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Tamura H.,Yamaguchi University | Takasaki A.,Saiseikai Shimonoseki General Hospital | Taketani T.,Yamaguchi University | Tanabe M.,Yamaguchi University | And 7 more authors.
Journal of Ovarian Research

Melatonin (N-acetyl-5-methoxytryptamine) is secreted during the dark hours at night by pineal gland, and it regulates a variety of important central and peripheral actions related to circadian rhythms and reproduction. It has been believed that melatonin regulates ovarian function by the regulation of gonadotropin release in the hypothalamus-pituitary gland axis via its specific receptors. In addition to the receptor mediated action, the discovery of melatonin as a direct free radical scavenger has greatly broadened the understanding of melatonin's mechanisms which benefit reproductive physiology. Higher concentrations of melatonin have been found in human preovulatory follicular fluid compared to serum, and there is growing evidence of the direct effects of melatonin on ovarian function especially oocyte maturation and embryo development. Many scientists have focused on the direct role of melatonin on oocyte maturation and embryo development as an anti-oxidant to reduce oxidative stress induced by reactive oxygen species, which are produced during ovulation process. The beneficial effects of melatonin administration on oocyte maturation and embryo development have been confirmed by in vitro and in vivo experiments in animals. This review also discusses the first application of melatonin to the clinical treatment of infertile women and confirms that melatonin administration reduces intrafollicular oxidative damage and increase fertilization rates. This review summarizes our recent works and new findings related to the reported beneficial effects of melatonin on reproductive physiology in its role as a reducer of oxidative stress, especially on oocyte maturation and embryo development. © 2012 Tamura et al; licensee BioMed Central Ltd. Source

Ohno S.,Shiga University of Medical Science | Omura M.,Saiseikai Shimonoseki General Hospital | Kawamura M.,Shiga University of Medical Science | Kimura H.,Shiga University of Medical Science | And 5 more authors.

Methods and results Our cohort consisted of 24 CPVT probands. Polymerase chain reaction (PCR)-based conventional genetic analysis did not identify any mutations in coding exons of RYR2 in these probands. They were screened using multiplex ligation-dependent probe amplification (MLPA). In probands identified with RYR2 exon 3 deletion, the precise location of the deletion was identified by quantitative PCR and direct sequencing methods. We identified two CPVT probands from unrelated families who harboured a large deletion including exon 3. The probands were 9- and 17-year-old girls. Both probands had a history of syncope related to emotional stress or exercise, exhibited bradycardia, and were diagnosed with left ventricular non-compaction (LVNC). We examined 10 family members and identified six more RYR2 exon 3 deletion carriers. In total, there were eight carriers, of which seven were diagnosed with LVNC (87.5%). Two carriers under the age of 4 years remained asymptomatic, although they were diagnosed with LVNC. Using quantitative PCR and direct sequencing, we confirmed that the deletions were 1.1 and 37.7 kb in length.Conclusion RYR2 exon 3 deletion is frequently associated with LVNC. Therefore, detection of the deletion offers a new modality for predicting the prognosis of patients with LVNC with ventricular/atrial arrhythmias, particularly in children.Aims Ryanodine receptor gene (RYR2) mutations are well known to cause catecholaminergic polymorphic ventricular tachycardia (CPVT). Recently, RYR2 exon 3 deletion has been identified in patients with dilated cardiomyopathy (DCM) and/or CPVT. This study aimed to screen for the RYR2 exon 3 deletion in CPVT probands, characterize its clinical pathology, and confirm the genomic rearrangement. © 2014 Published on behalf of the European Society of Cardiology. All rights reserved. Source

Abe Y.,Saiseikai Shimonoseki General Hospital
Handchirurgie Mikrochirurgie Plastische Chirurgie

