[Hokkaido igaku zasshi] The Hokkaido journal of medical science最新文献

The Hokkaido Medical Society is a group of doctors and medical researchers in Hokkaido. Its purpose is to contribute to medicine and to the improvement of medical treatment. This symposium was carried out in order to inform citizens about the condition known as sudden death. We hypothesize that the incidence of sudden death tends to increase in line with the incidence of metabolic syndrome. Approximately four hundred patients were transported to our hospital by ambulance in a state of cardiopulmonary arrest (CPA) last year. The number of CPA patients who are treated in our hospital has increased in comparison to the previous decade. The theme of this year is "The clinical condition and treatment of diseases associated with sudden death" in view of the above mentioned situation. In 2015, it was reported that sudden death occurred in an American pilot and that the co-pilot was forced to make an emergency landing. Interestingly, sudden death can ever sometimes occur in pilots who undergo regular physical examinations. Numerous diseases and conditions are associated with sudden death, including: acute myocardial infarction, irregular pulse, cardiac insufficiency, cerebrovascular disease, aortic dissection and choking. We are of the opinion that the frequency of sudden death is very high in the fields of emergency medicine, cardiovascular medicine, cardiovascular surgery and neurosurgery. In this symposium, we presented and explained the condition that is known as sudden death and the current state of treatment of sudden death in emergency medicine, cardiovascular medicine, cardiovascular surgery and neurosurgery departments of the Hokkaido University Graduate School of Medicine in October, 2015. We hope that the symposium will help the citizen audience to understand the condition and treatment of sudden death, and also to help prevent sudden death.

Introduction: Neovascularization consists of angiogenesis and vasculogenesis during which bone marrow-derived endothelial progenitor cells (EPCs) are mobilized for blood vessel formation. Pigment epithelium-derived factor (PEDF) is known to be a potent inhibitor of angiogenesis in some solid carcinomas. However, the effects of PEDF on human esophageal squamous cell carcinoma (ESCC) and vasculogenesis are still unknown. The purpose of this research was to investigate the effect of PEDF on angiogenesis, tumor growth, and vasculogenesis in ESCC.

Materials and methods: The PEDF gene was transduced to the TE8 ESCC cell line not secreting endogenous PEDF and the HEC 46 cell line originally secreting endogenous PEDF by lentivirus-based vectors expressing PEDF. In vitro endothelial cell proliferation and migration assays were performed using the supernatant derived from PEDF-overexpressing cells. In in vivo experiments, the effects of PEDF on chronological tumor growth, intratumoral microvessel density (MVD), tumor cell apoptosis, and the frequency of EPCs in peripheral blood and tumor tissues were examined in murine subcutaneous tumor models.

Results: PEDF inhibited endothelial cell proliferation and migration in vitro and showed potent in vivo antitumor properties by inhibiting MVD in the human ESCC cell line that did not secrete endogenous PEDF. However, in the cell line secreting endogenous PEDF, additional PEDF gene transfer showed no inhibition of angiogenesis and no subsequent antitumor properties. With respect to vasculogenesis, PEDF was found to have potential to suppress vasculogenesis; the frequency of EPCs both in peripheral blood and tumor tissue was decreased in mice implanted with PEDF-overexpressing TE8 and HEC46 cells.

Conclusion: PEDF may have potent antiangiogenic and antitumor effects in ESCC cells naturally not secreting endogenous PEDF and can be expected to be applied as gene therapy in the future.

The introduction of robotic surgical system is one of the most exciting topic in the field of the surgery. In this symposium, we presented and explained the present condition of robotic-assisted laparoscopic surgeries performed in the department of Urology, Gastroenterology and Gynecology of the Hokkaido University Hospital. By using this surgical system, laparoscopic surgery, which is generally considered to be difficult, can be safely performed by surgeons. Especially in radical prostatectomy against localized prostate cancer, this surgical approach brought the decrease in peri- and postoperative problems including blood loss and postoperative urinary incontinence in comparison with open or laparoscopic radical prostatectomy. We wish that this symposium would help the audience to understand the present condition and new vista of the future in robotic-assisted laparoscopic surgeries.