[Current status in molecular-targeted therapy and IFNα for renal cell carcinoma in Japan].

It has been two years since molecular-targeted therapy became available for advanced renal cell carcinoma (RCC) in Japan. It shall be validated whether molecular-targeted therapy really improved the prognosis of patients with advanced RCC in the near future. Here we review the two phase III clinical studies that demonstrated the superiority of sunitinib and temsirolimus over IFNα and discuss optimal therapy including IFNα for advanced RCC in the future biomarker era.

An accurate quantitative LC/ESI-MS/MS method for sirolimus in human whole blood.

Sirolimus is a widely used immunosuppressant that requires therapeutic drug monitoring (TDM). We optimized a preanalytical procedure that allows for the accurate quantiation of sirolimus in whole blood by LC/ESI-MS/MS with minimal matrix effects. Sirolimus is highly lipophilic, and solvents containing greater than 50% methanol were required to maintain sirolimus recovery.

Effect of Rikkunshi-to on appetite loss found in elderly dementia patients: a preliminary study.

Background: Functional gastrointestinal symptoms are frequently found in elderly dementia patients. In such a case, we attempt treatment by the administration of antidepressants or second-generation antipsychotics. However, these medications have a risk of side-effects.

Identification and elimination of ion suppression in the quantitative analysis of sirolimus in human blood by LC/ESI-MS/MS.

Ion suppression can negatively affect the performance characteristics of LC/ESI-MS/MS based methods, and we wished to identify sources of ion suppression in an assay for quantitating sirolimus in human whole blood. We first compared the peak areas of sirolimus and ascomycin added to human blood samples treated with and without extraction using octadecyl silyl (ODS)-silica gel after protein precipitation, and we found that water-soluble compounds cause the ion suppression for both drugs. Post-column infusion studies indicated that compounds retained in the sample after ODS extraction and protein precipitation caused ion suppression.

Vertical-coupling optical interface for on-chip optical interconnection.

We present a vertical-coupling optical interface with a grating coupler for transmitting and receiving optical signals between single-mode optical fibers and microphotonic waveguides with a view to realize on-chip optical interconnection. The optical interface consisting of a simple grating structure with a reflective mirror and an optical power combiner exhibits high optical coupling efficiency and wide tolerance range for the misalignment of optical fibers. The optical interface exhibits high coupling efficiency even if the optical input is almost vertical to the chip surface.

Evolutionary changes of the target sites of two microRNAs encoded in the Hox gene cluster of Drosophila and other insect species.

MicroRNAs (miRs) are noncoding RNAs that regulate gene expression at the post-transcriptional level. In animals, the target sites of a miR are generally located in the 3' untranslated regions (UTRs) of messenger RNAs. However, how the target sites change during evolution is largely unknown.

State classification of heart rate variability by an artificial neural network in frequency domain.

This paper examines the feasibility of accurate state classification of autonomic nervous activity (ANA) based on the power spectral pattern of the heart rate fluctuations (HRFs). Some attempts have been made to utilize artificial neural networks (ANNs) to classify HRFs for clinical diagnoses such as ischemic cardiomyopathy, arrhythmia or sleep apnea. To establish the firm bases for making such clinical diagnoses, it may be important to examine the classification accuracy for the data in physiologically well defined conditions by e.

[Family health assistance according to the psychoanalysis approaches: a proposal for caring].

These theoretical reflections are based on a critical assessment of practices which include the patient's family participation in the treatment of the individual in health services. The objective is to question the health work organization in the clinic approach which values a certain concept of man. When a family member looks for help, health professionals develop practices oriented by the conception of family as a harmonious system.

Origins and evolution of microRNA genes in Drosophila species.

MicroRNAs (miRs) regulate gene expression at the posttranscriptional level. To obtain some insights into the origins and evolutionary patterns of miR genes, we have identified miR genes in the genomes of 12 Drosophila species by bioinformatics approaches and examined their evolutionary changes. The results showed that the extant and ancestral Drosophila species had more than 100 miR genes and frequent gains and losses of miR genes have occurred during evolution.

The neutral theory of molecular evolution in the genomic era.

The neutral theory of molecular evolution has been widely accepted and is the guiding principle for studying evolutionary genomics and the molecular basis of phenotypic evolution. Recent data on genomic evolution are generally consistent with the neutral theory. However, many recently published papers claim the detection of positive Darwinian selection via the use of new statistical methods.

Late recurrence of giant cell tumour of bone after curettage and adjuvant treatment: a case report.

We report a rare case of late recurrence of a giant cell tumour (GCT) of bone 16 years after curettage and cryosurgery treatment. A 46-year-old man presented with swelling and progressively worsening pain in the lateral aspect of his right distal femur. He had undergone 4 procedures elsewhere to manage a GCT of bone and its recurrence 16 to 23 years previously.

[Effectiveness study of the universal newborn hearing screening].

This article discusses the insufficiency of family participation in a program of Universal Newborn Hearing Screening. As it is a premature detection of hearing alterations, with the possibility of reduction of damages caused by these, it becomes essential the family participation during all the diagnosis process. The aim of the text is to understand the absence of the mothers of infants born between May 2002 and June 2004 at Center of Integral Attention to the Health of the Woman (Unicamp) when returning to a second hearing evaluation.

Bizarre accessory metatarsal located between the left fourth and fifth metatarsals: a case report.

We report a case of bizarre accessory metatarsal located between the left fourth and fifth metatarsals without a supernumerary digit in a 6-year-old girl. The accessory metatarsal was resected to alleviate foot pain on walking. This metatarsal dysplasia might have arisen from sequential failures of digital formation at an early stage of development.

Subcapital femoral neck fracture after fixation of an intertrochanteric fracture with a proximal femoral nail: a report of two cases.

