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Lipoma of the transverse colon with intussusception is a rare disease. We report our experience of a case of lipoma of the transverse colon with intussusception that was successfully treated by laparoscopic surgery. The case was an 81-year-old woman who consulted a local clinic with a chief complaint of abdominal pain. The patient was referred to our department because abdominal CT scan revealed intussusception of the transverse colon. A fist-sized abdominal mass was found along with corresponding tenderness in her left upper abdominal area to the periumbilical area. The patient was diagnosed with intussusception caused by transverse colon tumor and was planned to undergo surgery. Intussusception associated with tumor was observed in the middle of the transverse colon. However, since the mobility in the abdominal cavity was favorable, partial resection of the transverse colon was performed through small laparotomy. The resection specimen showed a semi pedunculated submucosal tumor 9 × 6 cm in size. Histopathologically, the patient was diagnosed with adipose tumor outgrown with mature adipocytes in varied sizes.

Background: Heat-shock protein 70 (HSP70) is important in host responses to various stresses. This study analyzed the correlation between preoperative serum concentrations of HPS70 and postoperative morbidity in patients with esophageal cancer. Materials and Methods: Serum samples were obtained preoperatively from 31 patients with esophageal squamous cell carcinoma. Serum HSP70 concentrations were measured by enzyme-linked immunosorbent assay and the relationships between serum HSP70 level and postoperative morbidities were analyzed. Results: The mean concentration of serum HSP70 was 9.71 ng/ml. When patients were dichotomized relative to this cutoff, no significant relationships between perioperative inflammatory markers and serum HSP70 level were observed. The incidence of postoperative complications was significantly lower in patients with HSP70 ≥9.71 ng/ml (p=0.0281). Conclusion: Preoperative serum level of HSP70 was significantly correlated with postoperative morbidities in patients with esophageal cancer. Therefore, enhancing the HSP70 level prior to invasive surgery could be a feasible strategy to prevent morbidity.

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have increased worldwide in people without underlying diseases. CA-MRSA can often cause serious bacterial infections, especially skin and soft tissue infections (SSTI). Here, we describe a case of severe subcutaneous abscess due to Panton-Valentine leucocidin (PVL)-positive CA-MRSA in an infant without underlying diseases. A 4-month-old girl presented with a 4-day history of fever, with extensive redness and swelling of the lumbar region and buttocks. She was diagnosed with extensive subcutaneous abscess of the lumbar region and buttocks. Surgical drainage was performed, and a substantial volume of pus was drained. MRSA was detected in the pus on culture. Antibiotic therapy that covered MRSA was also administered for 3 weeks, and the abscess healed. As it was a severe SSTI due to MRSA, analysis of MRSA revealed PVL-positive MRSA. This patient had no underlying disease or history of antibiotic administration, and as MRSA was present in the nasopharyngeal cavity, it was considered a case of CA-MRSA. Furthermore, the prevalence of PVL-positive CA-MRSA in MRSA isolated from patients with SSTI has also increased in Japan. The Infectious Diseases Society of America recommends surgical intervention and empirical antibiotic therapy for MRSA-complicated SSTI cases in an era of CA-MRSA. Pediatricians must strongly consider the possibility of MRSA in children with severe SSTIs.

Purpose Tissue engineering of esophagus is required for management of long-gap esophageal atresia (LGEA). Collagenous connective tissue membranes fabricated by in-body tissue architecture (iBTA), called biosheets, can repair esophageal defects and generate tissues similar to native esophagus. However, iBTA requires second-stage surgery because of heterotopic preparation of biosheets. Our aim was to develop orthotopic iBTA for primary engineering of the esophagus by interposing a tubular mold to the esophageal defect. Method The cervical esophagus of six rats was transected. An acrylic tube (internal diameter 2.6 mm, length 7.0 mm) was inserted and fixed between the ends of the upper and lower esophagus, and a 3 mm-long esophageal defect was created. Four weeks later, the rats were sacrificed for histological analysis. Results Postoperatively the rats could intake liquid food. After four weeks, the esophageal defects were filled with regenerated tissues. Histologically the new esophageal walls stained positive for collagen type I. The inner surfaces were covered with stratified squamous epithelium that expressed pan-cytokeratin. In only one of six rats, regeneration of muscular-like tissue was suggested by positive immunohistochemical staining for desmin. Conclusion Orthotopic iBTA can regenerate a substitute esophagus with esophageal epithelium and collagenous wall. This technique may be a novel treatment for esophageal atresia with gaps of various lengths including LGEA.

