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A quantitative trait locus (QTL) analysis was conducted on grain appearance in Emi-no-kizuna, a rice cultivar that has superior and stable appearance of the brown rice grain and high tolerance to high temperature stress, by using F3 lines derived from Emi-no-kizuna and Tomohonami. The investigation was performed 2013 and 2015. In summer 2013 the air temperature was higher and the larger differences in grain appearance were observed. In the QTL analysis, a highly contributing locus, qGA8, was detected at the end of the short arm of chromosome 8. Because trends of reduced the occurrence of white immature kernel and increased the percentage of perfect grain were observed in Emi-no-kizuna genotype in both years, qGA8 is likely to be an important QTL that is dominant in the superior grain appearance of Emi-no-kizuna. Also, qGA8 was linked to a QTL associated with days to heading. Another QTL, qGA7, associated with grain appearance was detected on chromosome 7 in 2013. Because no negative correlation was found between the genotype of qGA8 and thousand grain weight, it should be possible to breed cultivars that possess Emi-no-kizuna genotype qGA8 without a decrease in thousand grain weight.

To investigate the genetic background responsible for blast resistance in Oryza sativa L. 'Hokuriku 193', QTL analysis was conducted using the F3 lines from the cross [ms-bo] Nekken 2 × Hokuriku 193 that were artificially infected with rice blast fungus (Magnaporthe grisea). QTLs were detected on chromosomes 1, 4, 6 and 12 that correlated with greater blast resistance in the Hokuriku 193-type lines. Notably, the QTL on chromosome 12 had a major effect and localized to the same region where Pi20(t), a broad-spectrum blast resistance gene, is positioned, suggesting strongly that the blast resistance of Hokuriku 193 was controlled by Pi20(t). Also, QTL analysis of the lines found to have no Pi20(t) detected two QTLs on chromosome 4 (qBR4-1 and qBR4-2) and one QTL on chromosome 6 (qBR6), of which qBR4-2 and qBR6 correlated with higher percentages of resistant plants in the Hokuriku 193-type lines. The blast susceptibility of BR_NIL (a NIL of Hokuriku 193 from which Pi20(t) was eliminated) was greater than that of Hokuriku 193, suggesting that elimination of Pi20(t) may markedly increase blast susceptibility. The disease severity of BR_NIL was mild, which might be the effect of qBR4-2 and/or qBR6.

In this study, we investigated the genetic basis of seed shattering and dormancy in Hokuriku 193 and bred an NIL improved these traits. Analysis of an F3 population from Hokuriku 193 × Koshihikari revealed a general correspondence between seed shattering and genotypes at the qSH1 locus, suggesting a strong influence of this locus on the seed shattering in Hokuriku 193. An F2 population from [ms-bo] Nekken 2 × Hokuriku 193 was also analyzed to identify quantitative trait loci (QTLs) for seed dormancy as measured by germination rate in the first December and March after seed harvest. The results revealed a concurrence QTLs of on chromosomes 1, 3, and 6 (qSDo1, qSDo3, qSDo6). In particular, qSDo1 and qSDo6 were considered regions worthy of active modification because they were QTL regions that promoted seed dormancy when carrying Hokuriku 193 genome regions around. SSDo_NIL, a near isogenic line (NIL) derived from Hokuriku 193 by introgressing Nekken 2 alleles only at the qSH1 locus and qSDo1, did not shatter, and its germination rate was significantly higher than that of Hokuriku 193. Yield performance was similar between SSDo_NIL and Hokuriku 193, suggesting that improvement of seed shattering and dormancy does not affect yield.

Summary The objective of this study was to characterise the status of health-related quality of life (HRQOL) in Japanese men with late-onset hypogonadism (LOH) treated with testosterone replacement therapy (TRT). HRQOL in 69 consecutive Japanese men with LOH undergoing TRT for at least 6 months was prospectively evaluated before and 6 months after the initiation of TRT using the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8). All eight-scale scores except for bodily pain (BP) in the 69 patients at 6 months after the introduction of TRT significantly improved compared with those before TRT; however, all scale scores except for BP in the 69 patients were significantly inferior to those in age-matched Japanese controls irrespective of the timing of SF-8. Multivariate analyses of several parameters revealed that both age and Aging Male Symptom (AMS) score had an independent impact on mental health (MH), despite the lack of an independent association between any score and the remaining factors examined. TRT appeared to significantly improve the status of HRQOL in men with LOH; however, even after the introduction of TRT, HRQOL associated with MH remained significantly impaired in elderly men and/or those with a high AMS score.

