We experienced a patient of thoracoabdominal aortic aneurysm complicated with abdominal angina due to obstruction of the celiac and the superior mesenteric arteries. Bilateral renal artery stenoses were also present. At the operation we used the Biomedicus centrifugal pump and the heparin bonded tube for partial bypass. Following endarterectomy of the obstructed arteries, graft replacement of the thoracoabdominal aorta using inclusion technique was performed. Although endarterectomy of the superior mesenteric artery was not successful and its reconstruction was abandoned, the celiac artery and the bilateral renal arteries were reconstructed successfully. Postprandial pain was totally disappeared after the operation.

We report three cases of skin disease successfully treated with juzentaihoto. Juzentaihoto has been used traditionally for deficiency of both Ki and Ketsu, and, at present, clinically for the treatment of various skin diseases. Toll-like receptors (TLRs) have recently been characterized as the receptors of innate immunity, which are mainly expressed on antigen-presenting cells. We previously reported that juzentaihoto enhanced interleukin-12 (IL-12) and interferon-γ (IFN-γ) production through modulation of TLR4signaling pathways in murine peritoneal exudative macrophages. Since Langerhans cells, a kind of the antigen-presenting cell, are known to exist in epidermis, we speculate that juzentaihoto improves T helper1and 2 (Th 1/2) balance through modulation of TLR signaling pathways in Langerhans cells. Our cases suggest that influence to acquired immunity through the innate immune signaling is assumed to be one of the mechanisms of juzentaihoto for controlling morbid states of the skin.
juzentaihoto ; Skin Diseases ; seconds ; Mechanism ; Possible

Uterine tumors are the most common type of gynecologic neoplasm. Uterine leiomyosarcoma (LMS) is rare, accounting for 2% to 5% of tumors of the uterine body. Uterine LMS develops more often in the muscle tissue layer of the uterine body than in the uterine cervix. The development of gynecologic tumors is often correlated with female hormone secretion; however, the development of uterine LMS is not substantially correlated with hormonal conditions, and the risk factors are not yet known. Radiographic evaluation combined with PET/CT can be useless in the diagnosis and surveillance of uterine LMS. Importantly, a diagnostic biomarker, which distinguishes malignant LMS and benign tumor leiomyoma (LMA) is yet to be established. Accordingly, it is necessary to analyze risk factors associated with uterine LMS in order to establish a method of treatment. LMP2-deficient mice spontaneously develop uterine LMS, with a disease prevalence of ∼40% by 14 months of age. It is therefore of interest whether human uterine LMS shows a loss of LMP2 expression. We found LMP2 expression is absent in human LMS, but present in human LMA. Therefore, defective LMP2 expression may be one of the risk factors for LMS. LMP2 is potentially a diagnostic biomarker for uterine LMS, and gene therapy with LMP2-encording DNA may be a new therapeutic approach.
Animals ; Biomarkers, Tumor ; biosynthesis ; genetics ; Cysteine Endopeptidases ; biosynthesis ; genetics ; Down-Regulation ; Female ; Gene Deletion ; Humans ; Interferon Regulatory Factor-1 ; biosynthesis ; genetics ; Leiomyoma ; metabolism ; Leiomyosarcoma ; diagnosis ; genetics ; metabolism ; Mice ; Mice, Knockout ; Proteasome Endopeptidase Complex ; metabolism ; Uterine Neoplasms ; diagnosis ; genetics ; metabolism

Epithelial ovarian cancer remains the lethal gynecological malignancy in women. The representative histotype is high-grade serous carcinoma (HGSC), and most patients with HGSC present at advanced stages with peritoneal dissemination. Since the peritoneal dissemination is the most important factor for poor prognosis of the patients, complete exploration for its molecular mechanisms is mandatory. In this narrative review, being based on the clinical, pathologic, and genomic findings of HGSC, chromosomal instability and epigenetic dynamics have been discussed as the potential drivers for cancer development in the fallopian tube, acquisition of cancer stem cell (CSC)-like properties, and peritoneal metastasis of HGSC. The natural history of carcinogenesis with clonal evolution, and adaptation to microenvironment of peritoneal dissemination of HGSC should be targeted in the novel development of strategies for prevention, early detection, and precision treatment for patients with HGSC.