We report the case of a 46-year-old Chinese male patient who visited our clinic complaining of infertility. Semen analysis revealed azoospermia, and azoospermia factor c region partial deletion (b1/b3) was detected using Y chromosome microdeletion analysis. Testicular sperm extraction was performed after genetic counseling. The bilateral ductus deferens and a portion of the epididymis were absent, whereas the remaining epididymis was expanded. Motile intratesticular spermatozoa were successfully extracted from the seminiferous tubule. On histopathology, nearly complete spermatogenesis was confirmed in almost every seminiferous tubule. To our knowledge, this is the first case report of b1/b3 deletion with a congenital bilateral absence of the vas deferens and almost normal spermatogenesis.
Asian Continental Ancestry Group ; Azoospermia ; Epididymis ; Genetic Counseling ; Humans ; Infertility ; Infertility, Male ; Male ; Middle Aged ; Semen Analysis ; Seminiferous Tubules ; Spermatogenesis* ; Spermatozoa ; Vas Deferens* ; Y Chromosome*

Onco-testicular sperm extraction is used to preserve fertility in patients with bilateral testicular tumors and azoospermia. We report the case of a testicular tumor in the solitary testis of a patient who had previously undergone successful contralateral orchiectomy and whose sperm was preserved by onco-testicular sperm extraction. A 35-year-old patient presented with swelling of his right scrotum that had lasted for 1 month. His medical history included a contralateral orchiectomy during childhood. Ultrasonography revealed a mosaic echoic area in his scrotum, suggesting a testicular tumor. The lesion was palpated within the normal testicular tissue along its edge and semen analysis showed azoospermia. Radical inguinal orchiectomy and onco-testicular sperm extraction were performed simultaneously. Motile spermatozoa were extracted from normal seminiferous tubules under microscopy and were frozen. Eventual intracytoplasmic sperm injection using the frozen spermatozoa is planned. Onco-testicular sperm extraction is an important fertility preservation method in patients with bilateral testicular tumors or a history of a previous contralateral orchiectomy.
Adult ; Azoospermia* ; Fertility ; Fertility Preservation ; Humans ; Infertility, Male ; Male ; Methods ; Microscopy ; Orchiectomy ; Scrotum ; Semen Analysis ; Seminiferous Tubules ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatozoa* ; Testicular Neoplasms* ; Testis* ; Ultrasonography

Introduction: Goshuyuto was effective in a case with intractable hiccups caused by the medulla oblongata dissemination of the cerebellum melanoma. Case:A 54-yearold male patient was diagnosed cerebellum malignant melanoma. He suffered from intractable hiccups caused by the medulla oblongata dissemination lesion of this melanoma. He was treated with some Western medicines such as Baclofen, Metoclopramide, Chlorpromazine and Clonazepam, which are usually used for the treatment of hiccups, but they were not effective. Therefore we gave him Goshuyuto which is Kampo medicine and his hiccups subsided immediately. Since then, he continues taking Gosyuyuto about a year and there has been no recurrence of hiccups thus far. Conclusion: Taking of Kampo medicine is the useful choice for a patient whom Western medicine is ineffective.

  The purpose of this study was to clarify the effects of ingesting chloridquellen and bicarbonate spring waters on electrogastrography and heart rate variability in humans. The subjects were ten young adults (average age 21.9 years old). Three and six cycles per minute (cpm) frequency of electrogastrography (EGG) were measured, as well as the high-frequency (HF: 0.15-0.40Hz) components, and the ratio of low-frequency (LF: 0.04-0.15Hz) components to HF components in heart rate variability (HRV) during 90 minutes. The taste of the water and pain or abnormalities in the stomach were also assessed by having the subjects answer a questionnaire. The subjects ingested the spa water or purified water and were asked to respond to the questionnaire after thirty minutes, and they also ingested no water on a different day and were questioned. The EGG-6 cpm frequency, presumably reflecting intestinal activity, did not change under any conditions. The EGG-3 cpm frequency, presumably reflecting stomach activity, significantly increased with bicarbonate spring waters immediately after ingestion and decreased after 30 min. Additionally, the 3 cpm frequency significantly increased with ingestion of purified water over the course of 30 min. The HF components in HRV, presumably reflecting cardiac parasympathetic activity, did not change under any conditions. The ratio of LF to HF components in HRV, presumably reflecting cardiac sympathetic activity, significantly increased with ingestion of purified water immediately and after 15 min, and bicarbonate spring waters after 30 min. There was a difference between ingestion of chloridquellen and purified water in the answers concerning the taste of the water in the questionnaire. These findings suggest that the constituent parts of chloridquellen water and other factors activate stomach and autonomic nervous activities in humans.