The objectives of this study were to determine whether the inhibition of clusterin expression in rat Sertoli cells enhances heat stress-induced apoptosis. The scrotums of rats were immersed in a water bath of 43 °C for 15 min. Testicular weight and germ cell number markedly decreased after the heat treatment in a time-dependent manner. In contrast, clusterin mRNA and protein expression levels were significantly up-regulated and peaked on day 21. The apoptotic index was markedly increased 1 day after the heat treatment. We then purified Sertoli cells from the rat testes, and an expression vector containing siRNA targeting the clusterin gene was transiently transfected into Sertoli cells. Following exposure to heat stress at 41 °C for 12 h, clusterin mRNA was markedly up-regulated after transfection with the control vector; however, the transfection of siRNA targeting the clusterin resulted in >70% reduction in the expression of clusterin mRNA. Furthermore, the apoptotic index in these Sertoli cells was significantly higher after the treatment with siRNA targeting the clusterin than control, and the most prominent difference was observed within 24 h after the heat treatment. These results suggest that an increase in the secretion of clusterin by Sertoli cells protects the testes from heat stress-induced injury.

A quantitative trait locus (QTL) analysis was conducted on grain appearance in Emi-no-kizuna, a rice cultivar that has superior and stable appearance of the brown rice grain and high tolerance to high temperature stress, by using F3 lines derived from Emi-no-kizuna and Tomohonami. The investigation was performed 2013 and 2015. In summer 2013 the air temperature was higher and the larger differences in grain appearance were observed. In the QTL analysis, a highly contributing locus, qGA8, was detected at the end of the short arm of chromosome 8. Because trends of reduced the occurrence of white immature kernel and increased the percentage of perfect grain were observed in Emi-no-kizuna genotype in both years, qGA8 is likely to be an important QTL that is dominant in the superior grain appearance of Emi-no-kizuna. Also, qGA8 was linked to a QTL associated with days to heading. Another QTL, qGA7, associated with grain appearance was detected on chromosome 7 in 2013. Because no negative correlation was found between the genotype of qGA8 and thousand grain weight, it should be possible to breed cultivars that possess Emi-no-kizuna genotype qGA8 without a decrease in thousand grain weight.

A promising new cultivar of rice (Oryza sativa L.) ‘Tachisuzuka’ has been developed for silage use with improved feeding value due to a radical decrease in spikelets. However, ‘Tachisuzuka’ has the problem of inefficient seed production. We investigated the effect of planting density on the spikelet number in ‘Tachisuzuka’ to find out how seed yields of this cultivar can be increased by means of cultivation methods. ‘Tachisuzuka’ was cultivated at six different planting densities, in the range of 7.4–22.2 hills m−2. Unlike in ordinary cultivars, there was a negative correlation between the spikelet number per unit area and hills per unit area. Moreover, the spikelet number increased by 67% under the low planting density. This result implies that the efficiency of seed production of ‘Tachisuzuka’ could be improved by low planting density through an increase in spikelet number per unit area.

In this study, we investigated the genetic basis of seed shattering and dormancy in Hokuriku 193 and bred an NIL improved these traits. Analysis of an F3 population from Hokuriku 193 × Koshihikari revealed a general correspondence between seed shattering and genotypes at the qSH1 locus, suggesting a strong influence of this locus on the seed shattering in Hokuriku 193. An F2 population from [ms-bo] Nekken 2 × Hokuriku 193 was also analyzed to identify quantitative trait loci (QTLs) for seed dormancy as measured by germination rate in the first December and March after seed harvest. The results revealed a concurrence QTLs of on chromosomes 1, 3, and 6 (qSDo1, qSDo3, qSDo6). In particular, qSDo1 and qSDo6 were considered regions worthy of active modification because they were QTL regions that promoted seed dormancy when carrying Hokuriku 193 genome regions around. SSDo_NIL, a near isogenic line (NIL) derived from Hokuriku 193 by introgressing Nekken 2 alleles only at the qSH1 locus and qSDo1, did not shatter, and its germination rate was significantly higher than that of Hokuriku 193. Yield performance was similar between SSDo_NIL and Hokuriku 193, suggesting that improvement of seed shattering and dormancy does not affect yield.

