Multiple marker evaluation in prostatic cancer with prostatic acid phosphatase, γ-seminoprotein and prostate-specific antigen

Serum prostatic acid phosphatase (PAP), γ-seminoprotein (γ-Sm), and prostate-specific antigen (PA) levels were measured in 63 untreated patients with prostatic cancer. The sensitivities of PAP, γ-Sm, and PA as markers of malignancy were 68%, 83%, and 77%, respectively. The latter two markers were more sensitive than PAP, especially in stage B disease. The specificities of PAP, γ-Sm, and PA were 95%, 93%, and 93%, respectively. Patients with multiple positive markers were very likely to have prostatic cancer. In reactivation of the disease, positive rates for γ-Sm and PA were higher than for PAP, indicating that the former two markers are more reliable for monitoring prostatic cancer.     

Antegradely insertable aortic balloon occlusion catheter for aortic arch repair

 We have developed an antegradely insertable aortic balloon occlusion catheter for aortic arch repair, and review our experiences of using it. The purpose of the present study was to examine the usefulness of the balloon for surgical treatment of aortic arch aneurysm. In 30 patients with aortic arch aneurysm, including 22 with a non-ruptured and 8 with a ruptured aneurysm, the catheter was antegradely inserted into the descending thoracic aorta through the aortic arch or the aneurysm without opening the pleural space after establishing antegrade selective cerebral perfusion and obtaining cardiac arrest. During distal anastomosis, the catheter occluded the aorta with continuous perfusion of the lower half of the body through an arterial cannula inserted into the femoral artery. Among the patients with a nonruptured aneurysm, two deaths (9.1%) occurred because of aorto-broncho-esophageal fistulae or cardiac arrest due to severe asthma attack within 30 days, and the other three hospital deaths were due to aspiration pneumonia, multiple organ failure with preoperative renal dysfunction, or low cardiac output syndrome due to perioperative myocardial infarction. Among the patients with a ruptured aneurysm, three deaths (37.5%) were due to acute myocardial infarction, respiratory failure, or intractable arrhythmia within 30 days, and another hospital death was caused by mediastinitis. No paraplegia was caused in any patient excluding one of the patients with a ruptured aneurysm who could not be weaned from the extracorporeal circulation due to perioperative myocardial infarction. There was no early postoperative serious visceral organ dysfunction except for two patients with postoperative low cardiac output syndrome or preoperative severe renal dysfunction. This catheter was effective in protecting the visceral organs and the spinal cord in the repair of an aortic arch aneurysm. Received: March 7, 2002 / Accepted: November 29, 2002     

Impact of preoperative serum sodium concentration in living donor liver transplantation

Background and Aims: The importance of hyponatremia in deceased donor liver transplantation (DDLT) has been recently discussed frequently. However, its impact on the outcomes in living donor liver transplantation (LDLT) has not yet been elucidated. The current study was designed to demonstrate the impact of pre‐transplant sodium concentration on postoperative clinical outcomes. Methods: One hundred and thirty‐four patients who underwent LDLT for end‐stage liver diseases were examined to evaluate the significance of pre‐transplant hyponatremia (Na ≤ 130 mEq/L) on the short‐term clinical outcomes and the efficacy of the Model for End‐Stage Liver Disease and serum sodium (MELD‐Na) score using the sodium concentration and original MELD score. Results: The preoperative sodium and MELD score for all patients were 133.9 mEq/L (range: 109–142) and 16.2 (range: 6–38), respectively. According to a multivariate analysis, not only the MELD score (P = 0.030) but also the sodium concentration (P = 0.005) were found to be significant predictive factors for short‐term graft survival. Preoperative hyponatremia was a significant risk factor for the occurrence of sepsis (P < 0.001), renal dysfunction (P < 0.001) and encephalopathy (P = 0.026). The MELD‐Na score was 19.6 (range: 6–51) and the area under the receiver–operator curve of that (c‐statistics: 0.867) was higher than MELD score and sodium concentration (c‐statistics: 0.820 and 0.842, respectively). Conclusion: Preoperative hyponatremia was a significant risk for postoperative complications and short‐term graft loss. The addition of sodium concentration to MELD score might therefore be an effective predictor for post‐transplant short‐term mortality in LDLT.     

