Surgical resection of cystic intraductal papillary adenocarcinoma of the bile duct: report of a case.
We describe a cystic intraductal papillary neoplasm of bile duct (IPNB) of adenocarcinoma treated with surgical resection. An 82-year-old man was admitted to our hospital because of distension of the right upper quadrant of the abdomen. On admission, a huge nontender mass was palpated in the right upper abdomen. Initial laboratory tests revealed the following serum values: aspartate aminotransferase, 123 IU/L; alanine aminotransferase, 113 IU/L; alkaline phosphatase, 376 IU/L; bilirubin, 1.6 mg/dL; alpha-fetoprotein, 7.4 ng/mL; CA19-9, 39.8 U/mL; carcinoembryonic antigen, 4.1 ng/mL; and Duke pancreatic monoclonal antigen t...
Source: Journal of Nippon Medical School - July 12, 2013 Category: Universities & Medical Training Authors: Shimoda T, Yoshida H, Hirakata A, Makino H, Yokoyama T, Maruyama H, Ueda J, Tanno M, Naito Z, Uchida E Tags: J Nippon Med Sch Source Type: research

In situ Search for Breast Cancer Stem Cells and Their Niche: The Film Sheet Epoxy Resin Embedding Method and Breast Cancer Stem Cells.
PMID: 23832410 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - July 12, 2013 Category: Universities & Medical Training Authors: Yamamoto Y, Oguro T, Mieda J, Ohashi R, Tsuchiya S Tags: J Nippon Med Sch Source Type: research

Abstracts of the 23rd nippon medical school foundation academic meeting for foreign researchers.
Authors: PMID: 23832411 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - July 12, 2013 Category: Universities & Medical Training Tags: J Nippon Med Sch Source Type: research

Four-dimensional flow magentic resonance imaging assessment of hemodynamics in patients after extracranial-intracranial bypass surgery.
PMID: 23470800 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Sekine T, Amano Y, Takagi R, Matsumura Y, Suzuki Y, Murai Y, Kumita S Tags: J Nippon Med Sch Source Type: research

Surgical technique of orthotopic liver transplantation in rats: the Kamada technique and a new splint technique for hepatic artery reconstruction.
Abstract Orthotopic liver transplantation (OLT) in rats is technically feasible and useful for the assessment of clinical liver transplantation and analysis of inflammatory liver diseases. OLT in rats was pioneered by Lee et al. in 1973 using hand-suture techniques of all vessels. This model has not been widely used due to the long operative time and technical demand. The cuff method was introduced by Kamada in 1979, and today, the Kamada technique is the one most commonly used worldwide. However, this technique does not include hepatic artery reconstruction, although this procedure is routinely performed in clini...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Ishii E, Shimizu A, Takahashi M, Terasaki M, Kunugi S, Nagasaka S, Terasaki Y, Ohashi R, Masuda Y, Fukuda Y Tags: J Nippon Med Sch Source Type: research

Signal processing in the mammalian retina.
Abstract Visual information contains many different elements, such as contrast, color, brightness, and movement. Each element is extracted from visual information in a specialized neural circuit of the retina. Finally, the extracted signals are reconstructed into coded signals at the retinal ganglion cells and sent to the higher visual center in parallel for further processing. Each specialized neural circuit has both ON- and OFF-pathways, and the signal processing in the ON-pathway is a mirror image of that in the OFF-pathway. This review focuses on the dichotomy of neural circuits in the mammalian retina. P...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Kaneda M Tags: J Nippon Med Sch Source Type: research

The influence of a direct renin inhibitor on the central blood pressure.
Abstract Background: Central blood pressure (CBP) is superior to brachial blood pressure as a predictor of cardiovascular risk in patients with hypertension. There is currently no consensus regarding whether a direct renin inhibitor (DRI) selectively acts on CBP. Methods: Thirty subjects with essential hypertension who showed a CBP of 140 mm Hg or higher after 12 weeks of treatment with a standard dose of a DRI (150 mg) were analyzed. The patients were randomly divided into 2 groups: the high-dose DRI group (n=15) received 300 mg of DRI per day, and the combination group (n=15) received both the standard dose of t...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Kubota Y, Takahashi H, Asai K, Yasutake M, Mizuno K Tags: J Nippon Med Sch Source Type: research

Rewarding effects of ethanol combined with low doses of morphine through dopamine D1 receptors.
This study investigated whether ethanol combined with low doses of morphine produces rewarding effects in rats. Ethanol (0.075-1.2 g/kg, intraperitoneal [i.p.]) alone did not induce place preference. A moderate dose (1 mg/kg, s.c.), but not a low dose (0.1 mg/kg), of morphine induced a significant place preference. The combination of ethanol (0.075-0.6 g/kg, i.p.) and 0.1 mg/kg of morphine, as well as low doses of morphine (0.03-0.1 mg/kg, subcutaneous [s.c.]) combined with ethanol (0.3 g/kg, i.p.), induced a significant place preference. The combined effect of ethanol and morphine was significantly attenuated by naloxone ...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Ise Y, Mori T, Katayama S, Nagase H, Suzuki T Tags: J Nippon Med Sch Source Type: research

