"Ko-ko-ro", meaning 'mind', is a complex higher order function of the human brain. The two distinct activities of mind that are best understood are the ability to recognize oneself, i.e., self-awareness, and the ability to read another mind. These two functions form the fundamental basis of humanity, thereby allowing us to conform and live in harmony within a given family, community, or society. The mind is formed under certain conditions within neural systems in the human brain, and potentially in some other primate brains. This activity is built upon the harmonic orchestration of various sub-components of mind formation, e.g., perception, sensing, cognition, learning and memory, emotion, consciousness, thoughts, desire, beliefs, and willingness. The current understanding of the mechanism of mind is limited, but growing evidence suggests that molecular, cellular, genetic, psychological, cognitive, and system neurobiological methods could help to further our knowledge of the mind. In this review, I will overview current understanding of the components of mind, particularly from a molecular neurobiological perspective, with anticipation that mapping the mind anatomically in molecular terms may ultimately be possible in the human brain.

View full abstract

It is supposed that mutations in genes of organism occur accidentally, but genetic fixations of the mutant species into all members of an organic species progress selectively. Directed protein evolution through the genetic fixation with the aim of the final goal as the molecular basis of organic evolution has always been progressing in tandem with the decrease of the degree of freedom of protein structure. This is evident in the continuous deceleration of the evolutionary amino acid substitution rate in protein. This seems to demonstrate the existence of the directed selection in also molecular evolution. In addition, it is supposed that directed protein evolution progresses by mainly the self-selection of organisms, and that the primary motive force of this self-selection is the stabilizing force with the aim of the final goal of the maximal stable condition of the non-equilibrium dynamic balance and harmonization of energy at the individual level of the organic species. Therefore, the primary factor of organic evolution is the self-selection of the organism itself, and the evolutionary factors of competition and symbiosis with the other species appear to be secondary.

View full abstract

New treatment modalities have been introduced to manage gastroesophageal varices, but their impact on prognosis of patients with the varices and hepatocellular carcinoma is not conclusive. The aim of the present study was to evaluate the influences of the variceal treatment on survival of such patients. Seventy-five patients, who were given a diagnosis of hepatocellular carcinoma and died between 1997 and 2004, were retrospectively reviewed in the endoscopic findings and treatments of gastroesophageal varices and causes of death. Additionally, the survival curves were compared between the groups with and without gastroesophageal varices or between the groups with and without the variceal treatments. Sixty (80.0%) of 75 patients had gastroesophageal varices, and 16 (26.7%) among them received the variceal treatments for variceal bleeding or the risk. Nine patients were endoscopically proven esophageal variceal bleeding, and 5 of them had received primary prophylaxis. Fifty-two (69.3%) and 2 (2.7%) of 75 patients died of the progression of hepatocellular carcinoma and the variceal bleeding, respectively. No significant difference was observed in the distribution of causes of death between patients with and without gastroesophageal varices (p=0.7695), while in patients with varices, the distribution of causes of death significantly differed between those with and without therapy (p=0.0020). Survival curves, however, did not differ significantly either between the groups with and wthout gastroesophageal varices (p=0.5502) or between the groups with and without variceal treatments (p=0.4446). Our study suggests that the overall survival rates in patients with hepatocallular carcinoma may be not affected by gastroesophageal varices if the varices are treated depending on the conditions. This may be originated from the improved management of varices in addition to the limited life-span because of tumor progression.

View full abstract

The volume, shape and size of cerebral ventricular system may change due to various pathologies directly or indirectly. Estimation of size of cerebral ventricles is important for evaluating changes due to growth, aging, intrinsic and extrinsic pathologies. Quantification using ex vivo techniques has considerable errors. In vivo studies using air or contrast media also introduce volumetric changes in the ventricles. Imaging of ventricular anatomy avoids these problems and allows repetitive studies following progression of ventricular system changes due to disease or natural processes. We have developed a methodology for automated extraction of ventricular system from magnetic resonance imaging. Once extracted, landmarks are located on the surface of ventricular system automatically. These landmarks are then used for calculation of the ventricular shape, volume and size. A total of 30 cases were analyzed. Physical dimensions of normal ventricles are presented in this paper.

