To date only a few reports discuss the bone mineral density loss associated with long-term androgen-deprivation therapy (ADT) for prostate cancer patients in Japan. We measured the bone mineral density (BMD) of prostate cancer patients who were undergoing ADT. A retrospective study was performed to measure bone mineral density (BMD) of 76 patients (59 to 89 years old) who underwent ADT from year 2004 to 2009 at Showa University Hospital. BMD, Young Adult Mean (YAM), T score and Z score were assessed every year. We excluded patients with bone metastasis. The patients were followed for at least one year and for at most five years.
We measured the bone density of three regions (lumber spine, total hip, distal radius). BMD in the three regions was decreased after the start of ADT; the Z score decreased in the same way. BMD decreased in the lumbar spine and total hip after the initial three-year period, but the loss of BMD ceased after three years. Distal radius BMD was further decreased at five years. It is known that lumbar spine and total hip are influenced by degenerative change in dual energy X-ray absorptiometry. Thus, we propose that the distal radius should be evaluated for BMD in patients who underwent long-term ADT for prostate cancer.

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We evaluated whether the retinopathy of the prematurity treatment model, which maintains neonatal rats in 80% oxygen up to postnatal day 12 (P12), is utilizable as a brain damage model. The rats were loaded in hyperoxia-normoxia cycle until P12 and then transferred under normoxic conditions (room air) for 24 hours (P13). Rats at P12 and P13 were sacrificed and the hippocampus was removed. Tissue cryosections were prepared and oxidative stress in the hippocampus was assessed by immunohistochemical staining for 8-hydroxy-2'-deoxyfuanosine (8-OHdG: a DNA marker for oxidative stress). Furthermore, reactive oxygen species (ROS), lipid hydroperoxide (malondialdehyde: MDA), and oxidized glutathione (GSSG) were determined. We also assayed Cu/Zn superoxide dismutase (SOD) mRNA and type 4 nicotinamide adenine dinucleotide phosphate oxidase (Nox4) mRNA. The amount of 8-OHdG positive cells increased in CA1, CA3 and the dentate gyrus in the hyperoxic group. At P12 and P13 in the hyperoxic group, ROS, Cu/Zn SOD mRNA, MDA, and GSSG levels were significantly increased. At P13, the Nox4 mRNA level was increased to 2.7 fold that of the control group. Nox4-mediated oxidative stress may lead to a neuronal injury. In this study, the oxidative stress markers were increased in the hyperoxic group at P12 which is a necessary period for maturation of neurons and retina. These results corresponded with other previous reports on the oxidative stress-induced brain damage model. Therefore, this encephalopathy model was thought to be a possible model for the study of health maintenance of the premature infant.

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To assess which among the clinical features, electroencephalography (EEG), 14-3-3 protein of cerebrospinal fluid (CSF) and magnetic resonance images (MRI) of the head is useful for early clinical diagnosis of Creutzfeldt-Jakob disease (CJD). We retrospectively analyzed the clinical features, EEG, CSF and MRI of six autopsy-proven cases of CJD. Five cases showed rapidly progressive dementia falling into akinetic mutism at three months. Both myoclonus and periodic sharp wave complexes of EEG were observed in all six cases in the advanced stage. Both CSF 14-3-3 protein and abnormal high signal on diffusion-weighted (DW) MRI were observed in all six cases; the latter was observed in the initial stage, earlier than the former. DW-MRI is useful for early clinical diagnosis of CJD.

