Horseshoe kidney is a common renal anomalies, but coexistence with abdominal aortic aneurysm (AAA) is rare. Horseshoe kidney may cause various technical difficulties of aneurysm repair. A 76-year-old man was referred to our hospital for treatment of AAA with a horseshoe kidney. Preoperative 3-dimensional computed tomography (3D-CT) scans showed a pair of normal renal arteries and 3 accessory renal arteries from the anterior wall to abdominal aorta just proximal to an aneurysm. At operation, the aneurysm was exposed through a transperitoneal approach, and artificial graft replacement was performed with a woven Dacron bifurcated graft preserving the renal isthmus. The accessory renal arteries were not reconstructed. The postoperative course was uneventful. Postoperative 3-D CT showed minor infarction of renal isthmus, but renal function was not impaired.

We encountered two cases of diabetes mellitus treated with insulin that improved with the administration of Mashinin-gan and Hachimi-jio-gan for constipation.
The first case is an 84-year-old woman who had been treated with 16 units of insulin per day. After receiving Mashinin-gan for constipation, as well as the regular dose of insulin, her blood sugar values declined. Her insulin dose was then reduced, her constipation improved and finally she stopped taking insulin. The second case is a 77-year old man who was also being treated with 16 units of insulin per day. He took Mashinin-gan and Hachimi-jio-gan for constipation, which improved his constipation and allowed him to reduce his insulin from 16 units to 4 units per day.
Neither Hachimi-jio-gan nor Mashinin-gan caused any serious adverse effects and seemed to be beneficial for aged diabetic patients in preventing side effects such as hypoglycemia. We conclude that these drugs are useful for the treatment of diabetes mellitus for the aged.

OBJECTIVE: The purpose of the present study was to elucidate the incidence of deep venous thrombosis (DVT) before treatment in ovarian cancer and the appropriate cut-off value of D-dimer (DD) for the diagnosis of DVT. METHODS: Between July 2007 and October 2008, eighty seven patients with presumed ovarian cancer (final diagnosis: ovarian cancer, n=59; borderline malignancy, n=28) were enrolled. Measurement of DD levels and subsequent venous ultrasonography were performed before treatment. RESULTS: The mean DD level was 4.1 microg/mL. Subsequent venous ultrasonography revealed DVT in 14 of 87 (16.1%) patients (ovarian cancer, 12 cases; borderline malignancy, 2 cases). None were found to have developed DVT if they had a DD level of <1.5 microg/mL. If 1.5 microg/mL was used as a cut-off value for DD levels to diagnose DVT, sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 61.6%, 33.3%, and 100%. There was noclinical onset of postoperative pulmonary thromboembolism. CONCLUSION: Our data suggest that presumed ovarian cancer patients with at least more than 1.5 microg/mL should be examined using venous ultrasonogaphy to detect DVT.
Fibrin Fibrinogen Degradation Products ; Humans ; Incidence ; Ovarian Neoplasms ; Sensitivity and Specificity ; Venous Thrombosis

Introduction: Compared with faculties in clinical and medical research departments, those in medical departments are not appropriately evaluated in terms of their contributions to or achievements in medical education. Therefore, the aims of this study were to investigate the contributions of medical department faculties to medical education, and to examine differences in contributions according to duty positions and specialties.

Methods: Five-grade self-assessments in relation to 20 items on a rating form for performance in medical education, which was developed by the Japan Society for Medical Education's Committee for Performance Evaluation, were carried out by medical department faculties in Japanese universities. The data were then totalized and analyzed.

Results and Discussion: Although faculties belonging to departments other than medical education units did not actively participate in examinations or the education system, they still made contributions to lectures and practice. In addition, faculties with positions with more duties tended to show greater participation in the education system.

Conclusion: Based on these findings, we recommend the use of a rating form as a standard scale to evaluate performance in medical education.

