Aims: To survey the changes in serum lipid profiles in patients with hypertension up to 12 months, and to investigate correlations between these values and the time after the start of olmesartan monotherapy. Methods: We retrospectively examined longitudinal changes in serum lipid profiles in patients with mild to moderate hypertension that had been newly treated with olmesartan monotherapy. Data from 139, 150, 185 and 188 patients were obtained for high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and total cholesterol (TC) levels, respectively, from the Clinical Data Warehouse of Nihon University School of Medicine. Generalized estimating equations and generalized linear mixed model with an inverse probability of treatment weighting method were used to analyze the relationships between these longitudinal blood examination data and explanatory variables of patient sex, age, diagnosis of diabetes mellitus (DM) and duration of olmesartan monotherapy. Results: Serum HDL-C and TC levels were associated with sex, but not with age, diagnosis of DM or duration of treatment. TG level was associated with the diagnosis of DM, but not with sex, age or treatment duration. LDL-C level was not associated with any of the explanatory variables. Subgroup analysis of the subjects divided by diagnosis of DM revealed a decrease in TC level in non-DM subjects (p = 0.0284), but not in DM subjects. Dunnett’s multiple-comparison test showed that none of the lipid parameters were changed significantly compared with baseline at any time point. Conclusions: Our study revealed that HDL-C, LDL-C, TG and TC levels were not influenced by olmesartan monotherapy up to 12 months. With respect to lipid metabolism, olmesartan may be used safely for patients with hypertension, because the effect on lipids may be negligible.
Background: It remains unknown whether knowledge of the status of progesterone receptor (PR) expression is useful for distinguishing between luminal A and B breast cancer subtypes and for providing an accurate prognosis for patients with estrogen receptor-positive (ER+) and human epidermal growth factor receptor 2-negative (HER2-) breast cancer. We aimed to assess the role of PR status in determining the biology and prognosis of early ER+ and HER2- breast cancer. Methods: This was a retrospective study of 105 patients with ER+ and HER2- breast cancer who underwent surgery between 2005 and 2013. Relapse-free survival (RFS), distant-metastasis-free survival (DFS) and overall survival (OS) were evaluated. The prognostic value of PR was evaluated using a Cox regression model. Results: Apart from the menstruation status, there were no significant differences between the PR+ and PR- patients. PR- patients exhibited a tendency towards a higher nuclear grade and Ki-67 labeling index. In particular, postmenopausal patients with PR expression status < 10% exhibited a significantly higher nuclear grade and tendency towards a higher Ki-67 labeling index. After a median follow-up of about 5 years, the 5-year RFS, DFS and OS rates of the PR+ and PR- patients were not significantly different. PR was not a significant prognostic factor by multivariate analysis. Conclusion: PR status does not have prognostic value for patients with early ER+ and HER2- breast cancer who received adequate therapies. However, it may be reasonable to use PR status for distinguishing between luminal A and B breast cancer subtypes.
We performed a proteomic analysis of human intervertebral discs to elucidate molecules that could be effective targets for the prevention and treatment of intervertebral disc degeneration. We obtained intervertebral discs from cases of degenerative spondylolisthesis (6 samples), lumbar disc herniation (7 samples), and autopsy specimens (5 samples), and prepared the respective protein extracts. To remove collagens and proteoglycans, which account for most of the proteins, we eliminated proteins > 100 kDa from the protein extracts using an ultra-filter, and the remaining fractions were subjected to LC-MS/MS using an ABI QSTAR. After comparing the protein profiles between these three groups, several disease-specific proteins were found: activation of complement was related to degenerative spondylolisthesis, and KRT3 was related to lumbar disc herniation. TTR was commonly related to both diseases. Thus, proteomic analysis of human intervertebral discs was possible using LC-MS/MS. Protein expression profiles that are characteristic of these diseases were elucidated. These results suggest novel potential target molecules for the prevention and treatment of intervertebral disc degeneration.
We report 3 cases of postoperative chylous ascites after laparoscopic colorectal cancer surgery. The first case was a 65-year-old man who underwent laparoscopic right hemicolectomy with D3 lymphadenectomy for ascending colon cancer. Chylous ascites began to develop the day after commencement of oral intake. He was treated by fasting and drainage. Once the chyle leakage had reduced the drainage tube was removed. He was discharged on the 21st postoperative day. The second case was a 60-year-old woman, and the third case was a 53-year-old man. They had both undergone laparoscopic high anterior resection with D3 lymphadenectomy for rectal cancer. Chyle leakage occurred, but was treated successfully by drainage alone in each patient. Fasting and total parenteral nutrition are not necessarily required in the treatment of chyle leakage after laparoscopic colorectal cancer surgery. It is important to diagnose chyle leakage early and to adequately drain it off.
A 40-year-old male visited our hospital with the chief complaint of exertional dyspnea, and was admitted due to severe left ventricular (LV) dysfunction. Although he received optimal medical therapy, including inotropic infusions, his signs and symptoms worsened during the hospital course, due to low-cardiac output, and he ultimately required intra aortic ballon pumping. Upon further investigation, he was diagnosed as having idiopathic dilated cardiomyopathy (DCM) and was approved as a candidate for heart transplant by the hospital committee. Consequently, implantation of a LV assist device (HeartMate II®) was performed to bridge the time to transplant. Herein, we report this first case of the use of the Heart Mate II in Nihon University for a young patient with severe LV dysfunction due to DCM.
A 63-year-old man exhibited an abnormal shadow in the lung during a routine physical examination and was admitted to our hospital. He was diagnosed with either hepatocellular carcinoma or poorly differentiated adenocarcinoma by percutaneous CT-guided lung tumor biopsy. Preoperative blood test showed normal serum AFP (alpha-fetoprotein) levels and high serum PIVKA-II (protein induced by vitamin K antagonist II) levels. Histologically, tubular adenocarcinoma with sheet-like proliferation and atypical trabecular cells were observed. Five years after surgical resection of the tumor, there has been no apparent recurrence.
The patient was a 73-year-old man. After receiving the diagnosis of abdominal distension and renal impairment at a nearby clinic, he was referred to our hospital for further detailed examination. He exhibited hypercalcemia associated with paraneoplastic syndrome, and abdominal CT scans showed a 37 cm mass in the abdominal cavity. He was diagnosed as having a giant intraperitoneal tumor and underwent laparotomy to improve his quality of life. The tumor was considered to have originated around the iliopsoas muscle, and was completely resected macroscopically. The tumor weighed 9.1 kg, and its fluid content was brown with a volume of 12,200 mL. The tumor was confirmed histopathologically to be a dedifferentiated liposarcoma. We report this case of a patient with a giant dedifferentiated liposarcoma with hypercalcemia and provide a review of the relevant literature.
Advances in stereotactic and functional neurosurgery during the second half of 20th Century have opened up an important new area in which collaboration between neurosurgeons and specialists in neurorehabilitation provides benefits for the control of a wide variety of disabilities caused by the damaged nervous system. It was for this reason that the Neurorehabilitation and Reconstructive Neurosurgery Committee was established within the World Federation of Neurosurgical Societies (WFSN) in 2000. Furthermore, the International Society for Reconstructive Neurosurgery (ISRN) was founded in 2005, in order to facilitate more the contribution of neurosurgeons working in the field of reconstruction of the nervous systems. The present paper summarizes briefly the history of this field of endeavor and its rapid development in close association with relevant areas of neurosurgery.