Objectives: To analyze the effect of human placental extracts (HPEx) on hepatocellular carcinoma cells in vitro. Methods: The hepatocellular carcinoma cell lines, namely, HLE and Huh-7, were used. The cells were subjected to a growth assay using the formazan dye method; the effect of combination treatment with sorafenib and HPEx was also assessed. The preventing normal cell damage effect of HPEx was analyzed by virtual therapy where possible; the experimental protocol was constructed on the basis of pre- and post-sorafenib treatment data. Cytotoxicity was measured by lactate dehydrogenase (LDH) assay. Results: HPEx caused significant dose-dependent suppression in the growth of HLE and Huh-7 cells. These tumor cells were significantly suppressed by combination treatment with HPEx and sorafenib. In addition, HPEx potentiated sorafenib sensitivity against tumor cells, and significantly prevented sorafenib-induced cytotoxicity in primary cultured rat hepatocytes under all designed experimental conditions. Specifically, pre-treatment with HPEx had a greater effect than post-treatment with HPEx. Conclusion: HPEx suppresses tumor cell growth, potentiates sorafenib efficacy, and has a preventing normal cell damage effect; this triple functionality of HPEx makes it a useful agent for liver cancer therapy.

We executed an acupuncture therapy to 62 lumbar spinal canal stenosis cases who were diagnosed by CT, MRI photo state and clinical symptom and examined the result.
The 36 men and 26 women in this study had a mean age of 67.3 years.
An acupuncture was executed by aiming to give an effect to the soft tissues and a blood circulation around the area where the stenosis was recognized then pierced facet joint closely and deeply and gave an electric acupuncture stimulus.
14 cases were very good and 17 cases had good results according to the JOA score. No cases worsened.
We concluded an acupuncture treatment was effective for treating lumbar spinal canal stenosis.

Delayed hemothorax following blunt chest trauma is classified as a late presentation of hemothorax after a nearly normal chest X-ray on admission. Here, we present a case of delayed hemothorax 5 days after blunt chest trauma with ribs and sternal fracture.

We have reviewed the Recommendations on Undergraduate Medical Education published by the General Medical Council (GMC) of the United Kingdom in 1993, and have visited the University of Leicester to see how they have revised their medical course to take account of the GMC's recommendations. The aim of the GMC's recommendations is to promote a culture of self directed learning which will be of value to the future medical practitioners in their postgraduate careers. To achieve this the GMC recommends a reduction in the burden of factual information delivered to the student while promoting learning through curiosity and the exploration of knowledge. The students are given an integrated view of clinical and basic scientific disciplines. The University of Leicester has reorganised its medical teaching around modules relating to body function rather than the traditional disciplines, with contributions being made by clinicians and basic scientists in the same module. The new course places great emphasis on carefully guided and structured self directed study and a reduced number of lectures. Clinical skills are introduced early in the curriculum, while a deeper understanding of selected scientific disciplines are achieved by a series of special study modules where the students undertake supervised scientific research.

  A 59-year-old female was started on oral carbamazepine for her psychological disorder on April 21 2004. Four weeks later, she developed generalized erythemas on the trunk and extremities, and ran a high fever of 38°C. A physical examination showed erythroderma, and laboratory examination revealed liver dysfunction and hypereosinophilia. Three days after admission, a number of small pustules emerged on the erythrodermic backgrounds. The skin lesions were improved by the withdrawal of carbamazepine and systemic prednisolone (50mg per day). However, acute pancreatitis was also developed during the course. HHV-6 IgG was increased up to x1280 on June 17. Also, HHV-6 DNA was detected with two peaks during the therapy. DLST with carbamazepine showed a high titer of stimulation index. This case was unique in the acute generalized exanthematous pustulosis (AGEP)-like clinical appearance and the development of acute pancreatitis. HHV-6 DNA was increased with double peaks, which might suggest a “re-reactivation” of HHV-6 by carbamazepine.

Running economy is an important factor in determining a performance of a long distance running. The purpose of this study was to examine the relationship between the running economy and the submaximal hopping economy. Twelve long-distance runners performed a submaximal repeated hopping exercise on a force platform at a frequency of 2.2Hz and the maximum five-repeated rebound jumping (5RJ). Jumping height, contact time, maximum ground reaction force and oxygen intake were recorded during submaximal repeated hopping exercise. In addition, they performed the submaximal running for a distance of 3200m on an outdoor 400m track. Oxygen intake was recorded during the submaximal running. Then running economy (RE = V/VO₂) was calculated by using oxygen intake (VO₂) and running speeds (V). Hopping economy (HE = h/VO₂) was calculated by using oxygen intake (VO₂) and average jumping height (h). As a result of this study, we confirmed that a submaximal repeated hopping exercise performed for a ten-minute period was an aerobic exercise and a steady-state exercise. There was a significant positive correlation between RE and HE (r = 0.805, p＜0.01). These results suggest that hopping economy is an important factor in running economy. On the other hand, we did not find a significant correlation between HE and 5RJ. Furthermore, between RE and RJ index of the submaximal hopping exercise, a significant positive correlation was found (r = 0.735, p＜0.01). Therefore, RE seems to be connected with the Stretch-shortening cycle (SSC) function of the legs. We conclude that the SSC ability of a long distance runner can be evaluated appropriately by using the submaximal repeated hopping exercise of this study.

Many reports say that DWI (diffusion-weighted-image) is very useful for the diagnosis of cerebral infarction, especially in the acute phase, but it is difficult to have a fine image because DWI is very sensitive to artifacts caused by the “body-move” of the patient.
About the degree of MPG (motion probing gradient), criteria are yet to be established. Many persons try in their own way. With MPG5, the intensity of CSF and that of the focal lesion are almost equal, so that it is difficult to distinguish infarcts from adjacent ventricles.
The stronger the degree of MPG is, the more artifacts or noises we get, We recommend MPG6 or 7 in the right-left direction.

A 58-year-old man was admitted for pneumonia after several business trips to Thailand, Vietnam, and Malaysia. Despite resolution of pneumonia on chest X-ray, high fever persisted. CT scan revealed a juxtarenal, atypical-shaped abdominal aortic aneurysm of 4.5cm in size, and this was thought to be the cause of persisting fever. After prolonged antibiotic treatment, surgical resection and prosthetic tube replacement of the aneurysm was performed. The aneurysm was a pseudoaneurysm, and histological examination showed chronic inflammation with no atherosclerotic change. It was thought to be of mycotic origin. On the 12th day after operation, he became febrile, and an arterial blood culture yielded Burkholderia pseudomallei. Antibiotics chosen according to sensitivity tests, were given. He was finally discharged with no exidence of persisting infection, on the 55th day after operation.

The approach for the heart and proximal aorta in a patient with a tracheostomy poses difficult problems such as mediastinitis and inadequate operative exposure. We report a case of successful surgical treatment for type A aortic dissection in a patient with tracheostomy using a Y shaped skin incision and median full-sternotomy. A 63-year-old woman with a tracheostomy was referred to our hospital because of type A thrombosed aortic dissection and cardiac tamponade. At first we treated the patient conseservatively, but follow-up CT taken on the 20th day after onset revealed that false lumen of the ascending aorta was patent and the size of ascending aorta had increased to 6cm in diameter. We therefore performed hemiarch replacement (24mm Hemashield gold graft) through a Y shaped skin incision and median full-sternotomy. The postoperative course was uneventful and she was discharged on the 19th postoperative day.