OBJECTIVE: The aim of the present study was to assess prognostic factors for patients with locally advanced cervical cancer treated with radiotherapy as the primary treatment and to assess the posttreatment cut-off levels of squamous cell carcinoma antigen (SCC-Ag) to predict three-year overall survival (OS) rates. METHODS: One hundred and twenty-eight patients with cervical squamous cell carcinoma (International Federation of Gynecology and Obstetrics [FIGO] stage IIB-IVA) treated using radiotherapy or concurrent chemoradiotherapy were identified. Of these patients, 116 who had SCC-Ag levels >1.5 ng/mL prior to treatment were analyzed retrospectively. RESULTS: Median age was 68 years (range, 27 to 79 years). The complete response rate was 70.7% and the three-year OS rate was 61.1%. The median levels of pretreatment and posttreatment SCC-Ag were 11.5 ng/mL (range, 1.6 to 310.0 ng/mL) and 0.9 ng/mL (range, 0.4 to 41.0 ng/mL), respectively. Multivariate analysis showed that pretreatment anemia (p=0.041), pelvic lymph node metastasis (p=0.016) and posttreatment SCC-Ag levels (p=0.001) were independent prognostic factors for three-year OS. The SCC-Ag level cut-off point for three-year OS rates, calculated using a receiver operating characteristic curve, was 1.15 ng/mL (sensitivity, 80.0%; specificity, 74.0%). CONCLUSION: Pretreatment anemia and pelvic lymph node metastasis are poor prognostic factors in locally advanced cervical cancer. Furthermore, posttreatment SCC-Ag levels <1.15 ng/mL predicted better three-year OS rates.
Anemia ; Antigens, Neoplasm ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Gynecology ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Obstetrics ; ROC Curve ; Sensitivity and Specificity ; Serpins ; Uterine Cervical Neoplasms

Objective: To evaluate gender differences in mentee’s preference for mentoring styles and topics in academic medicine in Japan.
Methods: We conducted a cross-sectional questionnaire survey of mentees at 6 graduate schools of medicine in Japan from December 2011 through January 2012. The study participants were 1700 Japanese-speaking graduate students and postdoctoral fellows. The primary outcome was the percentage of respondents who desired to be mentored with a particular style or topic.
Results: A total of 676 （227 women） mentees responded to the survey. Women were less likely than men to prefer a hierarchical mentoring relationship （men, 82%; women, 71%; p＝0.001） but were more likely to desire a mentor for career consultation （men, 51%; women, 64%; p＝0.001）. Women were more likely than men to want guidance in developing a research portfolio （men, 85%; women, 90%; p＝0.04）, in computer skills／statistical skills （men, 68%; women, 81%; p＝0.001）, and in long-term career planning （men, 38%; women, 50%; p＝0.003）.
Conclusion: Women mentees in Japan express different preferences for mentoring styles and topics from men. Mentors in Japan must take these differences into consideration.

OBJECTIVE: In the present study, we evaluated changes in CA-125 cut-off values predictive of complete interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) using receiver operating characteristic (ROC) analysis. METHODS: This retrospective single-institution study included patients with International Federation of Gynecology and Obstetrics (FIGO) stage III epithelial ovarian cancer and a pre-NAC serum CA-125 level of greater than 40 U/mL who were treated with neoadjuvant platinum-based chemotherapy followed by IDS between 1994 and 2009. Logistic regression analysis was used to evaluate univariate and independent multivariate associations with the effect of clinical, pathological, and CA-125 parameters on complete IDS, and ROC analysis was used to determine potential cut-off values of CA-125 for prediction of the possibility of complete IDS. RESULTS: Seventy-five patients were identified. Complete IDS was achieved in 46 (61.3%) patients and non-complete IDS was observed 29 (38.7%). Median pre-NAC CA-125 level was 639 U/mL (range, 57 to 6,539 U/mL) in the complete IDS group and 1,427 U/mL (range, 45 to 10,989 U/mL) in the non-complete IDS group. Median pre-IDS CA-125 level was 15 U/mL (range, 2 to 60 U/mL) in the complete IDS group and 53 U/mL (range, 5 to 980 U/mL) in the non-complete IDS group (p<0.001). Multivariate analyses performed with complete IDS as the endpoint revealed only pre-IDS CA-125 as an independent predictor. The odds ratio of non-complete IDS was 10.861 when the pre-IDS CA-125 level was greater than 20 U/mL. CONCLUSION: The present data suggest that in the setting of IDS after platinum-based NAC for advanced ovarian cancer, a pre-IDS CA-125 level less than 20 U/mL is an independent predictor of complete IDS.
Gynecology ; Humans ; Logistic Models ; Multivariate Analysis ; Neoplasms, Glandular and Epithelial ; Obstetrics ; Odds Ratio ; Ovarian Neoplasms ; Retrospective Studies ; ROC Curve

OBJECTIVETo clarify the seasonal differences of the trace element excretion in sweat, the trace element concentration in sweat and their loss during exercise were compared between summer and winter.

