PURPOSE: The objective of this study is to evaluate the relationship of atheroembolic risk factors with postoperative recovery of renal function after on-clamp partial nephrectomy (PN) with warm ischemia in patients with staged T1-2 renal cell carcinoma (RCC). MATERIALS AND METHODS: A total of 234 patients from 2004 to 2012 were included, and their clinicopathologic and operative parameters, including atheroembolic risk factors were reviewed retrospectively. Renal function, as determined by estimated glomerular filtration rate (eGFR) and measurement of serum creatinine level (Cr) at each scheduled follow-up for a median four years, was compared between the high-risk (HR) group (n=49, > or = five risk factors) and the low-risk (LR) group (n=185, < five risk factors). RESULTS: Except for baseline renal function and number of risk factors for atheroembolism, differences in characteristics between groups were comparatively insignificant. At 3 months after the operation, Cr and eGFR differed significantly between the two groups (p < 0.05), but no differences were observed afterward. Significant deterioration from baseline in Cr and eGFR was observed in both groups at 1 month after the operation, with a greater change in the HR group (p < 0.05). From measurement to measurement, significantly faster deterioration in Cr and eGFR was observed in the HR group than in the LR group until 6 months after the operation (Cr: LR, 0.02 mg/dL and HR, 0.13 mg/dL; eGFR: LR, 1.50 mL/min/1.73 m2 and HR, 6.38 mL/min/1.73 m2; p < 0.05). CONCLUSION: The presence of atheroembolic risk factors may negatively influence postoperative recovery of renal function after PN in patients with localized RCC.
Atherosclerosis ; Carcinoma, Renal Cell* ; Creatinine ; Embolism ; Embolism, Cholesterol ; Follow-Up Studies* ; Glomerular Filtration Rate ; Humans ; Nephrectomy* ; Retrospective Studies ; Risk Factors* ; Warm Ischemia

Primary ovarian choriocarcinoma arising from a germ cell is an extremely rare occurrence, especially in postmenopausal women, and the prognosis is poor. Non-gestational choriocarcinoma of the ovary (NGCO) accounts for 0.6% or less of all ovarian neoplasms. It is important to distinguish gestational choriocarcinomas of the ovary (GCO) from other carcinomas because of the poor prognosis of NGCO. We describe a case of NGCO with lung metastasis in a 55 year old woman, which we present together with a brief review of the literature.
Choriocarcinoma ; Choriocarcinoma, Non-gestational ; Female ; Germ Cells ; Humans ; Lung ; Neoplasm Metastasis ; Ovarian Neoplasms ; Ovary ; Postmenopause ; Pregnancy ; Prognosis

Although assisted reproductive technology is associated with higher rates of interstitial pregnancy and heterotopic pregnancy, heterotopic pregnancy after bilateral salpingectomy is still extremely rare. We report a case of heterotopic pregnancy after bilateral salpingectomy in an in vitro fertilization/embryo transfer patient, who underwent cornual resection by laparotomy due to ruptured cornual pregnancy. However, 3 days after surgery, the remaining intrauterine pregnancy miscarried, and a dilatation and curettage was performed.
Dilatation and Curettage ; Embryo Transfer ; Embryonic Structures ; Female ; Fertilization in Vitro ; Humans ; Laparotomy ; Pregnancy ; Pregnancy, Heterotopic ; Reproductive Techniques, Assisted ; Salpingectomy

This study was performed to compare the fatigue limit of stainless steel wires and Fiber-reinforced composites (FRC) under conditions of permitting physiologic tooth movement, and to evaluate the clinical value of FRCs which was used to reinforce the anchorage unit. The stainless steel wire groups were divided into round and rectangular wire groups. The FRC groups were divided into uni-directional and woven groups, with resin coating and without resin coating in the proximal area. After the number of cycles to failure of each of the 6 groups were measured within the 5 x 10(5) cycle fatigue limit simulating the orthodontic treatment period, the fatigue limit of each group was compared with each other. The findings of this study were as follows. In stainless steel wires, the fatigue limit of rectangular wires were higher than that of round wires. But there was no statistically significant difference (p > 0.05). In FRCs with resin coating and without resin coating in the interproximal area, the fatigue limit of uni-directional type was higher than that of the woven type (p < 0.05). In uni-directional and woven type FRCs, the fatigue limit of FRC with resin coating in the interproximal area was higher than that of FRC without resin coating (p < 0.05). As the FRCs and stainless steel wires did not fracture until the 5 x 10(5) cycle fatigue limit which clinically is useful, it is sufficient to use FRC and stainless steel wire for reinforcing anchorage. When esthetics is important and the attachment of additional devices are necessary, it seems sufficient to use FRC as anchorage reinforcement.
Esthetics ; Fatigue* ; Stainless Steel* ; Tooth Movement ; Tooth*