View full abstract

We examined the results for pectus excavatum (PE) repair using conventional methods—sternal elevation by modified Ravitch procedure (SEMR), sternal elevation elevation by metal struts (SEMS), sternal turnover (ST) and costoplasty (CP)—and minimally invasive repair of PE (MIRPE) in 80 patients (65 boys and 15 girls) operated between July 1972 and March 2005 at the First Department of Surgery, Nagasaki University Hospital. Of 80 patients, 23 (28.8%) had asymmetric PE, while 57 (71.2%) had symmetric PE. The medians of cosmetic appearance index, functional impairment index and CT index were 0.022, 0.160 and 5.0395, respectively. A significant (p<0.0001) difference was observed among the operative methods for operating time, blood loss and hospital stay; the median of operating time was 85, 252.5, 145, 170 and 170 min for MIRPE, ST, CP, SEMR and SEMS, respectively; the median of blood loss was 5, 299.5, 243, 105.5 and 547.5 mL for MIRPE, ST, CP, SEMR and SEMS, respectively; the median of hospital stay was 10, 18.5, 30.5, 9.0 and 23.5 days for MIRPE, ST, CP, SEMR and SEMS, respectively. Postoperative complications were noted in 23 patients (28.8%), and the most common complication was wound infections. Epidural analgesia was used for postoperative pain control in 12 (75.0%) of 16 patients receiving MIRPE and 4 (7.7%) of 52 patients receiving ST in 1991 or later. The present study suggests that SEMR and MIRPE will be most versatile methods for children among the 5 operation procedures because of minimum invasion and short hospital stay; MIRPE has advantages that it has no incision of anterior chest wall and that it does not require resection of rib cartilages.

View full abstract

A 20-year-old female had noted a mild truncal instability during her childhood. At 12 years of age, she became aware of decreased visual acuity. She was made a diagnosis of retinitis pigmentosa at that time. On admission, deep tendon reflexes were absent in all limbs. The patient's deep sensations were impaired throughout her entire body, except for her face and neck. Superficial sensations were impaired on her legs. Sensory nerve action potentials were not elicited, but motor nerve conductions were all within normal ranges. A biopsy of the sural nerve showed a marked reduction in the myelinated fibers, but not in the unmyelinated fibers. The neurological findings were consistent with the hereditary sensory and autonomic neuroathy type II disease. The relationship between these two diseases remains unsolved.

View full abstract

A 60-year-old woman was admitted to Nagasaki Prefectural Shimabara Hospital, with a painful tumor in her umbilical region. The tumor was about 1×1 cm in size. Histological examination of biopsied specimens revealed it to be a metastatic adenocarcinoma. Abdominal computed tomography and ultrasonography revealed a cystic tumor of about 23 mm in diameter in the pancreatic body. In addition, serum levels of cancer antigen 19-9 were elevated. With a tentative diagnosis of pancreatic tumor, she underwent surgery. When we opened her peritoneal cavity, there was no evidence of intra-abdominal disseminations, liver metastases or ascites. At that time, distal pancreatectomy accompanied by splenectomy was the procedure of choice. Histological examination revealed a moderately differentiated adenocarcinoma in the pancreatic body along with fatty replacement of the pancreatic tail. The umbilical tumor was a metastatic adenocarcinoma, which is referred to as a Sister Mary Joseph's nodule.

View full abstract

We herein present a case of pneumatosis cystoides intestinalis. A 56-year-old woman was admitted to Nagasaki Prefectural Shimabara Hospital with diffuse and mild abdominal pain. A plain abdominal X-ray revealed free air in the right subphrenic space, and computed tomography showed an extraluminal gas-filled lesion adjacent to the small intestine. With a tentative diagnosis of perforation of the small intestine, a laparotomy was performed, although she had little tenderness and no rigidity on physical examination. Upon opening the peritoneal cavity, multiple bullae-like cysts were noted on approximately one meter of the ileal serosa; however, no site of perforation was detected. Removal of the portion of what appeared to be the affected bowel was the procedure of choice. The resected specimens histologically showed pneumatosis cystoides intestinalis without any perforation. Her postoperative course was uneventful and she has been doing well with no evidence of recurrence as of the end of June 2005.

View full abstract