To investigate the genetic background responsible for blast resistance in Oryza sativa L. ‘Hokuriku 193’, QTL analysis was conducted using the F3 lines from the cross [ms-bo] Nekken 2 × Hokuriku 193 that were artificially infected with rice blast fungus (Magnaporthe grisea). QTLs were detected on chromosomes 1, 4, 6 and 12 that correlated with greater blast resistance in the Hokuriku 193-type lines. Notably, the QTL on chromosome 12 had a major effect and localized to the same region where Pi20(t), a broad-spectrum blast resistance gene, is positioned, suggesting strongly that the blast resistance of Hokuriku 193 was controlled by Pi20(t). Also, QTL analysis of the lines found to have no Pi20(t) detected two QTLs on chromosome 4 (qBR4-1 and qBR4-2) and one QTL on chromosome 6 (qBR6), of which qBR4-2 and qBR6 correlated with higher percentages of resistant plants in the Hokuriku 193-type lines. The blast susceptibility of BR_NIL (a NIL of Hokuriku 193 from which Pi20(t) was eliminated) was greater than that of Hokuriku 193, suggesting that elimination of Pi20(t) may markedly increase blast susceptibility. The disease severity of BR_NIL was mild, which might be the effect of qBR4-2 and/or qBR6.

This study aimed to investigate the effects of testosterone replacement therapy (TRT) on lower urinary tract symptoms (LUTS) in men with late-onset hypogonadism (LOH) and to identify parameters predicting the efficacy of TRT in improving LUTS. This study included 60 consecutive Japanese men who were diagnosed with LOH and subsequently received TRT between January 2009 and December 2014. In this series, 250 mg of testosterone was injected intramuscularly every 3 or 4 weeks in all patients. The following parameters were retrospectively reviewed: body mass index (BMI), Aging Male Symptom (AMS) score, International Prostate Symptom Score (IPSS), International Index of Erectile Function–5 (IIEF-5) score, residual urine volume, prostate volume, serum levels of the prostate-specific antigen (PSA), and total- and free-testosterone levels before and 6 months after TRT. No significant differences were observed in BMI, residual urine volume, or prostate volume between surveys before and after TRT. The AMS score, IPSS, and IIEF-5 score were significantly improved and significant increases were noted in the serum levels of PSA and total- and free-testosterone levels after TRT. An analysis of IPSS subscores documented the significant improvement in storage symptom scores, but not in voiding symptom scores after TRT. Multivariate analyses of parameters assessed in this study identified the pretreatment AMS score, posttreatment IIEF-5 score, and prostate volume as independent predictors of improvements in IPSS following TRT. This study revealed that TRT appeared to have considerable therapeutic effects on LUTS, particularly on storage symptoms, in men with LOH.

glomerular volume density Vv[glom] were assessed. Creatinine and urea serum levels were assessed preoperatively and before euthanasia. Data was compared by one-way ANOVA with Bonferroni’s post-test. RESULTS: No difference was found for stereological measurements between controls and right kidneys. The arterial and selective clamping for 30 minutes does not cause significant glomerular damage, while the en bloc clamping for the same time causes a significant decrease in the glomerular density in a pig model. On the other hand, the selective clamping when compared with arterial occlusion showed no difference. There was no significant difference in creatinine and urea serum levels at different times of withdrawal. CONCLUSIONS: Based on this swine model study, arterial or selective clamping techniques should be favored over en bloc clamping, especially when long ischemia times are expected. By the other hand, in this study, selective arterial clamping technique was not less harmful than clamping the renal artery.

vasoactive agent. The primary aim of the study was to construct agespecific CDDU parameters for patients without organic erectile dysfunction. METHODS: A retrospective review was conducted to identify patients without organic ED who underwent in-office testing with intracavernous pharmacologic erection augmented by visual sexual stimulation and CDDU over a 5 year period. Patients were further characterized by demographic and Doppler data. Specifically, CDDU characteristics including pre and post-visual stimulation peak systolic velocity (PSV) and resistive index (RI) were identified. Patients with post-visual stimulation PSV > 35cm/s and RI > 0.9 were included in the analysis. Pearson correlation test was used to evaluate the association between ordinal age groups with PSV and RI measurements. RESULTS: 259 patients with a mean age 53.7 and a mean BMI of 27.2 were found to have normal Doppler parameters (PSV>35cm/s, RI>.90). For the entire cohort, average post-visual stimulation PSV was 59.8 (35.0-115.5) and average RI was 0.99 (.9-1.0). A majority of patients had limited medical co-morbidities, with only 29%, 7%, and 10% reporting hypertension, Diabetes, and heart disease, respectively. Priapism, as defined by needing an injectable reversible agent, occurred in 93% of patients. Doppler parameters were then analyzed across sequential decades and when age was categorized to 70, a negative correlation coefficient was obtained for pre-visual stimulation PSV (-0.09, P1⁄40.164), post-visual stimulation PSV (-0.23, P1⁄40.005) and RI (-0.005, P1⁄4.937). Pre-visual stimulation, post-visual stimulation and RI were also stratified using age as continuous variable and with a cutoff of age 1⁄4 60 (Table 1). CONCLUSIONS: No patients were diagnosed with arterial insufficiency or cavernous venous occlusive disease. There appears to be an age-related decline in post-visual stimulation PSV. Characterization of Doppler parameters in patients without organic ED can be used to construct cutoffs to further define age-specific normalcy.

