"Welcome to OBGYN World!" A novel recruitment event for medical students organized by the Japan Society of Obstetrics and Gynecology.

"Welcome to OBGYN World!" A novel recruitment event for medical students organized by the Japan Society of Obstetrics and Gynecology. Since 2012, the number of doctors in Japan who specialize in obstetrics and gynecology has shown a decreasing trend. To increase the number of doctors majoring in obstetrics and gynecology, the Japanese Trainees in Obstetrics and Gynecology subcommittee developed a new recruitment event called Welcome to OBGYN World! (WOW!); the aim of this event was to focus on lower grades of medical students. The present report describes the content of WOW! and the results of a post-event questionnaire administered to participating students and tutors. WOW! was held online in order to avoid the risk of Coronavirus Disease 2019 infection for participants. Sixty of the 82 medical schools nationwide (73.2%) participated in this event. Overall, there were 285 participating students, ranging from first to fourth grade in medical school, and 106 tutors were involved to teach material at the event. In the post-event questionnaire survey, 97.6% (248/254) and 100% of the participants stated they now had a high degree of interest in obstetrics and gynecology and found the specialty attractive, respectively. Furthermore, 93.6% (90/94) of the tutors stated that WOW! had helped recruitment activities in their universities. Based on this outcome, members of the Japanese Trainees of Obstetrics and Gynecology subcommittee will now try to increase the number of doctors specializing in obstetrics and gynecology by holding WOW! annually.

Malignant transformation from mature cystic teratoma of the ovary.

We present a case of malignant change of an ovarian mature cystic teratoma. Our patient was a 48-year-old woman and she visited a primary care doctor presenting with abdominal pain. At her first visit, her pelvic tumor measured 70 × 50 mm by ultrasonography. She was diagnosed as rupture of the malignant tumor occurred secondary to mature cystic teratoma and she took the surgery (abdominal total hysterectomy, bilateral oophorectomy and partial omentectomy). Pathologic diagnosis was squamous cell carcinoma (SCC) occurred secondary to mature cystic teratoma. Treatment with paclitaxel/carboplatin (TC chemotherapy) and gemcitabine hydrochloride/carboplatin (GC chemotherapy) after operation was not effective, and the refractory ileus resulting from rapid progression of the disease continued. She was died of disease progression 7 months after the diagnosis of ovarian cancer. We discuss about the clinical characteristics of malignant transformation of mature cystic teratoma and considered about the treatment of the ovarian SCC.

Hypnotic effect of volatile anesthetics is mediated by PKC-γ dynamics.

BACKGROUND: Although protein kinase C-γ (PKC-γ) is a target for the effects of volatile anesthetics, the molecular mechanisms of the kinase function remain unclear. We examined the effects of different types of anesthetics on PKC-γ knockout mice, and investigated the dynamics of the kinase in mouse brain. METHODS: We measured the required number of times for loss of righting reflex (rtfLORR) after administration of isoflurane, sevoflurane, and propofol on PKC-γ knockout mice and compared with those of wild-type mice. We also used immunoblotting to investigate the intracellular distribution of PKC-γ and phosphorylated PKC-γ (p-PKC-γ) in brain of wild-type mice anesthetized by these anesthetics. RESULTS: Isoflurane and sevoflurane significantly prolonged the rtfLORRs in PKC-γ knockout mice compared with those in wild-type mice, while no significant difference was observed between knockout and wild-type mice treated with propofol. Examination of the cellular fractions showed that PKC-γ was significantly decreased, whereas p-PKC-γ was significantly increased in the synaptic membrane fraction (P2). There was no significant change in the supernatant fraction (S). In propofol-treated mice, PKC-γ and p-PKC-γ showed no significant changes in P2 or S. CONCLUSION: Our results provide new evidence to support the possibility of the involvement of PKC-γ in the actions of volatile anesthetics.

[Prognostic study of preoperative serum levels of CEA and CA 19-9 in colorectal cancer].

