary fat energy restriction even in KK mice with HF diet-induced obesity. We also suggested that the combination of fat energy restriction and fish oil feeding decreased fat droplets and ameliorated hepatic hypertrophy and insulin resistance with suppression of de novo lipogenesis in these mice.

We report the complex dielectric function along and perpendicular to the IrO2 planes in the layered perovskite Sr2IrO4 determined by spectroscopic ellipsometry in the spectral range from 12 meV to 6 eV. Thin high quality single crystals were stacked to measure the c-axis optical conductivity. In the phonon response we identified 10 infrared-active modes polarized within the basal plane and only four modes polarized along the c-axis, in full agreement with first-principle lattice dynamics calculations. We also observed a strong optical anisotropy in the near-infrared spectra arising from direct transitions between Ir 5d t2g Jeff = 1/2 and Jeff = 3/2 bands, which transition probability is highly suppressed for light polarized along the c-axis. The spectra are analyzed and discussed in terms of relativistic LSDA+U band structure calculations.

n-3 Polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have protective effects against the pancreatic β-cell dysfunction through several mechanisms. Thiazolidines are insulin sensitizers and are used in treating patients with type 2 diabetes. Our previous study demonstrated that a combination of fish oil, which is rich with EPA and DHA, and pioglitazone exerts beneficial effects on obesity and diabetes through their actions on the liver and adipose tissue. However, it remains largely unknown whether such combination therapy affects the pancreas. To answer this question, KK mice, which serve as a model for obesity and type 2 diabetes, were treated for 8 weeks with fish oil and pioglitazone. The combined regimen suppressed pancreatic islet hypertrophy (mean islet area decreased by an average of 49% vs. control) compared with mice treated with fish oil or pioglitazone alone (decreased by an average of 21% and 32% vs. control, respectively). Compared with the controls, individual or combined treatment significantly increased the percentage of β-cell area in the pancreatic islets, significantly decreased endoplasmic reticulum stress, and reduced the percentage of apoptotic cell death in the pancreatic islets. These findings suggest that fish oil and/or pioglitazone prevents β-cell dysfunction by improving the insulin resistance and decreasing the ER stress.

Galanin-like peptide (GALP) is a neuropeptide involved in the regulation of feeding behavior and energy metabolism in mammals. While a weight loss effect of GALP has been reported, its effects on lipid metabolism have not been investigated. The aim of this study was to determine if GALP regulates lipid metabolism in liver and adipose tissue via an action on the sympathetic nervous system. The respiratory exchange ratio of mice administered GALP intracerebroventricularly was lower than that of saline-treated animals and fatty acid oxidation-related gene mRNA levels were increased in the liver. Even though the respiratory exchange ratio was reduced by GALP, this change was not significant when mice were treated with the sympatholytic drug, guanethidine. Lipolysis-related gene mRNA levels were increased in the adipose tissue of GALP-treated mice compared with saline-treated animals. These results show that GALP stimulates fatty acid β-oxidation in liver and lipolysis in adipose tissue and suggest that the anti-obesity effect of GALP may be due to anorexigenic actions and improvement of lipid metabolism in peripheral tissues via the sympathetic nervous system.

We examined the effects of fish oil and fenofibrate (FF) on the pancreatic islet hypertrophy, and on the modification of glucose and lipid metabolic dysfunctions in KK mice with insulin resistance. The mice were fed one of four diets [25 en% lard/safflower oil (LSO), 25 en% fish oil (FO), or each of these diets plus 0.1 wt% FF (LSO/FF, FO/FF)] for 9 weeks. FO group and both FF groups had significantly lower final body and adipose tissue weights than LSO group. Pancreatic islet hypertrophy was observed only in LSO group but not in the other groups with fish oil or FF. And, it is likely that fish oil has a stronger therapeutic effect on islet hypertrophy. Plasma adiponectin level was significantly higher in FO group but not in both FF groups. Expression of hepatic lipogenic enzyme genes such as fatty acid synthase (FAS) and stearoyl-CoA desaturase-1 (SCD-1) was lower in FO groups with or without FF, whereas fatty acid oxidation-related mRNAs such as acyl-CoA oxidase (AOX) and uncoupling protein-2 (UCP-2) were more abundant in FF groups with or without fish oil.Our results suggest that both fish oil and FF improve pancreatic islet hypertrophy with the amelioration of insulin resistance. Fish oil enhances insulin sensitivity by increasing plasma adiponectin; however, the beneficial effect of FF on insulin resistance seems to be independent of the plasma adiponectin level. These results mean that improvement of glucose and lipid metabolic dysfuctions in diabetic KK mice are independently approached by fish oil and FF.

