The main treatment options for malignant tumors are surgery, chemotherapy, and radiotherapy. Surgical reconstruction is important to preserve vital functions and the patient's social wellbeing following tumor resection. Head and neck, esophageal, breast, and orthopedic surgical reconstructions are frequently performed. Some cases are complicated by delayed wound healing due to radiotherapy, malnutrition, and other factors. A variety of advanced reconstructive techniques, ranging from skin grafting to the use of free flaps, pedicled flaps, and artificial materials, have been developed. In our experience of treating patients with hypopharyngeal and esophageal cancers, reconstructive surgery, mainly autologous transfers such as free jejunal transfer, enables aggressive resection. Successful engraftment of reconstructed tissues and minimization of complications are important to preserve vital functions, particularly feeding and respiration.
Air pollution is associated with significant adverse health effects, including increased morbidity and mortality. The global increase in the prevalence of diseases that are associated with exposure to air pollution is of great concern. In particular, severe PM2.5 (particles less than 2.5 micrometers in diameter) pollution occurs in Asian countries due to increasing emissions of air pollutants caused by the countries' rapid economic growth. Many studies have been performed to clarify the association between PM2.5 and disorders such as asthma, ischemic cardiovascular diseases, arteriosclerosis, cancer, neurological disorders, and diabetes mellitus. It is important to protect populations that are susceptible to such pollution. While the characterization and monitoring of pollutant components currently dictates pollution control policies, it will be necessary to identify susceptible populations in order to adequately target prevention strategies for the health effects of air pollution. This review describes the recent advances in our understanding of the health effects of PM2.5 and the role of oxidative stress in these effects, and discusses prevention strategies.
The estrogen receptor α (ERα) functions as a ligand-inducible transcription factor and plays pivotal roles in various biological processes in reproductive and non-reproductive organs. Expression of the ERα gene is subject to complicated regulation. The gene has a multiple promoter system which regulates spatial and temporal expression of ERα transcripts. Furthermore, the 5′-untranslated regions (5′-UTRs) of ERα mRNAs have shown potency for post-transcriptional modulation. To elucidate the regulatory mechanisms of ERα expression, we comparatively examined the genomic organization of the 5′-regions of the ERα genes and the splicing profiles of their transcripts with distinct 5′-ends. Our analyses revealed the presence of multiple novel promoters and untranslated exons in the 5′-regions of the genes and showed that alternative promoter usage and alternative splicing generate numerous ERα transcripts with unique 5′-UTRs in species-specific manners. In this manuscript, we review recent images of human, mouse, and rat ERα gene structures and describe alternative splicing and expression patterns of their 5′-UTR isoforms.
We report a case of lumbar vertebral fracture with severe osteoporosis due to ankylosing spinal disorder (ASD) in a 79-year-old woman who fell on her behind and was hospitalized for low back pain with first lumbar vertebral fracture (L1 fx.). She was transferred to our hospital for detailed investigation of the fracture after twelve days of conservative therapy. X-ray and CT images showed L1 fx. with ossification of the anterior longitudinal ligament at the level of the first thoracic vertebra to the fifth lumbar vertebra. Disc heights at each level between the vertebrae were maintained. Her bone mineral density was only 36% of the young adult mean. We concluded that the L1 fx. had occurred due to ASD with severe osteoporosis. After fifteen days of hospitalization for observation, an operation was performed for firm fixation with instrumentation and fiber cables from the eighth thoracic vertebra to the fifth lumbar vertebra (five above and four below fixation to L1 fx.). The patient was kept in bed for rest for four weeks after surgery so that the soft tissue in the operated region could heal. Rehabilitation was started with a tilting table for standing five weeks after the operation. Rehabilitation was suspended at six weeks because the patient suffered shortness of breath with pleural effusion, but it was re-started at nine weeks after three weeks of pleural effusion therapy in intensive care. She was able to walk at twelve weeks after the operation without any paralysis and was then transferred to another hospital for further rehabilitation. In cases of ASD, it is necessary to achieve firm fixation with instrumentation for vertebral fx. due to osteoporosis. This case of ASD showed the importance of long fusion fixation with instrumentation and fiber cables to maintain the posture of a patient with severe osteoporosis and to avoid instrumentation failure.