A pre-existing partnership between the Japanese Government and Keio University paved the way for K-12 education to embrace distance learning. The university has been engaging in the revision of educational ICT policies in Japan for many years. In Japan, universities have been accumulating knowledge in distance learning practices since the emergence of the Internet, though earlier educational ICT policy required the ICT system in K-12 education to depend on dedicated Internet lines. In December 2019, the Japanese Ministry of Education, Culture, Sports, Science, and Technology (MEXT) announced a new ICT policy to allow K-12 education to launch distance learning classes via public cloud on the Internet. The university’s experience with running distance learning, bundled with the stipulations of the new educational ICT policy, enabled K-12 education to carry out distance learning. New subjects can be taught daily, and continuity of education is ensured in disaster situations, such as the Covid-19 pandemic. The research team at Keio University built the “Nagasaki-Takaoka Model” as a reference model with the added aim of ensuring data security and trust in the open network. In December 2020, Takaoka City successfully deployed the “Nagasaki-Takaoka Model” across all public schools.

Introduction: Comprehensive genomic profiling (CGP) was widely adopted in Japan after its coverage by national healthcare insurance began in June 2019. We investigated the clinical utility of CGP in pediatric and adolescent young adults (AYA) solid tumor patients. Materials and Methods: Between November 2017 and December 2019, 13 patients who progressed with or who were likely to progress with standard therapies were recruited to the PROFILE-F study to undergo CGP using either FoundationOneⓇ CDx or FoundationOneⓇ Heme. Results: The median age was 28 years old. Tumor types were as follows: neuroblastoma (n = 1), Wilms’ tumor (n = 1), rhabdomyosarcoma (n = 2), Ewing sarcoma (n = 1), gastric cancer (n = 1), rectal cancer (n = 1), osteosarcoma (n = 1), neuroendocrine tumor (n = 2), salivary gland carcinoma (n = 1), tracheal adenoid cystic carcinoma (n = 1), and thymic cancer (n = 1). In 92% of cases, at least one genomic alteration was identified, including CDKN2A (four cases), TP53 (three cases), and MYC (two cases). Actionable aberrations were found in 10 cases (77%), and a clinical trial candidate was found in seven cases (54%). However, no patients were able to receive biomarker-matched therapy according to their genomic alterations. Conclusions: Further efforts to increase basket trials and collection of clinical genomic data to predict response are necessary to advance precision cancer medicine and surgical management in pediatric and AYA populations.

Purpose Pneumothorax often develops in patients with Marfan syndrome (MFS). Here, we examined the effects of conservative and surgical pneumothorax treatments in children with MFS. Methods In this study, 23 patients, less than 20 years old, diagnosed with both MFS and pneumothorax between 1999 and 2019 were included. All data were collected retrospectively from patients’ medical records. Results In total, 18 of 23 patients (78%) had relapsed pneumothorax either on the ipsilateral or contralateral side. Among these 18 patients, 6 (26%) patients had multiple relapses. Conservative and surgical treatments of pneumothorax were attempted in 33 and 29 lungs, respectively. The conservative treatment was attempted as a definitive therapy in 21 lungs. Twelve conservative treatments (57%) failed, which required surgical intervention. In 9 lungs (43%) with successful conservative treatment, 6 (67%) had ipsilateral relapses. In contrast to the above findings, only 4 (13%) ipsilateral relapses were observed in 29 surgical treatments. Conclusions Our study revealed a low response and high relapse rate when MFS adolescents who diagnosed pneumothorax were subjected to the conservative treatment modality. Thus, we recommend surgical intervention as the first line of therapy to treat pneumothorax in adolescents diagnosed with MFS. Level of Evidence Ⅲ (Treatment Study)

