Androgen promotes squamous differentiation of atypical cells in cervical intraepithelial neoplasia via an ELF3-dependent pathway.

Background: Since the human papillomavirus vaccines do not eliminate preexisting infections, nonsurgical alternative approaches to cervical intraepithelial neoplasia (CIN) have been required. We previously reported that FOXP4 (forkhead box transcription factor P4) promoted proliferation and inhibited squamous differentiation of CIN1-derived W12 cells. Since it was reported that FOXP expressions were regulated by the androgen/androgen receptor (AR) complex and AR was expressed on the CIN lesions, in this study we examined the effects of androgen on CIN progression.

A case of synchronous high-grade cervical intraepithelial neoplasia and metastatic squamous cell carcinomas of unknown primary in rectum.

We report a case of synchronous high-grade cervical intraepithelial neoplasia (CIN) and metastatic squamous cell carcinomas (SCCs) of unknown primary in the rectum. A 74-year-old woman was diagnosed with CIN3 by biopsy of the uterine cervix. Magnetic resonance imaging showed two masses in the outer rectal wall.

Mucinous, endometrioid, and serous ovarian cancers with peritoneal dissemination are potent candidates for P-cadherin targeted therapy: a retrospective cohort study.

Background: Aberrant expression of P-cadherin has been reported in various cancers, and has been attracting attention as a target for cancer treatment. Ovarian cancer, the leading cause of death among gynecologic malignancies, is classified into four histological subtypes: serous, mucinous, endometrioid, and clear cell, and each has distinct biological behavior. Although a negative survival impact in serous ovarian cancer patients and some functional role in peritoneal dissemination have been reported, differences of P-cadherin expression in histological subtypes and the proportion and distribution of positive cells remain to be investigated.

A direct endoscopic approach for left-sided infrarenal para-aortic lymphadenectomy immediately after hysterectomy for endometrial cancer treatment: left dome formation (LDF).

Background: Endoscopic surgery for infrarenal para-aortic lymphadenectomy has been widely accepted. Two major approaches, "transperitoneal" and "extraperitoneal", are generally used; however, they have several disadvantages. A "transperitoneal" approach to the left para-aortic region is usually indirect, often performed after wide extension of the right para-aortic region.

Comparison Study of BD Onclarity HPV With digene HC2 High-Risk HPV DNA Test and Roche Cobas 4800 HPV for Detecting High-Risk Human Papillomavirus in Japan.

Objectives: To evaluate the clinical performance of novel detection kits for 14 high-risk human papillomavirus (hrHPV) types with the BD Onclarity HPV Assay (Onclarity; Becton Dickinson, Sparks, MD).

Methods: Two cervical specimens from 144 women were obtained and placed in BD SurePath Collection Vials. The first specimen was used for cervical cytology and digene HC2 High-Risk HPV DNA Test (HC2; Qiagen, Germantown, MD), and the second specimen was used for Onclarity and Roche Cobas 4800 HPV (Cobas; Roche Molecular Systems, Pleasanton, CA).

Detection of circulating tumor cells in cervical cancer using a conditionally replicative adenovirus targeting telomerase-positive cells.

Circulating tumor cells (CTC) are newly discovered biomarkers of cancers. Although many systems detect CTC, a gold standard has not yet been established. We analyzed CTC in uterine cervical cancer patients using an advanced version of conditionally replicative adenovirus targeting telomerase-positive cells, which was enabled to infect coxsackievirus-adenovirus receptor-negative cells and to reduce false-positive signals in myeloid cells.

Solitary Gastric Metastasis from a Stage IA Serous Ovarian Carcinoma: A Case Report with Literature Review.

Gastric metastasis from ovarian cancer is exceptionally rare and generally occurs in advanced stages. A 71-year-old woman presented with a solitary gastric submucosal mass 8 years after the diagnosis of a stage IA ovarian serous adenocarcinoma. Endoscopy showed a tumor covered with normal gastric mucosa.

FDG-PET-positive ovarian thecoma with GLUT5 expression: Five cases.

Positron emission tomography (PET) with fluorodeoxyglucose F18 ( F-FDG) is useful for detecting malignancies, but benign lesions occasionally have false-positive F-FDG uptake. Here, we report the cases of five postmenopausal women with solid ovarian tumors suspected to be ovarian cancer on magnetic resonance imaging and F-FDG uptake. Mean age of the five patients was 57 years (range, 53-65 years).

Enterocele: what is the clinical implication?

Purpose: Because of the rarity of diagnosis, the clinical implication of enterocele remains unclear. This study was designed to clarify the characteristic symptoms and the role of surgical treatment for enterocele.

Methods: We reviewed a defecography database prospectively maintained from 1998 to 2004.

Clinical and physiologic outcomes after transvaginal rectocele repair.

Purpose: This study was designed to evaluate the clinical and physiologic outcomes after transvaginal rectocele repair.