METHODSSweat samples were collected from ten healthy adult males. Bicycle ergometer exercise was conducted by each subject at a heart rate of 140 beats/min for 1 hour, in summer and in winter. Sweat was collected by the arm bag method.

RESULTSConcentrations of major (Na, K, Ca, and Mg) and trace elements (Zn, Cu, Fe, Ni, Mn, and Cr) in sweat tended to be lower in summer than in winter, and significantly lower concentrations of Mg (p<0.01), Na, Cu, and Mn (p<0.05) were found in summer. The sweat volume in summer (0.90 L) was 1.7-fold larger than that in winter (0.52 L) (p<0.01). The amount of loss of each element to sweat calculated from the concentrations in sweat and sweat volume showed no significant difference between summer and winter.

CONCLUSIONSIt is suggested that there was no significant difference in the amount of loss of trace elements in sweat due to exercise between summer and winter.

BACKGROUND: The canonical Wnt/β-catenin signaling pathway is a fundamental regulatory system involved in various biological events. ICG-001 selectively blocks the interaction of β-catenin with its transcriptional co-activator cyclic AMP response element-binding protein (CBP). Recent studies have provided convincing evidence of the inhibitory effects of ICG-001 on Wnt-driven disease models, such as organ fibrosis, cancer, acute lymphoblastic leukemia, and asthma. However, the effects of ICG-001 in atopic dermatitis (AD) have not been investigated. OBJECTIVE: To investigate whether β-catenin/CBP-dependent signaling was contributed in the pathogenesis of AD and ICG-001 could be a therapeutic agent for AD. METHODS: We examined the effects of ICG-001 in an AD-like murine model generated by repeated topical application of the hapten, oxazolone (Ox). ICG-001 or vehicle alone was injected intraperitoneally every day during the development of AD-like dermatitis arising from once-daily Ox treatment. RESULTS: Ox-induced AD-like dermatitis characterized by increases in transepidermal water loss, epidermal thickness, dermal thickness accompanied by increased myofibroblast and mast cell counts, and serum levels of thymic stromal lymphopoietin and thymus and activation-regulated chemokine, and decreases in stratum corneum hydration, were virtually normalized by the treatment with ICG-001. Elevated serum levels of periostin tended to be downregulated, without statistical significance. CONCLUSION: These results suggest that β-catenin/CBP-dependent signaling might be involved in the pathogenesis of AD and could be a therapeutic target.
Animals ; Asthma ; Chemokine CCL17 ; Cyclic AMP Response Element-Binding Protein ; Cyclic AMP ; Dermatitis ; Dermatitis, Atopic ; Fibrosis ; Mast Cells ; Mice ; Myofibroblasts ; Oxazolone ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Water

Objectives To analyze the effects of feeding Helianthus tuberosus (HT) tubers on glucose tolerance and lipid profile in rats fed a high-fat diet (HFD). Methods A normal HFD or HFD including 10 w/w% HT tubers (HFD + HT) was fed to F334/Jcl rats. After 10 weeks, organ weights, glucose tolerance, and lipid profile were analyzed. Results The body weight, liver weight, and epidermal fat content in the HFD group were higher than those of the normal group, and similar to those of the HFD + HT group. The oral glucose tolerance test at 10 weeks revealed that the blood glucose level 30 min after beginning the test in the HFD + HT group was significantly lower than that in the HFD group. Liver triglyceride and total cholesterol levels in the HFD + HT group were significantly lower than those in the HFD group. Fecal triglyceride and total cholesterol levels in the HFD + HT group were higher than those in the HFD group. Histological analyses revealed that fat and glycogen accumulation increased in the HFD group, but decreased in the HFD + HT group. Conclusions These results indicate that HT tubers have anti-fatty liver effects based on improvements in glucose tolerance and the hepatic lipid profile.