Pulmonary hypoplasia is a rare entity in a fetus with imperforate anus. The fetus was diagnosed with high-type imperforate anus with rectourethral fistula based on the dilated fetal bowel and the presence of bowel calcification at 19 weeks of gestation. As gestation advanced, fetal ultrasonography demonstrated development of pulmonary hypoplasia, progressive bowel dilation, and persistent oligohydramnios from 28 weeks of gestation despite a fluid-filled bladder without hydroureter or hydronephrosis. To prevent further worsening of pulmonary hypoplasia caused by thoracic compression due to bowel dilation and oligohydramnios, a male neonate was delivered by cesarean section at 32 weeks of gestation. The neonate showed respiratory failure requiring full respiratory support. Although a catheter did not pass through the urethra into the bladder at birth, cystourethrography revealed the patency of fistula and stenosed lower urinary tract. Prenatal and postnatal findings strongly suggested that the meconium in the colon might have passed into the urethra in the penis, resulting in the physical blockage of urine outflow to the amniotic space which leads urine flow from the bladder to the colon through the fistula, which resulted in subsequent oligohydramnios and bowel dilation. To the best of our knowledge, this is the first case report of a fetus with imperforate anus developing pulmonary hypoplasia possibly due to urethral obstruction.

Infants with Alagille syndrome (AGS) frequently develop neonatal cholestasis, and some AGS infants who suspected of biliary atresia subsequently undergo the Kasai operation with the diagnosis of biliary atresia. The aim of this study was to investigate the effect of the Kasai operation on liver and patient outcomes among AGS patients, using a meta-analysis. A systematic review and meta-analysis of studies describing the outcomes of AGS patients with/without the Kasai operation were conducted. The analyzed outcomes were liver transplantation, not living with the native liver, and mortality for any reason. We identified 6 studies (394 AGS patients). All studies were retrospective cohort or case-control studies. The incidences of liver transplantation, not living with the native liver, and mortality were significantly higher in AGS patients who underwent the Kasai operation than in those who did not undergo the Kasai operation (odds ratio: 6.46, 95% CI 3.23–12.89, p

Tracheomalacia is a major cause of morbidity in conditions such as oesophageal atresia. However, symptoms usually improve with age. A more rapid growth of tracheal cartilage can be induced by basic-Fibroblast Growth Factor (b-FGF). This study aimed to investigate whether slow-release b-FGF could act as a novel treatment for tracheomalacia.Biodegradable gelatin hydrogel sheets incorporating 0.5, 5, or 50 μg/20 μl of b-FGF solution were inserted between the cervical trachea and esophagus of rats. No intervention was performed in rats in a control group. All animals were sacrificed 4 weeks later, and the luminal area of the cervical trachea and the thickness of the cartilage were measured.The mean luminal areas in the control group and in the b-FGF groups were 3.1, 3.2, 3.8, and 2.6mm(2), respectively, and showed a peak area at 5 μg of b-FGF. A significant difference was seen only between the control group and the b-FGF 5 μg group (p0.05). The mean thickness of the tracheal cartilage was 0.12, 0.13, 0.19, and 0.32 mm in the control and the b-FGF groups, respectively, and showed a dose-dependent increase, which was statistically significant between the b-FGF 5 μg or 50 μg groups and the control group (p0.01).This study showed that slow-release b-FGF enlarges the tracheal lumen and thickens the cartilage in a dose-dependent fashion.

Background Plasma citrulline has been reported to be a good indicator of intestinal functional volume in patients with intestinal dysfunction. We reconfirmed the facts and also investigated the dynamic changes of plasma citrulline in acute-phase patients with intestinal dysfunction. Methods We measured plasma citrulline in six patients with intestinal dysfunction who were in the acute and chronic phase for more than 6 months. Results Four patients out of six could be withdrawn from total parenteral nutrition, and their plasma citrulline level dynamically changed according to their intestinal states and finally increased up to 15 nmol/mL. Two patients, who could not be withdrawn from parenteral nutrition, showed very low levels of plasma citrulline throughout the treatment course (under 15 nmol/mL). Conclusion The cut-off level of plasma citrulline indicating permanent intestinal dysfunction may be 15 nmol/mL in our data. In the acute phase, plasma citrulline changed dynamically according to the intestinal state and may be a good indicator of fluctuating intestinal functions. Thus, although only a few patients were enrolled in this study, plasma citrulline may be a good indicator of stable-state as well as acute-unstable-state intestinal functions.

