This study investigated the effects of progesterone(P4) on the production and survival of neurons in the hippocampal dentate gyrus of adult male mice.The administration of P4(4 mg/kg) for 3 consecutive days beginning ...This study investigated the effects of progesterone(P4) on the production and survival of neurons in the hippocampal dentate gyrus of adult male mice.The administration of P4(4 mg/kg) for 3 consecutive days beginning on the 0-2 nd day after the first BrdU-injection(BrdU-D0-2) produced an approximately twofold increase in the number of 28-and 56-day-old BrdU(+) cells in comparison to the controls,whereas it did not alter the number of 24 /48-h-old BrdU(+) cells.P4 preferentially promoted the survival of newborn neurons when administered at BrdU-D5-7,but not at BrdU-D10-12 and BrdU-D15-17.Androstenedione(Ad),testosterone(TE),or estradiol(E2) at the same-dose of P4,when administered at BrdU-D0-2,could not replicate the effect of P4,while the inhibition of 5 alpha-reductase by finasteride did not affect the P4-action,indicating that the P4-effect is exerted by P4 itself but not by its metabolites.On the other hand,the P4R antagonist RU486 partially suppressed the P4-effect,while inhibitors for Src,MEK,or PI3K totally suppressed the P4-effect.Finally,the P4-enhanced survival of newborn neurons was accompanied by a potentiation of spatial learning and memory,which was P4R-dependent.These findings suggest that P4 enhances the survival of newborn neurons through P4R and /or the Src-ERK and PI3K pathways independent of its influence on cell proliferation,which is well correlated with the potentiated spatial cognitive function of P4-treated animals.展开更多
The dynamical processes of a typical linear dune including morphological features, dune ridge swing range and crest height were investigated at different monitoring periods in the hinterland of Tengger Desert. The res...The dynamical processes of a typical linear dune including morphological features, dune ridge swing range and crest height were investigated at different monitoring periods in the hinterland of Tengger Desert. The results indicated that the development of linear dune depends on not only the northwesterly prevailing wind, but also the winds from northeast and southwest. The dune ridge swayed along its fundamental strike and took on an eastward movement gradually. The original dune strike was NW70° on August 3, 1994, and then changed to NE15° on April 21, 2001. The dune crest increased by 1.8 m longitudinally, which manifested strong wind-blown sand activities in this region. Wind erosion frequently occured at the bottom of sand dune, while sand accumulation appeared on its mid-upper section. The mean wind erosion depth was 25 cm on the bottom of linear dune and the height difference of the control points on the dune’s ridge was 1.13 m. Although the linear dune swayed laterally, the horizontal displacement of its ridge moved eastward 5.8 m averagely. The swing range of the dune crest line is very distinct, with a maximum value of 13.2 m. The highest site on the K-profile swayed on both sides of the dune ridge and the heights were 19.88 m at the control point K5, 19.61 m at K6 and 19.05 m at K7, respectively. The results indicated that the lateral swing of the linear dune was distinct under the northwesterly wind and it moved toward east gradually.展开更多
MHD stability of the Large Helical Device (LHD) plasmas produced with intenseneutral beam injection is experimentally studied. When the steep pressure gradient near the edge isproduced through L-H transition or linear...MHD stability of the Large Helical Device (LHD) plasmas produced with intenseneutral beam injection is experimentally studied. When the steep pressure gradient near the edge isproduced through L-H transition or linear density ramp experiment, interchange-like MHD modes whoserational surface is located very close to the last closed flux surface are strongly excited in acertain discharge condition and affect the plasma transport appreciably. In NBI-heated plasmasproduced at low toroidal field, various Alfven eigenmodes are often excited. Bursting toroidalAlfven egenmodes excited by the presence of energetic ions induce appreciable amount of energeticion loss, but also trigger the formation of internal and edge transport barriers.展开更多
Small-bowel enteroscopy with the double-balloon method was developed to improve access to the small intestine. This study evaluated the usefulness of this method for the resection of small-intestinal Peutz-Jeghers pol...Small-bowel enteroscopy with the double-balloon method was developed to improve access to the small intestine. This study evaluated the usefulness of this method for the resection of small-intestinal Peutz-Jeghers polyps. Two patients with Peutz-Jeghers syndrome underwent nonsurgical doubleballoon enteroscopic resection of polyps throughout the small intestine. Multiple polyps in the jejunum were successfully resected via the oral route, as were the polyps in the ileum via the anal route. All 18 polyps (10-60 mm in size) were resected without subsequent bleeding or perforation. Histopathologically, 3 large polyps (>30 mm diameter) were hamartomas with adenomatous components. Double-balloon enteroscopy was safe and useful for the diagnosis and the treatment of Peutz-Jeghers polyps throughout the small intestine. Double-balloon enteroscopic polypectomy might preclude complications of Peutz-Jeghers syndrome, including intussusception, bleeding, and tumorogenesis, thereby obviating the need for multiple laparotomies.展开更多
