Conversion of endoscopic nasobiliary drainage to internal drainage by means of endoscopic scissor forceps.
Explore the source record for details and available documents.
Bile Duct Neoplasms↗
Biomedical subjects
S Watanabe
Publications and source records attributed to S Watanabe.
Endoscopic ultrasonography in patients with thyroid cancer: its usefulness and limitations for evaluating esophagopharyngeal invasion.
BACKGROUND AND STUDY AIMS: Although computed tomography (CT) and magnetic resonance imaging (MRI) are useful for detecting esophagopharyngeal invasion by thyroid cancer, they cannot assess the depth of invasion, which is important for the surgical planning. In the present study, endoscopic ultrasonography (EUS) of the esophagus was used to assess esophagopharyngeal invasion by thyroid cancer, and the value of this technique was assessed prospectively. PATIENTS AND METHODS: Between 1 December 1998 and 31 December 2000, EUS examinations were carried out in 59 patients in whom esophagopharyngeal invasion by thyroid cancer was suspected due to large tumors or tumors with poor mobility. The EUS findings were evaluated in 52 patients (10 men, 42 women; mean age 62.4 years; mean tumor size 39.5mm) with complete resections, and compared with the pathological results. RESULTS: The diagnostic specificity and accuracy of EUS in assessing invasion into the muscularis propria (82.9 %, 82.7 %) were greater than those of MRI (60 %; P = 0.034, 65.4 %; P = 0.044) and esophagography (58.8 %; P = 0.034, 60 %; P = 0.028). The accuracy for detecting cancer invasion located in the upper part of the lobe was less than for invasion in the middle and/or lower parts of the lobe ( P = 0.020). Conclusions. EUS is useful for assessing esophagopharyngeal invasion by thyroid cancer, although its effectiveness may be limited in thyroid lesions located in the upper part of the lobe.
Adenocarcinoma, Follicular↗
A new combined surgical procedure for severe descending necrotizing mediastinitis with bilateral empyema.
In this report, we will describe the treatment of a 38-year-old man with severe descending necrotizing mediastinitis (DNM) with bilateral empyema. DNM is a rare disease with a high mortality rate, and when accompanied by bilateral empyema, this is particularly serious and potentially fatal. To improve the prognosis of such patients, the establishment of an adequate surgical procedure for satisfactory debridement and drainage is essential. This is the first report on a new combined surgical procedure consisting of right standard posterolateral thoracotomy and left video-assisted thoracoscopic surgery (VATS) for severe DNM with bilateral empyema.
Adult↗
Primary chylopericardium treated with video-assisted thoracoscopic surgery.
Here, we report on a 30-year-old female with primary chylopericardium who successfully underwent thoracic duct clipping and partial pericardiectomy using video-assisted thoracoscopic surgery (VATS). Recently, a few cases of this disease have been treated utilizing VATS. This is a fully detailed description of the treatment of primary chylopericardium including a description of intraoperative findings and photographs obtained during the course of VATS.
Adult↗
Expression of p33(ING1) in hepatocellular carcinoma: relationships to tumour differentiation and cyclin E kinase activity.
BACKGROUND: Inhibitor of growth-1 (ING1) is a new candidate for the tumour suppressor gene that encodes a 33k Da protein (p33(ING1)). While reduction of p33(ING1) is an important event in some human cancers, the expression of p33(ING1) in human hepatocellular carcinoma (HCC) remains to be examined. We evaluated p33(ING1) expression in various liver diseases including HCC. METHODS: Expression of p33(ING1) was evaluated immunohistochemically not only in the normal liver (n = 5), but also in specimens of chronic hepatitis (n = 39) and HCC (n = 86). We also analysed the relationship between p33(ING1) expression and cyclin E kinase activity detected by autoradiography in 29 HCCs. RESULTS: Expression of p33(ING1) was reduced in HCC, especially in moderately and poorly differentiated HCCs, and those at advanced stages. Furthermore, expression of p33(ING1) correlated inversely with cyclin E kinase activity. CONCLUSIONS: These data suggest that reduction of p33(ING1) may contribute to the process of malignant transformation, progression and dedifferentiation of HCC via an increase of cyclin E kinase activity.