Amphibians have been used for over a century as experimental animals. In the field of developmental biology in particular, much knowledge has been accumulated from studies on amphibians, mainly because they are easy to observe and handle. Xenopus laevis is one of the most intensely investigated amphibians in developmental biology at the molecular level. Thus, Xenopus is highly suitable for studies on the mechanisms of organ differentiation from not only a single fertilized egg, as in normal development, but also from undifferentiated cells, as in the case of in vitro organogenesis. Based on the established in vitro organogenesis methods, we have identified many genes that are indispensable for normal development in various organs. These experimental systems are useful for investigations of embryonic development and for advancing regenerative medicine. Developmental Dynamics 238:1309-1320, 2009. (c) 2009 Wiley-Liss, Inc.

Introduction We have designed an engineered graft fabricated from a biodegradable scaffold using chondrocytes and applied this construct to augment repair of tracheal stenosis. This study investigated the feasibility of using such tissue-engineered airways with autologous chondrocytes in a rabbit model. Material and Methods Chondrocytes were isolated and expanded from the auricular cartilage of New Zealand white rabbits, then seeded onto composite 3-layer scaffolds consisting of a collagen sheet, a polyglycolic acid mesh, and a copolymer (l-lactide/ ɛ -caprolactone) coarse mesh. The engineered grafts were implanted into a 0.5 × 0.8-cm defect created in the midventral portion of the cervical trachea. Gelatin sponges that slowly released basic fibroblast growth factor (b-FGF) were then placed on the constructs, which were retrieved 1 or 3 months after implantation. Results The biodegradable scaffold seeded with chondrocytes could maintain airway structure up to 3 months after implantation. Tracheal epithelial regeneration occurred in the internal lumen of this composite scaffold. Three months after implantation, staining of the sections showed cartilage accumulation in the engineered tracheal wall. Conclusion This composite biodegradable scaffold may be useful for developing engineered trachea. A gelatin sponge slowly releasing b-FGF might enhance chondrogenesis.

A case of vesico-appendiceal fistula caused by appendiceal cancer is reported. A 37-year-old male was admitted with the chief complaint of suspended dust in the urine. Under cystoscopy, a tumor (1 cm diameter) was found in the right posterior wall of the bladder. Transurethral resection of the bladder tumor was performed. The pathological outcome was intestinal metaplasia without malignancy. Preoperative abdominal computed tomography suggested vesico-appendiceal fistula, retrospectively. Therefore, appendectomy with partial cystectomy was attempted. However, the appendix was adhered to the sigmoid mesocolon, therefore, appendectomy, partial cystectomy, and sigmoid colectomy were performed. We diagnosed the tumor as mucinous adenocarcinoma. The patient has been receiving adjuvant chemotherapy with tegafur-gimeracil-oteracil potassium for 17 months, because he refused right hemicolectomy. There was no evidence of recurrence after 58 months of follow-up. Vesico-appendiceal fistula caused by appendiceal cancer is very rare. Our case is the 21st case reported in Japan.

We report here on a case of condyloma acuminatum in the neourethra after urethroplasty for hypospadias. A 37-year-old male visited an other clinic with the chief complaint of a meatal tumor. He had undergone a urethroplasty for hypospadias in his childhood. He was diagnosed as having condyloma acuminatum of the urethral meatus, and was referred to our hospital. Some other lesions in the neourethra were recognized under urethroscopy. We firstly resected the meatal tumor, and diagnosed it as condyloma acuminatum, pathologically. Thereafter, we performed transurethral resection of the urethral condyloma acuminatum. Recurrence of the condyloma acuminatum was noted after 6 months, postoperatively, so we performed TUR again. No recurrence has been seen to date.

We report a case of percutaneous bacillus Calmette-Guérin (BCG) perfusion therapy for carcinoma in situ (CIS) of upper urinary tract after radical cystectomy with ileal neobladder. A 42-year-old man underwent radical cystectomy and ileal neobladder diversion due to the recurrence of CIS in prostatic urethra after transurethral resection of bladder tumor 3 times and 2 courses of intravesical BCG therapy. Final pathological findings showed the presence of CIS in the right distal ureteral margin. After the radical cystectomy, our diagnosis was CIS in the right residual ureter, because of positive urine cytology and negative radiographic findings in the upper urinary tract. We performed the percutaneous BCG perfusion therapy for CIS of the right upper urinary tract after the construction of the percutaneous nephrostomy by intentionally inducing hydronephrosis. No recurrence was found after 3 years of BCG perfusion therapy.

