A retroperitoneal bronchogenic cyst: laparoscopic treatment

Subdiaphragmatic bronchogenic cysts are rare, and those located retroperitoneally are exceptional. We describe a retroperitoneal cyst presenting as an asymptomatic adrenal mass which was treated with laparoscopic surgery with three trocars.     

Acetylcholine-induced translocation of RhoA in freshly isolated single smooth muscle cells of rat bronchi

By using immunofluorostaining and confocal laser microscopy, acetylcholine-induced translocation of RhoA was visualized in freshly isolated bronchial smooth muscle cells of the rat. The cellular distribution of RhoA at rest was observed uniformly in the cytosolic space with no staining in the nucleus, whereas acetylcholine stimulation induced a relocalization of RhoA to the cell periphery. From the results of line scans and surface plots, the peripheral to cytosolic ratio of RhoA was significantly increased by acetylcholine stimulation. Thus, the present study clearly demonstrated an acetylcholine-induced translocation of RhoA to the plasma membrane in single bronchial smooth muscle cells of the rat.     

半侧面肌痉挛的异常肌反应：F波还是三叉神经反射？

目的：半侧面肌痉挛（HFS）的患者经常出现异常肌反应（AMR），本研究旨在探讨AMR的传人冲动是由逆向面神经刺激还是顺向三叉神经刺激所介导。方法：记录28例HFS患者口轮匝肌的AMR。给予患者的面神经以阈下刺激或弱的皮肤刺激后，当AMR出现时进行记录。结果：可记录到24例（86％）患者的AMR，通常包括早期的恒定部分（平均开始潜伏期10．0ms）和后期的可变部分（平均开始潜伏期35．3ms），类似于眨眼反射的R1和R2。AMR的早期或（和）晚期部分通常在面神经的阈下刺激（43％）及皮肤刺激（88％）后引出。结论：AMR可能是由三叉神经传人冲动介导，而不是面神经的逆向激活，并且是三叉神经反射的一个类型。     

Staged cranial reconstruction after epidural abscess associated with dural substitute exposure

Cadaveric dura mater was widely used for a long time but has recently been associated with the transmission of Creutzfelt-Jakob disease. Expanded polytetrafluoethylene sheet has been suggested as a suitable alternative in Japan. Recently epidural abscesses associated with exposure to Expanded polytetrafluoethylene have been on the increase in Japan.We experienced one case of staged cranial reconstruction for chronic ulcer of the head associated with MRSA epidural abscess.Surgical Technique: the exposed expanded polytetrafluoethylene must be completely removed along with the skin. Reconstruction of dura mater should be made watertight with the application of autologous free fascia lata collected from the paralyzed thigh. Autologous free fascia lata is reconstructed with the rectus abdominis muscle so that there is no dead space remaining. Calvarial bone should be reconstructed in a separate operation as at a second stage.     

Etidronate and hormone replacement therapy (HRT) for postmenopausal women with osteoporosis despite HRT

Hormone replacement therapy (HRT) is effective treatment for postmenopausal bone loss and osteoporosis. However, postmenopausal women with low bone mass fail to respond after a few years of HRT and some postmenopausal women show no bone response to HRT. In these cases, additive therapy is necessary. Bisphosphonates are highly effective in postmenopausal osteoporosis. We investigated the effects of adding etidronate, a bisphosphonate, to HRT. The addition of etidronate to HRT improved bone density (4.40+/-1.12% increase per year) in patients showing no increase or even a decrease after at least 1 year of HRT (5.39+/-2.40% decrease per year).