Relationship between the combination of polyunsaturated fatty acids intake and psychological distress during pregnancy: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

No studies have examined the association of the combination of n-3 polyunsaturated fatty acids (PUFAs) and n-6 PUFAs intake with psychological distress during pregnancy. To examine these associations, we divided Japanese pregnant women into 25 groups based on combining quintiles of n-3 PUFAs intake and quintiles of n-6 PUFAs intake. We conducted multivariable logistic regression analyses to assess the risk of psychological distress during pregnancy (Kessler Psychological Distress Scale ≥ 5 or 13). Compared to the third quintile of both n-3 PUFAs and n-6 PUFAs intake, the groups with unbalanced intake, high intake of both, and low intake of both were associated with a higher risk of both Kessler Psychological Distress Scale ≥ 5 and 13 in early and mid-pregnancy. Further research is needed to identify the precise combination of n-3 PUFAs and n-6 PUFAs intake associated with the lowest psychological distress during pregnancy.

Characterization and biological evaluation of the introduction of PLGA into biosilicate®.

The aims of this study were to characterize different BS/PLGA composites for their physicochemical and morphological characteristics and evaluate the in vitro and in vivo biological performance. The physicochemical and morphological modifications were analyzed by pH, mass loss, XRD, setting time, and SEM. For in vitro analysis, the osteoblast and fibroblast viability was evaluated. For in vivo evaluations, histopathology and immunohistochemistry were performed in a tibial defect in rats. After incubation, all composites presented lower values in pH and mass loss over time. Moreover, XRD and SEM analysis confirmed that the composites degraded over time. Additionally, pore formation was observed by SEM analysis after incubation mainly in BS/PLGA groups. BS/PLGA showed significantly increased in osteoblast viability 24 h. Moreover, BS/PLGA composites demonstrated an increase in fibroblast viability in all periods analyzed when compared to BS. In the in vivo study, after 2 and 6 weeks of implantation of biomaterials, histopathological findings revealed that the BS/PLGA composites degrades over time, mainly at periphery. Moreover, can be observed the presence of granulation tissue, bone formation, Runx-2, and RANKL immunoexpression in all groups. In conclusion, BS/PLGA composites present appropriate physicochemical characteristics, stimulate the cellular viability, and enhance the bone repair in vivo. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1063-1074, 2017.

[Surgical treatment of an endobronchial inflammatory pseudotumor].

A 62-year old man with an abnormal chest radiograph was referred to our hospital for further evaluation. Chest computed tomography (CT) revealed a 3.0 cm tumor on the hilum of the right S3 segment. Bronchofiberscopic findings showed a polypoid tumor arising from right B3. Brushing cytology under bronchofiberscopy couldnot diagnose the tumor. The tentative preoperative diagnosis was primary lung cancer or a metastatic lung tumor. To confirm the histopathological diagnosis, a right upper lobectomy was performed. Intraoperative histopathological examination showed a pulmonary inflammatory pseudotumor.

Chronic hepatitis C beta-interferon-induced severe hypertriglyceridaemia with apolipoprotein E phenotype E3/2.

The mechanisms of hypertriglyceridaemia and changes in plasma lipoprotein subfractions by beta-interferon treatment were studied in a hepatitis C patient with apo E phenotype E3/2. Plasma levels of triglyceride (TG) were increased by treatment with 6 x 10(6) beta-interferon and reached 8.06 mmol/l at 4 weeks of treatment. Low energy and low fat diet reduced them to half the maximal level. Plasma levels of LDL1 (1.019 < d < 1.045)-C, LDL2 (1.045 < d < 1.063)-C, HDL2-C and HDL3-C were 0.39, 0.31, 0.21 and 0.28 mmol/l, respectively, which are low, but the plasma levels of IDL, which is a remnant of TG-rich lipoproteins, was normal at 7 weeks of treatment. The distribution of plasma lipoprotein subfractions returned to normal after interferon treatment was discontinued. The mass and activity of lipoprotein lipase (LPL) were reduced to half the baseline level by interferon treatment. The activity of hepatic triglyceride lipase (HTGL) which transforms IDL to LDL was normal. The patient's apo E phenotype was E3/2; with that phenotype the removal of TG-rich lipoproteins and IDL through the receptors of the remnant and LDL is impaired. But the IDL plasma level was normal, probably because of normal HTGL activity and high LDL-receptor activity. Lymphocyte LDL-receptor activity was double that of the control. We conclude that interferon caused the low mass and activity of LPL which in turn caused the hypertriglyceridaemia. And no retention of the remnant of TG-rich lipoproteins in this patient with apo E3/2 and low levels of LDL subfractions was due to the active removal of them through LDL-receptors as well as the impaired production of them by suppression of LPL by interferon.

