Aging processes being extremely complex, mechanisms of age-related hearing loss (ARHL) have not been elucidated. Although oxidative stress and apoptotic cell death are involved in progression of ARHL, number of trial to treat ARHL is limited. Heat shock response is characterized by induction of heat shock proteins (Hsps) in response to stresses such as heat shock, which diminishes during aging. Hsps act as molecular chaperones, and some Hsps also inhibit apoptotic pathways. Here, we examined age-related expression of Hsps in the cochlea of ARHL model DBA/2J mice and control CBA/N mice. Western blot assay revealed that CBA/N mice showed constant expression of Hsp70 and Hsp110 with age, but not in DBA/2J mice. The result suggests that pharmacological upregulation of Hsps might attenuate ARHL. We administered DBA/2J mice with food containing geranylgeranylacetone (GGA) that induces Hsps in the cochlea, and found that its administration suppresses ARHL examined by ABR test and histological examination though protection is specific for the apical part of the cochlea. These results demonstrate that dietary supplementation of GGA could be an effective therapeutic strategy for treatment of ARHL.

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Preventing air leaks after major lung resection for cancer is mandatory for successful fast-track surgery. We herein report our results of performing pneumostasis by combining bioabsorbable mesh and fibrin glue, without suturing. As a result, combining bioabsorbable mesh and glue reduced the duration of chest tube drainage, postoperative hospital stay, and pulmonary complications after major lung resection for cancer.

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Purpose: To evaluate the fragility of the corneal endothelium after cataract surgery in diabetes patients. Patients and methods: 32 eyes of 32 cases were performed cataract surgery, and measured corneal endothelial cell density (CD) and central corneal thickness (CCT). The amount of changing value each index both before and 1, 3, 7, 14 and 30 days after surgery. All patients were divided in two groups by FBS (fasting blood sugar) 110 mg/dl or HbA1c 5. 8% of preoperation blood examination, and each groups were compared. Results: The changing value of CD at 1day of high-FBS group (n=13) was significantly increased (P< 0. 05) than normal FBS group (n=19) . Thereafter it became stable with the same level of normal group at 1 month. Each of the changing value of CD was increased in high-HbA1c group (n=14) at 1day and in normal HbA1c group (n=18) for 1 week. The CCT changing value were not difference between each groups. Conclusion: Corneal endothelium is more fragile to cataract surgery in high-FBS groups, although it could be compensated. It is important minimum surgical damage to endothelium at cataract surgery to diabetes patients and more stable control of blood sugar before surgery.

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We conducted a retrospective study investigating the clinical features, prognoses and prognostic factors of 21 patients who underwent resection of pulmonary metastases from colorectal cancer. There were 11 men and 10 women, with an average age of 66 years old. The average interval between the primary and secondary operations was 894 days. Fewer than three lung tumors were resected at each operation, the average number of tumors was 1. 29, and the average dimension was 19. 1mm. Fourteen patients underwent partial resection of the lung, 1 underwent segmentectomy, and 6 underwent lobectomy. One patient underwent partial resection of both lungs simultaneously. There were no major complications in the perioperative period. Five of the seven late deaths were cancer-related, and the 5-year survival rate after lung resection was 45. 2%. Nine patients suffered recurrence:in the lungs in four, the liver in four, and locally in one. The disease-free 5-year survival rate after lung resection was 29. 8%. The overall survival of eight patients with liver metastases was poor, but there were no other significant factors. These findings suggest that a better prognosis can be achieved by performing complete resection of lung metastases, although further investigation of prognostic factors is necessary.

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We sometimes encounter cases requiring a laparoscopic gastrectomy along with postlaparoscopic cholecystectomy. In these cases, we need to perform an unusual and difficult procedure for adhesion of the bulbus and the hepatoduodenal ligament. Seprafilm^TM is known to reduce the incidence and the extent of peritoneal adhesion. However, it is difficult to place Seprafilm^TM via laparoscopic surgery. We report a new technique for placement of Seprafilm^TM under the laparoscopic cholecystectomy. Laparoscopic placement of Seprafilm^TM is carried out in 6 steps as follows: (1) preparation for inserting the delivery tube using an Endopouch Retriver^TM, (2) division of Seprafilm^TM into 3cm×6cm pieces along with its covering paper, (3) rolling of each piece and tying it with a rubber band, (4) inserting the rolled Seprafilm^TM into the delivery tube, (5) pushing the rolled piece with a 10mm Cherry Dissector^TM, and (6) under laparoscopic view, directing the delivery tube to the desired location and pushing out the piece with the Cherry Dissector^TM. The pushed piece spreads automatically. In this method, there is no need to grasp the Seprafilm^TM, and it can be easily placed while keeping it dry.

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We report a rare case of Crohn's disease with AA amyloidosis without renal involvement. A 73-year-old woman was admitted to our hospital with fever and diarrhea. We observed severe distension of the colon by the abdominal X-ray on hospitalization. Abdominal CT revealed edematous wall thickening from the ileum to the colon, and extension of the ileum. AA amyloidosis was diagnosed histologically by duodenal endoscopic biopsy specimen. We did not find any lesions in the colon by colonoscopy. Intestinal radiographic examination revealed many areas of stenosis and distension, longitudinal ulcer, and aphthoid lesions in the small intestine. Medical treatment was carried out by the diagnois of Crohn's disease with amyloidosis. Symptoms such as the diarrhea were improved with bowel rest by fasting and antibiotic intravenous injections, but her symptoms exacerbated when the diet was changed to per os. Patients with AA amyloidosis in Crohn's disease often have renal dysfunction such as nephrotic syndrome due to renal amyloidosis, but we did not observe any signs of renal dysfunction such as proteinuria in the clinical course of this patient. By maintaining her Crohn's disease in remission, this patient has remained in good condition without any exacerbation symptoms of gastrointestinal amyloidosis for four years.

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