To realize an excitation of electron Bernstein waves (EBW) via mode conversion from X-mode waves injected from the high magnetic field side (HFS), new inner-vessel mirrors were installed close to a helicM coil in ...To realize an excitation of electron Bernstein waves (EBW) via mode conversion from X-mode waves injected from the high magnetic field side (HFS), new inner-vessel mirrors were installed close to a helicM coil in the large helicM device (LHD). 77 GHz electron cyclotron (EC) wave beams injected from an existing EC-wave injection system toward the new mirror are reflected on the mirror so that the beams are injected to plasmas from HFS. Evident increases in the electron temperature at the plasma core region and the plasma stored energy were observed by the HFS beam injection to the plasmas with the line-average electron density of 7.5~ 1019 m-3, which is slightly higher than the plasma cut-off density of 77 GHz EC-waves, 7.35~ 1019 m-3. The heating efficiency evaluated from the changes in the time derivative of the plasma stored energy reached ,,~70%. Although so far it is not clear which is the main cause of the heating effect, the mode-converted EBW or the X-mode wave itself injected from the HFS, an effective heating of high-density plasma over the plasma cut-off of EC-wave was successfully demonstrated.展开更多
Spinal and bulbar muscular atrophy (SBMA) is an inherited adult onset motor ne uron disease caused by the expansion of a polyglutamine (polyQ) tract within the androgen receptor (AR), affecting only males. The charact...Spinal and bulbar muscular atrophy (SBMA) is an inherited adult onset motor ne uron disease caused by the expansion of a polyglutamine (polyQ) tract within the androgen receptor (AR), affecting only males. The characteristic pathological f inding is nuclear inclusions (NIs) consisting of mutant AR with an expanded poly Q in residual motor neurons, and in certain visceral organs. We immunohistochemi cally examined 11 SBMA patients at autopsy with 1C2, an antibody that specifical ly recognizes expanded polyQ.Our study demonstrated that diffuse nuclear accumul ation of mutant AR was far more frequent and extensive than NIs being distribute d in a wide array of CNS nuclei, and in more visceral organs than thus far belie ved. Mutant AR accumulation was also present in the cytoplasm, particularly in t he Golgi apparatus; nuclear or cytoplasmic predominance of accumulation was tiss ue specific. Furthermore,the extent of diffuse nuclear accumulation of mutant AR in motor and sensory neurons of the spinal cord was closely related to CAG repe at length. Thus, diffuse nuclear accumulation of mutant AR apparently is a cardi nal pathogenetic process underlying neurological manifestations, as in SBMA tran sgenic mice, while cytoplasmic accumulation may also contribute to SBMA pathophy siology.展开更多
Background. We investigated the possible roles of the interleukin(IL)-15 and IL-15 receptor (IL-15R) system in a heightened state of B-cell activation and differentiation in intestinal mucosa with inflammatory bowel d...Background. We investigated the possible roles of the interleukin(IL)-15 and IL-15 receptor (IL-15R) system in a heightened state of B-cell activation and differentiation in intestinal mucosa with inflammatory bowel disease (IBD).Meth ods. The expression of IL-15 and IL-15RαmRNA and protein in inflamed colonic mucosal tissues with IBD, and in control tissues was examined by reverse transcr iptase-polymerase chain reaction and immunohistological methods. The effects of recombinant(r)IL-15 on the expression of IL-15Rαon lamina propria B cells an d the production of immunoglobulin G (IgG) were analyzed in vitro, using lamina propria mononuclear cells (LPMCs)isolated from control tissues. Results. The int ensity of IL-15 and IL-15RαmRNA was greater in the mucosal tissues of patient s with IBD, especially in those of patients with ulcerative colitis (UC), than i n control tissues. Compared to control tissues, mononuclear cells positive for I L-15Rαprotein were observed in greater proportions in tissue sections from pat ients with IBD, especially in those from patients with UC, where IL-15Rαprotei n was localized to CD20-positive B cells to a significant degree. There were in creases in the proportions of IL-15Rα-positive B cells and IgG-producing cel ls in rIL-15-or rCD40L-stimulated cultures of LPMCs, with stimulatory effects being greater in the presence of their combination.Conclusions. These data sugg est that the IL-15 and IL-15R system may play important roles in the activatio n and differentiation of lamina propria B cells in patients with IBD, especially in those with UC.展开更多