In the breeding of rice cultivars for use for whole-crop silage, accurate evaluation of shattering is important because its characteristics affect the digestibility of grains by animals. However, measurements of the rice grain pedicel breaking tensile strength (BTS) using a conventional shattering testing device, such as the TR-II, are laborious. We tested a universal testing machine (UTM), a device used for physical analysis, as a labor-saving technique for measuring rice grain pedicel BTS. A simple attachment consisting of a holding clip and a polyethylene string to the coupler was prepared to adapt the UTM for BTS measurement. There were significant (P

Objectives: To determine the effect of surgical varicocele repair in improving testicular Leydig cell function as shown by increased testosterone production. Methods: Eligible studies were searched in Medline and the Pubmed database, and cross-referenced as of 31 May 2011 using the terms “varicocele,”“testosterone” and “surgery.” The database search, quality assessment and data extraction were independently carried out by two reviewers. Only studies including patients with testosterone evaluation before and after surgery were considered for the analysis. A systematic review and meta-analysis was carried out for continues variables using random effect models. Results: Out of 125 studies, a total of nine were selected, including 814 patients. The combined analysis showed that mean serum testosterone levels after surgical treatment increased by 97.48 ng/dL (95% confidence interval 43.73–151.22, P = 0.0004) compared with preoperative levels. Conclusions: Surgical treatment of varicocele significantly increases testosterone production and improves testicular Leydig cell function.

The rice cultivar ‘Chumroo’ is commonly cultivated in the mid- and high-altitude areas of Bhutan. This cultivar has shown durable blast resistance in that area, without evidence of breakdown, for over 20 years. Chumroo was inoculated with 22 blast isolates selected from the race differential standard set of Japan. The cultivar showed resistance to all the isolates. To identify the resistance gene(s), Chumroo was crossed with a susceptible rice cultivar, Koshihikari. The F1 plants of the cross showed resistance. Segregation analyses of 300 F3 family lines fitted the segregation ratio of 1:2:1 and indicated that a single dominant gene controls the resistance to a blast isolate Ao 92-06-2 (race 337.1). The Chumroo resistance locus (termed Pi46(t)) was mapped between two SSR markers, RM6748 and RM5473, on the terminal region of the long arm of chromosome 4, using linkage analysis with SSR markers. The nearest marker, RM5473, was linked to the putative resistance locus at a map distance of 3.2 cM. At the chromosomal region, no true resistance genes were identified, whereas two field resistance genes were present. Therefore, we designated Pi46(t) as a novel blast resistance locus.

‘Tachisuzuka’ is a new rice (Oryza sativa L.) cultivar for whole-crop silage (WCS) use. Agronomic characters were recorded from 2007 to 2009. The culm length of Tachisuzuka was 11 cm longer than that of Kusanohoshi. The short panicle of Tachisuzuka was morphologically similar to that of the short panicle 1 (sp1) mutant. Tachisuzuka exhibited high lodging resistance in the yellow ripening stage, the optimal period for harvesting, and a month after yellow ripening. The straw yield of Tachisuzuka was remarkably higher than that of Kusanohoshi but its grain yield was lower. A portion of grains are undigested and excreted in feces by cattle fed with rice WCS, and this loss of nutrients should not be disregarded. The low grain/straw ratio of Tachisuzuka indicates that the loss of nutrients in cattle fed with Tachisuzuka WCS should be lower than with Kusanohoshi WCS. Low sugar content of rice plants is considered a cause of silage deterioration. The sugar content of Tachisuzuka was markedly higher than that of Kusanohoshi.

