A randomized controlled trial was conducted to ascertain whether bone mineral density (BMD) in the proximal femur and L2-4 could be increased by instructing elderly persons to stand on one leg for 1 min 3 times/day to apply mechanical stress, i.e., body weight applied to the femoral head. Subjects were 47 outpatients ≥ 60 years old (3 men, 44 women). Data were analyzed for 18 women who performed the exercise and 13 women who did not. Dual-energy X-ray absorptiometry was performed to measure BMD. No significant differences were seen in the percent change in BMD in L2-4 or proximal femur between groups. Comparing the number of subjects with increased BMD from L2-4 to Ward's triangle at month 6 of the study revealed the only significant difference to be in the neck BMD (7 of 11 women in the exercise group vs. 2 of 10 women in the control group; P = 0.0436). One-minute unipedal standing with eyes open seemed effective for improving femoral neck BMD in patients with osteoporosis and preventing hip fractures, particularly in elderly individuals.

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The expression of the CD133 cancer stem cell marker correlates with metastasis and prognosis for many cancers, but no correlation has been established in colorectal cancer. We used immunohistochemical analysis to examine the relationship between CD133 expression and clinical malignancy factors such as lymph node metastasis and hepatic metastasis in colorectal cancer. The subjects of this study were 104 patients with colorectal cancer who were examined in our hospital and treated by surgical excision of the tumor between 2004 and 2007. Representative tissue sections were immunohistochemically stained using an anti-CD133 antibody. Patients showing staining of 50% or more of the tumor gland duct were classified into the CD133-positive group, which consisted of 36 patients. Those staining less than 50% of the tumor gland duct were classified into the CD133-negative group, which consisted of 68 patients. Patients with lymph node metastasis accounted for 63.9% of the positive group (23/36 patients) and 33.8% of the negative group (23/68 patients), and the difference was significant (P = 0.00331). Patients with hepatic metastasis accounted for 27.8% of the positive group (10/36 patients) and 10.3% of the negative group (7/68 patients), and the difference was significant (P = 0.0218). Classification of these patients according to cancer stage determined on the basis of the International Union Against Cancer (UICC) stage showed that five patients were in stage I, one patient in stage II, 20 patients in stage III, and 10 patients in stage IV in the positive group; and 20 patients were in stage I, 22 patients in stage II, 18 patients in stage III, and eight patients in stage IV in the negative group. There was a significant difference in the numbers of patients in each group (P = 0.000127). Differences in the number of patients with lymphovascular invasion and those with venous invasion were also significant between the groups (P = 0.0248 and P = 0.0292, respectively). No significant differences were observed for any other factors. These findings indicate that the CD133-positive group has a higher risk of metastasis.

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The aim of the present study was to evaluate the correlation between parameters of the videofluoroscopic dysphagia scale (VDS) and the outcome of dysphagia to determine the usefulness of the VDS in patients admitted to convalescent rehabilitation wards. Patients (n = 23) with stroke-related dysphagia admitted to our rehabilitation hospital between April 2007 and March 2009. Medical records and videofluoroscopy findings on admission to hospital were reviewed retrospectively and the VDS score was calculated by adding individual VDS parameters. Subjects were divided into two groups: those who were able to ingest orally without tube feeding before discharge (Group 1) and those who still needed tube feeding on discharge (Group 2). The VDS scores were compared between the two groups. There were no significant differences in any individual parameter on the VDS between the two groups. However, the total VDS score was significantly lower in Group 1 patients (p < 0.05), as was the time from stroke onset to admission to our hospital (p < 0.05). There were no significant differences in any other parameters evaluated. The findings of the present study suggest that the total VDS score may be useful in predicting the prognosis of stroke-related dysphagia.

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Visceral fat accumulation in lifestyle-related diseases increases the risk of atherosclerosis. Matrix metalloproteinases (MMPs) play an important role in the progression of atherosclerosis. We examined atherogenic factor-overlapped model rats to clarify the relationships among visceral fat, oxidative stress, and MMPs. We used four groups of male, 11-month-old, spontaneously hypertensive hyperlipidemic rats (SHHRs) or Sprague-Dawley (SD) rats. Animals were fed either a diet of high fat and 30% sucrose solution (HFDS) or a normal diet (ND) ad libitum for 6 months. The visceral fat weight increased by approximately three fold in SHHR-HFDS compared to SHHR-ND. The oxidative stress marker in plasma and MMP-9 mRNA expression in white blood cells increased in SHHR-HFDS compared to the other groups. A correlation was determined between oxidative stress and visceral fat or MMP-9 mRNA in all rats. Lipid deposition and immunostaining of CD68 and MMP-9 were observed mainly in the intima of aorta in SHHR-HFDS, while tissue inhibitor of metalloproteinase-1 mRNA expression decreased in both SHHR groups. The findings suggested that increased oxidative stress due to the visceral fat accumulation induced MMP-9 expression and macrophage accumulation in the intima of aorta in lifestyle-related disease model rats.