OBJECTIVE: Optimized ovarian stimulation protocols are required for the success of in vitro fertilization (IVF). The purpose of this study was to estimate whether the ovarian reserve test using exogenous follicle-stim...OBJECTIVE: Optimized ovarian stimulation protocols are required for the success of in vitro fertilization (IVF). The purpose of this study was to estimate whether the ovarian reserve test using exogenous follicle-stimulating hormone (FSH) could predict ovarian response in IVF.METHODS: This was a prospective observational study of 110 patients who underwent their first IVF cycle. The FSH test was administered as 150 IU of urinary FSH daily from day 3 to day 6 of the menstrual cycle preceding the IVF cycle for evaluation of the plasma estradiol level. Outcomes of IVF, including ovarian response, were analyzed. RESULTS: A negative correlation was observed between the duration of stimulation and the result of the FSH test (r = -.238, P = .014) and between the dose of FSH per retrieved mature oocyte (metaphase II oocyte) and the result of the FSH test (r = -.308, P < .001). In addition, our results showed that the result of the FSH test was significantly lower in poor responders defined by FSH of 400 IU/metaphase II oocyte or greater (207 ±149 compared with 293 ±174 pg/mL, P =.007). CONCLUSION: The FSH test can be a useful tool for determining the conditions of individualized clinical management plans and optimizing stimulation protocols in IVF.展开更多
Background and Study Aim: Ensdoscopic ultrasound- gui- ded fine- needle aspiration (EUS- FNA) has been reported as a useful techni que for histological diagnosis of submucosal or extrinsic gastrointestinal and p ancre...Background and Study Aim: Ensdoscopic ultrasound- gui- ded fine- needle aspiration (EUS- FNA) has been reported as a useful techni que for histological diagnosis of submucosal or extrinsic gastrointestinal and p ancreatic lesions. The aim of this study was to evaluate the use of EUS- FNA fo r the diagnosis of lesions either within or adjacent to the wall of the colon an d rectum. Patients and Methods: A total of 22 patients with a lesion within the wall of, or adjacent to, the colon or rectum underwent EUS- FNA. They were divi ded into two groups: patients who had previously had a malignancy (the “ previo us + ve" group, n=11), and patients who had not previously had a malignancy (th e “ previous - ve" group, n = 11). In the four patients who had lesions locate d proximal to the sigmoid colon, EUS- FNA was performed using a guide wire and overtube. The success rates for adequate tissue sampling and for detecting malig nant and benign masses by EUS- FNA were evaluated and the success rate for dete ction was compared with the success rate of EUS and computed tomography. Results : Sufficient tissue for evaluation was obtained from 21 of be 22 patients (95.5 % ). The overall rate of detection of malignant and benign masses was 95.5% ( 21/22) for EUS- FNA and 81.8% (18/22) for pre- EUS- FNA imaging investigati ons. Of the 11 patients in the previous + ve group, ten were diagnosed with recurrences of primary malignancies; of the 11 patients in the previous - ve group, four we re diagnosed with primary malignancies and seven were diagnosed with benign lesi ons. There were no complications related to the EUS- FNA procedure. Conclusions : EUS- FNA is a safe techniquewhich is useful in the planning of treatment for patients who have a mass within the wall or adjacent to the wall of the entire l ength of the colon or rectum.展开更多
In this study, genetic polymorphisms, NQO1 C609T, GSTM1 positive/null, and GSTT1 positive/null, were examined with reference to cervical cancer risk in a population- based incident case- control study in Japanese. The...In this study, genetic polymorphisms, NQO1 C609T, GSTM1 positive/null, and GSTT1 positive/null, were examined with reference to cervical cancer risk in a population- based incident case- control study in Japanese. The cases comprised 131 cervical cancer patients: 87 cases with squamous cell carcinoma (SCC) and 44 with adenocarcinoma (ADC) or adenosquamous carcinoma (ADSC). Controls were sampled from 320 healthy women who underwent a health checkup. The cervical cancer risk was substantially elevated with smoking for all cases, SCC cases, and ADC/ADSC cases (OR = 4.50, 95% CI = 2.48- 8.17, P <0.001; OR = 5.68, 95% CI = 2.99- 10.78, P <0.001; and OR = 2.57, 95% CI = 1.09- 6.08, P = 0.032; respectively). The frequency of the NQO1 609TT genotype, reported to be associated with null enzyme activity, was higher in individuals with all cases and SCC than in the healthy controls (OR = 1.97, 95% CI = 1.06- 3.66, P = 0.032; and OR = 2.42, 95% CI = 1.21- 4.82, P = 0.012; respectively), but not in ADC/ADSC cases. Analysis of polymorphisms for GSTM1 and GSTT1 showed no significant differences between cervical cancer patients and controls. In stratification analysis, significant elevated risk of all cases and SCC was associated with the NQO1 609TT genotype among nonsmokers (OR = 2.15, 95% CI = 1.08- 4.30, P = 0.030; and OR = 2.83, 95% CI = 1.21- 6.31, P = 0.011; respectively), but not smokers. No gene- gene interaction was observed in our case subjects. This is the first report that the NQO1 gene might be important in relation to the risk of squamous cell carcinoma of the cervix.展开更多