Subcapital femoral neck fractures are a rare complication after fixation of an intertrochanteric fracture with a proximal femoral nail. We report 2 such cases where the patients had severe osteoporosis, based on Singh's index and pathological findings. In one case there was a technical error leading to a tip-apex distance of more than 20 mm, but osteoporosis appeared to be a more significant cause than any technical problems.

Combined preoperative autologous blood donation and intra-operative cell salvage for hip surgery.

Purpose: To review records of 161 consecutive hip surgery patients for whom preoperative autologous blood donation (PABD) was used in combination with intra-operative cell salvage (ICS).

Methods: 114 women and 14 men aged 41 to 86 (mean, 64) years underwent 135 primary total hip arthroplasties (THAs), whereas 19 women and 7 men aged 16 to 52 (mean, 35) years underwent 26 rotational acetabular osteotomies (RAOs). Two or 3 weeks before the operation, patients deposited one unit (400 ml) of blood weekly, so long as their haemoglobin levels exceeded 110 g/l (if they had osteoarthritis) or 100 g/l (if they had rheumatoid arthritis).

Spontaneous variability analysis for characterizing cardiovascular responses to water ingestion.

This paper examines the effect of water ingestion on the cardiovascular system, utilizing advanced fluctuation analysis. The ingestion of water has been known to significantly raise the blood pressure in subjects with autonomic disorders, resulting in the effect of preventing syncope occurrences. For precise characterization of the effect of water ingestion, head-up tilt experiments at 80 degrees have been conducted for fourteen healthy subjects, ranging in age from 16 to 24.

Activation of fibrinolysis by reinfusion of unwashed salvaged blood after total knee arthroplasty.

In 19 patients with RA and 20 with OA who underwent autotransfusion with unwashed salvaged blood (USB) after total knee arthroplasty, we performed serial measurement of D-dimer, FgDP, t-PA, and PIC in the plasma and salvaged blood. The PIC level at the completion of salvaged blood transfusion was closely correlated with the volume of USB reinfused in the RA group (p<0.001).

Seven years of chronological changes of serum chromium levels after Metasul metal-on-metal total hip arthroplasty.

Although many authors have reported the serum concentrations of metal ions in patients who had metal-on-metal coupling prostheses, most of the studies were not longitudinal, and the follow-up periods were short. We evaluated the longitudinal changes of serum chromium levels in 44 patients who had undergone unilateral metal-on-metal total hip arthroplasty for a minimum of 7 years postoperatively. Although there was a consistent increase in the mean serum chromium level until 3 years after implantation, there was little difference in the levels from years 3 to 7 postoperatively.

Studies on the adsorption property and structure of polyamine-ended poly(ethylene glycol) derivatives on a gold surface by surface plasmon resonance and angle-resolved X-ray photoelectron spectroscopy.

The adsorption properties and structure of polyamine-ended poly(ethylene glycol) (PEG) derivatives on a flat gold surface were studied by means of surface plasmon resonance (SPR) and X-ray photoelectron spectroscopy (XPS) using PEG(5k)-block-poly[2-(N,N-dimethylamino)ethyl methacrylate](7.5k) [PEG-b-PAMA(5k/7.5k)] and pentaethylenhexamine-ended PEG(5k) [N6-PEG(5k)], which had 48 and 6 amino groups at the omega-end, respectively.

Dislocation after Hemiarthroplasty due to Insufficiency Fracture of the Superior Acetabulum: A Case Report.

Insufficiency fracture of the superior part of the acetabulum after hemiarthroplasty has not been reported before. Here we report a case of dislocation after hemiarthroplaty due to insufficiency fracture of the acetabulum. In our patient, insufficiency fracture of the ilium immediately above the acetabulum produced obvious evidence of compression and collapse that led to dislocation of the outer head of the femoral component.

Closed irreducible dislocation of the interphalangeal joint of the thumb: report of two cases.

Two cases of closed dislocation of the interphalangeal joint of the thumb are presented. It was impossible to achieve manual reduction in either patient. This rare injury required open reduction with anatomical repositioning of the volar plate in both patients.

Clinical effects of high oral dose of donepezil for patients with Alzheimer's disease in Japan.

Background: Donepezil 10 mg/day gained approval in Japan in August 2007 for the treatment of cognitive dysfunction in advanced Alzheimer's disease.

Methods: We evaluated the efficacy and adverse effects of donepezil when the dose was increased to 10 mg/day in 61 Japanese patients with Alzheimer's disease. Cognitive function was evaluated using the Revised Hasegawa Dementia Scale and mini-mental state examination at the day before starting, and at 4, 8 and 24 weeks after starting donepezil 10 mg/day.

The new technique of precise insertion of lag screw in an operative treatment of trochanteric femoral fractures with a short intramedullary nail.

In order to reduce the incidence of cut-out, which is one of the serious postoperative complications of trochanteric femoral fractures, we paid special attention to the placement of lag screw in the femoral head. As a result, we devised a new technique that allows insertion of the lag screw at the first attempt into the optimal position on both planes, inferior half on the antero-posterior view and exactly central on the lateral view, without the need for any special devices other than the basic original set, using a trochanteric nail. For this technique, we have evaluated the proximal femoral profile under image intensifier, on the true lateral view projected parallel to the axis of the femoral neck and not on the conventional lateral view (Lauenstein view) with the projection parallel to the axis of the femoral shaft in a coronal plane.

Rotational acetabular osteotomy for secondary osteoarthritis after surgery for developmental dysplasia of the hip.

The treatment of residual deformity following surgery for developmental dysplasia of the hip remains controversial. The rationale for the use of the rotational acetabular osteotomy (RAO) is that it increases the weight-bearing area by shifting the osteotomized acetabulum to cover the femoral head. This can improve joint function as well as achieve relief of pain.