Blotting, Western↗
Molecular identification of Trichophyton rubrum isolate from a dog by chitin synthase 1 (CHS1) gene analysis.
A nonsporulating isolate from a dog with dermatophytosis was identified as Trichophyton rubrum by molecular analysis. The nucleotide sequence analysis of the chitin synthase 1 (CHS1) gene from the isolate indicated more than 99% sequence similarity with other human and canine isolates of T rubrum. The molecular typing suggested that isolates of T. rubrum from human and canine sources were genetically identical.
Animals↗
TL, EPR and optical absorption studies on natural alexandrite compared to natural chrysoberyl.
The TL, optical absorption (OA) and EPR properties of natural Brazilian alexandrite and chrysoberyl have been investigated. The TL measurements for natural alexandrite show five peaks between 100 and 450 degrees C, with their emission spectrum having 370 and/or 570 nm components. The intensity of the 320 degrees C TL peak was found to be enhanced with pre-annealing treatment, more prominently above 600 degrees C. The OA and EPR measurements showed that this kind of heat treatment induces the Fe2+ --> Fe3+ conversion in the natural sample. Chrysoberyl samples exhibited the TL peaks at the same temperatures as alexandrite samples, but the glow curves were more than 200 times less intense than alexandrite ones.
Beryllium↗
On the quasi-equilibrium problem in thermally stimulated luminescence and conductivity.
Strong doubts havc been expressed about the validity of the quasi-equilibrium (QE) assumption used in the derivation of the analytical expressions of thermoluminescence (TL). So far there is no established method available to check if QE actually prevails during the emission of an experimental TL signal. The present study shows that the level of QE changes with a change in the heating rate beta. The change in the level of QE in its turn gets reflected in a change in peak shape when the system turns to a non-QE condition. This property is used as the first ever experimental method to test whether or not the emission of a given glow peak occurs under the QE condition. An essential condition for holding the QE condition is found to be T(R)/taum> or = 10(-3) where T(R) and taum are the glow peak recording duration and the maximum value of the free carrier lifetime, respectively. This relation between T(R) and taum is useful in finding the approximate value of taum. The value of taum being a function of the concentration and cross section of the TL related centres, one may be able to assess these basic parameters from the study of TL glow curves. The theoretical results are discussed in the perspective of LiF (TLD-100).
Fluorides↗
Intubating laryngeal mask airway size selection: a randomized triple crossover study in paralyzed, anesthetized male and female adult patients.
UNLABELLED: We determined the optimal size of intubating laryngeal mask airway (ILM) for ventilation and blind tracheal intubation in men and women. We also determined the distance the tracheal tube needs to protrude beyond the distal aperture to ensure that the cuff is through the vocal cords. Fifty male and 50 female anesthetized, paralyzed patients (ASA physical status I or II, aged 18-80 yr) were studied. Three operators (A, B, and C) were involved for the purposes of blinding. The size 3, 4, or 5 ILM was inserted into each patient in random order by Operator A, and the quality of ventilation was scored (adequate, suboptimal, or failed) by Operator B. The fiberoptic position (correct, too shallow, or too deep) and the distance between the distal aperture and the vocal cords was determined by Operator B. A single attempt at blind intubation was made by Operator C. Operators B and C were blinded to the size of the ILM. Operator C was also blinded to the information recorded by Operator B. All ILMs were inserted into the laryngopharynx at the first attempt. For men and women, the ventilation score was smaller for the Size 3 than the Size 4 or 5 (all: P < 0.002). For men, correct positioning was less common with the Size 3 than the Size 4 or 5 (both: P < 0.02). For women, correct positioning was similar among sizes. For men, tracheal intubation was successful less frequently with the Size 3 (84%) than the Size 4 (100%) or 5 (98%) (both: P < or = 0.01). For women, tracheal intubation success was similar among sizes (Size 3, 4, and 5: 86%, 96%, and 92%, respectively). Intubation was always successful if the ILM was correctly positioned and always failed if it was too shallow or deep. In both male and female patients, the distance between the distal aperture and the vocal cords increased with increasing ILM size (all: P < 0.04) and patient height (P < 0.0001) and was always longer for men (all: P < 0.0001). The overall mean distance (95% confidence interval) that the tracheal tube needed to protrude was 10-12 cm (8-13 cm) in men and 8-11 cm (8-12 cm) in women. We conclude that for men, the Size 4 and 5 ILMs are better than the Size 3 for ventilation and blind intubation. For women, the Size 4 and 5 ILMs are better than the Size 3 for ventilation, but there is no difference among sizes for blind intubation. The length the tracheal tube must protrude from the distal aperture to ensure that the cuff is completely through the vocal cords is 8-13 cm, depending on ILM size, the tracheal tube size, and the sex and height of the patient. IMPLICATIONS: For men, the Size 4 and 5 intubating laryngeal mask airways are better than the Size 3 for ventilation and blind tracheal intubation. For women, the Size 4 and 5 are better than the Size 3 for ventilation, but there is no difference among sizes for blind intubation. The length the tracheal tube must protrude from the distal aperture of the intubating laryngeal mask airway to ensure that the cuff is completely through the vocal cords is 8-13 cm, depending on the size of the mask and tracheal tube and on the sex and height of the patient.