We examined the effects of low-dose fish oil ingestion on hepatic lipid accumulation caused after high cholesterol feeding in C57BL/6J mice. The mice were fed purified experimental diets consisting of 20 energy % (en%) safflower oil (SO or SO/CH), 2 en% fish oil + 18 en% safflower oil (2FO or 2FO/CH), or 5 en% fish oil + 15 en% safflower oil (5FO or 5FO/CH) with or without 2 weight % (wt %) cholesterol for 8 weeks. Hepatic triglyceride and total cholesterol contents were significantly lower in groups that were fed diets containing fish oil and cholesterol than in those that were fed safflower oil and cholesterol. The hepatic mRNA levels of fatty acid synthase (FAS) were lower in groups fed cholesterol or fish oil. Fatty acid oxidation-related hepatic gene expressions were higher in fish oil-fed groups. Fecal cholesterol excretion was higher in all cholesterol-fed groups; cholesterol excretion was high in groups fed fish oil and cholesterol. These results suggest that low-dose fish oil diets improve lipid metabolism by modifying the expression of lipid metabolism-related genes in the liver and increasing fecal cholesterol excretion.

We report the feasible technique in lower rectal surgery. The Rectum Catcher (Matsumoto et al. in Surg Endosc 22:1905–1909, 2008) is made of stainless steel, with a circle of diameter 6 mm punched out at a distance of 5 mm from the top and covered with a short-cut T-tube. A vessel tape is inserted into the stainless steel and the short-cut T-tube. The rectum is grasped using the Rectum Catcher at a proximal rectum of the cancer, and the location of the cancer is confirmed using an intra-operative colonoscopy. In the next step, the Rectum Catcher is applied at the distal rectum of the cancer, and which easily occludes the rectum, and we confirm that the cancer is not at the distal rectum from the Rectum Catcher, using an intra-operative colonoscopy. The rectal lumen is irrigated. Then, the linear cutter is positioned just distal rectum to the Rectum Catcher, and the rectum is transected adequately. From January 2009 to the present, this study included 18 patients undergoing laparoscopic-assisted low and ultralow anterior resection for lower rectal cancer, using the Rectum Catcher and an intra-operative colonoscopy. Using the Rectum Catcher and an intra-operative colonoscopy, we can easily make a decision of the location of rectal cancer in lower rectum and irrigation of rectal lumen can be easily performed to safely cut the bowel being occluded, in the narrow laparoscopic view of the pelvic cavity. The combination between the Rectum Catcher and an intra-operative colonoscopy is useful for performing laparoscopic rectal surgery.

Both soy isoflavone and n-3 polyunsaturatedfatty acids are known to reduce the levels of bone-resorbingcytokines; however, the synergistic effects of these foodingredients have not been examined yet. This study wasperformed to elucidate the effect of concomitant intake ofsoy isoflavone and fish oil on bone mass in ovariectomizedmice. Eight-week-old ddY female mice were subjectedto ovariectomy (OVX) or sham surgery, and then fed anAIN-93G with safflower oil (So) as a control lipid source,isoflavone-supplemented safflower oil (So ? I), fish oilinstead of safflower oil (Fo) or isoflavone-supplemented fishoil (Fo ? I) for 4 weeks. Femoral bone mineral density wassignificantly decreased by OVX; however, this decrease wasinhibited by the intake of isoflavone and/or fish oil. Histomorphometricanalyses showed that bone volume and trabecularthickness in the distal femoral trabecular bone weresignificantly lower in the So group than in the sham group,but those were restored in the Fo ? I groups. The number ofosteoclasts was significantly decreased by isoflavone intake, Original article. オンライン版はSpringerLinkで The Japanese Society for Bone and Mineral Research and Springer 2010. 45p.

