Male mice of dd-strain, at 3 weeks of age were used at the start of the exercise training. The exercise training continued successively throughout the 3 to 7 weeks of age. The trained group was divided groups ; namely, light-, middle- and heavy-trained groups, which were exercised on a treadmill. The treadmill exercise program for light-, middle- and heavy-trained groups consisted of running at speeds of 6 m/min, 10 m/min and running up a 10% grade at a speed of 12 m/min for 10 min 5 times a week, respectively. The untrained group was used as control under normal laboratory condition. The skin and Achilles tendon of the four groups were sampled and their collagen content were examined by means of concentration of hydroxyproline. The collagen content in the skin of growing mice did not recognize significant difference among the four groups. On the other hand, the collagen content in the Achilles tendon of growing mice clearly recognized significant difference between the middle-trained and untrained groups and/or between the middle-trained and light-trained groups. However, middle-exercise training reduced the accumulation of collagen in the Achilles tendon of grow. ing mice.

Branching morphogenesis of the fetal mouse submandibular gland (SMG) is regulated by signaling through the ErbB and FGF families of tyrosine kinase receptors, whose members activate the ERK-1/2 pathway. The four Sprouty (Spry) proteins are inhibitory modulators of ERK-1/2. There is little information on their expression during pre- and postnatal development of the SMG. Qualitative RT-PCR detected mRNAs for Spry1, 2, and 4 from embryonic day 13 (E13) through postnatal day 7 (P7), but only trace amounts of Spry1 and 2 in adult SMGs. More sensitive quantitative RT-PCR revealed that transcripts for all four Spry isoforms are expressed, and each shows individual patterns of variation across fetal and early postnatal stages, and that there are very low levels of Spry1 and 2, but no Spry3 and 4, in adult glands. EGF, FGF7 and FGF10 upregulate expression of mRNA for Spry1, but only FGF7 upregulates Spry2 mRNA. EGF strongly induces an activating phosphorylation of all four Spry isoforms, but both FGFs do so only minimally. Quantitative RT-PCR of samples collected by laser capture microdissection showed that transcripts for Spry1 are confined to the epithelium of E13 SMG rudiments. The isoform-specific temporal variation in the patterns of expression of Spry1, 2, 3 and 4 suggests a potentially important role for these negative modulators of growth-factor driven ras/ERK-1/2 signaling at stages when the SMG is most actively undergoing branching morphogenesis.

Postoperative infections should be comprehensively controlled in the context of infection control, rather than as activities of individual surgeons. We started a surgical site infection (SSI) surveillance program in 2009 in which prophylactic measures for preventing SSIs were applied. These measures were as follows : 1) screening for nasal carriage of methicillin-resistant Staphylococcus aureus ; 2) dental checks and oral screening ; 3) antibiotic prophylaxis in the intra- and postoperative period ; 4) control of glucose levels to ≤160 mg/dl in the immediate postoperative period ; and 5) early removal of surgical drain. After the introduction of prophylactic measures, we reexamined SSI surveillance and added the following prophylactic measures at the beginning of 2011 : 6) data concerning SSI and compliance with prophylactic measures for all surgical and ward staff were published monthly, and the Infection Control Team (ICT) and surgeons performed weekly ward visits to assess SSIs ; 7) recommendations were made for wearing two pairs of gloves and surgical hoods to cover the hair, scalp, ears and neck ; and 8) collaboration with diabetologists was implemented to control glucose levels in diabetics. We compared incidences of SSI in cardiovascular surgery from the periods before (469 cases, Group B) and after (118 cases, Group A) introduction of the additional prophylactic measures. Clinical characteristics of patients in each group did not differ significantly. Operative time was significantly shorter in Group A (400±116 min) than in Group B (434±145 min). Compliance with antibiotic prophylaxis in the intraoperative period improved progressively from 93% in Group B to 99% in Group A. Compliance with control of glucose levels to ≤160 mg/dl on postoperative day 1 improved progressively from 71% in Group B to 81% in Group A. Duration of drain placement was significantly shorter in Group A (2.9±1.8 days) than in Group B (3.6±2.9 days). Incidence of SSI decreased significantly from 6.0% in Group B to 0.8% in Group A. Revision of preventive measures based on the results of surveillance and enhancement of cooperation between the ICT and surgeons could help to decrease the incidence of SSI.

