Selective intraarterial injection of ICG for fluorescence angiography as a guide to extirpate perimedullary arteriovenous fistulas.

Background: Fluorescence angiography with indocyanine green (ICG) provides real-time information regarding the patency of vessels. To enhance the capability to delineate flow direction, flow velocity and sequence of dye filling in different components of complex spinal vascular lesions such as perimedullary arteriovenous fistulas (AVFs), we tried selective intraarterial injection of ICG with catheterization in the proximity of the AVFs.

Method: Prior to taking the position for surgery, a metallic introducer sheath was placed into the femoral artery, and placed over the patient's lateral buttock.

Prevalence of airflow limitation in patients diagnosed and treated for symptoms of chronic bronchitis by general practitioners in Tochigi Prefecture, Japan.

Objective: Physicians have provided care to only 0.2 million of the 5.3 million Japanese over the age of 40 years old who have chronic obstructive pulmonary disease (COPD).

Metastatic brain sarcoma with gliomatous component.

Here we report a metastatic brain carcinosarcoma from the uterus that posed a problem on diagnosis by containing an extensive gliomatous component. A 56-year woman developed motor aphasia 3 months after hysterectomy for a uterine tumor. Magnetic resonance imaging (MRI) demonstrated a left frontal cystic tumor, which was treated by stereotactic radiosurgery.

[Colorectal cancer].

Recent advances in chemotherapy and chemoradiation therapy for colorectal cancer have made neoadjuvant treatment an eligible therapeutic option for selected cases of marginally resectable colorectal cancer. However, marginally resectable colorectal cancer is not well defined. The authors suggest that a primary lesion is marginally resectable if extended resection such as pelvic exenteration and pancreaticoduedenectomy are not completely curative.

Ectopic gastric mucosa and pancreatic ducts in the rectum.

A 68-year-old woman with fecal occult blood was referred to Dokkyo Medical School Hospital. Colonoscopy demonstrated a flat lesion in the rectum, and endoscopic mucosal resection of the lesion was performed. Histologic examination revealed that it contained ectopic gastric mucosa, which had a gastric foveolar and glandular mucinous phenotype, as demonstrated by immunohistochemistry.

Patients in whom active tuberculosis was diagnosed after admission to a Japanese university hospital from 2005 through 2007.

To identify problems in early diagnosis of tuberculosis and to design countermeasures against the disease, we examined the status of active tuberculosis among patients admitted to a university hospital that did not have an isolation ward for tuberculosis. Between 2005 and 2007, we analyzed demographic characteristics, disease type, chest radiologic findings, and the process leading to diagnosis. Active tuberculosis was diagnosed after admission in 55 patients (34 males and 21 females): pulmonary tuberculosis, 26; tuberculous pleuritis, 13; tuberculous meningitis, 6; miliary tuberculosis, 4; tuberculous pericarditis, 3; lymph-node tuberculosis, 2; and tracheal and bronchial tuberculosis, 1.

Over-expression of the LTC4 synthase gene in mice reproduces human aspirin-induced asthma.

Background: The pathogenesis of aspirin-induced asthma (AIA) is presumed to involve the aspirin/non-steroidal anti-inflammatory drug (NSAID)-induced abnormal metabolism of arachidonic acid, resulting in an increase in 5-lipoxygenase (5-LO) metabolites, particularly leukotriene C(4) (LTC(4) ). However, the role of LTC(4) in the development of AIA has yet to be conclusively demonstrated.

Objective: The aim of this study was to evaluate the contribution of the lipid product LTC(4) secreted by the 5-LO pathway to the pathogenesis of AIA.

Comparative study between high-dose fluvastatin and low-dose fluvastatin and ezetimibe with regard to the effect on endothelial function in diabetic patients.

It is well established that statins improve the prognosis of patients with coronary artery disease. However, it is still unclear whether the protective effects of statins relate to lipid lowering alone or whether other pleiotropic effects may contribute. Thus, we compared the endothelial function among two groups of diabetic patients treated with fluvastatin 60 mg (F60) or fluvastatin 20 mg combined with ezetimibe 10 mg (F20/E10).