Although obesity is recognized to be a risk factor for chronic kidney disease (CKD), few studies have reported the association between obesity and CKD in the young population. We investigated the relationship between obesity and renal function including proteinuria in young Japanese.This cross-sectional study consisted of 16,031 men and 5,746 women aged from 20 to 39 years who received health examinations. The subjects were stratified into four age groups (20-24, 25-29, 30-34, and 35-39 years) or into four groups based on the number of risk factors (hypertension, hyperglycemia, dyslipidemia, and hyperuricemia). The relationship between obesity and risk factors and the relationship between obesity and estimated glomerular filtration rate (eGFR) were analyzed.There were no significant differences in eGFR between obese and nonobese groups, except in the male 35-39 years age group. Body mass index (BMI) in both men and women increased with increase in number of risk factors (P0.001). Multivariate analysis revealed that hypertension, hyperglycemia, dyslipidemia, and hyperuricemia were independently associated with obesity. Obesity and the risk factors were independently associated with proteinuria.The present study indicated that obesity was an independent risk factor for proteinuria in healthy subjects younger than 40 years of age. The other risk factors were independently associated with obesity. These findings suggest that obesity causes proteinuria concomitantly with other risk factors such as hypertension, diabetes, and dyslipidemia in young adults.

Quantitative trait locus (QTL) analysis was performed to identify the chromosomal region controlling rice stripe virus (RSV) resistance in Japanese upland rice, Kanto 72. As a result, two QTLs were detected on chromosomes 2 and 11. Using near-isogenic lines possessing a single QTL (QTL-NILs) on chromosomes 2 and 11, the effects of two QTLs were evaluated. The target QTL regions were introduced in the genetic background of Koshihikari with marker-assisted selection. A combined QTLNIL, possessing two QTLs, was developed from the cross between two QTL-NILs. Investigation of RSV resistance using three QTL-NILs revealed that the effects of the two QTLs clearly differed in the reaction to RSV. The QTL on chromosome 11 provided a major effect on reducing the infection rate of RSV. The QTL on chromosome 2 did not affect the infection rate, but made symptoms of diseased plants milder. The combined QTL-NIL showed high and stable resistance to RSV equivalent to upland rice, Kanto 72. From these results, RSV resistance in upland rice, Kanto 72, was controlled by the complementary effect of two QTLs. Major agricultural traits of the three QTL-NILs were not significantly different to those of Koshihikari, therefore, these QTL-NILs were thought to be useful in RSV-resistant rice breeding. Discipline: Plant breeding Additional key words: near-isogenic lines, quantitative trait loci, rice breeding

Coenzyme Q (CoQ), also called ubiquinone, is an electron transfer molecule in the respiratory chain; it is also a lipid-soluble antioxidant. Most cereal crops produce mainly CoQ9, which has nine isoprene units, whereas humans produce mainly CoQ10, with 10 isoprene units. CoQ10 is a very popular food supplement. Using the cultivar Nipponbare, we previously produced CoQ10-enriched rice plants (Nipponbare-type CoQ10-enriched rice plants) by introduction of the gene for decaprenyl diphosphate synthase (DdsA). In Nipponbare-type CoQ10-enriched rice plants, seed CoQ10 content per weight was increased to up to 10 times that of wild-type rice. However, seed CoQ10 level of those rice plants is still insufficient for practical use, and further 10-times increase in CoQ10 content have been expected. Here, we confirmed preferential accumulation of CoQ in bran and germ of rice seed, and produced improved CoQ10-enriched rice plants by using 2 kinds of giant embryo rice lines, Haiibuki and Chukei-toku 70 (Toku 70). In giant embryo line-type CoQ10-enriched rice plants, seed CoQ10 content per weight was increased to up to 1.4 times (Haiibuki-type) or 1.8 times (Toku 70-type) that in Nipponbare-type CoQ10-enriched rice plants, demonstrating that use of giant embryo rice lines is effective to increase seed CoQ10 content per weight.

Summary The objective of this study was to assess the impact of seminal clusterin level on spermatogenesis in infertile men. This study included 89 men who visited our clinic due to infertility, consisting of 28, 33, and 28 diagnosed with normospermia, oligozoospermia and nonobstructive azoospermia (NOA) respectively. The seminal clusterin concentrations measured by enzyme-linked immunosorbent assay were 47.9, 28.2 and 18.4 ng ml−1 in men with normospermia, oligozoospermia and NOA, respectively, with significant differences among these three groups (P