Although cholesterol plays various important roles in the body, when overconsumed, it causes atherosclerosis and results in ischemic heart disease. On the other hand, dietary fish oils contain n-3 fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which prevent ischemic heart disease. This effect of n-3 fatty acids mainly results from the combined effects of inhibiting lipogenesis via a decrease of the mature form of sterol regulatory element-binding proteins (SREBPs) and stimulating fatty acid oxidation, via peroxisome proliferator-activator receptor (PPAR) α activation in the liver. In this study, we examined the interactive effects on lipid metabolism of dietary 2% cholesterol (w/w) and 20 or 50% energy fish oil. In a safflower oil diet with 2% cholesterol, hepatic lipids accumulated. On the other hand, hepatic lipids did not accumulate in the fish oil diets with cholesterol. Furthermore, in the groups with fish oil energy ratios of 20%, the negative feedback control of cholesterol affected SREBP-2, and the actions of fish oil and cholesterol were equivalent, but this was not observed in the cases with fish oil energy ratios of 50%. The results of this study suggest that differences in lipid accumulation in the body are due to differences in lipid source and energy ratios which differentially impact the control of transcription factors by cholesterol., Research Articles

Aim: The aim of our study is to elucidate the interactive effects on lipid metabolism of fenofibrate and two fish oils with EPA and DHA contents in mice.Methods: Female C57BL/6J mice were fed purified experimental diets containing safflower oil (SO), EPA-rich menhaden oil (MO) or DHA-rich tuna oil (TO) with or without 0.1% fenofibrate for 8 weeks. At the end of the experiments, we measured plasma lipids and hepatic triglycerides and cholesterol, and the hepatic mRNA expression of lipogenic and lipidolytic genes.Results: Plasma TG levels fell in the group fed MO or TO alone and fell significantly in all fenofibrate-treated groups. Although plasma total cholesterol levels fell significantly in fish oil-fed groups, fenofibrate treatments increased significantly plasma total cholesterol levels in these fish oil groups, but not in the group fed SO alone; however, hepatic triglyceride and total cholesterol levels markedly decreased in MO-or TO-fed mice. In lipid synthesis, the hepatic mRNA level of SREBP-1c was not reduced in either fish oil group; however, Insig-1 mRNA decreased in MO and TO feeding groups by about half and FAS or SCD-1 mRNA decreased significantly in MO and TO feeding groups, compared with the SO feeding group. In both fish oil groups, SREBP-2 mRNA decreased significantly and HMG-CoA reductase mRNA also decreased with/without fenofibrate. On the other hand, fenofibrate supplementation significantly induced the mRNA expression of AOX and UCP-2, which play a role in lipid catabolism, in all diets. CYP7A1 mRNA increased markedly in mice fed MO diet with fenofibrate, compared with TO diet with fenofibrate.Conclusion: These data suggest that differences in dietary contents of EPA and DHA do not influence the inhibition of lipogenesis, and that fenofibrate supplementation stimulates fatty acid oxidation, regardless of the oil type; however, cholesterol catabolism was induced by a combination of EPA-rich fish oil and fenofibrate, which suggests that EPA has a greater synergistic ability for cholesterol catabolism induction by fenofibrate than DHA.

To investigate the metabolism and distribution of docosapentaenoic acid (22:5n-6, DPA) in the liver and testis of growing rats, 22:5n-6 was administered to their dams. Newborn rats with a low hepatic arachidonic acid (20:4n-6, AA) level were generated by administrating a diet rich in docosahexaenoic acid (22:6n-3, DHA) but n-6 fatty acid (FA) free to pregnant dams. After parturition, 22:5n-6 or linoleic acid (18:2n-6, LA) was administered with a high level of 22:6n-3 to the dams until weaning. At weaning, the hepatic 20:4n-6 level was significantly highest in the DPA-DHA but not LA-DHA diet-fed animals. The hepatic delta-6 desaturase (D6D) mRNA abundance was significantly lower in both the LA-DHA and DPA-DHA diet-fed animals, connoted with the 20:4n-6 content recovered by 22:5n-6 that did not involve D6D and supporting the occurrence of retroconversion in the liver of the growing rats. The low D6D level in the 3-week-old testis was not in proportion to the elevated 22:5n-6 level, implying that early testicular 22:5n-6 accumulation might require supply from the circulation system.

Objective: Diacylglycerol (DAG)-rich oil has been suggested to suppress postprandial hyperlipidemia and promote negative caloric balance by increasing energy expenditure (EE), due to small intestine physiochemical dynamics that differ from triacylglycerol (TAG). We studied the effect of DAG on postprandial glucose/insulin metabolism by loading of carbohydrate with oil. Further, to reveal the mechanism for increased EE by DAG, we measured plasma serotonin, which is mostly present in the small intestine and mediates peripheral sympathetic thermogenesis. Methods and Procedures: Randomized crossover study with 2-week wash-out interval between differing fat ingestion. Seven male, lean, Japanese students ingested DAG or TAG oil with 40 g of carbohydrate. Measurements of metabolic parameters were performed before and at 2, 4, and 6 h after fat ingestion. Plasma serotonin levels and cholesterol concentration in each lipoprotein were measured using high-performance liquid chromatography (HPLC). Results: The substitution of DAG for TAG decreased very-low-density lipoprotein-cholesterol (VLDL-C) by 45.6% at 2 h, and decreased serum insulin by 41.3% at 4 h after ingestion. The incremental area under the curve (IAUC) for VLDL-C was positively correlated with the IAUC for insulin. Concurrently, DAG elevated plasma serotonin levels by 47.3% at 2 h, while TAG did not influence. Discussion: This study indicates that the substitution of DAG for TAG suppresses the postprandial increase in serum VLDL-C and insulin. This study also demonstrates that DAG ingestion increases plasma serotonin, proposing a possible mechanism for a postprandial increase in EE by DAG.