Adolescent↗
A new model to evaluate the diet-induced prothrombotic state, using He-Ne laser-induced thrombogenesis in the carotid artery of apolipoprotein E-deficient and low-density lipoprotein receptor-deficient mice.
Epidemiological studies suggest the high fat content of the Western diet to be responsible for atherosclerosis and its thrombotic complications. Despite such a prevailing view, few animal experiments have so far succeeded in demonstrating enhanced thrombogenicity due to a high fat diet. Even a high fat and a very high cholesterol (1%) diet has failed to demonstrate an enhanced thrombotic reaction in rodents and rabbits. The aim of the present study was twofold. First, we wanted to establish a new, sensitive and specific thrombosis model in mice, which can then be used to study the effect of diets. Second, we intended to employ such a thrombosis model in investigations into the effect of high or low fat diets on thrombosis. The technique described uses a laser to induce thrombus formation in the exposed carotid artery of apolipoprotein E-deficient and low-density lipoprotein receptor-deficient mice. Thrombus formation was recorded on video, analysed by computer, and the size of thrombus was calculated by image analysis software. Thrombotic status was evaluated by analysing a total of 61 individual images of the thrombotic reaction, which were taken over 600 s. The severity of atherosclerosis was assessed by image analysis of the stained elastic fibers. Two kinds of diets were used: the Western type, high fat diet contained 20% fat (w/w) and 0.05% cholesterol (w/w); the low fat diet contained 7% fat, without cholesterol. These diets were on the basis of AIN93G and were given to mice for 4 or 8 weeks. The high fat diet significantly enhanced both the thrombotic reaction and the development of atherosclerosis as compared with the low fat diet.
Animals↗
Combined use of percutaneous ethanol injection and radiofrequency ablation for the effective treatment of hepatocelluar carcinoma.
Radiofrequency ablation (RFA) and percutaneous ethanol injection (PEI) therapy are currently used for the treatment of hepatocellular carcinoma (HCC). The purpose of this study was to evaluate the usefulness of combination therapy of PEI and RFA (PEI-RFA). Seventy-three patients with biopsy-proven HCC and liver cirrhosis underwent RFA after a bolus injection of ethanol into HCC. The volume of coagulated necrosis in the liver caused by PEI-RFA was estimated and compared with that by RFA alone. Coagulated necrosis areas in the liver of patients treated with PEI-RFA were significantly larger than those of patients treated with RFA alone. In PEI-RFA group, the volume of coagulated necrosis was significantly correlated with the amounts of ethanol injected into HCC. No major complications were observed during and after the PEI-RFA treatment. These results indicate that PEI-RFA is more effective than RFA alone and can make dramatic improvement of therapeutic effects in RFA therapy for HCC with fewer sessions of treatments. Therefore, PEI-RFA is considered to be a practical and promising option and may open up new avenues for the treatment of HCC.
Adult↗
[Combined surgery for cardiovascular disease and general thoracic lesions].