For clinical practice guidelines for the management of hypertension with CKD, the Japanese Society of Nephrology (JSN) and the Japanese Society of Hypertension (JSH) evaluated recently published evidence in corporation with each other. After considerable and careful discussion, both JSN and JSH revised their respective guidelines [the Evidence-based Clinical Practice Guideline for CKD 2013 (JSN-CKD GL 2013) and JSH2014]. This section will mainly introduce anti-hypertensive therapy recommended for the management of hypertension with CKD in both guidelines. Recommendation statements for the Management of Hypertension with CKD are as follows: 1) Anti-hypertensive therapy in CKD is strongly recommended to inhibit or prevent the progression of renal dysfunction and to prevent the occurrence or recurrence of CVD by reducing blood pressure (BP) (Grade A). 2) In all diabetic CKD, the target level of clinic BP is recommended as130/80 mmHg, irrespective of the presence or absence of albuminuria/proteinuria (Grade B). 3) In all non-diabetic CKD, the target level of clinic BP is strongly recommended as consistently140/90 mmHg, irrespective of the presence or absence of albuminuria/proteinuria (Grade A). 4) In non-diabetic CKD with A2 and A3 categories, the target level of clinic BP can be set as130/80 mmHg (Grade C1). 5) In diabetic CKD with A1 category, ARBs and ACE inhibitors are suggested as first-line anti-hypertensive drugs(Grade C1). 6) In diabetic CKD with A2 and A3 categories, ARBs and ACE inhibitors are recommended as first-line anti-hypertensive drugs (Grade A). 7) In non-diabetic CKD with A1 category, ARBs, ACE inhibitors, calcium channel blockers (CCBs) and diuretics are recommended as first-line anti-hypertensive drugs (Grade B). 8) In non-diabetic CKD with A2 and A3 categories, ARBs and ACE inhibitors are recommended as first-line anti-hypertensive drugs (Grade B).

The effects of two quantitative trait loci (QTLs) controlling the resistance to rice stripe virus (RSV) identified in a Japanese upland rice line, Kanto 72, (URK 72) were evaluated using near-isogenic lines (NILs). Two NILs carrying a single QTL (QTL-NILs) on chromosomes 2 and 11, respectively, were developed by marker-assisted selection (MAS). The target QTL regions were introduced from the donor parent, Chugoku 40, which was bred from URK 72, into the genetic background of Koshihikari. Another line, which was a combined QTL-NIL, was developed from the cross between the two QTL-NILs to analyze the interaction of the two QTLs. Investigation of RSV resistance using the three NILs revealed that the effects of the two QTLs clearly differed in the reaction to RSV. The QTL on chromosome 11 exerted a major effect on reducing the infection rate of RSV. Although the QTL on chromosome 2 did not affect the infection rate, the symptoms of the diseased plants were milder. The combined QTL-NIL displayed a high level of resistance to RSV, while the infection rate and the symptom types of the diseased plants were similar to those of URK 72 or Chugoku 40. Since the major agronomic characters of the three QTL-NILs were the same as those of Koshihikari, these QTL-NILs were considered to be useful gene sources for RSV resistance rice breeding.

Recent reports suggest the relationship of short-term blood pressure (BP) variability to cardiovascular target organ damage. In this study, short-term BP variability was assessed as the standard deviation of daytime and nighttime BP in 36 hospitalized patients with chronic renal failure (CRF) who underwent ambulatory BP monitoring. Positive correlations were observed between body mass index (BMI) and daytime systolic and diastolic BP variability, BMI and nighttime diastolic BP variability, cholesterol and daytime systolic BP variability, cholesterol and nighttime systolic and diastolic BP variability, nocturnal decline in BP and nighttime diastolic BP variability, and plasma concentration of norepinephrine (p-NE) and nighttime systolic BP variability. In multivariate linear regression analyses, BMI showed the strongest association with daytime and nighttime diastolic BP variability (p < .005 and p < .05). On the other hand, cholesterol and p-NE were the primary determinants of daytime and nighttime systolic BP variability, respectively (p < .01 and p < .0005). Interestingly, CRF patients with ischemic heart disease (IHD) had significantly increased daytime systolic and diastolic BP variability and nighttime systolic BP variability (p < .05 or less). Furthermore, logistic regression analysis demonstrated that nighttime systolic BP variability was an independent risk factor of IHD in patients with CRF (odds ratio 1.50 [95% confidence interval 1.01 to 2.25]; p < .05). Taken together, short-term BP variability is suggested to be affected by BMI, cholesterol, and p-NE in CRF patients. Furthermore, sympathetic nerve overactivity may be involved in cardiovascular complications in CRF patients through the increase in nighttime systolic BP variability.