Objective To assess the release of angiogenin into peritoneal fluid i n women w ith and without endometriosis by measuring its concentration with reference to d isease stage, presence of red lesions, and phase of the ...Objective To assess the release of angiogenin into peritoneal fluid i n women w ith and without endometriosis by measuring its concentration with reference to d isease stage, presence of red lesions, and phase of the menstrual cycle. Design Retrospective study. Setting Nagoya City University Hospital. Patient(s) Sixty- four women with endometriosis (n = 38) and cystadenomas (n = 26) for whom surger y was scheduled in the proliferative or secretory phase of the menstrual cycle. Intervention(s) Peritoneal fluid samples were obtained at laparotomy or laparosc opy. Main outcome measure(s) Angiogenin concentrations in the peritoneal fluid, as measured by ELISA. Result(s) Angiogenin concentration in the peritoneal fluid was markedly elevated in the endometriosis patients (median 515 ng/mL, interqua rtile range 151-1763 ng/mL) comparedwith the cystadenoma (control) patients (195 ng/mL, 98-324 ng/mL)-, with values corre lating with the extent of the disease. No significant differences between the pr oliferative phase and the secretory phasewere observed in either the controls or the endometriosis patients. Conclusion(s) The inflammation associated with endo metriosis, through increasing levels of peritoneal fluid angiogenin, might promo te angiogenesis for progression of the disease and correlate with the extent of the disorder.展开更多
There are two subtypes of hepatitis B virus genotype A (HBV/ A) and they are p rovisionally designated Aa (“a”standing for Africa/Asia) and Ae (“e”for Euro pe). In a case-control study, 78 HBV/Aa, 78HBV/Ae, and 78...There are two subtypes of hepatitis B virus genotype A (HBV/ A) and they are p rovisionally designated Aa (“a”standing for Africa/Asia) and Ae (“e”for Euro pe). In a case-control study, 78 HBV/Aa, 78HBV/Ae, and 78HBV/D carriers from several co untries were compared. The prevalence of HBe antigen (HBeAg) in serum was signif icantly lower in carriers of HBV/Aa than in carriers of HBV/Ae (31%vs. 49%; P = .033), with a difference more obvious in the carriers aged 30 years or younger (34%vs. 67%; P = .029). HBV DNA levels in the carriers of HBV/Aa (median, 3.4 6 log copies/mL; 95%CI, 2.93-3.95)were significantly lower than those of carri ers of HBV/Ae (6.09 log copies/mL; 95%CI, 4.24-7.64) or of carriers ofHBV/D (5 .48 log copies/mL; 95%CI, 4.06-7.02), regardless of the HBeAg status (P< .001) . The most specific and frequent substitutions in 54 HBV/Aa isolates were double substitutions for T1809 (100%) and T1812 (96%) immediately upstream of the pr ecore initiation codon, which would interfere with the translation of HBeAg in H BV/Aa infections. They were not detected in 57 HBV/Ae or 61 HBV/D isolates exami ned. The double mutation in the core promoter (T1762/A1764)was more frequent in both HBV/Aa (50%) and HBV/Ae (44%) than in HBV/D isolates (25%; P< .01), wher eas the precore mutation (A1896) occurred in HBV/D isolates only (48%; P < .000 1). In conclusion, the clearance of HBeAg from serum may occur by different mec hanisms in HBV/Aa, HBV/Ae, and HBV/D infections, which may influence clinical ma nifestations in the Western countries where both genotypes A and D are prevalent .展开更多
Background. Breakthrough hepatitis (BTH), defined as a flare of transaminases alanine aminotransferase (ALT),can occur during lamivudine monotherapy for hepatitis B virus (HBV) infection. There have been many reports ...Background. Breakthrough hepatitis (BTH), defined as a flare of transaminases alanine aminotransferase (ALT),can occur during lamivudine monotherapy for hepatitis B virus (HBV) infection. There have been many reports of lamivudine resistant mutations within the C domain of the viral reverse transcriptase; however, the appearance of these mutants is not necessarily correlated with BTH during lamivudine therapy. Methods and Results. Entire serial HBV genomic sequences before and during lamivudine therapy for 4 patients with BTH and 1 patient without BTH were analyzed and showed changes in the pre S region. These changes may be associated with ALT flares. Further investigation in a cohort of 36 patients with a median treatment period of 25 months showed that 21 patients had a rise in HBV DNA titer, of whom 18 had BTH. Univariate statistical analyses showed that possible prognostic indicators for the occurrence of BTH were pre S deletions (P = 0.03) and L180M/M204L mutations (P = 0.04). By multivariate Cox regression analyses, significant variables were pre S deletions (hazard ratio, 0.17; 95%confidence internal (CI), 0.044-0.66) and precore mutations (hazard ratio, 5.70; 95%CI 1.74-18.71) prior to the commencement of lamivudine monotherapy. Interestingly, BTH occurred after the selection of the wild type species in the pre S region during lamivudine monotherapy. Conclusions. These results suggest that patients with HBV pre S deletionmutants should bemonitored carefully during lamivudine therapy.展开更多
The visualization of transparent perfluorocarbon liquid (PFCL) using triamcinolone acetonide is described. Intravitreal injection of triamcinolone acetonide enabled visualization of residual PFCL intraoperatively. In ...The visualization of transparent perfluorocarbon liquid (PFCL) using triamcinolone acetonide is described. Intravitreal injection of triamcinolone acetonide enabled visualization of residual PFCL intraoperatively. In addition, it was shown that triamcinolone acetonide could visualizePFCL in an in vitro preparation of balanced salt solution. This in vitro experiment confirmed that triamcinolone acetonide also could be adsorbed by PFCL outside the vitreous. Triamcinolone acetonide was helpful to visualize transparent PFCL both in vivo and in vitro, and may be useful at the end of vitrectomy to completely remove residual PFCL from the eye.展开更多