A 64-year-old man underwent chemotherapy after radical cystectomy for bladder cancer (UC, G3, pT3aN1M0). Three years later, computed tomography showed a left adrenal mass, and we performed left adrenalectomy. Histological findings showed that the adrenal mass was a metastasis of the bladder cancer. Over 6 years after salvage chemotherapy, the patient had no evidence of metastasis to other parts of the body. In the case of a solitary metastasis of bladder cancer, surgical resection should be positively considered.

This study aimed to develop a novel procedure for treating long-gap pure esophageal atresia. This procedure, which entails the combined use of laparoscopy and natural orifice translumenal endoscopic surgery (NOTES), would enable primary repair without cervical and thoracic incisions and prevent postoperative gastroesophageal reflux disease (GERD).Nonsurvival experiments were conducted in 9 pigs to study the technical feasibility. The procedure comprised the following: (1) creation of the disease model by laparoscopic resection of the lower esophagus; (2) laparoscopic fundoplication, complete mobilization of the stomach, and enlargement of the esophageal hiatus; (3) formation of a peroral transesophageal entry site into either the postmediastinum or the right thoracic cavity followed by fashioning a tunnel to the peritoneal cavity; (4) gastric pull-up by using both laparoscopy and NOTES; (5) esophagoesophageal anastomosis using BraceBar™, a prototype of the double T-bar suturing device (Olympus Medical Systems Co., Tokyo, Japan).Laparoscopic procedures were performed without complications. The postmediastinal tunnel was successfully created three times with a complication of pleural injury. However, gastric pull-up via this route could not be completed due to porcine anatomical reasons. Gastric pull-up through the right thoracic route was achieved five times in six attempts. Two disorientations and a hemorrhagic death occurred during the procedures.This study showed that combined use of laparoscopy and NOTES enabled gastric pull-up without cervical and thoracic incisions. Our method has the potential of lowering the incidence of GERD and enabling primary repair of this disease.

Plasma citrulline has been reported to be a good indicator of intestinal functional volume in patients with intestinal dysfunction. We reconfirmed the facts and also investigated the dynamic changes of plasma citrulline in acute-phase patients with intestinal dysfunction.We measured plasma citrulline in six patients with intestinal dysfunction who were in the acute and chronic phase for more than 6 months.Four patients out of six could be withdrawn from total parenteral nutrition, and their plasma citrulline level dynamically changed according to their intestinal states and finally increased up to 15 nmol/mL. Two patients, who could not be withdrawn from parenteral nutrition, showed very low levels of plasma citrulline throughout the treatment course (under 15 nmol/mL).The cut-off level of plasma citrulline indicating permanent intestinal dysfunction may be 15 nmol/mL in our data. In the acute phase, plasma citrulline changed dynamically according to the intestinal state and may be a good indicator of fluctuating intestinal functions. Thus, although only a few patients were enrolled in this study, plasma citrulline may be a good indicator of stable-state as well as acute-unstable-state intestinal functions.

Ras guanyl nucleotide-releasing protein 2 (RASGRP2), one of the Ras guanine exchange factors, is implicated as a critical regulator of inside-out integrin activation in human lymphocytes, neutrophils and platelets. However, the activities of this protein in endothelial cells remain unclear. In the current study, we identify a physiological function in blood vessel formation for XRASGRP2, which is the Xenopus ortholog of mammalian RASGRP2. XRASGRP2 over-expression induced ectopic vascular formation, and XRASGRP2-knockdown embryos showed delayed vascular development. We also investigated the upstream signaling of XRASGRP2 in endothelium formation. XRASGRP2 expression was up-regulated in the presence of VEGF-A and down-regulated following VEGF-A depletion. XRASGRP2 knockdown abolished the ectopic induction of endothelial cells by VEGF-A in the posterior ventral blood island. These results suggest that XRASGRP2 is essential for vascular formation during Xenopus development.

Construction of engineered respiratory tract using tissue-engineered cartilage has not yet been reported. In order to generate artificial trachea using human chondrocytes obtained from tracheal cartilage, we investigated whether human tracheal chondrocytes can act as a cell source to fabricate engineered airway patches to augment stenotic parts of the trachea. After informed consent, chondrocytes were obtained from five patients who needed tracheal surgery. A small piece of resected tracheal cartilage was digested by collagenase type 2 for 3–4 h. This yielded chondrocytes, which were expanded in vitro and seeded onto biodegradable scaffolds; these were then implanted subcutaneously in athymic mice. The implanted constructs were retrieved 8 weeks later for histologic and biochemical analysis. In monolayer cultures, chondrocytes proliferated well, showing a 100- to 1,000-fold increase in 1 month. Once expanded, the cells lost their original morphological and biologic characteristics, but the engrafted scaffold showed histologic and biochemical characteristics of cartilage. Viable chondrocytes and extracellular matrix were detected, and glycosaminoglycan (GAG) in vivo was present. Here we show that a small piece of human tracheal cartilage can generate sufficient chondrocytes in vitro and form tracheal cartilage architecture in an in vivo environment.