Objectives: Radon (222Rn) is a noble gas and a component of water in many hot spring spas. The Hot Springs Law and the Guideline of Analytical Methods of Mineral Springs (revised edition) of Japan classify springs containing 74 Bq/kg or more of radon as “hot springs” and those with radon levels exceeding 111 Bq/kg as “medical springs”, also called “radioactive springs”. Komono Town, one of the foremost spa and health resort destinations in Mie Prefecture, is the site of many radioactive springs. For the purpose of regional vitalization of this area through radioactive springs, it is necessary to confirm the safety and effectiveness of their use. To evaluate the exposure dose due to radioactive spring usage, it is important to measure radon concentration in air, especially in high-humidity air such as in bathing rooms. Methods: The concentration of radon in air was analyzed using an activated charcoal detector (PICO-RAD; AccuStar Labs) with a desiccant (Drierite; 8-mesh anhydrous calcium sulfate; W.A. Hammond Drierite Company, Ltd.) and a liquid scintillation counter (LSC LB-5; Hitachi Aloka Medical, Ltd.). A DPO (2,5-diphenyloxazole) + POPOP (1,4-bis- (5-phenyl-2-oxazolyl)-benzene) toluene solution (Wako Pure Chemical Industries, Ltd.) was used as a liquid scintillator. Activated charcoal detectors were set up in and around the radioactive spring facilities. Results and Discussion: In a radioactive spring facility, radon concentration in air in the bathing room and changing room were relatively high at about 50 Bq/m3. In the corridor on all floors and at the entrance, these values were approximately 10-30 Bq/m3, indicating that radon in hot spring water diffuses into the air and spreads within the facility. Outdoors, radon concentration was 12.5 Bq/m3 at a campsite near the discharge point of the radioactive spring.   Exposure dose is calculated under the assumption of a two-day stay, during which the visitor will use the bath for several hours. The results obtained show that the exposure dose at the hot spring facility is lower than the exposure dose from daily environmental radiation or medical devices. These conclusions are considered sufficient to confirm the safety of the hot spring facility.

Objectives: Radon (222Rn) is a noble gas found in the water of hot spring spas (“onsen”). In Japan, the Hot Springs Law and the Guideline of Analytical Methods of Mineral Springs (revised) classify springs containing 74 Bq/kg of radon as “hot springs” and those with levels exceeding 111 Bq/kg as “medical springs”, also called “radioactive springs”. According to the notification article (the Nature Conservation Bureau of the Ministry of the Environment in Japan), bathing in a radioactive springs may alleviate the effects of gout, arteriosclerosis, and hypertension as well as chronic conditions such as cholecystitis, gallstones, and skin and gynecological diseases. Drinking water from these springs may treat gout, chronic digestive disorders, chronic cholecystitis, gallstones, neuralgia, muscle pain, and arthralgia. To determine exposure doses from radioactive springs, it is important to establish an easy and accurate method of measuring radon concentration in water and humid air in bathing areas. Methods: This study measured the concentration of airborne radon using an activated charcoal detector (PICO-RAD: AccuStar Labs), desiccant (Drierite; 8 mesh of anhydrous calcium sulfate: W.A. Hammond Drierite Company, Ltd.), a liquid scintillation counter (LSC LB-5: Hitachi Aloka Medical, Ltd.), and 2,5-diphenyloxazole(DPO) + 1,4-bis (5-phenyl-2-oxazolyl) benzene(POPOP) toluene solution (Wako Pure Chemical Industries, Ltd.) were used as the liquid scintillator. Results and Conclusions: This study evaluated radon exposure doses due to radioactive spring at a spa in Komono town, Mie prefecture. After water was piped from hot spring storage tanks into bathtubs, only 5.3-18.0% of the radon remained in the water. Two days later, only 0.25% remained, likely due to radioactive decay and increased diffusion into the air from bathing and recirculating filters. Thus, we investigated radon levels in the humid bathroom air around the radioactive hot spring and determined the total radon exposure from spa water and air. The total exposure dose was calculated assuming a two-day stay, during which customers used the bath for some number of hours. Our findings confirm the safety and efficacy of the hot spring facility. This study was supported in part by a grant from the Daido Life Welfare Foundation.

