Background and Aims : Human follicles selected for further development are thought to receive precise signals from gonadotropins and locally produced growth factors for survival. In this experiment, the mechanisms of the regulation of proliferation and steroidogenesis by GDF-9 and Br-cAMP in human ovarian cells were investigated. Methods : SVOG cells were cultured and treated with GDF-9 and Br-cAMP. The expression of HOXA7 and cofactors were examined by Western blot analysis and/or RT-PCR. The cell proliferation was measured by thymidine incorporation assay. Results : Treatment with GDF-9 resulted in a significant increase of cell proliferation. Although the treatment with Br-cAMP increased the expression of StAR protein, this treatment resulted in a significant decrease of cell proliferation compared with the control and no change in HOXA7 or its cofactors. Conclusion : The present study demonstrated that GDF-9 had a stimulatory effect and cAMP had an inhibitory effect on the proliferation of SVOG cells. These results may reflect the characteristics of this human cell line as luteinized granulosa cell. Therefore, this culture system will be useful for studying the effects of local factors and gonadotropin on the regulation of human luteinized granulosa cells in the future.

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In 1987 we started renal transplantation program with cyclosporine at our institution, Department of Urology in Gunma University Hospital.During this 20-year period, we have performed 19 cadeveric renal transplantations.The graft survival rates were 95% (1 year), 76% (5 years), 44% (10 years), and patient survival rates were 100% (1 year), 87% (5 years), 73% (10 years). These results were similar to those of nationwide study and reports from other institutions.

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Aims : We held a workshop for nurses on the proper method of disposal of medical waste and reviewed the current ways adopted for waste disposal. Then, we studied the effects of the workshop on the amount of medical waste and the nurses' knowledge of medical waste disposal.
Materials and Methods : We held the workshop for 64 nurses at Hospital A and changed the method of classifying medical waste at this hospital, where all medical waste was treated as infectious waste. We, therefore, provided instructions for dividing the waste into three types : infectious waste, industrial waste and general waste. Then, we evaluated the effect of the workshop on the amount of infectious waste and the nurses' knowledge of it medical waste disposal.
Result : The average score in a test on waste classification increased from 9.0 (SD3.6) to 10.9 (SD3.1). (P<0.001) -on a maximum score of 14. Also, the amount of infectious waste decreased.
Conclusion : The workshop increased the knowledge of the nurses on the classification of medical waste, and changing the method of classifying medical waste decreased the amount of infectious waste.

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Video-assisted thoracoscopic surgery has been useful for resection of a cystic mass in the mediastinum. However, there are difficulties that a thin wall of the cyst are easy to rupture, and that a large and tension cyst also interferes with a thoracoscope vision. Therefore, we present herein a convenient method using a Foley catheter and dye. A cystic mass is punctured directly with a needle and the content is aspirated. After removal of the needle, an 18F Foley urethral catheter is inserted into the mass. Then, the balloon is inflated with normal saline, and the content in the mass is almost removed through another lumen of the Foley catheter. Next, the cystic mass is inflated with diluted indocyanine green (ICG) through the lumen, , and refilled with an adequate volume of ICG solution to detect the wall. The ICG solution is aspirated, and removal of the mass is accomplished simply by deflating the balloon. Finaly, the mass can be removed from the thoracic cavity. Using ICG can make the margin clearer. We have successfully treated 2 patients with this technique.

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We herein report two very rare cases of esophageal foreign bodies that were removed using an endoscopic esophageal balloon dilation catheter with an attached percutaneous transluminal coronary angioplasty (PTCA) inflation device. Esophageal food impaction is a common medical emergency that often requires endoscopic therapy. However, the cases we report involve an ume seed and a shell, respectively, which are very rare in food impaction. We attempted to remove the foreign bodies using the usual endoscopic removal technique, but were unable to do so. As an alternative approach, we used an endoscopic esophageal balloon dilation catheter, and this proved to be successful and safe. Therefore, we conclude that this removal technique is useful for difficult cases of food impaction that cannot be treated using the normal procedure.

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An 18 year-old male was admitted to our hospital suffering from a large tumor which was located at the right frontal bone. He was diagnosed to have acute myeloid leukemia (AML) with granulocytic sarcoma (GS). A chromosomal analysis showed t (8 ; 21), and a flow cytometric analysis demonstrated the leukemic cells to be positive for CD56.
Systemic chemotherapy and radiation therapy to the GS, but the patient experienced a relapse in the lumbar vertebrae. He underwent an umbilical-cord blood stem cell transplantation, however, he died 7 months thereafter. GS is a localized tumor consisting of leukemic myelolasts, which is generally observed as a complication of either AML, myelodysplastic syndrome, or myelobproliferative disorders. We herein report this case due to its rarity, even though various sites of GS have been reported.

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