[A model of quality of life in the patients with Crohn's disease].

PURPOSE: To identify the integrated impact of psychological, social, and clinical factors onto the quality of life (QOL) in the patients with Crohn's disease. SUBJECTS AND METHODS: Two hundred twenty two out-patients participated in a cross-sectional questionnaire survey in which health-related QOL (SF36), disease-specific symptoms, psychological adaptation and social support were measured. Multi-variable regression models were used to test the impact of clinical, psychological, and social factors on the patient's QOL and symptom reports. RESULTS: The patient's symptoms and health-related QOL were significantly associated not only with disease activities, but also with the patient's psychological adaptation and the quality of social support. CONCLUSION: The results strongly suggest that a psychoeducational intervention may be useful in combination with a clinical intervention to improve the patient's QOL.

A combination therapy with simvastatin and ursodeoxycholic acid is more effective for cholesterol gallstone dissolution than is ursodeoxycholic acid monotherapy.

Inhibitors of 3-hydroxy,3-methylglutaryl coenzyme A (HMG-CoA) reductase have been reported to decrease the cholesterol saturation index (CSI) in duodenal bile in humans and to prevent formation of cholesterol gallstones in animal studies. We performed a prospective study to evaluate the role of HMG-CoA reductase inhibitors as gallstone-dissolving agents. Fifty patients with radiolucent gallstones in a gallbladder opacifying at drip infusion cholecystography were treated with either 10 mg/day simvastatin plus 600 mg/day ursodeoxycholic acid (group 1, n=26) or 600 mg/day ursodeoxycholic acid alone (group 2, n=24) for 12 months. The ratio of solitary to multiple gallstone cases was 21:29. Plasma lipid levels were assessed and ultrasonographic examination of the gallbladder was performed at baseline and at 3-month intervals during treatment. Duodenal bile sampling was performed in five patients in each group at baseline and after 12 months of treatment. Plasma cholesterol decreased significantly in group 1 but not in group 2. In solitary gallstone cases, no significant difference in dissolution rates was observed between groups 1 (3 of 9, 33%) and 2 (4 of 12, 33%). In contrast, the dissolution rate in multiple gallstone cases was significantly higher in group 1 (12 of 17, 71%) than in group 2 (3 of 12, 25%) (p < 0.01). Bile cholesterol saturation index was significantly decreased (p < 0.01) but did not significantly differ between the two groups. These results suggest that combination therapy with simvastatin and ursodeoxycholic acid is more effective for cholesterol gallstone dissolution than ursodeoxycholic acid monotherapy in patients with multiple gallstones.

Essential roles of the winged helix transcription factor MFH-1 in aortic arch patterning and skeletogenesis.

Mesenchyme Fork Head-1 (MFH-1) is a forkhead (also called winged helix) transcription factor defined by a common 100-amino acid DNA-binding domain. MFH-1 is expressed in non-notochordal mesoderm in the prospective trunk region and in cephalic neural-crest and cephalic mesoderm-derived mesenchymal cells in the prechordal region of early embryos. Subsequently, strong expression is localized in developing cartilaginous tissues, kidney and dorsal aortas. To investigate the developmental roles of MFH-1 during embryogenesis, mice lacking the MFH-1 locus were generated by targeted mutagenesis. MFH-1-deficient mice died embryonically and perinatally, and exhibited interrupted aortic arch and skeletal defects in the neurocranium and the vertebral column. Interruption of the aortic arch seen in the mutant mice was the same as in human congenital anomalies. These results suggest that MFH-1 has indispensable roles during the extensive remodeling of the aortic arch in neural-crest-derived cells and in skeletogenesis in cells derived from the neural crest and the mesoderm.