  We previously reported that in patients with Alzheimer’s disease (AD), the number of baths that patients report taking at their first evaluation at a memory clinic was significantly decreased in comparison to before the onset of dementia. Based on this research, we thought further longitudinal evaluation was needed regarding the relationship between the number of baths, cognitive impairment and depression state after AD progression. In the present study, we reevaluate the number of baths; cognitive function tests (Hasegawa’s Dementia Scale-Revised [HDS-R], Mini Mental State Examination [MMSE] and Wechsler Adult Intelligence Scale-Revised [WAIS-R]); and the depression assessment (Zung Self-rating Depression Scale [SDS]) 1 year after first evaluation.   At the first evaluation, the average number of baths taken by 65 AD patients (16 male, 49 female; range: 64-90 years, average: 79.5±5.6 years), was 5.6±1.6 bathsweek. At the reevaluation, this number had decreased to 4.9±1.9 bathsweek. In the WAIS-R, a significant positive correlation was found between the score change in number of baths and the change in performance intelligence quotient (PIQ) and total intelligence quotient (TIQ). However, no significant correlation was found between the score change in number of baths and the change in HDS-R, MMSE, or verbal intelligence quotient in WAIS-R or SDS.   We further evaluated the present series by dividing the study population into two subtypes: a group of patients in which the number of baths decreased 1 year after the first evaluation, and a group in which there was no change. There were no significant differences in background factors (e.g. average age at first evaluation) between the groups. Although, no significant difference was observed between the groups in number of baths before dementia onset (both were 6.7 timesweek), a significant difference was found at the first evaluation (5.3 bathsweek vs 5.9 bathsweek, respectively). No significant differences were observed between the groups in cognitive function test or depression assessment at the first evaluation. However, on reevaluation the group with the decreased number of baths showed significantly lower PIQ and TIQ scores in WAIS-R and a significantly higher SDS score.   The results of the present study suggested that number of baths decreased along with the progression of AD and the greatest participating factor was the practical dysfunction reflected by the PIQ score in WAIS-R. Furthermore, we considered the existence of two subtypes: patients in whom the number of baths decreases with AD progression and those in whom there is no change.

  In Japan, the Hot Springs Law and the Guideline of Analytical Methods of Mineral Springs (revised) classify springs containing 74 Bq/kg of radon as “hot springs” and those with radon levels exceeding 111 Bq/kg as “medical springs” called “radioactive spring”. Radon is a noble gas that easily diffuses in air.   This study evaluates exposure dose due to radon when using a radioactive spring at a spa in the Toriido area, Komono town, Mie district, Mie prefecture.   After bath water was supplied through a pipe from hot spring storage tanks to bathtubs, only 5.3-18.0% of radon remained in the water. Two days later, only 0.3-0.4% of the radon remained in the bath water due to radioactive decay and diffusion into air being increased by bathing and recirculation filtering.   The calculated effective dose from bathing in radioactive hot spring was 2.8-12.0 nSv, and that from drinking radioactive hot spring water was 5.1-23.3 nSv. To determine the total effective dose from use of the hot spring facility that may effects on human health, it is necessary to analyze radon concentrations not only in the water but also the surrounding air.

 Because bathing frequency decrease as Alzheimer disease (AD) worsens, we investigated the relation between cognitive disfunction and bathing frequency.  We asked AD patients and their caregivers about the number of times the patient bathed per week before onset of dementia and the time of first clinical consultation. We investigated the relation between scores from a cognitive function test (Hasegawa’s Dementia Scale-Revised [HDS-R], the Mini Mental State Examination [MMSE] and Wechsler Adult Intelligence Scale-Revised [WAIS-R]), and a depression assessment (Zung Self-rating Depression Scale [SDS]) and number of baths taken per week.  Before onset of dementia, the average number of baths taken by 89 AD patients (26 men, 63 women; range: 63-90 years, average: 79.8 years), was 6.6 times/week. At evaluation time, this number had decreased significantly to 5.3 times/week (p<0.001). A significant positive correlation was found between perfomance Intelligence Quotient (IQ) and total IQ of the WAIS-R and number of baths (p<0.001, p<0.01, respectively). No significant correlation coefficient was found between HDS-R, MMSE, verbal IQ of the WAIS-R and the SDS and number of baths. Reasons of the patients gave for less frequent bathing were that bathing was troublesome or was forgotten and that thermoregulation of bath water had become impossible.  The results suggested that in AD patients, number of baths taken decreased with aggravation of cognitive dysfunction and that there were multiple participating factors including memory disturbance, depressive state, and, particularly, executive dysfunction.