PURPOSE: Carcinoembrionic Antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) are the most frequently used tumor markers in the clinical setting of colorectal cancer. The aim of this study is to evaluate the prognostic value of preoperative serum levels of CEA and CA 19-9 in colorectal cancer patients. METHODS: Serum levels of CEA and CA 19-9 were examined in 586 patients with colorectal cancer. Cut-off levels were calculated at reference value:<2.5 ng/mL (group A) versus >2.5 ng/mL (group B) for CEA and, <37 U/mL (group A) versus >37 U/mL (group B) for CA 19-9. RESULTS: According to tumor progression, each marker tended to show a higher level. Group A showed a significantly better prognosis than group B in both CEA and CA 19-9. In Dukes classification A, B and C, only CEA showed a better prognosis in group A than group B. At the time of recurrence compared to the pre-operative point, the CEA and CA 19-9 levels were significantly higher in both group A and B, however. In relation to the necessity of adjuvant chemotherapy (5-FU containing regimen) in Dukes A, the cases without adjuvant chemotherapy in group B of CEA showed a poor prognosis. CONCLUSION: The measurement of preoperative serum CEA and CA 19-9 is useful for prognostic prediction in colorectal cancer. Cut-off levels calculated at the reference value reflect the prognosis in this study. Especially, preoperative CEA reveals a potential high risk group in Dukes A which should be carefully treated by adjuvant chemotherapy to avoid recurrence.

[Effects of intravenous anesthetics on acidosis induced apoptosis in primary brain cell culture].

BACKGROUND: We have reported protective effects of intravenous anesthetics on the brain cell. This study examined the effects of extracellular Ca2+ on acidosis-induced apoptosis and the protective effects of intravenous anesthetics on such appearance of apoptosis. METHODS: Using the primary culture of rat cerebellular granule cells, extracellular acidosis was produced at pH 6.7 and pH 6.3 and the extracellular Ca2+ free condition was produced by 1 mM EGTA instead of 1.2 mM CaCl2. The cell death was determined by the calcein method and the measurement of apoptosis was done using the screening kit for apoptosis with TUNEL method. Bcl-2 mRNA was detected using quantified RT-PCR method. Midazolam, pentobarbital and propofol were used as typical intravenous anesthetics. RESULTS: Under extracellular acidosis, the significant cell death was detected 6 hr after exposure to acidosis. Moreover, in case of extracellular Ca2+ free/acidosis condition, there was a greater incidence of cell death. Such cell death was much enhanced 20 hr after exposure to acidosis. Furthermore, in case of extracellular acidosis and Ca2+ free condition, there were a significant increase of apoptosis and significant changes of bcl-2. By treatment with intravenous anesthetics, the significant inhibition of cell death and appearance of apoptosis were observed. In these protections by intravenous anesthetics, midazolam and pentobarbital significantly increased the bcl-2 levels. CONCLUSIONS: We demonstrated that intracellular Ca2+ modulates the appearance of apoptosis under acidosis. Moreover it seems that the inhibitory effects of midazolam and pentobarbital on acidosis-induced apoptosis are different from that of propofol.

[A case report: an ileus caused by cecal volvulus and intersigmoidal hernia due to mesenterium commune].

A 33-year old woman was referred to our hospital because of gradually progressing abdominal pain and abdominal distension. A computed tomography demonstrated that distended cecum was located in the left retroperitoneal space. Barium enema revealed that the descending colon was positioned at the right side of the abdomen and transverse colon became severely tapered. Ceacal volvulus in addition to the internal herniation into the left retroperitoneal space was clinically diagnosed. The patient received an emergent operation. Operative findings showed that mesenterium commune, no fixation of the colon to the retroperitonium, and the internal herniation of terminal ileum to transverse colon into the sigmoid mesentery. Moreover, the cecal volvulus was diagnosed at the left retroperitoneal space. The mesenterium commune with internal herniation and cecal volvulus is extremely rare but one of important causes of acute abdomen.

Pure gastric yolk sac tumor that was diagnosed after curative resection: case report and review of literature.