Anoctamin 5 (ANO5)/TMEM16E belongs to a member of the ANO/TMEM16 family member of anion channels. However, it is a matter of debate whether ANO5 functions as a genuine plasma membrane chloride channel. It has been recognized that mutations in the ANO5 gene cause many skeletal muscle diseases such as limb girdle muscular dystrophy type 2L (LGMD2L) and Miyoshi muscular dystrophy type 3 (MMD3) in human. However, the molecular mechanisms of the skeletal myopathies caused by ANO5 defects are poorly understood. To understand the role of ANO5 in skeletal muscle development and function, we silenced the ANO5 gene in C2C12 myoblasts and evaluated whether it impairs myogenesis and myotube function. ANO5 knockdown (ANO5-KD) by shRNA resulted in clustered or aggregated nuclei at the body of myotubes without affecting differentiation or myotube formation. Nuclear positioning defect of ANO5-KD myotubes was accompanied with reduced expression of Kif5b protein, a kinesin-related motor protein that controls nuclear transport during myogenesis. ANO5-KD impaired depolarization-induced [Ca²⁺]i transient and reduced sarcoplasmic reticulum (SR) Ca²⁺ storage. ANO5-KD resulted in reduced protein expression of the dihydropyridine receptor (DHPR) and SR Ca²⁺-ATPase subtype 1. In addition, ANO5-KD compromised co-localization between DHPR and ryanodine receptor subtype 1. It is concluded that ANO5-KD causes nuclear positioning defect by reduction of Kif5b expression, and compromises Ca²⁺ signaling by downregulating the expression of DHPR and SERCA proteins.
Active Transport, Cell Nucleus ; Calcium Channels, L-Type ; Cell Membrane ; Chloride Channels ; Humans ; Muscle Development ; Muscle Fibers, Skeletal ; Muscle, Skeletal ; Muscular Diseases ; Muscular Dystrophies ; Muscular Dystrophies, Limb-Girdle ; Myoblasts ; RNA, Small Interfering ; Ryanodine Receptor Calcium Release Channel ; Sarcoplasmic Reticulum

This study was performed to evaluate clinical practicality of the rebonding method with flowable resin without the removal of the residual resin on the debonded teeth and debonded bracket base after debonding. The samples of the control group (group I) were rebonded with Transbond XT(R) using the usual rebonding method after the residual resin was removed. At experimental group, the brackets were rebonded with Transbond XT(R) (group II) and CharmFil Flow(R) (group III) without removal of residual resin which is the possibility becoming the index for rebonding to similar position with initial bonding. The shear bond strength of the each group was measured. Patterns of bonding failure were evaluated with modified ARI score, and the shear bond strength according to patterns of bonding failure at experimental group was compared. Between the control group (6.51 +/- 1.21 MPa) and the group II rebonded with Transbond XT(R) (6.30 +/- 1.01 MPa) did not have significantly difference in the shear bond strength (p = 0.534), and the shear bond strength of group II was significantly lower than the group III rebonded with CharmFil Flow(R) (7.29 +/- 1.54 MPa) (p = 0.009). At control group, there was not large difference in distribution of bonding failure pattern. But at experimental group, bond failure did not occur in interface between the resin-enamel. and bond failure between the resin-bracket, within the resin was distributed similarly. There was not significantly difference in the shear bond strength according to patterns of bonding failure at experimental group (p > 0.05). The result of this study showed that the method suggested in this study and flowable resin as rebonding adhesive could be useful in clinically.
Adhesives ; Orthodontic Brackets* ; Tooth

We cultured the rabbit inner medullary collecting duct (IMCD) cells as monolayers on collagen-coated membrane filters, and investigated distribution of the P2Y receptors by analyzing nucleotide-induced short circuit current (Isc) responses. Exposure to different nucleotides of either the apical or basolateral surface of cell monolayers stimulated Isc. Dose-response relationship and cross-desensitization studies suggested that at least 3 distinct P2Y receptors are expressed asymmetrically on the apical and basolateral membranes. A P2Y2-like receptor, which responds to UTP and ATP, is expressed on both the apical and basolateral membranes. In addition, a uracil nucleotide receptor, which responds to UDP and UTP, but not ATP, is expressed predominantly on the apical membrane. In contrast, a P2Y1-like receptor, which responds to ADP and 2-methylthio-ATP, is expressed predominantly on the basolateral membrane. These nucleotides stimulated intracellular cAMP production with an asymmetrical profile, which was comparable to that in the stimulation of Isc. Our results suggest that the adenine and uracil nucleotides can interact with different P2Y nucleotide receptors that are expressed asymmetrically on the apical and basolateral membranes of the rabbit IMCD cells, and that both cAMP- and Ca2+-dependent signaling mechanisms underlie the stimulation of Isc.
Adenine ; Adenosine Diphosphate ; Adenosine Triphosphate ; Membranes ; Nucleotides ; Uracil ; Uracil Nucleotides ; Uridine Diphosphate ; Uridine Triphosphate