Survival times of patients with a first hip fracture with and without subsequent major long-bone fractures.
This study compared the survival times of community-dwelling patients with hip fracture who had or did not have a subsequent major long-bone fracture. Hazard ratios and risk factors for subsequent fractures and mortality rates with and without subsequent fractures were calculated. MATERIALS AND METHODS: Of 844 patients with hip fracture from 2000 through 2008, 71 had a subsequent major long-bone fracture and 773 did not. Patients who died of other causes, such as perioperative complications, during hospitalization were excluded. Such exclusion allowed us to determine the effect of subsequent fracture on the survival o...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Angthong C, Angthong W, Harnroongroj T, Naito M, Harnroongroj T Tags: J Nippon Med Sch Source Type: research

Administration of cilostazol, an antiplatelet, to patients with acute-stage cerebral infarction and its effects on plasma substance P level and latent time of swallowing reflex.
Discussion: No significant time-dependent change in plasma substance P level was found probably because of large individual differences but, 28 days after the start of treatment, this value tended to become higher in cilo group than in non-cilo group (P
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Abe A, Nishiyama Y, Hagiwara H, Okubo S, Ueda M, Katsura K, Katayama Y Tags: J Nippon Med Sch Source Type: research

Pitfalls in training simulated patients to respond appropriately to questions from medical students in family history-taking activities: the current situation surrounding the training of simulated patients for learning activities at Nippon Medical School.
In conclusion, training SPs to respond appropriately to questions about family history in medical interviews is very important. Medical students have to learn how to take family histories accurately, so SP trainers should pay attention to training SPs in giving appropriate responses to students' questions, bearing in mind the differences between family history taking and everyday conversations about the family. PMID: 23470807 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Aso R, Inoue C, Yoshimura A, Shimura T Tags: J Nippon Med Sch Source Type: research

Team-based learning using an audience response system: a possible new strategy for interactive medical education.
Abstract Following the "Guidelines for reporting TBL" by Haidet et al, we report on a team-based learning (TBL) course we adopted for our 4th-year students in 2011. Our TBL course is a modified version of the one suggested in the guidelines, but its structure generally follows the core elements described therein. Using an audience response system (ARS), we were able to obtain individual and group readiness assurance test scores immediately and give instant feedback to the students. Instructors were thus able to monitor students' understanding in real time and so appreciated the system, which supports int...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Fujikura T, Takeshita T, Homma H, Adachi K, Miyake K, Kudo M, Takizawa T, Nagayama H, Hirakawa K Tags: J Nippon Med Sch Source Type: research

Ultrasound detection of lacunae-like image of a cesarean scar pregnancy in the first trimester.
We describe a case of cesarean scar pregnancy that was initially misdiagnosed on the basis of current ultrasonographic criteria. Ultrasonographic images at 9 weeks' gestation demonstrated no gestational sac but did show a bulging mass in uterine wall with irregularly shaped hypoechoic areas, which resembled the lacunae in placenta previa. Color Doppler imaging demonstrated that the lacunae-like areas were richly perfused. Cesarean scar pregnancy was finally diagnosed with magnetic resonance imaging, which showed a lack of myometrium in the lower anterior uterine wall with placental invasion. Histological examination of the...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Sekiguchi A, Okuda N, Kawabata I, Nakai A, Takeshita T Tags: J Nippon Med Sch Source Type: research

Simultaneous treatment of pterygium and temporal conjunctivochalasis.
We report such a surgical method and describe the results of two cases. Two patients presented with pterygium accompanied by temporal conjunctivochalasis. We decided to perform simultaneous pterygium excision and free conjunctival autograft transfer using the excess conjunctiva from the conjunctivochalasis surgery. The free graft was obtained from the bulbar conjunctiva from the 6 to 8 o'clock position in the conjunctivochalasis. To reduce the temporal conjunctivochalasis, the conjunctiva was extended and sutured to the perilimbal conjunctiva and episclera at the 6 o'clock position using 8-0 polyglactin suture. Tear menisc...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Suzuki H, Shiwa T, Oharazawa H, Igarashi T, Takahashi H Tags: J Nippon Med Sch Source Type: research

