Journal of Nippon Medical School
Online ISSN : 1347-3409
Print ISSN : 1345-4676
ISSN-L : 1345-4676
Volume 72, Issue 3
Displaying 1-10 of 10 articles from this issue
Photogravure
Review
  • Zenya Naito
    2005 Volume 72 Issue 3 Pages 137-145
    Published: 2005
    Released on J-STAGE: July 27, 2005
    JOURNAL FREE ACCESS
    The roles of lumican, a member of the small-leucine-rich-proteoglycan (SLRP) family, in pathological fibrosis, cancer tissues and tumor cell growth were reviewed. Lumican is predominantly localized in the areas of pathological fibrosis including the thickened intima of human coronary arteries, ischemic and reperfused hearts, and acute pancreatitis and chronic pancreatitis (CP)-like lesions adjacent to pancreatic cancer nests. In these lesions, lumican mRNA and protein were transiently and ectopically overexpressed in most of the vascular smooth muscle cells (VSMCs) that migrated into the thickened intima, myocardial cells adjacent to an ischemic lesion, acinar cells, islet cells and fibroblasts of pathological pancreatic tissues. The low expression level of lumican in breast cancer is associated with rapid progression and poor survival. Lumican mRNA in breast cancer is overexpressed in fibroblasts adjacent to cancer cells but not in cancer cells. Furthermore, the high expression level of lumican is associated with a high pathological tumor grade, a low estrogen receptor level in the cancer tissues, and young age of patients. The suppression of lumican expression in culture cells induces their cell growth. Lumican-transfected tumor cells are characterized by a strong suppression of their anchorage-independent growth and capacity of invasion. Lumican significantly suppressed subcutaneous tumor formation in syngenic mice, with a concomitant decrease in cyclin D1 expression level, and induced and/or enhanced the apoptosis of these cells. The autocrine mechanism in cancer cells and the paracrine mechanism in cancer cells and fibroblasts via transforming growth factor (TGF)-beta and Smad signals may play important roles in the regulation of tumor growth by SLRPs.
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  • Yuji Shimizu, Yasunori Hiraoka, Kazuya Iwamoto, Hirofumi Takahashi, Hi ...
    2005 Volume 72 Issue 3 Pages 146-148
    Published: 2005
    Released on J-STAGE: July 27, 2005
    JOURNAL FREE ACCESS
    Whether complete resection was possible with TURP was explained. A lot of adenoma remains after transurethral resection of the prostate (TURP), the other hand transurethral enucleation of the prostate (TUE) is useful for complete resection of an adenoma.
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Original
  • Kiyonori Furukawa, Takashi Tajiri, Hideyuki Suzuki, Yoshihiro Norose
    2005 Volume 72 Issue 3 Pages 149-154
    Published: 2005
    Released on J-STAGE: July 27, 2005
    JOURNAL FREE ACCESS
    Purpose: To examine whether sterile water and brushes are necessary for hand washing before surgery. Method: Twenty-two operating room nurses were randomly divided into two groups as follows: 11 nurses who used 7.5% povidone iodine (PVI group) and another 11 nurses who used 4% chlorhexidine gluconate (CHG group) to wash their hands using the rubbing method. All the nurses were examined for bacterial contamination of their hands before and after surgical hand rubbing. We used tap water to wash the hands at the sink used for washing surgical instruments in the operating room and non sterilized plastic brushes. Results: No bacteria were detected in the tap water. Before washing the hands, the number of bacteria detected was 5.0×103 cfu/H in the PVI group and 4.0×103 cfu/H in the CHG group, which were similar in both groups. After washing the hands, the median value of the bacteria decreased to 8.7×102 cfu/H in the PVI group and 0 cfu/H in the CHG group. Conclusions: Sterile water and brushes are not necessary for preoperative scrubbing up. When using tap water for surgical hand washing, 1) the hand-rubbing method should be used; 2) a quick-alcohol-based disinfectant scrub should be used; 3) the concentration of free chloride in the water should be maintained at over 0.1 PPM; 4) the bacterial contamination of the water should be checked; and 5) the faucet should be routinely cleaned and sterilized.
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  • Munehisa Fukuhara, Eiji Uchida, Takashi Tajiri, Takayuki Aimoto, Zenya ...
    2005 Volume 72 Issue 3 Pages 155-164
    Published: 2005
    Released on J-STAGE: July 27, 2005
    JOURNAL FREE ACCESS
    Purpose: Vascular endothelial growth factor (VEGF) is thought to play a crucial role in the process of cancer growth and metastasis. In this study, the expression of VEGF in liver metastases of pancreatic cancer was investigated using an established hamster model. Methods: Pancreatic cancer cells (PGHAM-1, 1×106) derived from N-nitrosobis (2-oxopropyl) amine (BOP)-induced pancreatic tumors in Syrian golden hamsters were transplanted into the pancreas of female hamsters. All hamsters were sacrificed at 21 days after transplantation and used for the histopathological examination of pancreatic and metastatic lesions (primary transplantation model). The metastatic liver tumors were minced with scissors and 1 mm3 tumors were retransplanted into the pancreas of a second hamster. All hamsters were sacrificed 21 days after retransplantation, and the pancreatic tumors were removed (back transplantation model). Immunohistochemical analyses using antibody against VEGF were performed for all pancreatic and liver tumors. Reverse transcription-polymerase chain reaction (RT-PCR) was performed to examine the expression of VEGF mRNA in the tumors. In addition, we investigated the proliferation of each tumor using Ag-NOR staining. Results: In the primary transplantation models, VEGF expression in the pancreatic tumors was positive, but that in the liver metastases was only weakly positive or negative. On the other hand, VEGF expression in the pancreatic tumors that had developed from the retransplantation of the liver tumors (back transplantation model) was strongly positive. VEGF mRNA was expressed in the pancreatic tumors of both primary and back transplantation models. In the metastatic liver tumors of the primary transplantation model, VEGF mRNA was expressed in all cases, although the immunohistochemical staining pattern was weakly positive or negative. Similarly, in the metastatic liver tumor of the back transplantation model, VEGF mRNA was expressed in all cases, although the immunohistochemical staining pattern was weakly positive or negative. No significant differences in Ag-NOR scores were found between the models. Conclusion: Our results suggest that VEGF expression usually occurs in PGHAM-1 cells but that VEGF expression is reduced during the process of liver metastasis and revived by retransplantation. Thus, the interrelationship between cancer cells and the organ environment might play an important role in VEGF expression.