To assess the clinical relevance of serum secretory leukocyte protease inhibitor (SLPI) levels in distinguishing patients with ovarian cancers from those with benign ovarian cysts, we determined concentrations with re...To assess the clinical relevance of serum secretory leukocyte protease inhibitor (SLPI) levels in distinguishing patients with ovarian cancers from those with benign ovarian cysts, we determined concentrations with reference to the FIGO stage and other clinical characteristics. Preoperative serum SLPI levels were measured in women with invasive epithelial ovarian cancer (n = 55), benign ovarian cysts (n = 25), or normal controls (n = 38) using an enzyme- linked immunosorbent assay (ELISA). The serum SLPI concentration was significantly elevated in the ovarian cancer patients (median 67 ng/ml, interquartile range 26- 124 ng/ml) as compared to the benign cyst patients (37 and 25- 66 ng/ml) or healthy women (32 and 25- 43 ng/ml). Using an SLPI cutoff of 50 ng/ml and a CA125 cutoff of 30 units/ml, with both markers elevated the sensitivity was 95% , the specificity was 100% , the positive predictive value was 100% , and the negative predictive value was 89% between the malignant and benign cyst patients. Serum SLPI levels could be useful for differentiating benign ovarian cysts from malignancies and to improve the specificity of diagnosis.展开更多
文摘This study investigated the effects of progesterone(P4) on the production and survival of neurons in the hippocampal dentate gyrus of adult male mice.The administration of P4(4 mg/kg) for 3 consecutive days beginning on the 0-2 nd day after the first BrdU-injection(BrdU-D0-2) produced an approximately twofold increase in the number of 28-and 56-day-old BrdU(+) cells in comparison to the controls,whereas it did not alter the number of 24 /48-h-old BrdU(+) cells.P4 preferentially promoted the survival of newborn neurons when administered at BrdU-D5-7,but not at BrdU-D10-12 and BrdU-D15-17.Androstenedione(Ad),testosterone(TE),or estradiol(E2) at the same-dose of P4,when administered at BrdU-D0-2,could not replicate the effect of P4,while the inhibition of 5 alpha-reductase by finasteride did not affect the P4-action,indicating that the P4-effect is exerted by P4 itself but not by its metabolites.On the other hand,the P4R antagonist RU486 partially suppressed the P4-effect,while inhibitors for Src,MEK,or PI3K totally suppressed the P4-effect.Finally,the P4-enhanced survival of newborn neurons was accompanied by a potentiation of spatial learning and memory,which was P4R-dependent.These findings suggest that P4 enhances the survival of newborn neurons through P4R and /or the Src-ERK and PI3K pathways independent of its influence on cell proliferation,which is well correlated with the potentiated spatial cognitive function of P4-treated animals.
基金supported by the National Key Basic Research Development Program of China (2009BAC54B01-1)National Natural Science Foundation of China (41071009 and 40701171)
文摘The dynamical processes of a typical linear dune including morphological features, dune ridge swing range and crest height were investigated at different monitoring periods in the hinterland of Tengger Desert. The results indicated that the development of linear dune depends on not only the northwesterly prevailing wind, but also the winds from northeast and southwest. The dune ridge swayed along its fundamental strike and took on an eastward movement gradually. The original dune strike was NW70° on August 3, 1994, and then changed to NE15° on April 21, 2001. The dune crest increased by 1.8 m longitudinally, which manifested strong wind-blown sand activities in this region. Wind erosion frequently occured at the bottom of sand dune, while sand accumulation appeared on its mid-upper section. The mean wind erosion depth was 25 cm on the bottom of linear dune and the height difference of the control points on the dune’s ridge was 1.13 m. Although the linear dune swayed laterally, the horizontal displacement of its ridge moved eastward 5.8 m averagely. The swing range of the dune crest line is very distinct, with a maximum value of 13.2 m. The highest site on the K-profile swayed on both sides of the dune ridge and the heights were 19.88 m at the control point K5, 19.61 m at K6 and 19.05 m at K7, respectively. The results indicated that the lateral swing of the linear dune was distinct under the northwesterly wind and it moved toward east gradually.
基金The project supported by the Core-University Program between Japan and China on Plasmas and Nuclear Fusion, and a Grant-in-Aid for Scientific Research from Japan Society for the Promotion of Science
文摘MHD stability of the Large Helical Device (LHD) plasmas produced with intenseneutral beam injection is experimentally studied. When the steep pressure gradient near the edge isproduced through L-H transition or linear density ramp experiment, interchange-like MHD modes whoserational surface is located very close to the last closed flux surface are strongly excited in acertain discharge condition and affect the plasma transport appreciably. In NBI-heated plasmasproduced at low toroidal field, various Alfven eigenmodes are often excited. Bursting toroidalAlfven egenmodes excited by the presence of energetic ions induce appreciable amount of energeticion loss, but also trigger the formation of internal and edge transport barriers.