A case of microhepatoma associated with schistosomiasis japonica diagnosed by enhanced ultrasonography after hepatic intraarterial injection of carbon dioxide gas.

The patient was a 58-year old man whose complaints were generalized malaise and right epigastralgia. He had liver cirrhosis and schistosomiasis japonica, previously diagnosed by laparoscopy. Computed tomography (CT) showed a high density funicular shadow in the liver. However no tumorous lesions in the liver were visualized. Ultrasonography (US) of the liver showed a reticulate or scaly pattern, but no images of tumorous lesions. Hepatic angiography showed a single, deeply colored image about 1cm in diameter, in the segmentum anterosuperior. Preoperative and intraoperative enhanced US with hepatic intraarterial injection of carbon dioxide gas was performed. It showed a hyperechoic tumor shadow about 1cm in the segmentum anterior. The segmentum anterosuperior including the tumor was partially resected. Pathologically, the tumor was found to be a hepatoma of Edmondson type II, caused by cirrhosis and schistosomiasis japonica. The patient's postoperative course was uneventful. Enhanced US with hepatic intraarterial injection of carbon dioxide gas was useful for the diagnosis and treatment of the microhepatoma associated with schistosomiasis japonica.

The effects of physical activity on rehabilitation for acute hepatitis.

We studied 19 patients with acute hepatitis who were instructed to follow a 5-stage exercise regimen. The mean period of hospitalization was 31.9 days, slightly shorter than the mean duration for acute hepatitis patients. The exercise program had no adverse effects on the patients. They returned to works an average of 9.5 days after discharge, demonstrating a marked reduction in the rehabilitation period. Hepatitis should be primarily treated under the internist's management. However, physical exercise should be recognized as an equally important treatment modality.

Small cell neuroendocrine carcinoma of the rectum.

Poorly differentiated small cell neuroendocrine (NE) carcinoma of the colon and rectum is a rare primary epithelial malignancy at this location. A case of a highly aggressive NE tumor of small cell type, combined with non-invasive well-differentiated papillary adenocarcinoma in villous adenoma is reported. The patient died rapidly with massive and progressive liver metastasis. The tumor cells were argyrophilic and diffusely immunoreactive for neuronspecific enolase and synaptophysin. Ultrastructural analysis disclosed NE-type cored granules in most of the small tumor cells. NE tumors of the colon and rectum are briefly reviewed.

Fulminant hepatitis following bone marrow transplantation in hepatitis B virus carrier siblings.

A 19-year-old male healthy hepatitis B virus (HBV) carrier developed fulminant hepatitis following allogenic bone marrow transplantation (BMT) from his brother, who was also a healthy HBV carrier, during the first complete remission of acute myelogenic leukemia (M1, FAB classification). Serum markers related to both HBV and hepatitis C virus (HCV) were elevated during active liver injury when a point mutation in the precore (pre-C) region occurred in the HBV. The patient received low-dose interferon alpha (IFN-alpha), while the dose of cyclosporin A was tapered; the patient eventually recovered from the liver injury. Fulminant hepatitis due to HBV and/or HCV following BMT is rare, and it is considered to have a very poor prognosis. The rationale for the use of low-dose IFN-alpha with cyclosporin A (CyA) is discussed.

Crohn's disease associated with pancreatitis of unknown etiology: a case report.

Pancreatitis is generally regarded to be an extra-intestinal complication of Crohn's disease unless the duodenum is directly involved. Some reports in the recent literature, however, suggested a possible association of pancreatitis with Crohn's disease. In this report, we describe a 25-year-old male with Crohn's disease and pancreatitis, the etiology of which was uncertain. The pancreatitis resolved along with the clinical improvement in Crohn's disease. This case supports the concept of an association between Crohn's disease and pancreatitis.

