Repair of skin defect after extensive resection for penile cancer: report of two cases, and clinical observation of patients with penile cancer at Mie University hospital]

Case 1: A 48-year-old male with stage 4 penile cancer is reported. We used peplomycin (PEP) and cisplatinum (CDDP) for preoperative chemotherapy. Chemotherapy was effective. Radical surgery with bilateral inguinal lymphadenectomy was done and skin defect was covered with a skin flap. Case 2: A 61-year-old male with stage 4 penile cancer underwent radical surgery after modified MBD therapy with methotrexate (MTX), PEP and CDDP. Emasculation with skin resection and inguinal and pelvic lymphadenectomy were performed. The skin defect was deep and wide. It was covered with a glacilis myocutaneous skin flap. Distal end of the flap became necrotic. It was covered with tensor fascia lata myocutaneous flap. Seventeen patients with penile cancer were treated between 1972 and 1990 at Mie University Hospital. Nine patients were in stage 1, 4 stage 2, 1 stage 3, 3 stage 4. Treatment consisted of surgery (3), surgery+chemotherapy (10), surgery+chemotherapy+irradiation (2), chemotherapy+irradiation (1), and surgery+irradiation(1). Cancer death was observed in 2 cases (stage 2), 2 patients died of other diseases, 10 are alive, and 3 patients were lost to follow up.     

Job satisfaction in Japanese nurses

This study investigated job satisfaction among nurses in Japan The instrument for measuring occupational satisfaction of hospital nurses developed by Stamps and her associates was used Initial items were reviewed by content experts who were familiar with measurement of work satisfaction among health professionals and nursing practice in Japan Based on the item analysis in the cultural context, several items were reworded or eliminated from the original version Twenty-five items were retained and translated into English by bilingual professionals The questionnaire was administered to 613 nurses Practising in a large, acute-care hospital in a southern part of Japan The results from testing psychometric properties of the translated version of the instrument were satisfactory It may be concluded that nurses in the study were not satisfied but not dissatisfied either On all items, they showed relatively strong commitment to their work However, extrinsic factors such as having little opportunities for promotion or less favourable working conditions appeared to negatively influence job satisfaction in the study The findings support the dual factor theory of Herzberg and also Maslow's theory Considering the lowest scored item, little opportunities for promotion, which reflects the employment system in Japan, administrators, who are usually male medical practitioners, should be made aware of a need for creating clinical ladder opportunities for nurses who would be promoted based on a merit system, instead of the current practice of a seniority system     

Scoliosis in cat cry syndrome

Background Cat cry syndrome is an autosomal disease accompanying abnormal deletion of chromosome 5 and occurs in only 1 of 50,000 neonates. Scoliosis has been reported as a skeletal complication in cat cry syndrome. The characteristics and causes of scoliosis in this rare syndrome are unknown. The purpose of this study was to present the characteristics of scoliosis in cat cry syndrome and to speculate on its causative mechanisms. Methods We report on 11 cases (5 boys and 6 girls) of cat cry syndrome. Detailed investigations of scoliosis, as well as physical and imaging examinations, were performed to characterize scoliosis and its causes. Average age at initial diagnosis of scoliosis was 4.3 years, and average age at final examination was 11.8 years. Results The incidence of scoliosis was as high as 73% (8/11). Most cases show a single right thoracic curve. Of the 8 patients with scoliosis, 3 patients who had increased muscular tone showed marked progression of scoliosis with growth. Conclusions Muscular hypertonia may play a key role in the progression of scoliosis in cat cry syndrome.     

The effect of dietary protein source on plasma cholesterol level and fecal steroid excretion in obese mice

Both goldthioglucose (GTG)-treated and the genetically obese (C57BL/6J ob/ob) mice were fed semisynthetic diets containing either soy protein isolate (SPI) or casein as a protein source, or laboratory chow. In GTG-induced obese mice, the plasma cholesterol level correlated positively with their body weight. The level was highest in mice fed high-fat diet, and lowest in ones fed laboratory chow. No difference was observed between SPI and casein groups whether the diet was low-fat or high-fat. Thus, in the GTG-treated mice, SPI did not have a hypocholesterolemic effect while dietary fat had a hypercholesterolemic effect, and laboratory chow contained some component(s) which can lower the plasma cholesterol level. Both neutral and acidic steroid contents in feces of the SPI group were not different from those of the casein group, and both groups of mice excreted a smaller amount of steroids than mice fed laboratory chow. Results of essentially the same tendency were obtained with normal mice regarding the effects of SPI and casein, although the degree of hypercholesterolemia was lower in high-fat-fed normal mice than in similarly fed GTG-treated mice. These results strengthened the inverse correlation between the amount of fecal steroids and the plasma cholesterol level upon feeding various proteins, indicating that the former is one of the important factors that determine the latter. The ob/ob mice showed a marked hypercholesterolemia irrespective of the kind of diet. The amount of fecal steroids was highest in the laboratory chow group and lowest in the casein group. This indicates that some factor(s) other than fecal steroid excretion is dominantly responsible for their hypercholesterolemia.     