皮膚筋炎を合併した直腸癌の1例を経験したので報告する. 症例は52歳, 男性. 全身の倦怠感と脱力感を認め入院. 顔面と胸部の紅斑, ヘリオトロープ疹を認め, LJDH, CPK, ALD, 抗核抗体の異常高値にて皮膚筋炎と診断され, ステロイドの投与を受けた. 同時に行われた注腸検査, 大腸内視鏡検査にてRaの直腸癌が発見されたため腹腔鏡補助下で低位前方切除術を施行した. 病理組織学的検査の結果はmp, ly3, v2, nl (251), stage IIIa, 根治度Aであった. 術後皮膚筋炎の症状は一時軽快し, 筋原性酵素の値も低下した. 術後1年経過した現在再発はなく生存中である. 悪性腫瘍と皮膚筋炎との間に何らかの因果関係を示すものと思われた. また, 本疾患は予後が比較的不良とされ, 患者のQOLを重視した腹腔鏡補助下術式も治療法選択肢の1つとして考慮されるべきであると思われた.

Background : Animal experiment studies have revealed a positive association between intake of citrus fruits and bone health. Nomilin, a limonoid present in citrus fruits, is reported to have many biological activities in mammalian systems, but the mechanism of nomilin on bone metabolism regulation is currently unclear. Purpose : To reveal the mechanism of nomilin on osteoclastic differentiation of mouse primary bone marrow-derived macrophages (BMMs) and the mouse RAW 264.7 macrophage cell line into osteoclasts. Study design : Controlled laboratory study. Effects of nomilin on osteoclastic differentiation were studied in in vitro cell cultures. Methods : Cell viability of RAW 264.7 cells and BMMs was measured with the Cell Counting Kit. TRAP-positive multinucleated cells were counted as osteoclast cell numbers. The number and area of resorption pits were measured as bone-resorbing activity. Osteoclast-specific genes expression was evaluated by quantitative real-time PCR; and proteins expression was evaluated by western blot. Results : Nomilin significantly decreased TRAP-positive multinucleated cell numbers compared with the control, and exhibited no cytotoxicity. Nomilin decreased bone resorption activity. Nomilin downregulated osteoclast-specific genes, NFATc1 and TRAP mRNA levels. Furthermore, nomilin suppressed MAPK signaling pathways. Conclusion : This study demonstrates clearly that nomilin has inhibitory effects on osteoclastic differentiation in vitro. These findings indicate that nomilin-containing herbal preparations have potential utility for the prevention of bone metabolic diseases.

Aquaporin (AQP) 7 and AQP9 are subcategorised as aquaglyceroporins which transport glycerin in addition to water. These AQPs may play a role in the homeostasis of energy metabolism. We examined the effect of AQP7, AQP9, and lipid metabolism-related gene expression in obese mice. In diet-induced obese (DIO) mice, excess lipid accumulated in the liver, which was hyperleptinemic and hyperinsulinemic. Hepatic AQP9 gene expression was significantly increased in both DIO and ob/ob mice compared to controls. The mRNA expression levels of fatty acid and triglyceride synthesis-related genes and fatty acid β oxidation-related genes in the liver were also higher in both mouse models, suggesting that triglyceride synthesis in this organ is promoted as a result of glycerol release from adipocytes. Adipose AQP7 and AQP9 gene expressions were increased in DIO mice, but there was no difference in ob/ob mice compared to wild-type mice. In summary, adipose AQP7 and AQP9 gene expressions are increased by diet-induced obesity, indicating that this is one of the mechanisms by which lipid accumulates in response to a high fat diet, not the genetic mutation of ob/ob mice. Hepatic AQP9 gene expression was increased in both obesity model mice. AQP7 and AQP9 therefore have the potential of defining molecules for the characterisation of obesity or fatty liver and may be a target molecules for the treatment of those disease.