Mimic mini-laparoscopic surgery is a simple and secure approach using direct placement of 3-mm trocars without noticeable scars.
Abstract Minimally invasive surgery is widely used in gynecology. Women who seek a cosmetic advantage (i.e., concealed scars) choose minimally invasive surgery. Although laparoendoscopic single-site surgery could be an ideal solution, some of our patients have had cosmetic problems, such as pigmentation and cicatrix of the umbilicus. In addition, umbilical eversion and umbilical herniation occasionally develop. Therefore, mini-laparoscopic surgery using 3-mm trocars can be recommended for patients who do not want the natural appearance of the navel to be altered. We have developed an approach to achieve a superior...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Ichikawa M, Akira S, Hamano E, Ono S, Mine K, Takeshita T Tags: J Nippon Med Sch Source Type: research

Congenital dermoid cyst at the anterior fontanelle: neuroimaging before and after fontanelle closure.
PMID: 23589932 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Nejat F, El Khashab M Tags: J Nippon Med Sch Source Type: research

Author's reply.
PMID: 23589933 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Adachi K Tags: J Nippon Med Sch Source Type: research

Requirement of E-cadherin Interactions for Langerhans Cell Differentiation.
PMID: 23657059 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Takahashi H, Watanabe E, Mayumi N Tags: J Nippon Med Sch Source Type: research

Role of the Placenta in Adverse Perinatal Outcomes among HIV-1 Seropositive Women.
Abstract Women seropositive for human immunodeficiency virus type 1 (HIV-1) are at an increased risk for a number of adverse perinatal outcomes. Although efforts to reduce mother-to-child transmission of HIV (MTCT) remain a priority in resource-limited countries, HIV testing and treatment have led to steep declines in MTCT in well-resourced countries. Even so, HIV seropositive pregnant women in the United States continue to deliver a disproportionately high number of preterm and low birth weight infants. In this mini-review, we address the role of the placenta in such HIV-related perinatal sequelae. We posit that ...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Ackerman Iv W, J Kwiek J Tags: J Nippon Med Sch Source Type: research

Dramatic alterations in the protein biosynthetic machinery accompany trophoblast fusion.
This report represents a summary of a seminar presentation at Nippon Medical School on September 24, 2012. It is a synopsis of some of our research on trophoblast fusion. PMID: 23657061 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: M Robinson J Tags: J Nippon Med Sch Source Type: research

Macrophages: are they involved in endometriosis, abortion and preeclampsia and how?
Abstract Macrophages hold a key role in both regulating and executing the body's own immune response under various conditions. Hence, although endometriosis, preeclampsia and abortions are clinically different, all three are regarded to involve highly complex immunological processes. The aim of our current work was to evaluate the role of macrophages within these gynaecological disorders. Macrophages have been shown to invade endometriosis lesions and to mediate propagation of endometriotic cyst growth. However this is the first time that significant GPER up-regulation in macrophages is demonstrated. This highligh...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Hutter S, Heublein S, Knabl J, Andergassen U, Vrekoussis T, Makrigiannakis A, Friese K, Mayr D, Jeschke U Tags: J Nippon Med Sch Source Type: research

Sleep disorders in functional dyspepsia and future therapy.
Abstract Sleep disorder is a common medical problem. Sleep disorder has been associated with several diseases, including pulmonary disease, gastroesophageal reflux disease (GERD) and fibromyalgia. Interest in sleep phenomenology and gastrointestinal functioning has recently increased, because sleep disorder causes significant morbidity, as evidenced by the increased need for general medical and mental health treatment for emotional problems. A number of studies have found an association between sleep disorders and functional gastrointestinal (GI) disorders. Although arousal from sleep serves several protective rol...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Futagami S, Shimpuku M, Yamawaki H, Izumi N, Kodaka Y, Nagoya H, Wakabayashi T, Shindo T, Kawagoe T, Sakamoto C Tags: J Nippon Med Sch Source Type: research

Assessment of cerebral circulation in the acute phase of subarachnoid hemorrhage using perfusion computed tomography.
Conclusion: Hemodynamic disturbances frequently occur after SAH. These abnormalities probably reflect the primary brain damage caused by initial hemorrhage. Perfusion CT is valuable for detecting hemodynamic changes in the acute stages of SAH. PMID: 23657064 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Tateyama K, Kobayashi S, Murai Y, Teramoto A Tags: J Nippon Med Sch Source Type: research

Effects of reduced dialysis fluid flow in hemodialysis.
Conclusions: In hemodialysis, the flow ratio (QB : QD) should be maintained at 1 : 2 to obtain a well-balanced dialysis efficiency. The present study has shown that the QD can be decreased while maintaining this flow ratio. A well-balanced QD setting can be financially and environmentally conscious. In addition, use of the K0A equation is a highly effective method to calculate a QB that allows an expected dialysis efficiency to be achieved in case the QD needs to be decreased uniformly, as when dialysis fluid is in short supply during times of disaster. PMID: 23657065 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Kashiwagi T, Sato K, Kawakami S, Kiyomoto M, Enomoto M, Suzuki T, Genei H, Nakada H, Iino Y, Katayama Y Tags: J Nippon Med Sch Source Type: research