文摘Small-bowel enteroscopy with the double-balloon method was developed to improve access to the small intestine. This study evaluated the usefulness of this method for the resection of small-intestinal Peutz-Jeghers polyps. Two patients with Peutz-Jeghers syndrome underwent nonsurgical doubleballoon enteroscopic resection of polyps throughout the small intestine. Multiple polyps in the jejunum were successfully resected via the oral route, as were the polyps in the ileum via the anal route. All 18 polyps (10-60 mm in size) were resected without subsequent bleeding or perforation. Histopathologically, 3 large polyps (>30 mm diameter) were hamartomas with adenomatous components. Double-balloon enteroscopy was safe and useful for the diagnosis and the treatment of Peutz-Jeghers polyps throughout the small intestine. Double-balloon enteroscopic polypectomy might preclude complications of Peutz-Jeghers syndrome, including intussusception, bleeding, and tumorogenesis, thereby obviating the need for multiple laparotomies.
基金supported by KAKENHI (Grant-in-Aid for Scientific Research(C), 21560862) of Japan
文摘To realize an excitation of electron Bernstein waves (EBW) via mode conversion from X-mode waves injected from the high magnetic field side (HFS), new inner-vessel mirrors were installed close to a helicM coil in the large helicM device (LHD). 77 GHz electron cyclotron (EC) wave beams injected from an existing EC-wave injection system toward the new mirror are reflected on the mirror so that the beams are injected to plasmas from HFS. Evident increases in the electron temperature at the plasma core region and the plasma stored energy were observed by the HFS beam injection to the plasmas with the line-average electron density of 7.5~ 1019 m-3, which is slightly higher than the plasma cut-off density of 77 GHz EC-waves, 7.35~ 1019 m-3. The heating efficiency evaluated from the changes in the time derivative of the plasma stored energy reached ,,~70%. Although so far it is not clear which is the main cause of the heating effect, the mode-converted EBW or the X-mode wave itself injected from the HFS, an effective heating of high-density plasma over the plasma cut-off of EC-wave was successfully demonstrated.
文摘Spinal and bulbar muscular atrophy (SBMA) is an inherited adult onset motor ne uron disease caused by the expansion of a polyglutamine (polyQ) tract within the androgen receptor (AR), affecting only males. The characteristic pathological f inding is nuclear inclusions (NIs) consisting of mutant AR with an expanded poly Q in residual motor neurons, and in certain visceral organs. We immunohistochemi cally examined 11 SBMA patients at autopsy with 1C2, an antibody that specifical ly recognizes expanded polyQ.Our study demonstrated that diffuse nuclear accumul ation of mutant AR was far more frequent and extensive than NIs being distribute d in a wide array of CNS nuclei, and in more visceral organs than thus far belie ved. Mutant AR accumulation was also present in the cytoplasm, particularly in t he Golgi apparatus; nuclear or cytoplasmic predominance of accumulation was tiss ue specific. Furthermore,the extent of diffuse nuclear accumulation of mutant AR in motor and sensory neurons of the spinal cord was closely related to CAG repe at length. Thus, diffuse nuclear accumulation of mutant AR apparently is a cardi nal pathogenetic process underlying neurological manifestations, as in SBMA tran sgenic mice, while cytoplasmic accumulation may also contribute to SBMA pathophy siology.
文摘Background. We investigated the possible roles of the interleukin(IL)-15 and IL-15 receptor (IL-15R) system in a heightened state of B-cell activation and differentiation in intestinal mucosa with inflammatory bowel disease (IBD).Meth ods. The expression of IL-15 and IL-15RαmRNA and protein in inflamed colonic mucosal tissues with IBD, and in control tissues was examined by reverse transcr iptase-polymerase chain reaction and immunohistological methods. The effects of recombinant(r)IL-15 on the expression of IL-15Rαon lamina propria B cells an d the production of immunoglobulin G (IgG) were analyzed in vitro, using lamina propria mononuclear cells (LPMCs)isolated from control tissues. Results. The int ensity of IL-15 and IL-15RαmRNA was greater in the mucosal tissues of patient s with IBD, especially in those of patients with ulcerative colitis (UC), than i n control tissues. Compared to control tissues, mononuclear cells positive for I L-15Rαprotein were observed in greater proportions in tissue sections from pat ients with IBD, especially in those from patients with UC, where IL-15Rαprotei n was localized to CD20-positive B cells to a significant degree. There were in creases in the proportions of IL-15Rα-positive B cells and IgG-producing cel ls in rIL-15-or rCD40L-stimulated cultures of LPMCs, with stimulatory effects being greater in the presence of their combination.Conclusions. These data sugg est that the IL-15 and IL-15R system may play important roles in the activatio n and differentiation of lamina propria B cells in patients with IBD, especially in those with UC.