We report a case in which feelings of abdominal distension and discomfort of the abdominal wall caused by malignant ascites were relieved by ultrasound-guided rectus sheath block. Case report: A 59-year-old man developed gastric cancer with malignant ascites and experienced feelings of abdominal distension, but no nausea, dyspnea, poor mobility, or limb edema. Symptom control was inadequate with diuretic therapy and abdominal paracentesis. Feelings of distension improved temporarily with ultrasound-guided rectus sheath block. A percutaneous catheter was then used to administer an infusion of 0.25% ropivacaine triweekly until his death 20 days later. Conclusion: Feelings of abdominal distension is one of various symptoms of severe ascites and is difficult to manage. Ultrasound-guided rectus sheath block can be used to relieve this symptom on a case-by-case basis.

We report a case whose left lower limb neuropathic pain accompanied by pelvic tumor invasion was remarkably eliminated by ultrasound-guided sciatic nerve block. Case report: The subject was a sixty year old male. Pharmacological therapy was given according to the WHO analgesic ladder, but his left lower limb pain failed to respond to drugs. His intractable lower limb neuropathic pain was alleviated by ultrasound-guided sciatic nerve block. Drug delivery can be achieved with a percutaneous catheter and a disposable infusion pump. Infusions were run at 5mlh^-1 with 0.1% ropivacaine. Conclusion: Neuropahic pain is sometimes hard to be controlled only by opioids or adjuvant analgesics, but there is a possibility of providing pain relief by combination use with nerve blocks. Interventional techniques can be highly effective but also have the potentiality to produce significant adverse effects. Many patients have factors which would be considered a near absolute contra-indication to the use of nerve blocks such as immuno-compromise or impairment of coagulation. Skillful application of peripheral neural blockade with ultrasound imaging broadens the options for providing optimal pain management. Palliat Care Res 2011; 6(1): 313-315

Objective : Risk factors for SSI after open heart surgeries were evaluated in relation to a bundle of SSI preventive measures. Methods : Research design is a retrospective cohort study. The study population was 1,579 patients who had received open heart surgeries at Kobe City Medical Center General Hospital from January 2008 to December 2010 (Period I : when standard infection prevention measures were implemented) and from January 2014 to December 2016 (Period II : after a relocation of the hospital to a new campus and enhanced infection prevention measures were implemented). Factors associated with SSI were determined using univariate modelling analysis followed by multi-variate logistic regression analysis. The Center for Disease Control and Prevention definition of SSI was used for case determination. Results : Overall SSI incidence was 4.5%. SSI incidence decreased significantly from 6.6% in Period I to 2.9% in Period II (p＜0.001). Significant improvement in adherence to the recommended preventive measures was observed in Period II in selection of appropriate antibiotics, discontinuation of prophylactic antibiotics within 72 h after surgery and glucose control on post-operative Day 1 and 2 (p＜0.001). A univariate analysis showed statistical significance in surgical procedure, surgical period, surgical duration, post-operative day 2 morning glucose level, administration of prophylactic antibiotics within 1 h before incision, 100% compliance with the Bundle. Complex surgery (odds ratio 2.5 ; 95%CI 1.3～4.8) were identified as a risk factor by multiple logistic regression. Surgical period (Period II, odds ratio 0.41 ; 95%CI 0.28～30.71) and administration of prophylactic antibiotics within 1 h before incision (odds ratio 0.57 ; 95%CI 0.33～0.97) reduced SSI risks. Conclusion : The study demonstrated administration of prophylactic antibiotics within 1 h before incision was particularly important for SSI prevention. Higher compliance with SSI bundle and a special attention to patients receiving complex surgery were also warranted.