The p53 tumor-suppressor protein prevents cancer development through various mechanisms, including the induction of cell-cycle arrest, apoptosis, and the maintenance of genome stability. We have identified a p53-inducible gene named TIGAR (TP53-induced glycolysis and apoptosis regulator). TIGAR expression lowered fructose-2,6-bisphosphate levels in cells, resulting in an inhibition of glycolysis and an overall decrease in intracellular reactive oxygen species (ROS) levels. These functions of TIGAR correlated with an ability to protect cells from ROS-associated apoptosis, and consequently, knockdown of endogenous TIGAR expression sensitized cells to p53-induced death. Expression of TIGAR may therefore modulate the apoptotic response to p53, allowing survival in the face of mild or transient stress signals that may be reversed or repaired. The decrease of intracellular ROS levels in response to TIGAR may also play a role in the ability of p53 to protect from the accumulation of genomic damage.
Persistent ascending or descending mesocolon is an embryological anomaly that occurs during the final process of intestinal development in organogenesis. Specifically, the primitive dorsal mesocolon fails to fuse with the parietal peritoneum in the fifth month of gestation. Herein, we describe a case of ascending colon cancer with persistent ascending and descending mesocolon treated by laparoscopic right hemicolectomy. Preoperative computed tomography imaging of the abdomen demonstrated that the descending colon shifted at the midline of the abdomen and the sigmoid colon was located under the ascending colon. The detailed preoperative imaging examination revealed malpositioning of the large intestine and aided in the procedural planning. Because persistent mesocolon may result in the formation of abnormal adhesions, an accurate preoperative diagnosis is essential. We propose that it is important to consider this anomaly when making the preoperative imaging diagnosis to ensure a safe operation.
Objective:Anastomotic leakage after laparoscopic low anterior resection in male rectal cancer patients with a narrow pelvis cannot be easily resolved. The objective of this study is to assess numerical information of narrow pelvis and to determine whether prediction of morbidity can be possible.Methods:Retrospective medical record review was performed. From July 2007 to January 2013, 43 consecutive male patients with low rectal cancer who underwent laparoscopic low anterior resection were divided into the anastomotic leakage–negative group and anastomotic leakage–positive group. Eleven anatomic parameters were measured from preoperative magnetic resonance imaging of pelvis and a new index called “pelvic index” was calculated.Results:The pelvic index (difference between the interspinous distance and the diameter of the mesorectum divided by the depth of the cavity of the lesser pelvis) in the leakage-positive group was significantly smaller than that in the negative group (P=0.038). Comparison between those 2 groups at the border of the cut-off value of the pelvic index (13.0) showed a significant difference.Conclusions:Preoperative assessment by the pelvic index can predict the narrow pelvis and risk of anastomotic leakage.
Electrogastrography (EGG) is a non-invasive diagnostic motility for recording gastric
myoelectrical activity. Gastric myoelectrical activity was first recorded in 1922.
Advances in recording equipment enabled widespread use of cutaneous EGG after 1985. Later,
introduction of multichannel EGG (M-EGG) enabled measurement of electrical activity
transmission. At present, M-EGG findings are used as objective indicators of gastric
motility disorders caused by various diseases. EGG measures two categories of gastric
electrical activity: electrical response activity, or spike potentials; and electrical
control activity, or slow waves. The appearance of abnormal rhythmic electrical activity
is indicative of abnormalities in gastric motility. The normal frequency range of gastric
electrical activity (normogastria) is around 3 cycles per min. Multiple EGG parameters
assist in the assessment of gastric myoelectrical activity, and significant correlations
between EGG and other gastric motility tests have been demonstrated in many studies. In
Japan, however, EGG remains in the exploratory stage, and its clinical use is limited.
There are large variations in procedures and systems used in previous studies, thus there
is a need for standardization of EGG procedures and technical terminology. Here, we
outline the current status of EGG and report the M-EGG procedures used in our department
in addition to our M-EGG findings.The abstract of this manuscript was presented
during an educational seminar titled "Current status of gastrointestinal motility tests
and keys for immediate implementation" at the 54th Annual Meeting of the Japan Society of
Smooth Muscle Research
This retrospective analysis found that placement of multi-layered anti-adhesion barriers using the half-overlap method provided the most effective prophylaxis. Prospective clinical trials are needed to further evaluate these methods of anti-adhesion prophylaxis.
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