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This study investigated the effect of N-[2- (2-oxo-1-imidazolidinyl) ethyl]-N-phenylurea (ethylene diurea, EDU) on oxygen-induced ischemic retinopathy (OIR) in a neonatal rat model. OIR was induced by maintaining daily cycles of 80% oxygen (20.5h), ambient air (0.5h), and a progressive return to 80% oxygen (3h) for 12 days (postnatal day: P12). The rats were treated intraperitoneally with EDU (30mg/kg body weight) or distilled water (DW) from P6 to P17. At P18, the percentage of avascular areas in the total retinal area (%AVA) was measured, and retinal neovascularization (NV) was scored in ADPase-stained retinas. Retinal superoxide dismutase (SOD) activity in the retina was also determined by a chemiluminescence method. The mean %AVA in the EDU-treated group (9.3 ± 1.7%, n = 16) was lower than in the DW group (18.2 ± 4.7%, n = 17). EDU did not significantly affect NV, but significantly increased SOD activity (1.36 ± 0.13 units/mg protein, n = 4) compared to DW treatment (1.04 ± 0.01 units/mg protein, n = 4, P = 0.032) at P18. These results suggest that EDU treatment decreased the %AVA, accompanied by an increase in normal retinal vascular growth and/or a decrease in vessel proliferation. The increased SOD activity observed in the present study is likely to involve the EDU-mediated effects.

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Myelodysplastic syndromes are a heterogeneous group of clonal hematopoietic stem cell disorders characterized by persistent peripheral cytopenia with morphological and functional abnormalities of hematopoietic cells. Mast cells infiltrate into or around tumor tissues and play a role in remodeling of the stromal microenvironment, contributing to tumor progression. Increased mast cell numbers are associated with fibrosis, angiogenesis and a poor prognosis in human carcinomas. The aim of this study was to determine whether mast cell infiltration contributes to myelofibrosis or angiogenesis in myelodysplastic syndromes. We evaluated the correlation between mast cell density and the extent of myelofibrosis and angiogenesis in myelodysplastic syndromes. Fifty bone marrow biopsies taken from patients with a diagnosis of myelodysplastic syndromes were examined. Grading of myelofibrosis was evaluated by silver impregnation staining. Mast cell density and microvessel density were evaluated by immunohistochemistry. Human mast cells have been divided into two phenotypes. We designated a tryptase-positive mast cell as MC_T and a chymase-positive mast cell as MC_TC. Microvessels were identified by CD34-positive endothelial cells. Microvessel density and the extent of myelofibrosis were significantly greater in patients with high MC_T and MC_TC density compared to those with low MC density. Based on this, we suggest that the presence of high mast cell numbers is associated with myelofibrosis and angiogenesis in myelodysplastic syndromes.

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We report here the first case of early gastric carcinoma showing the histological features of choriocarcinoma and hepatoid adenocarcinoma. A 68-year-old woman was admitted to our hospital for treatment of gastric cancer detected by her primary care physician. X-ray examination of the stomach and esophagogastroduodenoscopy revealed a 0-I type, 25 × 20mm tumor occupying the greater wall of the upper gastric body. The biopsy specimens obtained from the tumor revealed a poorly differentiated adenocarcinoma, and a total gastrectomy with lymph node dissection was carried out. Macroscopically, there was a protruding lesion (0-I type) measuring 25 × 20mm in size in the upper third of the greater curvature of the stomach. Microscopically, features of choriocarcinoma and hepatoid adenocarcinoma were present in the tumor. Immunohistochemically, the choriocarcinoma component was positive for the β-subunit of human chorionic gonadotropin and human placental lactogen. The hepatoid carcinoma component was positive for α-fetoprotein. To the best of our knowledge, there is only one similar case report of advanced gastric cancer, the our present patient is the first case of early gastric carcinoma showing the coexistence of choriocarcinoma and hepatoid carcinoma. This patient is still alive 19 months after surgery, without recurrence.

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Peutz-Jeghers (P-J) syndrome is an inherited disorder characterized by multiple hamartomatous gastrointestinal polyps, mucocutaneous pigmentation, and an increased risk of both digestive tract and non-digestive tract cancers. P-J type polyps are characteristic of P-J syndrome but rarely present as solitary polyps. Though cancerous lesions frequently develop from polyposis in P-J syndrome, reports of malignancy in solitary colorectal P-J type polyps are rare; our literature search identified only two examples. This report describes a non-Peutz-Jeghers syndrome patient with a solitary P-J type polyp showing the hamartoma-adenoma-carcinoma sequence.

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