Objective: To investigate the possibility of prediction of the histological type of ovarian tumors by preoperative imaging in patients had undergone surgery for pregnancy-associated ovarian tumors. 　Methods: Maternal ovarian tumor was detected by ultrasonography (USG) examination and magnetic resonance image (MRI) and operation was performed in 18 pregnant women. 　In 18 cases, collected medical records, USG/MRI and pathologic findings were analyzed retrospectively. 　Results: Histopathological diagnoses were parovarian cyst, simple cyst, mucinous cystadenoma, a combination of mucinous cystadenoma and mature cystic teratoma, mature cystic teratoma, hemorrhagic lutein cyst, immature teratoma (Grade1), a combination of mucinous cystadenocarcinoma and mature cystic teratoma. The rate of agreement between the tissue pattern predicted by USG and the histopathological diagnosis was 25%. Matching rate for dermoid cysts was 37.3%. Immature teratoma (G1) could not be predicted preoperatively, but a combination of mucinous cystadenocarcinoma (G1) and mature cystic teratoma was diagnosed as ovarian cancer and a low malignant potential case by some gynecologists. MRI was useful for the diagnosis of dermoid cyst. On the other hand, it was quite difficult to diagnose the tumors as malignant by MRI. 　Conclusions: USG can make images at a given cross-section in real-time, and follow the time course of their changes. On the other hand, MRI may display excellent tissue contrast to target tissues and delineate more accurate morphological changes. The combined use of USG and MRI may further improve the diagnosis of ovarian tumors.

抄録全体を表示

　Exfoliative toxin A (ETA) produced by Staphylococcus aureus causes bullous impetigo and staphylococcal scalded skin syndrome. The exfoliative activity of ETA is ascribed to its highly restricted degradation between Glu₃₈₁-Gly₃₈₂ of desmoglein 1, a component protein of desmosomes. Since the peptidase activity of ETA has been yet to be demonstrated other than desmoglein 1, the entity as a peptidase and its molecular mechanism remain to be elucidated. In the present study, we determined the peptidase activity using recombinant ETA molecules and synthetic fluorescent peptidyl substrates, while the exfoliative activity was examined by a neonatal mouse model. Although peptidase activity was trivial as compared with the S. aureus glutamyl endopeptidase GluV8, pro-ETA starting from Phe24 (Phe24-ETA) and the mature form from Glu39 (Glu39-ETA) exhibited the activities toward LLE-, AE-, and LE-MCA, but not toward LLQ-, LD- or AAA-MCA, indicating a Glu-specific endopeptidase activity. This activity was statistically higher in Glu39-ETA than Phe24-ETA and was inhibited by the serine protease inhibitor Pefabloc. Deletion of the α1 region at positions 42-56 as well as substitution of active Ser233 to Ala abrogated the peptidase activity. In accord with these results, intraepidermal blister formation and epidermolysis were induced more exclusively by Glu39-ETA than Phe24-ETA. ETAs without proteolytic activity as well as GluV8 did not cause an exfoliative reaction. These results suggest that the highly restricted Glu-specific endopeptidase activity of ETA is involved in exfoliative activity and that the α1 region is required for these functions.

抄録全体を表示

　Background: The influence of the extent of aortic replacement on the aortic root replacement is unclear. We investigated the clinical outcomes of the aortic root replacement in terms of the extent of aortic replacement and evaluated quality of life (QOL) after surgery. 　Methods: Thirty six patients were enrolled in this study. The mean age was 59.0 ± 13.1 years. The 36 patients were divided into three groups according the extent of aortic replacement: 21 patients with replacement of the ascending aorta (SB), 7 patients with hemi-arch replacement (HB), and 8 patients with total aortic arch replacement (TB). Postoperative health-related QOL was evaluated by SF-36 Version 2. 　Results: The hospital mortality in the 36 patients was 2.8%. The patient (TB) died from fungal infection of the prosthetic graft. Three late deaths (8.6%) were observed: cerebral hemorrhage in one (SB), pneumonia in one (SB), and unknown in one (HB). The 5-year survival was 94.1 ± 5.7% in the SB group, 100% in the HB and 87.5 ± 11.7% in the TB groups, respectively (p=0.84). One patient (4.8%) in the SB group had an aorta-related event 7 years after surgery. No patinets had aorta-related events in both the HB and the TB groups. There was no significant difference in postoperative health-related QOL among the three groups. 　Conclusions: Aortic root replacement at our hospital achieved excellent results. Neither long-term survival nor postoperative QOL differed significantly according to the extent of aortic root replacement. We plan to extend the present study by including a larger number of subjects.

抄録全体を表示

Several studies have reported that adult height is positively associated with risk of cancer on the hypothesis that height is a marker of childhood physical condition, and others that the risk of cancer was higher for participants with higher serum uric acid levels. We conducted a cross sectional study of 1,350 men aged 30-89 years undergoing general health check-ups. Since body mass index (BMI) is regarded as a surrogate marker of current physical condition for hyperuricemia risk, we performed a stratified analysis of this risk based on BMI. Of the total study population, 368 men were diagnosed with hyperuricemia (serum uric acid > 7.0mg/dl), and a positive association between height and prevalence of hyperuricemia was detected, which was independent of classical cardiovascular risk factors. The adjusted odds ratio (OR) and 95% confidence interval (CI) for hyperuricemia of an increment of 1 SD for height (6.7cm) was 1.17 (CI: 1.01-1.35). Analysis of this association according to BMI status (non-overweight or overweight) disclosed a positive association only for non-overweight men. The adjusted ORs and CIs for hyperuricemia of an increment of 1 SD for height were 1.26 (1.05-1.52) for non-overweight and 1.01 (0.79-1.29) for overweight subjects. Height was found to be positively associated with the risk of hyperuricemia for Japanese men, especially non-overweight men (BMI < 25kg/²) which suggests that childhood social and physical conditions may contribute to the development of hyoeruricemia in adulthood.

抄録全体を表示

A 52-year-old female who had undergone subtotal thyroidectomy for Graves’ disease 20 years previously was referred to us with nodules in both lobes in her remnant thyroid. Although benign follicular tumors were most likely to be considered on further examinations, total remnant thyroidectomy was performed due to the increasing size of the nodules. Diagnoses of papillary carcinoma (follicular variant) and minimally invasive follicular carcinoma were strongly suspected based on the findings of the histological examination. In follow-up examinations after subtotal thyroidectomy for Graves’ disease, not only function but also structure of the remnant thyroid, should be focused on. Although rare, the possibility for carcinoma should be considered if nodules present in the remnant thyroid.

抄録全体を表示