Immunohistochemical analysis of REG Iα expression in ulcerative colitis-associated neoplastic lesions.

Background And Aims: The regenerating gene (REG)Iα has been identified by microarray analysis as a gene that is distinctly overexpressed in ulcerative colitis (UC), and its protein product is suggested to play a pivotal role in the development of UC-associated carcinoma. In the present study, we investigated the significance of REG Iα expression as a diagnostic marker of UC-associated neoplasia.

Methods: Tissue samples were obtained from colectomy specimens from 31 patients with long-standing UC (mean disease duration 17.

Differential modulation of immunostimulant-triggered NO production by endoplasmic reticulum stress inducers in vascular smooth muscle cells.

We investigated the effects of endoplasmic reticulum (ER) stress inducers thapsigargin (TG) and tunicamycin (Tm) on immunostimulant lipopolysaccharide/interferon (LPS/IFN)-induced expression of isoform of nitric oxide synthase (iNOS) and nitric oxide (NO) production in vascular smooth muscle cells. LPS/IFN-induced iNOS mRNA expression was markedly enhanced by TG, whereas iNOS mRNA expression was strongly attenuated by Tm. Similarly, production of iNOS protein was markedly upregulated by TG but virtually eliminated by Tm.

Development of the human trochlear nucleus: a morphometric study.

Background: The trochlear nucleus, the smallest of the extraoculomotor nuclei, is unique or even curious, because the nerve roots emerge dorsally from the superior medullary velum after decussation. Little information is available on the developmental anatomy of this nucleus in humans.

Design/subjects: We examined serial brain sections from 10 premature infants aged 20-39 weeks of gestation to document the histology and morphometry.

Atypical lymphoplasmacytic and immunoblastic proliferation of autoimmune disease : clinicopathologic and immunohistochemical study of 9 cases.

Atypical lymphoplasmacytic immunoblastic proliferation (ALPIB) is a rare lymphoproliferative disorder (LPD) associated with autoimmune disease (AID). To further clarify the clinicopathologic, immunohistological, and genotypic findings of ALPIB in lymph nodes associated with well-documented AIDs, 9 cases are presented. These 9 patients consisted of 4 patients with systemic lupus erythematosus, 3 patients with rheumatoid arthritis, and one case each with Sjögren's syndrome and dermatomyositis.

Distribution of IgG4- and/or IgG-positive plasma cells in Hashimoto's thyroiditis: an immunohistochemical study.

Background And Study Aim: Recently, immunohistochemistry has shown numerous IgG4-positive plasma cells in a subset of Hashimoto's thyroiditis (HT), and this type of HT (IgG4 HT) appears to be a subtype of IgG4-related sclerosing disease. However, little is known about the distribution pattern of plasma cells in IgG4 thyroiditis. To clarify the distribution pattern of IgG4-positive plasma cells, 33 cases of HT demonstrating abundant lymphoplasmacytic infiltrate were studied.

Fluvastatin upregulates endothelial nitric oxide synthase activity via enhancement of its phosphorylation and expression and via an increase in tetrahydrobiopterin in vascular endothelial cells.

Background: An HMG-CoA reductase inhibitor, fluvastatin, appears to act directly on the blood vessel wall to stabilize plaques in situ, agents that share this property have been termed vascular statins.

Methods: We investigated the effects of fluvastatin on endothelial nitric oxide synthase (eNOS) phosphorylation and expression, as well as terahydrobiopterin (BH4) metabolism, in human umbilical vein endothelial cells (HUVEC).

Results: Fluvastatin was observed to enhance eNOS phosphorylation at Ser-1177 and Ser-633 through the PI3-kinase/Akt and PKA pathways, respectively.

Role of glucocorticoid receptor in the inhibitory effect of medroxyprogesterone acetate on the estrogen-induced endothelial nitric oxide synthase phosphorylation in human umbilical vein endothelial cells.