Mutational analysis of familial and sporadic hyperekplexia

Hyperekplexia is a rare, autosomal dominant neurological disorder characterized by hypertonia, especially in infancy, and by an exaggerated startle response. This disorder is caused by mutations in the ?1 subunit of the inhibitory glycine receptor (GLRA1). We previously reported two GLRA1 point mutations detected in 4 unrelated hyperekplexia families; both mutations were at nucleotide 1192 and resulted in the replacement of Arg²⁷¹ by a glutamine (R271Q) in one case and a leucine (R271L) in the other. Here, 5 additional hyperekplexia families are shown to have the most common G-to-A transition mutation at nucleotide 1192. Haplotype analysis using polymorphisms within and close to the GLRA1 locus suggests that this mutation has arisen at least twice (and possibly four times). In 2 additional families, a third mutation is also presented that changes a tyrosine at amino acid 279 to a cysteine (Y279C). Five patients with atypical clinical features and equivocal or absent family history of hyperekplexia and 1 patient with a classical presentation but no family history are presented in whom a mutation in the GLRA1 gene was not detected. Thus, only clinically typical hyperekplexia appears to be consistently associated with GLRA1 mutations, and these affect a specific extracellular domain of the protein.     

Effects of iodine-enriched egg (IE-egg) on nasal allergy: basic and clinical investigations

The effect of iodine-enriched egg (IE-egg) on nasal allergy was investigated using an experimental allergic model. In addition, the effect of IE-egg was investigated using patients with yearly nasal allergy. IE-egg could suppress the leakage of pontamine sky blue dye in the experimental allergic model. beta-Glucuronidase activity in the perfusate was suppressed with the ingestion of IE-egg. The symptoms of the patients with yearly nasal allergy were mitigated by the ingestion of IE-egg. beta-Glucuronidase activity in the pituita of nasal allergic patients tended to be decreased.     

Clinical studies on the transabdominal resection of esophagocardial cancer and cervical anastomosis using bypass methods. Analysis of data on 76 patients

Transabdominal resection for esophagocardial cancer and reestablishment of alimentary continuity using bypass methods were performed in 76 patients. Thirteen underwent a bypass with a gastric tube and in 30, a colonic segment was prepared. In the remaining 33, a jejunal segment was used as a bypass organ, with considerable success. The 5 year survival rates were 68.8 per cent in those with stages (I+II), 16.5 per cent in those with stage III, 12.6 per cent in those with stage IV and 22.5 per cent in all cases, indicating similar results compared to those with cancer located in the upper third of the stomach with the limited proximal extension within the esophagocardial junction and operated on during the same period.     

Select types of supporting cell in the inner ear express aquaporin-4 water channel protein

Aquaporins (AQPs) confer a high water permeability on cell membranes and play important parts in secretory and absorptive epithelia in kidney and other organs. Here we investigate whether AQPs are expressed in the sensory epithelia of the inner ear, where a precise volume regulation is crucial. By use of specific antibodies it was found that the inner ear contains AQP1 and 4 while being devoid of detectable levels of AQP2, 3 or 5. Immunofluorescence and postembedding immunogold labelling revealed a strictly non-epithelial distribution of AQP1, confirming previous data. In contrast, AQP4 protein and mRNA (visualized by in situ hybridization) were concentrated in select types of supporting cell, including Hensen's cells and inner sulcus cells. Immunogold particles signalling AQP4 were confined to the basolateral plasma membrane of Hensen's cells and to the basal plasma membrane of Claudius cells and inner sulcus cells. AQP4 was also found in supporting cells of the vestibular end organs, but was absent from transitional epithelial cells and dark cells. Strong labelling for AQP4 and AQP4-mRNA was associated with the central part of the cochlear and vestibular nerves. Hair cells were consistently unlabelled. Our findings indicate that AQP4 may facilitate osmotically driven water fluxes in the sensory epithelia of the inner ear and thus contribute to the volume and ion homeostasis at these sites.