Evaluation of antipsychotic and relative drugs using disruption of prepulse inhibition as an animal model for schizophrenia

The prepulse inhibition (PPI) is a phenomenon in which a weak prepulse attenuates the response to a subsequent startling stimulus. The PPI, a model of sensorimotor gating, is deficient in patients with schizophrenia and some other psychiatric disorders. In rodents, PPI can be disrupted by methamphetamine or phencyclidine, which causes psychotomimetic symptoms, and the dopaminergic agonist-induced PPI is reversed by dopamine D2 receptor antagonists and a dopaminergic partial agonist aripiprazole. However, in general, the glutamate receptor antagonist-induced PPI is reversed by atypical antipsychotics such as clozapine, but not by typical antipsychotics such as haloperidol. Therefore, PPI is believed to have face, construct, and predictive validity for the PPI disruption in schizophrenia, and it is widely used as a model to study the neurobiology of this disorder and for screening antipsychotics. Recently, various inbred mouse strains and genetically modified mouse lines have been examined and the studies using PPI indicated the involvement of various neurotransmitters such as dopamine, glutamate, serotonin, GABA and neuropeptide in the biological basis of sensorimotor gating. In addtition, mood stabilizers such as valproate and lamotrigine or alpha7 nicotinic receptor agonists have reported to reverse the PPI disruption.     

Structural and functional diversity in the PAR1b/MARK2‐binding region of Helicobacter pylori CagA

Helicobacter pylori (H. pylori) cagA‐positive strains are associated with gastritis, peptic ulcerations, and gastric adenocarcinoma. Upon delivery into gastric epithelial cells, the cagA‐encoded CagA protein specifically binds and aberrantly activates SHP‐2 oncoprotein in a manner that is dependent on CagA tyrosine phosphorylation. CagA‐deregulated SHP‐2 then elicits aberrant Erk activation while causing an elongated cell shape known as the hummingbird phenotype. In polarized epithelial cells, CagA also binds to PAR1b/MARK2 and inhibits the PAR1b kinase activity, thereby disrupting tight junctions and epithelial cell polarity independent of CagA tyrosine phosphorylation. We show here that the CagA‐multimerization (CM) sequence that mediates interaction of CagA with PAR1b is not only essential for the CagA‐triggered junctional defects but also plays an important role in induction of the hummingbird phenotype by potentiating CagA‐SHP‐2 complex formation. We also show that the CM sequence of CagA isolated from East Asian H. pylori (referred to as the E‐CM sequence) binds PAR1b more strongly than that of CagA isolated from Western H. pylori (referred to as the W‐CM sequence). Within Western CagA species, the ability to bind PAR1b is proportional to the number of W‐CM sequences. Furthermore, the level of PAR1b‐binding activity of CagA correlates with the magnitude of junctional defects and the degree of hummingbird phenotype induction. Our findings reveal that structural diversity in the CM sequence is an important determinant for the degree of virulence of CagA, a bacterial oncoprotein that is associated with gastric carcinogenesis. (Cancer Sci 2008; 99: 2004–2011)     

Intravagal parathyroid adenoma

An extremely rare case of intravagal parathyroid adenoma is presented. The tumour caused fusiform swelling of the left vagus nerve was shelled out. Post-operatively the left recurrent nerve palsy was recovered in the two months. Serum calcium level returned to normal on the tenth day after the surgical operation without symptoms of hypocalcaemia.     

Surfer's ear in Japan

Fifty-one Japanese professional surfers were examined in order to analyze surfer's ear. Forty-one cases (80%), 71 ears, were diagnosed as surfer's ear. In 19 cases (37%), 30 ears, the external auditory canals had stenosed by more than 50%. In general, surfer's ear begins to appear after 5 years and is further aggravated by continued surfing. The age at which surfing is taken up has no influence on the appearance of surfer's ear. Surfers who surf on northern (colder) coasts have severer surfer's ear than those who frequent the southern (warmer) coasts.