Methods: Between June 2000 and January 2003, 30 females (mean age, 62 (range, 45-78) years) with a symptomatic large rectocele (>3 cm) underwent transvaginal rectocele repair (anterior levatorplasty). Six months after surgery, a physiologic evaluation was performed by using defecography (depth of rectocele) and anorectal manometry (maximum resting pressure, maximum squeeze pressure, rectal threshold, and maximum tolerable volume).

Sclerosing therapy of internal hemorrhoids with a novel sclerosing agent. Comparison with ligation and excision.

Background And Aims: Patients with prolapsing internal hemorrhoids were treated with a novel sclerosing agent (OC-108), and the results were compared with surgery of ligation and excision.

Patients And Methods: This study included 20 years or older patients with prolapsing internal hemorrhoids who visited ten medical institutions in Japan from October 2000 to October 2002. Investigation on surgery was also performed.

Perineal puborectalis sling operation for fecal incontinence: preliminary report.

Purpose: This study was designed to evaluate the safety efficacy, and impact on quality of life of the perineal puborectalis sling operation for fecal incontinence.

Methods: Since August 2001, we performed the perineal puborectalis sling operation on eight patients with idiopathic fecal incontinence. A specially designed polyester mesh sling was introduced along the puborectalis muscle, from a posterior perianal incision, running to a small suprapubic incision.

Mucosal plication (Gant-Miwa procedure) with anal encircling for rectal prolapse--a review of the Japanese experience.

Although mucosal plication for rectal prolapse, known as the Gant-Miwa procedure, is described in some English textbooks, it has been infrequently performed in the West. However, this procedure has been used and developed in conjunction with anal encircling in Japan since the 1960s and is still considered to play a major role in the treatment of rectal prolapse. Certain technical details have been found necessary to ensure the success of the procedure, especially in the technique of anal encircling.

Long-term results and quality-of-life outcomes in patients with transsphincteric fistulas after muscle-filling procedure.

Purpose: This study was designed to evaluate long-term results and quality-of-life outcomes after the muscle-filling procedure for posterior transsphincteric fistulas.

Methods: A questionnaire was mailed to 207 patients who had been treated by the muscle-filling procedure for posterior transsphincteric fistulas with cryptoglandular origin at the Social Health Insurance Hospital during a ten-year period. One hundred fifty-one patients who returned their questionnaires were included in this retrospective study.

Identification of genes upregulated in the inflamed colonic lesions of Crohn's disease.

To identify the molecular mechanism which primarily plays a role in the pathogenesis of Crohn's disease (CD) without prior hypothesis, differential display method was employed to detect differentially expressed genes between the inflamed and uninflamed colonic samples from one patient with CD. The mRNA levels of these genes were subsequently semi-quantitated in affected and unaffected tissues from six patients using reverse transcriptase polymerase chain reaction (RT-PCR). Six genes including long form FLICE inhibitory protein (FLIP(L)) were found to be consistently overexpressed in the inflamed colonic CD tissues.

Sphincter-preserving techniques for anal fistulas in Japan.

After the articles by Eisenhammer, Parks, Hanley, and Goligher and the classification system established by Sumikoshi, surgeons in Japan became very active in creating and modifying new sphincter-preserving surgical procedures for low intersphincteric and ischiorectal fistulas. This article reviews the literature, summarizes each procedure, identifies the transitions, and discusses recurrence rates, cures, and subsequent variations. Japanese surgeons favor sphincter-preserving techniques for low intersphincteric fistulas that involve partial or complete coring out of fistula tracts.

Tacrolimus in corticosteroid-resistant ulcerative colitis.

We report a case of refractory ulcerative colitis treated with tacrolimus. The patient was a 73-year-old woman with a 45-year history of ulcerative colitis. An attack unresponsive to intravenous corticosteroid therapy occurred when she was age 73.

Muscle-filling procedure for transsphincteric fistulas.

Purpose: During transsphincteric fistula surgery, laying open the entire fistula track can cause grave damage. Thus, a surgical procedure that excises the primary abscess only is preferable. However, the primary abscess of a transsphincteric fistula is located in the postanal space.

[Team approach of Crohn's disease therapy].

Under the current conditions that etiologies of Crohn's Disease (CD) are not detected and then no radical therapy existed, it is necessary that the CD patients can be medically managed by not only medical doctors but also other co-medical staffs such as nurses, dietitians, social workers and ET (Enterostomal Therapist) nurses for their cure & care therapy. There are some different therapeutic steps; 1) Nutritional Therapy, 2) Drug Therapy, 3) Surgical Therapy and 4) Psychological (Mental) Support. In Japan, Nutritional Therapy headed by Elemental Enteral Nutrition is recommended as for 1st choice standard therapy for CD patients, who are mainly very young and are required to have themselves acceptable for long-term therapeutic controls.