In contrast to ventricular myocytes, the structural and functional importance of atrial transverse tubules (T-tubules) is not fully understood. Therefore, we investigated the ultrastructure of T-tubules of living rat atrial myocytes in comparison with ventricular myocytes. Nanoscale cell surface imaging by scanning ion conductance microscopy (SICM) was accompanied by confocal imaging of intracellular T-tubule network, and the effect of removal of T-tubules on atrial excitation-contraction coupling (EC-coupling) was observed. By SICM imaging, we classified atrial cell surface into 4 subtypes. About 38% of atrial myocytes had smooth cell surface with no clear T-tubule openings and intracellular T-tubules (smooth-type). In 33% of cells, we found a novel membrane nanostructure running in the direction of cell length and named it 'longitudinal fissures' (LFs-type). Interestingly, T-tubule openings were often found inside the LFs. About 17% of atrial cells resembled ventricular myocytes, but they had smaller T-tubule openings and a lower Z-groove ratio than the ventricle (ventricular-type). The remaining 12% of cells showed a mixed structure of each subtype (mixed-type). The LFs-, ventricular-, and mixed-type had an appreciable amount of reticular form of intracellular T-tubules. Formamide-induced detubulation effectively removed atrial T-tubules, which was confirmed by both confocal images and decreased cell capacitance. However, the LFs remained intact after detubulation. Detubulation reduced action potential duration and L-type Ca2+ channel (LTCC) density, and prolonged relaxation time of the myocytes. Taken together, we observed heterogeneity of rat atrial T-tubules and membranous ultrastructure, and the alteration of atrial EC-coupling by disruption of T-tubules.

In contrast to ventricular myocytes, the structural and functional importance of atrial transverse tubules (T-tubules) is not fully understood. Therefore, we investigated the ultrastructure of T-tubules of living rat atrial myocytes in comparison with ventricular myocytes. Nanoscale cell surface imaging by scanning ion conductance microscopy (SICM) was accompanied by confocal imaging of intracellular T-tubule network, and the effect of removal of T-tubules on atrial excitation-contraction coupling (EC-coupling) was observed. By SICM imaging, we classified atrial cell surface into 4 subtypes. About 38% of atrial myocytes had smooth cell surface with no clear T-tubule openings and intracellular T-tubules (smooth-type). In 33% of cells, we found a novel membrane nanostructure running in the direction of cell length and named it 'longitudinal fissures' (LFs-type). Interestingly, T-tubule openings were often found inside the LFs. About 17% of atrial cells resembled ventricular myocytes, but they had smaller T-tubule openings and a lower Z-groove ratio than the ventricle (ventricular-type). The remaining 12% of cells showed a mixed structure of each subtype (mixed-type). The LFs-, ventricular-, and mixed-type had an appreciable amount of reticular form of intracellular T-tubules. Formamide-induced detubulation effectively removed atrial T-tubules, which was confirmed by both confocal images and decreased cell capacitance. However, the LFs remained intact after detubulation. Detubulation reduced action potential duration and L-type Ca2+ channel (LTCC) density, and prolonged relaxation time of the myocytes. Taken together, we observed heterogeneity of rat atrial T-tubules and membranous ultrastructure, and the alteration of atrial EC-coupling by disruption of T-tubules.

Phytobezoars are the most common bezoars composed of non-digestible food materials, such as fiber, seeds, skin of fruits. The predisposing factors of bezoars are altered gastrointestinal motility and anatomy. It is uncommon for bezoars occurring in patient with normal gastric anatomy to cause impaction on the duodenal bulb. We experienced a phytobezoar at the duodenal bulb causing gastric outlet obstruction in a patient who had no predisposing factors. The patient was treated by endoscopic removal.
Bezoars ; Duodenum ; Fruit ; Gastric Outlet Obstruction ; Gastrointestinal Motility ; Humans ; Seeds ; Skin