If bone metastasis of renal cell carcinoma is neglected, pain, paralysis, and pathologic fracture develope; consequently, the patient's quality of life is significantly lowered. We investigated the local effect of the radiation therapy to the patients with metastasis. The investigation targeted 22 cases (27 parts) of renal cell carcinoma with bone metastasis that were treated with radiation therapy in our hospital during the last 6 years. We analyzed cell type, presence or absence of organ metastasis, irradiated site, therapeutic dose, treatment period, and combination therapy. The object was classified into 2 groups by metastatic site: the group with metastasis in the vertebra, and the group of metastasis in the pelvis or long bones. We examined re-calcification rate, length of time to recalcification emergence, pain relief and duration of effect as therapeutic effects. The irradiated site was vertebra in 14, pelvis in 7, and long bone in 6 patients. The therapeutic dose was 15 to 50 Gy, and the average was 35.7 Gy. No difference was found in the re-calcification rate and length of time to recalcification according to the metastatic site. The pain relief effect was significant in the pelvis and long bone group compared to the vertebra group. The effect lasted longer when the radiation dose was 35 Gy or more, compared with a lower dose. The radiation therapy for renal cell carcinoma with bone metastasis was effective to relieve pain and improve the patients' quality of life. The results showed that early detection and recognition of bone metastasis provide local control.

A 41-day-old female infant with VACTERL association was transferred to the pediatric intensive care unit of our hospital. She had been delivered at 36 weeks gestation by spontaneous vaginal delivery and weighed 2340 g. Esophageal atresia type A with long gap, anal atresia, cardiac anomaly (atrial septal defect and patent ductus arteriosus), thoracic vertebral dysplasia, left renal agenesis, and minor anomalies (left-side facial nerve palsy, left-side difficulty in hearing, and the absence of the right thenar) had been diagnosed by various examinations. She was transferred to our hospital to receive treatment for heart failure due to a cardiac anomaly. We recognized vaginal atresia during a radical operation for anal atresia (rectovestibular fistula) at 8 months of age. Furthermore, magnetic resonance imaging (MRI) revealed agenesis of the uterus. MURCS association includes Mullerian duct aplasia or hypoplasia, renal aplasia, and cervicothoracic somite dysplasia. This is the first case of complete VACTERL association combined with MURCS association.

Body stalk anomaly is characterized by severe scoliosis, severe pulmonary hypoplasia, and giant omphalocele. The prognosis of the disease is poor and most obstetricians consider it fatal. Very few patients with body stalk anomaly survive. We report the case of a baby diagnosed with body stalk anomaly in fetal life, who was saved by intensive care after birth. We closed the giant omphalocele successfully by placing karaya gum sheets over it, which created a humidified environment and promoted natural skin epithelization over the skin defect.

A method of the quantitative analysis was established for the determination of deacylgymnemic acid (DAGA) in the alkaline hydrolysate of the sample containing gymnemic acids which are ingredients of Gymnema sylvestre R. BR. leaves, by means of high-performance liquid chromatography. This method was used for comparing the contents of gymnemic acids in various samples. The amount of gymnemic acids analyzed as DAGA in 70% ethanol extract of dry leaves was about twice that in hot water extract. The commercial health-supplemental foods of five companies were investigated for the contents of gymnemic acids as DAGA and there were large differences from 38 to 251 mg in the dosage per day recommended by each company.

With the monolayer technique, values of about 99.7 A for rabbit anti-egg albumin IgG antibody, and about 58.9 A for Fab fragment of IgG were obtained as the thickness of the adsorbed antibody layer. As these values determined in the saturated state were confirmed, it may be reasonable to assume that they correspond approximately to the long axis of both molecules.

