Immunoreactivity of prostate-specific antigen (PSA), a kallikrein-like enzyme present in the seminal plasma, was demonstrated by indirect immunoperoxidase staining using a PSA antiserum in the apical cytoplasm along the luminal border of small-sized duct epithelial cells of the major salivary (parotid and submandibular) gland of both sexes (56/56, 100%). No PSA-like immunoreactivity was seen in large-sized duct epithelial cells and acinar cells. Minor salivary gland ducts were negative. When inflammatory and atrophic changes were observed, ductal expression of PSA-like immunoreactivity was decreased (12/37, 32%) and the site of intracellular localization often became diffusely cytoplasmic. The immunoreactivity was absorbed by human seminal plasma. Immunoreactivities of prostatic acid phosphatase and sex hormone receptors were undetectable in the salivary gland. Twenty-nine (34%) of 86 salivary gland tumors with ductal differentiation were immunoreactive for PSA mainly in the cytoplasm. A PSA monoclonal antibody ER-PR8 detected immunoreactivity in the prostate but not in the salivary glands or their tumors. Prostate-specific antigen-like immunoreactivity in small-sized (intercalated) duct epithelial cells of the major salivary gland and their tumors may be due to cross-reactivity of the antiserum with kallikrein-like substances.

Fast-track anesthesia with early extubation (EE) is playing an increasingly important role in pediatric cardiac surgery. We examined the pre- and intra-operative factors contributing to successful EE, and outcomes after right heart bypass surgery (RHB). We retrospectively reviewed the medical records of 71 consecutive children (median age=14 months) admitted over a 4-year period to the pediatric intensive care unit (PICU) of our university-based hospital, after RHB. We compared the characteristics and outcomes of 38 children (54%) extubated <3 h, with those of 33 (46%) extubated >or=3 h after surgery. Odd ratios (OR) and 95% confidence intervals (CI) were calculated. Variables associated with EE included a lower dose of intra-operative fentanyl (OR: 0.95; 95% CI, 0.92-0.99; P=0.03), nitroglycerin (OR: 0.23; 95% CI, 0.07-0.73; P=0.01), and a lower inotropic score (OR: 0.76; 95% CI, 0.61-0.94; P=0.01) on admission. EE was correlated with fewer postoperative respiratory complications (OR: 0.09; 95% CI, 0.02-0.57; P=0.01) and shorter stay in the PICU (OR: 0.88; 95% CI, 0.76-1.03; P=0.12). Our data suggest that EE after RHB could be facilitated in patients with a preserved cardiac function and lower pulmonary vascular resistance. EE could be followed by fewer postoperative pulmonary complications.

This study examines the impact of a U. S. teacher training program on eight Japanese English professionals' teaching beliefs and practices after the completion of the program. It also investigates the teachers' perspectives on how they resolve tensions, if any, between their teaching beliefs, Japanese teaching contexts, and new knowledge learned in the program. The data were collected mainly through qualitative methods such as multiple interviews with teachers and through document analysis. The results suggest that while the teachers considered the training experiences to be positive, they faced difficulties in applying their new knowledge in their own teaching contexts due to school, social, and cross-cultural factors. Despite the challenges, the data also revealed that the teachers attempted to negotiate the gap between expectations in these contexts and their teaching beliefs. We conclude that in order to understand the impact of teacher education programs, it is important to explore teachers' perspectives on their learning to teach. 本論文では、アメリカにおける英語教員研修が、研修後日本人英語教員の信念や授業に どのような効果をもたらすかについて８名の参加者を対象として考察する。さらに、帰 国後、彼らが英語教員としての信念、日本の教育環境、研修で学んだ知識、これらの狭間 で何らかの困難を経験しているかどうか、経験しているならばそれをどのように解決しよ

A case of 69-year-old woman with endometrioid adenocarcinoma of the ovary with functioning stromal cells is presented. The patient complained of genital bleeding. Endometrial curettage revealed endometrial hyperplasia. Pre-operative levels of serum estradiol and progesterone were elevated, and serum gonadotropin levels were suppressed. The surgical specimen contained fist-sized, bilateral, solid, ovarian tumors and a mildly enlarged uterus. Histologically, the proliferating, atypical, columnar cancer cells resembled early secretory, endometrial epithelial cells with subnuclear vacuolation, and there were clusters of fat-laden foamy cells in the stroma. Immunohistochemically, the cancer cells were positive for cytokeratin and progesterone receptor but negative for estrogen receptor. The stromal foamy cells were immunoreactive for vimentin, progesterone receptor, P450 side chain-cleavage, 3 beta-hydroxysteroid dehydrogenase, and adrenal 4-binding protein. Immunoreactivities of P450c-17 alpha hydroxylase and aromatase were only focally observed. These findings indicated that the stromal cells were steroidogenic and mainly produced progesterone. The cancer cells that expressed progesterone receptors showed morphologic changes in response to hormonal stimulation.

No abstract

A 23-year-old healthy man was scheduled for extraction of his mandibular third molars under general anesthesia with nasotracheal intubation. Sudden sinus tachycardia up to 170 beats/min occurred when applying an epinephrine solution-soaked swab into the nasal cavity for preventing epistaxis during intubation. This was presumably evoked by submucosal migration of the swab into a false passage created because of the force applied during a prior failed attempt at nasal passage of the tracheal tube, and rapid epinephrine absorption by the traumatized mucosa. The causes of the unexpected severe tachycardia in our patient are discussed.

No abstract

In the past, ryotei was closely associated with the lives of Japanese people, not only for banquets but also for weddings, funerals, business meetings, etc. Also, Ryotei is a place where geisha entertain her customer. In recent years, however, the business has been closing down due to changes in lifestyles. On the other hand, Japanese food has been registered as an intangible cultural heritage by UNESCO, and the value of ryotei has begun to be reevaluated as a place where Japanese traditional culture is comprehensively passed down.The purpose of this study is to clarify the architectural characteristics, such as the year of construction and structure, of about 150 ryotei throughout Japan, as well as their actual operations, such as lunches and weddings.