We report pregnancy with the delivery of a healthy child by TESE-ICSI 7 years after bilateral adult orchidopexy. A 29-year-old patient presented with infertility and previous bilateral cryptorchidism, but no surgical treatment had ever been performed. His partner had been assessed by a gynaecologist, and no contributing female factors were detected. Orchidopexy and conventional testicular sperm extraction (TESE) were performed and microdissection TESE 10 months after orchidopexy. The second microdissection TESE with intracytoplasmic sperm injection (ICSI) was performed 7 years after orchidopexy. The couple achieved pregnancy with the delivery of a healthy child by TESE-ICSI. It is concluded that bilateral orchidopexy in adulthood progresses spermatogenesis gradually, and microdissection TESE may succeed after a certain period of time following treatment.

若年者高血圧の特徴および治療について,臨床上重要と思われることを中心に概説した.主な特徴は,二次性高血圧症の頻度が高いこと,本態性高血圧症では軽症例が多く臓器合併症が少ないことである.病態生理的には,交感神経機能およびレニン-アンジオテンシン系の亢進が指摘されている.治療は減塩や適性体重の維持など非薬物療法が中心になるが,薬物療法では患者の病態生理を考慮し降圧薬を選択する.若年者高血圧の早期発見,早期治療は将来の心血管系疾患の予防という観点から重要である.

In cultured vascular smooth muscle cells (VSMCs), interleukin-1beta (IL-1beta) stimulates inducible nitric oxide synthase (iNOS) expression and nitric oxide (NO) production. IL-1beta also activates phospholipase A2 (PLA2), and induces lipoxygenase (LOX) and cyclooxygenase-2 (COX-2). The present study investigated whether these metabolites are involved in the regulation of IL-1beta-induced NO production and iNOS expression. Pretreatment with ONO-RS-082, the secretory PLA2 (sPLA2) inhibitor, at 1 to 10 micromol/l reduced IL-1beta-stimulated nitrite production and iNOS expression. Nordihydroguaiaretic acid (NDGA, 1 to 10 micromol/l), the LOX inhibitor, also reduced IL-1beta (10 ng/ml)-stimulated nitrite production and iNOS expression in a dose-dependent manner. Exogenous 12(S)-hydroxyeicosatetraenoic acids (HETE) enhanced the IL-1beta-stimulated nitrite production and iNOS expression. On the other hand, the COX inhibitors, indomethacin and NS-398, had little effect on nitrite production or iNOS expression. These results suggest that LOX products play important roles in the regulation of stimulus-induced NO production in VSMCs.

Prevention of osteoporosis and renal osteodystrophy are important for the long-term quality of life in dialysis patients. We examined whether administration of menatetrenone (vitamin K2) improves bone metabolism in continuous ambulatory peritoneal dialysis (CAPD) patients. Administration of a single dose of menatetrenone (15 mg) revealed that the 24-h pharmacodynamics in CAPD patients were comparable to those in control individuals. In a 12-month period of oral menatetrenone administration (45 mg/day), eight stable CAPD patients were studied for blood-bone metabolism parameters and for bone mineral content. Blood concentration of menatetrenone was detectable during the experiment period. Only at 12 months did active vitamin D3 and bone-type alkaline phosphatase (ALP) fall significantly, while total ALP rose significantly. Bone mineral density measured by dual-energy X-ray absorptiometry remained at the same level throughout the study period, suggesting that menatetrenone may protect against bone mineral loss in CAPD patients. These results show that the same dose of oral menatetrenone can be given to CAPD patients as to control individuals, and that menatetrenone can be used safely for 1 year in CAPD patients.

慢性血液透析患者におけるリハビリテーション (以下, リハビリ) の現況および効果につき, 糖尿病の有無で検討した. 対象は1996年4月から2000年11月までの期間, 入院下においてリハビリを施行した血液透析患者47例で, 糖尿病群19例 (平均年齢66.6歳) と非糖尿病群28例 (平均年齢67.5歳) とに分けた. リハビリを開始するまでの透析期間は, 糖尿病群では50.2±40.1 (mean±SD) 日, 非糖尿病群では97.3±94.4日であり, 糖尿病群で有意に短かった (p