文摘OBJECTIVE: Optimized ovarian stimulation protocols are required for the success of in vitro fertilization (IVF). The purpose of this study was to estimate whether the ovarian reserve test using exogenous follicle-stimulating hormone (FSH) could predict ovarian response in IVF.METHODS: This was a prospective observational study of 110 patients who underwent their first IVF cycle. The FSH test was administered as 150 IU of urinary FSH daily from day 3 to day 6 of the menstrual cycle preceding the IVF cycle for evaluation of the plasma estradiol level. Outcomes of IVF, including ovarian response, were analyzed. RESULTS: A negative correlation was observed between the duration of stimulation and the result of the FSH test (r = -.238, P = .014) and between the dose of FSH per retrieved mature oocyte (metaphase II oocyte) and the result of the FSH test (r = -.308, P < .001). In addition, our results showed that the result of the FSH test was significantly lower in poor responders defined by FSH of 400 IU/metaphase II oocyte or greater (207 ±149 compared with 293 ±174 pg/mL, P =.007). CONCLUSION: The FSH test can be a useful tool for determining the conditions of individualized clinical management plans and optimizing stimulation protocols in IVF.
文摘Background and Study Aim: Ensdoscopic ultrasound- gui- ded fine- needle aspiration (EUS- FNA) has been reported as a useful techni que for histological diagnosis of submucosal or extrinsic gastrointestinal and p ancreatic lesions. The aim of this study was to evaluate the use of EUS- FNA fo r the diagnosis of lesions either within or adjacent to the wall of the colon an d rectum. Patients and Methods: A total of 22 patients with a lesion within the wall of, or adjacent to, the colon or rectum underwent EUS- FNA. They were divi ded into two groups: patients who had previously had a malignancy (the “ previo us + ve" group, n=11), and patients who had not previously had a malignancy (th e “ previous - ve" group, n = 11). In the four patients who had lesions locate d proximal to the sigmoid colon, EUS- FNA was performed using a guide wire and overtube. The success rates for adequate tissue sampling and for detecting malig nant and benign masses by EUS- FNA were evaluated and the success rate for dete ction was compared with the success rate of EUS and computed tomography. Results : Sufficient tissue for evaluation was obtained from 21 of be 22 patients (95.5 % ). The overall rate of detection of malignant and benign masses was 95.5% ( 21/22) for EUS- FNA and 81.8% (18/22) for pre- EUS- FNA imaging investigati ons. Of the 11 patients in the previous + ve group, ten were diagnosed with recurrences of primary malignancies; of the 11 patients in the previous - ve group, four we re diagnosed with primary malignancies and seven were diagnosed with benign lesi ons. There were no complications related to the EUS- FNA procedure. Conclusions : EUS- FNA is a safe techniquewhich is useful in the planning of treatment for patients who have a mass within the wall or adjacent to the wall of the entire l ength of the colon or rectum.
文摘In this study, genetic polymorphisms, NQO1 C609T, GSTM1 positive/null, and GSTT1 positive/null, were examined with reference to cervical cancer risk in a population- based incident case- control study in Japanese. The cases comprised 131 cervical cancer patients: 87 cases with squamous cell carcinoma (SCC) and 44 with adenocarcinoma (ADC) or adenosquamous carcinoma (ADSC). Controls were sampled from 320 healthy women who underwent a health checkup. The cervical cancer risk was substantially elevated with smoking for all cases, SCC cases, and ADC/ADSC cases (OR = 4.50, 95% CI = 2.48- 8.17, P <0.001; OR = 5.68, 95% CI = 2.99- 10.78, P <0.001; and OR = 2.57, 95% CI = 1.09- 6.08, P = 0.032; respectively). The frequency of the NQO1 609TT genotype, reported to be associated with null enzyme activity, was higher in individuals with all cases and SCC than in the healthy controls (OR = 1.97, 95% CI = 1.06- 3.66, P = 0.032; and OR = 2.42, 95% CI = 1.21- 4.82, P = 0.012; respectively), but not in ADC/ADSC cases. Analysis of polymorphisms for GSTM1 and GSTT1 showed no significant differences between cervical cancer patients and controls. In stratification analysis, significant elevated risk of all cases and SCC was associated with the NQO1 609TT genotype among nonsmokers (OR = 2.15, 95% CI = 1.08- 4.30, P = 0.030; and OR = 2.83, 95% CI = 1.21- 6.31, P = 0.011; respectively), but not smokers. No gene- gene interaction was observed in our case subjects. This is the first report that the NQO1 gene might be important in relation to the risk of squamous cell carcinoma of the cervix.
文摘Objective To assess the release of angiogenin into peritoneal fluid i n women w ith and without endometriosis by measuring its concentration with reference to d isease stage, presence of red lesions, and phase of the menstrual cycle. Design Retrospective study. Setting Nagoya City University Hospital. Patient(s) Sixty- four women with endometriosis (n = 38) and cystadenomas (n = 26) for whom surger y was scheduled in the proliferative or secretory phase of the menstrual cycle. Intervention(s) Peritoneal fluid samples were obtained at laparotomy or laparosc opy. Main outcome measure(s) Angiogenin concentrations in the peritoneal fluid, as measured by ELISA. Result(s) Angiogenin concentration in the peritoneal fluid was markedly elevated in the endometriosis patients (median 515 ng/mL, interqua rtile range 151-1763 ng/mL) comparedwith the cystadenoma (control) patients (195 ng/mL, 98-324 ng/mL)-, with values corre lating with the extent of the disease. No significant differences between the pr oliferative phase and the secretory phasewere observed in either the controls or the endometriosis patients. Conclusion(s) The inflammation associated with endo metriosis, through increasing levels of peritoneal fluid angiogenin, might promo te angiogenesis for progression of the disease and correlate with the extent of the disorder.