We recently experienced an 87-yr-old man with gastric yolk sac tumor. Preoperative diagnosis was poorly differentiated adenocarcinoma in the cardia of stomach without apparent metastasis. A total gastrectomy was performed. The precise histological examination after surgery revealed the tumor was composed of pure gastric yolk sac tumor without adenocarcinomatous components. The surgical margin and the resected lymph nodes were histologically negative for the tumor and a curative resection was performed. Five months after the operation, enlargement of the intraabdominal lymph nodes occurred with elevation of serum alpha fetoprotein (AFP), and the patient died 2 mo later. Gastric yolk sac tumors are very rare, and only six cases of gastric yolk sac tumors have been previously reported in the literature. Five out of six cases are accompanied by components of adenocarcinoma, and our present case is the second report of pure gastric yolk sac tumor to the best of our knowledge.

Inhibitory effects of extracellular matrix modulator(s) on lipopolysaccharide (LPS)- and acidosis-damaged glia containing cerebellar granule cell cultures.

The inhibitory effects of a novel chondroitin sulfate compound on lipopolysaccharide (LPS)- and acidosis-induced neuronal dysfunctions were examined. Cell viabilities in cultured neurons and/or astrocyte-rich cerebellar granule cells were measured by the calcein-AM method. Ten and 20 microg, as a final dosage, of LPS damaged less than 20% cells during a-2 h incubation. More than 5000 ng/ml of chondroitin sulphate-dipalmitoylphosphatidylethanolamine (CS-PE), but not chondroitin sulfate (CS) treatment, significantly inhibited such damage. Twenty microg of LPS damaged more than 40% cells during 24 h incubation, and these cell damages were significantly inhibited by less than 1000 ng/ml of CS-PE. Moreover, treatments with between 5 and 500 ng/ml CS-PE, but not CS, significantly reduced the number of acidosis-damaged cells in a dose-dependent manner. The current results indicate that modulator(s) of ECM and its derivative containing covalently linked dipalmitoylphosphatidylethanolamine show neuroprotective effects under conditions of brain inflammation.

Larval and juvenile development of the Echinometrid sea urchin Colobocentrotus mertensii: emergence of the peculiar form of spines.

The development of Colobocentrotus mertensii from embryos to larvae and early juveniles was observed to give the first detailed description of larval and juvenile formation and skeletal structures in echinometrid sea urchins. The first larval spicules appeared at the mesenchyme blastula stage, whereas, in many echinoids, spicules were formed after gastrulation. From late eight-armed larva to juvenile, body color of C. mertensii was deep red, which has never been described for any echinoid before. The adult form of C. mertensii is characteristic in that the spines at the aboral side are short, truncated and pavement-like. The first sign of peculiar adult features could be seen in the juvenile spines and adult spines, which are broader than those of closely related Anthocidaris crassispina. The primary podia emerged on the left side of larval body were more stout and thicker in C. mertensii than in A. crassispina. The present study shows that developmental process of larval structure of C. mertensii is in general similar to the A. crassispina and the differences is first seen in juvenile structure including the distribution of pigment spots and morphology of adult spine.

Regulation of brain cell environment on neuronal protection: role of TNFalpha in glia cells.

Bacterial endotoxin lipopolysaccharide (LPS) treatment of neuron-rich cells and glia-rich cells exhibited significant cell damage 12 hr after incubation, although no severe or significant cell damage induced by LPS appeared in neuron-glia co-cultured cells. Moreover, severe and significant time-dependent cell damage was induced by a larger dose treatment (10 mM) of glutamate (Glu), and this damage was seen in neuron-rich cells, neuron-glia co-cultured cells, and glia-rich cells. Examining extracellular tumor necrosis factor alpha (TNFalpha) induced by either LPS or Glu treatment, the levels of extracellular TNFalpha induced by LPS were significantly higher than those induced by Glu. These significant increases of TNFalpha were measured within 2 hr after LPS treatment in neuron-glia co-cultured cells and glia-rich cells, although no significant changes were detected in the neuron-rich cells. With Glu treatment, a significant increase in TNFalpha levels was detected after 6 hr of Glu treatment only in glia-rich cells. Our results indicate that cerebral TNFalpha is mainly produced in glia cells and that its production is dependently regulated by each stimulant. In addition, the production of TNFalpha is not directly related to the trigger of cell injury.