Effects of cimetidine on lidocaine distribution in rats.

The effects of cimetidine on the disappearance from plasma, plasma protein binding, tissue distribution, tissue binding in vitro and uptake by erythrocytes of lidocaine were studied in rats. The plasma disappearance of lidocaine after a 10 mg/kg bolus injection was analyzed by a two-compartment open model. In the cimetidine-treated rats (50 mg/kg bolus injection, the plasma total body clearance (Cltot), the volume of distribution at the steady state (Vdss) and the elimination rate constant of the central compartment (kel) of lidocaine decreased by 27, 28 and 32% of those of the non-treated rats, respectively. The plasma concentration of lidocaine at the steady state, after a loading dose (7.62 mg/kg body weight) followed by an infusion (0.16 mg/min/kg), increased from 1.62 to 2.69 micrograms/ml after cimetidine treatment. The tissue-to-plasma concentration ratio (Kp) in spleen, stomach and skin decreased to 64, 62 and 62% of the values of the non-treated rats. In addition, the blood-to-plasma concentration ratio (Rb) decreased by 26% in cimetidine-treated rats. In vitro tissue-to-plasma concentration ratios (Kp, vitro) of lidocaine in spleen, stomach and skin homogenate were decreased to 58, 45 and 68% by cimetidine treatment. In these tissues, the percentage decreases of Kp, vitro agreed with those of Kp determined in vivo. The decrease of Kp by cimetidine treatment may be due to the inhibition of tissue binding of lidocaine. The uptake of lidocaine by erythrocytes was decreased by cimetidine treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Urinary tract infections in patients undergoing transurethral prostatectomy.

The incidence of urinary tract infections was determined in 1,660 patients undergoing transurethral prostatectomy. Preoperative infection was found in 25% of all patients and in 35% of the 276 patients aged 80 years or over. Of the 1,251 patients without a preoperative infection, 17% had postoperative infections. The incidence of new postoperative infection was significantly related to the duration of surgery and the weight of the resected prostate. The incidence of infection was higher in summer than in winter months.

Epididymitis after transurethral prostatectomy.

Transurethral prostatectomy was performed in 2,407 patients and open subcapsular prostatectomy in 308 patients. Postsurgical epididymitis developed in 1.0% of the patients undergoing transurethral resection and in 3.2% of the patients undergoing open resection (P less than 0.05). Factors associated with the incidence of epididymitis, such as prostate weight and operating time, were also associated with the incidence of urinary tract infection. Epididymitis was significantly associated with the presence of preoperative catheterization and postoperative urinary tract infection.

Comparison of transurethral and open subcapsular prostatectomy: relation to weight of the prostate.

The results of transurethral prostatectomy in 2,269 men and open subcapsular prostatectomy in 300 men were compared. The only significant differences between the two groups were in the duration of hospital stay (18.3 vs 26.2 days) and the number of days that the drainage catheter was indwelling (5.4 days in the transurethral and 10.9 days in the open surgery group [P less than 0.01, both comparisons]). Blood loss, the need for transfusion, the amount of blood transfused, and the duration of surgery, catheterization, and hospital stay were all related to prostate size. Transurethral resection was superior to open resection for prostates weighing less than 20 gm; prostates of 20 gm to 30 gm were the easiest to enucleate.

Transurethral resection in prostatic cancer.

Complications arising from transurethral and open subcapsular prostatectomy were studied in 121 patients with prostatic cancer and in 121 patients matched in age and prostate weight who had undergone prostatectomy for benign prostatic hypertrophy (BPH). After transurethral resection, cancer patients had a significantly longer hospital stay than did patients with BPH (P less than 0.01) and more had complications, such as perforation and bleeding. Compared to transurethral prostatectomy, open resection resulted in greater blood loss and more complications for the cancer patients. It is concluded that transurethral resection is as safe for most cancer patients as it is for patients with BPH, but the dangers of massive bleeding and dissemination of the cancer cells should not be overlooked.