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The interest in mental health of the mother and child has increased after the campaign of “Healthy Parent and Child 21”. Likewise, investigations into the critical factors related to postpartum depression have also increased. In addition, more attention has been paid to the precipitating factors inpostpartum depression and also the timing of the depressed state during the gestation period. However, there are few continuous investigations from the gestation period through postpartum to clarify the time of change to the depressed state. Therefore, to consider an effective method to discover whether the pregnancy depressed state can become a risk of postpartum depression, the following were investingated: a postpartum depression prediction standard [Postpartum Depression Predictors Inventory Revised (PDPI-R)], Edinburgh postpartum depression self-assessment vote [Edinburgh postsnatal Depression scale (EPDS)]; SF-36 [for MOS Short-Form_36_Item Health_Survey, Japan, and Pittsburgh sleep questionnaire, Japanese edition] Pittsburgh Sleep Quality Index; (PSQI)]. We utilized PSQI. For any advanced stage, which continued one month after giving birth, both the early time and metaphase were investigated.
The pregnant subjects who participated in this investigation visited the following facilities for treatment: an assistant maternity hospital an obstetrics and gynecology department clinic and three institutions of the university hospital. There was no medical history of depression.
The purpose of this investigation was explained to all 77 subjects participating in the study, who were seen four times during pregnancy and after delivery. The average age of the 77 subjects was 33.61±4.54 years and 70.1% had no previous delivery experience.
The results obtained from those subjects who participated throughout the 4 surveys showed that, in the early stage and at the 1-month after-birth stage, there was a relation between PDPI-R and EPDS. It may be thought that continuous survey on whether they desired or planned pregnancies may help reveal depression in early stages.
Furthermore, only checking the development of fetuses and the risk of hypertension syndrome by the time of pregnancy or delivery may delay the discovery of depression.
In order to reveal depression at an early stage, it is necessary to check whether their physical and overall health as well as their vitality is not declining, by utilizing SF-36, and PSQI.

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The aim of this work was to evaluate our method for surgical treatment of lumbar canal stenosis (LCS). This procedure, introduced by Watanabe K, is a laminectomy that involves splitting of a lumbar spinous process. It requires a special retractor and lighting; the procedure is minimally invasive for tissues supporting the back, especially the back muscles. We compared the results of “splitting laminectomy” with conventional laminectomy in terms of operation duration, amount of bleeding, and improvement of JOA scores in the past 3 years. Operation duration was longer, whereas the amount of bleeding was smaller for the splitting laminectomy compared to the conventional procedure; the difference was significant (p<0.05). There was a tendency for some patients who underwent the conventional laminectomy to develop lumbago after the operation. We describe the method and results in detail. We can conclude that the short-term results of splitting laminectomy of LCS are better in comparison with the conventional procedure.

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We report the long-term follow-up of a case of relatively rare congenital anomalous systemic arterial supply to the basal lung. A 25-year-old male presented with hemoptysis and low-grade fever and underwent chest roentgenography, computed tomography (CT), and MR angiography (MRA). Aortography revealed an anomalous systemic arterial supply to the left basal lung. Physical examination revealed no abnormal findings except for weak breathing sounds around the left lower back lung field. In September 1999, the patient underwent surgical operation. By intrathoracic observation, the aberrant artery (9 mm in diameter) was found to branch from the thoracic aorta and to supply the left basal segment. Telangiectasia on visceral pleura of the S10 was observed. Although two pulmonary arteries were observed, they were as thin as 2.5 mm. The aberrant artery was separated after triple ligation and left lower lobectomy was performed. He was discharged from hospital 23 days after the operation. On July 10, 2014, 14 years and 9 months after the surgery, 3D CT was performed and showed no aneurysmal change of the cut end of the aberrant artery branch. The postoperative course was uneventful and the patient is doing well at 14 years and 9 months after surgery.

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A 57-year-old male tried to run onto a train, and bruised his left upper abdomen on the guard fence of the station platform. Epigastric acute pain developed and he was then quickly taken to a nearby hospital. He had oppressive pain and symptoms of peritoneal irritation in the epigastrium. On abdominal CT, free air was found around the liver surface. He was diagnosed as perforative peritonitis, and admitted to our department. Five hours after the bruising event, when the abdominal cavity was observed using a laparoscope, a moderate amount of contaminated ascitic fluid was found under the left diaphragm. Although no abnormality in the stomach or duodenum was found, an inflammation sign with white moss was observed around the upper small intestine, and thus a small incision (4cm) was made at the upper median abdominal area. When an external search was conducted, a perforation site of approximately 1.5cm by 1.0cm was observed on the small intestine about 35cm from Treitz' ligament toward the anus. After trimming, we closed the perforation site by suturing and completed the surgery. Clear lesions of other organs were not observed. His postoperative course was good, and he was discharged from our hospital on the 12th day after the surgery. Cases of small intestinal perforation due to blunt abdominal trauma are comparatively rare, and diagnosis of the perforation site prior to the surgery is difficult. We present a case in which diagnostic laparoscopy was useful for the identification and treatment of a gastrointestinal perforation site.

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