A retroperitoneal laparoscopic approach was found to be useful for treating primary retroperitoneal tumors located below the level of the renal vessels., Background: Inflammatory pseudotumors were mostly encountered in the lung. Retroperitoneal inflammatory pseudotumors are relatively rare. Although laparoscopic surgery with a modified flank position is widely performed for retroperitoneal tumors, we placed the patient in the supine position to maintain the normal anatomical view of the retroperitoneal space. We report a case of retroperitoneal inflammatory pseudotumor extracted via retroperitoneoscopic surgery in the supine position. Methods and Results: A 53-year-old man presented with back pain and frequent urination. Ultrasonographic examination revealed a solid tumor above the urinary bladder. This tumor was diagnosed as a primary retroperitoneal tumor by computed tomography, magnetic resonance imaging, and angiography. The retroperitoneoscopic procedure was adopted to remove this tumor. Histopathologic examination revealed an inflammatory pseudotumor. There was no evidence of recurrence 5 years after surgery. Conclusions: The diagnosis of the inflammatory pseudotumor is rarely made before histologic examination. Only pathologic examination allows the correct diagnosis. Consequently, most patients undergo surgical treatment. A recurrence rate of 25% has been reported for inflammatory pseudotumors. Thus, radical resection is needed. The retroperitoneal laparoscopic approach with the patient in the supine position is useful for surgically treating these primary retroperitoneal tumors located below the level of the renal vessels.

Objective To characterize the changes in seminogram findings in infertile men after varicocelectomy. Methods This study included 71 consecutive infertile men who underwent microsurgical low ligation varicocelectomy and received 3 semen analyses, 1 before microsurgical varicocelectomy and again at 3 and 12 months after. Total motile sperm count (TMSC) was calculated using the following formula: [volume (mL) × concentration (millions/mL) × motility (%)]. Results Despite the lack of significant changes in the proportion of sperm with abnormal morphology, sperm concentration, motility, and TMSC in the 71 patients were significantly higher at 3 and 12 months after varicocelectomy than before surgery. However, no further improvement in these parameters at 12 months after varicocelectomy was noted compared with those at 3 months. Furthermore, when the included men were divided into 3 groups according to preoperative TMSC as 9 million, TMSCs at 3 months after varicocelectomy in all 3 groups were significantly higher than those before varicocelectomy; however, TMSCs at 12 months after surgery in all groups were similar to those at 3 months. Conclusion The level of improvement in semen parameters at 3 months after varicocelectomy may be stable at 12 months after surgery, irrespective of baseline values of TMSC. Therefore, varicocelectomy could be offered as a therapeutic option for infertile men, even for couples with an older woman, because its efficacy is evaluable at 3 months after surgery, and assisted reproductive technology could be immediately applied to ineffective cases.

INTRODUCTION AND OBJECTIVES: Rap1 is a member of the Ras family small GTPases and activated by an array of guanine nucleotide exchange factors (GEFs) downstream of various extracellular stimuli. We discovered RA-GEF-2 (also called Rapgef6) as a specific GEF for Rap1 and analyzed its physiological functions through generation of mice carrying homozygous deletion of the gene encoding it [RA-GEF-2 knockout (KO) mice]. We have found that these mice exhibit prominent male infertility and analyzed the mechanism underlying RA-GEF-2’s function in the process of spermatogenesis. METHODS: To assess the fertility of RA-GEF-2 KO mice, we mated male RA-GEF-2 KOmice with female wild-type mice for 72 hours. Threeweeks later, we counted the number of fetuses.We also carried out measurement of the pituitary hormones [i. e., luteinizing hormone (LH), follicle stimulatinghormone (FSH)and testosterone] byELISAassay.The concentration and motility of epididymal sperms were measured with Makler Chamber and sperm morphology was analyzed by scanning electron microscopy. We also identified the expression of RA-GEF-2 in testis using real-timePCRandWesternblotting. Furthermore,weclarified the localization of RA-GEF-2 in testis by immunohistochemistry. We found that RA-GEF-2 was located on the apical junction, so we further assessed the expression of N-cadherin by Western blotting and immunohistochemistry. RESULTS: The pregnancy rate and the number of fetuses were low after mating with male RA-GEF-2 KO mice. Although the body weight and pituitary hormones levels showed no difference between KO and wild-type mice, the weight of testis was significantly low in KO mice. In addition, the concentration and motility of epididymal sperms were decreased. Furthermore, malformed sperms were ubiquitously observed in KO mice. Histological examination showed marked atrophy of the testis and hypospermatogenesis in KO mice. Because RA-GEF-2 was expressed on the luminal side of seminiferous tubules, it could be related to the apical ectoplasmic specialization (ES) that maintains the polarity of the spermatids and confers adhesion to Sertoli cells in the semiferous epithelium. We found that loss of RA-GEF-2 altered the expression of N-cadherin which was thought to be a marker of Sertoli cell. CONCLUSIONS: RA-GEF-2 KO mice exhibited marked testicular atrophy and a severe defect in mature sperm formation. RA-GEF-2 may function as a regulator of N-cadrin during the process of spermatogenesis and that might be one of the main causes of male infertility in RA-GEF-2 knockout mice.