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  • Naoyuki Kuriyama, Hiromoto Ito
    2005 Volume 72 Issue 3 Pages 165-173
    Published: 2005
    Released on J-STAGE: July 27, 2005
    JOURNAL FREE ACCESS
    The lumbar paraspinal muscles were examined by surface electromyography (EMG) in 22 patients with low back pain and 22 healthy volunteers. Surface electrodes were placed bilaterally on the lumbar multifidus and longissimus muscles at the level of the spinous process of the third lumbar vertebra. Kinesiologic EMG was recorded, in standing resting position, during the following trunk motions: trunk forward flexion and extension, lateral bending and axial rotation. No muscular activity was observed in the full trunk flexion position in the control group. In contrast, continuous muscle activity was observed in the low back pain group. On axial rotation, an intermuscular time lag was observed at the beginning of the motion in the control group. In the low back pain group, there was no such time lag. Paraspinal muscle activities restricted lumbar range of motion, and protect from injury for movement. This suggests their role as stabilizers.
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  • Shuichi Kuroda, Masataka Akimoto
    2005 Volume 72 Issue 3 Pages 174-178
    Published: 2005
    Released on J-STAGE: July 27, 2005
    JOURNAL FREE ACCESS
    With pressure sores, surface damage indicates that subcutaneous fat tissue necrosis has occurred. We hypothesized that formation of necrosis under a pressure sore changes the stress distribution, which in turn affects further extension of the necrosis. In the present study, two-dimensional finite element models were used to perform analysis under different undermining size conditions. Greater stress concentration was observed in the larger undermining model. This may be the reason that, in clinical situations, a large area of undermining necrosis is sometimes observed under the skin of sores with a small area of damage.
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Report on Experiments and Clinical Cases
  • Takafumi Chin, Yoshinori Sakata, Shunsuke Amenomori, Yasuhiro Yamamoto ...
    2005 Volume 72 Issue 3 Pages 179-181
    Published: 2005
    Released on J-STAGE: July 27, 2005
    JOURNAL FREE ACCESS
    After repairing a nasal fracture, it is customary to provide postoperative support for the nasal bone with intranasal, antibiotic-soaked gauze packing and an external splint. However, in cases of a skull base fracture with liquorrhea, this procedure is generally contraindicated because of the risk of infection. To lessen this risk, the authors used a bioabsorbable pin which is ultimately absorbed by the body through the natural process of hydrolysis. An intranasal support was inserted from outside the skin down to the maxilla. The operative results were satisfactory with no postoperative complications such as an inflammatory reaction or an infection.
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  • Kiyonori Furukawa, Nobuhiko Taniai, Hideyuki Suzuki, Teruro Kiyama, Ts ...
    2005 Volume 72 Issue 3 Pages 182-186
    Published: 2005
    Released on J-STAGE: July 27, 2005
    JOURNAL FREE ACCESS
    We describe two patients with abdominal incisional hernias, which occurred after appendectomy and replacement of an artificial blood vessel. Both were treated by operative hernial repair with the Composix® Kugel Patch (C.R. Bard Inc.), a composite mesh that combines polypropylene mesh and expanded polytetrafluoroethylene (Gore-Tex®). The mesh has various beneficial characteristics. It is a reinforcing material for the abdominal wall; even when in direct contact with the intestinal tract it is minimally adherent to the intestinal tract. The mesh expands readily and is easily fixed to the abdominal wall because it has a shape-memory ring. The long-term results of operative repair with this mesh have not yet been reported, but it is hoped that the aforementioned characteristics will yield favorable outcomes.
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  • Ken Takahashi, Hiroshi Yoshida, Yasuhiro Mamada, Nobuhiko Taniai, Yosh ...
    2005 Volume 72 Issue 3 Pages 187-190
    Published: 2005
    Released on J-STAGE: July 27, 2005
    JOURNAL FREE ACCESS
    We report a case of double cancer of the liver and esophagus, an extremely rare condition that can be very difficult to treat. A tumorous lesion was pointed out in segment 6 of the liver of a 69-year-old man under treatment for liver cirrhosis. Abdominal computed tomography and angiography revealed a hepatocellular carcinoma. The patient underwent transcatheter arterial embolization and partial resection of segments 5 and 6. Fourteen months later, a small elevated lesion was detected in the esophagus during an endoscopic examination. The patient was treated by endoscopic mucosal resection and radiation therapy at a total dose of 50 Gy. Histological examination revealed a squamous cell carcinoma with cancer cells confined within the epithelium of the esophagus. Over the 6 years since the hepatectomy, there have been no signs of recurrence. We report a successful curative resection in an extremely rare form of double cancer with a poor prognosis.
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