著者らは最近,肝臓に原発した扁平上皮癌の1例を経験した.患者は71歳男子で,肝臓の右葉下半部を占める塊状の腫瘤を形成し,その周辺部の肝組織には,小豆大から拇指頭大の肝内転移巣をみとめたが,他臓器への転移はみとめなかった.組織学的には癌胞巣の中心部に癌真珠の形成をみる分化型の扁平上皮癌であった.この型の癌の組織発生について,多少の考察を加えた.

Summary The monolayer technique in the observation of the antigen-antibody reaction is applicable to desorption experiments irrespective of the valency of the antigenic substance. It offers a new method of measurement of the strength of combination between haptens and antibodies. This strength can be expressed as relative desorption strength. The values of relative desorption strength significantly depend upon the number of atoxyl groups per molecule and higher values are obtained with the haptenic compounds containing greater number of atoxyl groups. However, differences exist in the desorption strengths of haptens with the same valence. Among the substances with two atoxyl groups, the atoxyl-azoamino acids, which are closer in chemical structure to the immunizing antigen, exhibit higher values than any other compounds. In addition they give no precipitate with the antiserum in contrast to other haptens with two atoxyl groups. It seems reasonable to assume that the haptens bearing two atoxyl groups in meta position constitute one single determinant group. In that sense it may be considered as univalent contrary to the current concept that a haptenic substance with two atoxyl groups is bivalent under any circumstances.

(1) Force-area curves were determined of monolayers of native ovalbumin and azo-ovalbumin with various number of diazonium groups. As a results it was found that the coupled diazonium groups do not contribute to the area of compressed protein film molecule, but tends to increase the thickness. (2) The mode of deposition, when the monolayers of azo-ovalbumins are deposited on metal slides covered with multilayers of barium stearate, was examined. Various types of deposited azo-ovalbumin films thus obtained were tested as to their antigenic activity. The results were discussed in relation to the structure of protein films.

Summary By the monolayer technique the relationship between the number of haptenic groups in azoproteins and the number of antibody molelules combined was quantitatively observed. The optical thickness of the antibody layer specifically attached to a monolayer film of atoxyl-azo-ovalbumin increases in linear relation to the increase in the number of haptenic atoxyl groups, until it reaches a “saturation” point with an antigen containing about 30 haptenic groups, and thereafter the thickness remains unchanged, even if the number of determinant groups is increased over 30. Quantitative observations were made with monolayer films of mixtures of azoprotein (containing a certain number of haptenic groups) and native ovalbumin in various proportions. The thickness of the antibody layer decreased proportionally with the decrease in the average number of haptenic groups per unit area in the mixture films (hetero-monolayers), approximately corresponding to the thickness of the antibody layer obtained with homogeneous film (homomonolayer) containing the same number of haptenic groups per molecule. In multilayer films the thickness of the antibody layer increased proportionally with the number of layers each containing the same number of haptenic groups. The ratio of increase in the thickness of the antibody layer is in complete accord with that in the case of a single monolayer experiment. From the experimental results described in this paper the significance of the thickness of the antibody layer in a monolayer technique was made clear in that it indicates the average density of antibodies adsorbed on an antigen monolayer film. The structural arrangements of the haptenic groups in the monolayer film and of the antibodies on the antigen film were discussed in terms of molecular orientation.

Open surgery is the standard therapeutic approach for renal malignant tumor in children; while in adults, laparoscopic radical nephrectomy (LRN) is used. Only few reports on LRN in children have been published because the most common form of pediatric renal malignancy, Wilms tumor, is well known for presenting with large palpable masses. Here, we report the case of a 13-year-old girl with small chromophobe renal cell carcinoma (RCC) who was managed by LRN. RCC is a rare condition, with an incidence rate of only 2–6% of all renal tumors in children. We found LRN for small RCC to be feasible and safe.

Frog larvae recieved transplants of autografts, allografts, and xenografts using Rana brevipoda and Rana japonica . Tail tip autografts heal rapidly, continue to grow but undergo degeneration at metamorphosis. Allografts and xenoqrafts also heal but show signs of rejection by the host's immune system. Onset of rejection depends upon the stage when grafts were performed. If transplants were made during early stages, onset was late; if performed later, onset was early. Because frog larvae will eventually undergo metamorphosis as a result of thyroxine effects, they are excellent experimental models for correlating the immune and endocrine systems with differentiation, growth, and aging.