We aimed to clarify which steroid receptor is involved in the inhibitory effect of medroxyprogesterone acetate (MPA) on estrogen-induced endothelial nitric oxide synthase (eNOS) phosphorylation in human umbilical vein endothelial cells (HUVEC). The progesterone/glucocorticoid receptor (GR) antagonist RU-486 and introduction of GR siRNA caused attenuation of the inhibitory effect of MPA on the estrogen-induced eNOS phosphorylation and eNOS activity in HUVEC.

Clinical outcome of hepatectomy for hepatocellular carcinomas≤2 cm.

Background: The treatment strategy for hepatocellular carcinomas (HCCs)≤2 cm (HCC2-) is still controversial. In this study, we retrospectively analyzed clinicopathological data for HCC2- and HCCs>2 cm (HCC2+) to establish the treatment strategy for HCC2-.

Methods: Between April 2000 and December 2008, 206 patients with single HCC, who underwent hepatectomy for the first time, and whose outcomes could be tracked, were included in the study.

GROα promotes invasion of colorectal cancer cells.

Growth-regulated oncogene α (GROα) is a chemokine that plays a role not only in inflammation, but also in tumorigenesis. Accumulating data suggest that GROα is involved in tumor development and invasion in various malignancies, such as melanoma and bladder cancer. However, the pathophysiological role of GROα in human colorectal cancers (CRCs) is still unknown.

Technical advancements and utilization of spine surgery--international disparities in trend-dynamics between Japan, Korea, and the USA.

Spine surgery has made radical advancements in the last two decades and provision has expanded a great deal. The history of the technical development is briefly reviewed. To analyze trends in utilization and to assess the macroeconomic demand for spine surgery, the incidence of all spine surgery per capita is estimated referring to diverse statistical data from the USA, Korea and Japan.

Creola bodies in infancy with respiratory syncytial virus bronchiolitis predict the development of asthma.

Background: Creola bodies (CrBs) in the sputum are an indicator of respiratory epithelial damage and appear specifically in bronchial asthma. We studied the presence and clinical significance of CrBs in infants with respiratory syncytial virus (RSV) bronchiolitis contributing to the development of asthma.

Methods: Aspirated sputum samples were collected from 33 infants admitted with acute RSV bronchiolitis.

DMBT1 is a novel gene induced by IL-22 in ulcerative colitis.

Background: Interleukin (IL)-22 is a recently identified cytokine that is suggested to play pivotal roles in various inflammatory diseases. Although the IL-22 receptor 1 (IL-22R1) is restrictively expressed in epithelial cells in the colon, the role of IL-22 in colonic diseases still remains unclear. In this study microarray analyses revealed that deleted in malignant brain tumors 1 (DMBT1) is a novel upregulated gene in IL-22-stimulated colon cancer cells.

Detection of desmoplastic reaction in biopsy specimens is useful for predicting the depth of invasion of early colorectal cancer: a Japanese collaborative study.

Background: We have previously demonstrated a relationship between the depth of submucosal invasion (SM depth) and the frequency of lymph node metastasis in resected submucosal invasive colorectal cancers (SICRCs). Here, we assessed the desmoplastic reaction (DR) in pretreatment biopsy specimens of SICRC to predict the SM depth.

Methods: A total of 359 patients with SICRCs, who had undergone surgical or endoscopic mucosal resection, were enrolled.

Relation between the antimicrobial susceptibility of clinical isolates of Pseudomonas aeruginosa from respiratory specimens and antimicrobial use density (AUD) from 2005 through 2008.

Objective: To examine the relation between annual trends in the antimicrobial susceptibility of Pseudomonas aeruginosa and drug usage, we compared annual changes in the susceptibility rates of P. aeruginosa clinical isolates during a 4-year period and annual trends in the overall usage of antimicrobials during the same period.

Methods: We studied annual trends in MIC(90)/MIC(50), antimicrobial use density (AUD), and antimicrobial susceptibility rates based on clinical breakpoints for 150 strains of P.