Continuous Infusion of Dexmedetomidine Improves Renal Ischemia-reperfusion Injury in Rat Kidney.
Conclusion: The present study demonstrates that continuous infusion of dexmedetomidine improves renal IRI. Moreover, with pentobarbital anesthesia, a dose of dexmedetomidine lower than the sedative dose also improves renal IRI. PMID: 23657066 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Sugita S, Okabe T, Sakamoto A Tags: J Nippon Med Sch Source Type: research

Concentration of PDGF-AB, BB and TGF-β1 as Valuable Human Serum Parameters in Adipose-derived Stem Cell Proliferation.
Conclusions: These results suggest that the effectiveness of HS on hASC proliferation depends on the concentrations of endogenous PDGFs. In addition, the Cellaid(®) device used in this study allows the simultaneous release of several growth factors from platelets, and our results have shown that it can be used to collect HS for future hASC-based therapies. PMID: 23657067 [PubMed - in process] (Source: Journal of Nippon Medical School)
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Josh F, Tobita M, Tanaka R, Orbay H, Ogata K, Suzuki K, Hyakusoku H, Mizuno H Tags: J Nippon Med Sch Source Type: research

Long-term Outcomes after Frey's Procedure for Chronic Pancreatitis with an Inflammatory Mass of the Pancreatic Head, with Special Reference to Locoregional Complications.
Abstract Background: Frey's procedure might be a good alternative to pylorus-preserving pancreaticoduodenectomy (PPPD) for patients with an inflammatory mass of the head of the pancreas, because it is technically easy and associated with low morbidity and good pain relief. Purpose: To analyze the short-term and long-term outcomes of Frey's procedure in comparison with PPPD and to evaluate the efficacy of Frey's procedure against preoperative locoregional complications. Patients and Methods: From August 1997 through December 2007, 6 patients underwent Frey's procedure (as described by Frey and Smith), and 10 patien...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Aimoto T, Uchida E, Matsushita A, Kawano Y, Mizutani S, Kobayashi T Tags: J Nippon Med Sch Source Type: research

Efficacy of eculizumab in a patient with paroxysmal nocturnal hemoglobinuria requiring transfusions 14 years after a diagnosis in childhood.
Abstract Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired clonal disorder characterized by chronic complement-mediated hemolysis. The humanized anti-C5 antibody eculizumab binds to the C5 protein and suppresses hemolysis by inhibiting C5b-9 generation. Here, we report on a 27-year-old woman who was found to have PNH in 1997 (at 13 years of age), without subsequent transfusions, thrombosis, or renal disorder. She had been experiencing frequent malaise and fatigue and was sometimes unable to participate in social activities. She had also experienced repeated hemolytic episodes due to infection, and the ...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Ueda T, Hayakawa J, Yamanishi M, Maeda M, Fukunaga Y Tags: J Nippon Med Sch Source Type: research

Laparoscopic resection of choledochal cyst: report of a case.
We report a choledochal cyst that was successfully treated with laparoscopic surgery. A 32-year-old Japanese woman was referred to our hospital with a suspected choledochal cyst. Magnetic resonance cholangiopancreatography and computed tomography showed the common bile duct to be grossly dilated to the hepatic confluence. A diagnosis of type-Ia choledochal cyst in the Todani classification was made, and laparoscopic resection was performed. The patient was placed in the lithotomy position under general anesthesia, and 4 ports were inserted. After the cystic duct was dissected, the hepatoduodenal ligament was incised and a ...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Shimizu T, Nakamura Y, Yoshioka M, Mizuguchi Y, Matsumoto S, Uchida E Tags: J Nippon Med Sch Source Type: research

Adenocarcinoma of the minor duodenal papilla: report of a case.
We report a rare case of adenocarcinoma of the minor papilla of the duodenum treated with transduodenal minor papillectomy. A 64-year-old woman was treated for an asymptomatic duodenal tumor detected on gastroduodenoscopy. Endoscopy showed a 15-mm sessile mass in the descending duodenum proximal to the major papilla. The major papilla was a villous 24-mm-diameter polypoid tumor. Histopathologic examination of the biopsy specimen showed tubular adenoma with moderate epithelial atypia. Transduodenal major and minor papillectomies were performed. The orifice of the duct of Santorini and the pancreatic duct were re-approximate...
Source: Journal of Nippon Medical School - May 26, 2013 Category: Universities & Medical Training Authors: Hoshino A, Nakamura Y, Suzuki H, Mizutani S, Ishii H, Watanabe M, Bou H, Yoshino M, Komine O, Uchida E Tags: J Nippon Med Sch Source Type: research