Background: Arthroscopy has been reported to be an efficient adjunct for the surgical treatment for distal radius fractures (DRF). However, performing wrist arthroscopy during palmar locking plate fixation seems to be troublesome. We have developed a surgical technique involving presetting of a palmar locking plate and an arthroscopic reduction technique (PART) of the fracture that can facilitate the procedure. This study is aimed to investigate the effectiveness of our technique in the treatment of DRF. Patients and Methods: 249 fractures of the distal radius were treated by PART. 205 fractures in 200 patients were followed-up on average for 15 (12-60) months. There were 46 men and 154 women with an average age of 62 (16-85) years. According to the AO/ASIF fracture classification system there were 51 extra-articular fractures, and 154 intra-articular fractures. Scapholunate interosseous ligament injuries were classified according to Geissler and tears of the triangular fibrocartilage complex according to Abe. On arthroscopic inspection, residual intra-articular fragment dislocation after reduction under fluoroscopy was evaluated. Final evaluation included a radiological examination, measurements of wrist and forearm motion, grip strength, the Mayo modified wrist score (MMWS), and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Results: On arthroscopic inspection, intraarticular dislocations were found to be residual in 22.7%, even if reduction seemed to have been achieved when viewed by fluoroscopy. Scapholunate interosseous ligament tears were recognized in 29.8%, and triangular fibrocartilage complex tears in 62.4%. The mean palmar tilt was 5.7 (- 10 to 16)°, radial inclination 26.0 (18-31)°, and ulnar variance 0.1 (- 2 to 5) mm. The mean extension of the wrist was 71 (50-85)°, and the mean flexion was 62 (40-79)°. The mean pronation of the forearm was 87.5 (70-90)°, and the mean supination was 89.1 (75-95)°. The mean grip strength was 90.0% (31-133%) of the opposite side. According to the MMWS there were 156 excellent, 47 good, and 2 fair results. The mean DASH score was 3.9. Conclusions: The palmar locking plate in combination with arthroscopic reduction technique (PART) leads to good and excellent results. It can be recommended for all fractures of the distal radius needing operative treatment. Arthroscopic reduction of intra-articular fragments is superior to reduction under fluoroscopy. PART allows also the detection of intra-articular soft tissue lesions such as scapholunate ligament tears and injuries of the triangular fibrocartilage complex. © Georg Thieme Verlag KG Stuttgart · New York. Source

Mori K.,Saiseikai Shimonoseki General Hospital | Sakaida I.,Yamaguchi University
Journal of Japanese Society of Gastroenterology

We report abdominal bleeding caused by an arteriovenous fistula (AVF) of the gastroepiploic artery. A 20-year-old man visited our hospital with epigastric pain and hypovolemic shock. Contrast-enhanced abdominal computed tomography revealed a high-density region within a huge low-density mass. Angiography revealed AVF of the gastroepiploic artery. Therefore, we performed transcatheter arterial embolization using n-butyl-2-cyanoacrylate (HistoacrylR) to control the intraperitoneal hemorrhage. Source

Takasaki A.,Saiseikai Shimonoseki General Hospital | Tamura H.,Yamaguchi University | Miwa I.,Yamaguchi University | Taketani T.,Yamaguchi University | And 2 more authors.
Fertility and Sterility

Objective: To examine whether thin endometria can be improved by increasing uterine radial artery (uRA) blood flow. Design: A prospective observational study. Setting: University hospital and city general hospital. Patient(s): Sixty-one patients with a thin endometrium (endometrial thickness [EM] <8 mm) and high radial artery-resistance index of uRA (RA-RI ≥0.81). Intervention(s): Vitamin E (600 mg/day, n = 25), l-arginine (6 g/day, n = 9), or sildenafil citrate (100 mg/day, intravaginally, n = 12) was given. Main Outcome Measure(s): EM and RA-RI were assessed by transvaginal color-pulsed Doppler ultrasound. Result(s): Vitamin E improved RA-RI in 18 (72%) out of 25 patients and EM in 13 (52%) out of 25 patients. L-arginine improved RA-RI in eight (89%) out of nine patients and EM in six (67%) patients. Sildenafil citrate improved RA-RI and EM in 11 (92%) out of 12 patients. In the control group (n = 10), who received no medication to increase uRA-blood flow, only one (10%) patient improved in RA-RI and EM. The effect of vitamin E was histologically examined in the endometrium (n = 5). Vitamin E improved the glandular epithelial growth, development of blood vessels, and vascular endothelial growth factor protein expression in the endometrium. Conclusion(s): Vitamin E, l-arginine, or sildenafil citrate treatment improves RA-RI and EM and may be useful for the patients with a thin endometrium. © 2010 American Society for Reproductive Medicine. Source

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