文摘There are two subtypes of hepatitis B virus genotype A (HBV/ A) and they are p rovisionally designated Aa (“a”standing for Africa/Asia) and Ae (“e”for Euro pe). In a case-control study, 78 HBV/Aa, 78HBV/Ae, and 78HBV/D carriers from several co untries were compared. The prevalence of HBe antigen (HBeAg) in serum was signif icantly lower in carriers of HBV/Aa than in carriers of HBV/Ae (31%vs. 49%; P = .033), with a difference more obvious in the carriers aged 30 years or younger (34%vs. 67%; P = .029). HBV DNA levels in the carriers of HBV/Aa (median, 3.4 6 log copies/mL; 95%CI, 2.93-3.95)were significantly lower than those of carri ers of HBV/Ae (6.09 log copies/mL; 95%CI, 4.24-7.64) or of carriers ofHBV/D (5 .48 log copies/mL; 95%CI, 4.06-7.02), regardless of the HBeAg status (P< .001) . The most specific and frequent substitutions in 54 HBV/Aa isolates were double substitutions for T1809 (100%) and T1812 (96%) immediately upstream of the pr ecore initiation codon, which would interfere with the translation of HBeAg in H BV/Aa infections. They were not detected in 57 HBV/Ae or 61 HBV/D isolates exami ned. The double mutation in the core promoter (T1762/A1764)was more frequent in both HBV/Aa (50%) and HBV/Ae (44%) than in HBV/D isolates (25%; P< .01), wher eas the precore mutation (A1896) occurred in HBV/D isolates only (48%; P < .000 1). In conclusion, the clearance of HBeAg from serum may occur by different mec hanisms in HBV/Aa, HBV/Ae, and HBV/D infections, which may influence clinical ma nifestations in the Western countries where both genotypes A and D are prevalent .
文摘Background. Breakthrough hepatitis (BTH), defined as a flare of transaminases alanine aminotransferase (ALT),can occur during lamivudine monotherapy for hepatitis B virus (HBV) infection. There have been many reports of lamivudine resistant mutations within the C domain of the viral reverse transcriptase; however, the appearance of these mutants is not necessarily correlated with BTH during lamivudine therapy. Methods and Results. Entire serial HBV genomic sequences before and during lamivudine therapy for 4 patients with BTH and 1 patient without BTH were analyzed and showed changes in the pre S region. These changes may be associated with ALT flares. Further investigation in a cohort of 36 patients with a median treatment period of 25 months showed that 21 patients had a rise in HBV DNA titer, of whom 18 had BTH. Univariate statistical analyses showed that possible prognostic indicators for the occurrence of BTH were pre S deletions (P = 0.03) and L180M/M204L mutations (P = 0.04). By multivariate Cox regression analyses, significant variables were pre S deletions (hazard ratio, 0.17; 95%confidence internal (CI), 0.044-0.66) and precore mutations (hazard ratio, 5.70; 95%CI 1.74-18.71) prior to the commencement of lamivudine monotherapy. Interestingly, BTH occurred after the selection of the wild type species in the pre S region during lamivudine monotherapy. Conclusions. These results suggest that patients with HBV pre S deletionmutants should bemonitored carefully during lamivudine therapy.
文摘The visualization of transparent perfluorocarbon liquid (PFCL) using triamcinolone acetonide is described. Intravitreal injection of triamcinolone acetonide enabled visualization of residual PFCL intraoperatively. In addition, it was shown that triamcinolone acetonide could visualizePFCL in an in vitro preparation of balanced salt solution. This in vitro experiment confirmed that triamcinolone acetonide also could be adsorbed by PFCL outside the vitreous. Triamcinolone acetonide was helpful to visualize transparent PFCL both in vivo and in vitro, and may be useful at the end of vitrectomy to completely remove residual PFCL from the eye.
文摘To assess the clinical relevance of serum secretory leukocyte protease inhibitor (SLPI) levels in distinguishing patients with ovarian cancers from those with benign ovarian cysts, we determined concentrations with reference to the FIGO stage and other clinical characteristics. Preoperative serum SLPI levels were measured in women with invasive epithelial ovarian cancer (n = 55), benign ovarian cysts (n = 25), or normal controls (n = 38) using an enzyme- linked immunosorbent assay (ELISA). The serum SLPI concentration was significantly elevated in the ovarian cancer patients (median 67 ng/ml, interquartile range 26- 124 ng/ml) as compared to the benign cyst patients (37 and 25- 66 ng/ml) or healthy women (32 and 25- 43 ng/ml). Using an SLPI cutoff of 50 ng/ml and a CA125 cutoff of 30 units/ml, with both markers elevated the sensitivity was 95% , the specificity was 100% , the positive predictive value was 100% , and the negative predictive value was 89% between the malignant and benign cyst patients. Serum SLPI levels could be useful for differentiating benign ovarian cysts from malignancies and to improve the specificity of diagnosis.