Surgical management of patients with concomitant critical cardiovascular disease and resectable general thoracic lesions is controversial. During a 16-year period (1985 to 2001), 15 patients underwent combined cardiovascular and general thoracic operations, of the 2,459 patients who underwent a cardiovascular operation requiring cardiopulmonary bypass at our institution. Patients had cardiovascular symptoms only and the general thoracic lesions were incidentally found by preoperative chest roentgenograms and/or computed tomography. Because of the cardiovascular disease, a pathological diagnosis was precluded before surgery. All except one descending thoracic aortic operation underwent concurrent pulmonary resection after neutralization of protamine following cardiovascular surgery requiring extracorporeal circulation. Lung pathology consisted of pulmonary bullae (n = 7), primary lung cancer (n = 4), benign lung tumor (n = 2), metastatic lung cancer (n = 1), and thymic cyst (n = 1). The pulmonary operations include bullectomy (n = 7), wedge resection (n = 6), lobectomy (n = 3), and removal of a thymic cyst (n = 1) including 2 staged procedures. The final diagnoses in 4 lung cancer cases were T1. N0M0, stage IA (n = 3) and T2N2M0, stage IIIA (n = 1). All malignancies including metastatic lung cancer, were able to be completely resected. The mean intraoperative bleeding volume for the cases was 997 +/- 221 ml, while mean duration of surgery was 382 +/- 31 minutes. Except for 2 cases required long term ventilatory support, the mean durations of tracheal intubation and ICU stay were 2.2 +/- 0.2 and 3.8 +/- 1.0 days respectively. Except for 1 surgical death, mean survival duration and 5-year survival rate were 59.7 +/- 12.5 (5-177) months and 66.3% respectively. These findings suggest that combined pulmonary resection with cardiovascular surgery is safe and offers a favorable prognosis to a selected group of patients.
Adult↗
[Esophagopericardial fistula occurring at the 22nd years after operation for achalasia presenting as myopericarditis].
We describe a case of pneumopericardium that resulted from esophagopericardial fistula occurring at the 22nd years after operation for achalasia in a 52-year-old male. Atypical features on initial examination suggested myopericarditis or congestive heart failure. A chest roentgenogram and computed tomography revealed development of pneumopericardium. Subsequent emergent pericardiocentesis relieved cardiac tamponade and enabled us to diagnose pyopneumopericardium and esophagopericardial fistula in postoperative period. The esophagopericardial fistula was surgically closed. However, the patient died 2 weeks postoperation of hemorrhage from duodenal ulcer. Autopsy confirmed the pre-mortem diagnosis of esophagopericardial fistula without evidence of malignancy. Early diagnosis and subsequent treatment appears to be most important. This case report reinforces the difficulty of this diagnosis and perhaps the need for clinical awareness and inclusion of this entity in a differential diagnosis.
Cardiac Tamponade↗
[Recurrent low output syndrome after the weaning from mechanical circulatory support for postcardiotomy cardiogenic shock].
We reviewed the cases of recurrent low output syndrome (LOS) after the weaning from mechanical circulatory support for postcardiotomy cardiogenic shock. Twelve patients were divide into 2 groups according to whether low output syndrome recurred or not, consisting of a recurrent low output syndrome (+) group [re-LOS (+) group, n = 6] and a recurrent low output syndrome (-) group [re-LOS (-) group, n = 6]. Between 2 groups, there was no statistical difference in preoperative left ventricular ejection fraction (LVEF), aortic closs-clamping time and cardiac index at the weaning from mechanical circulatory support. Only the LVEF at the weaning in the re-LOS (+) group was significantly less than that in the re-LOS (-) group (0.39 +/- 0.08 vs 0.62 +/- 0.19, p < 0.05). All patients in the re-LOS (-) group survived to discharge, while in the re-LOS (+) group, although 3 patients were re-supported by intra-aortic balloon pumping, 4 of 6 patients died of multiple organ failure and 2 survivors were in New York Heart Association class III. The results suggest that the key to survive to discharge after the weaning from mechanical circulatory support is whether the cardiac contraction could recover or not.
Aged↗
Human granulocyte-macrophage colony-stimulating factor (hGM-CSF) stimulates primitive and definitive erythropoiesis in mouse embryos expressing hGM-CSF receptors but not erythropoietin receptors.
Although erythropoietin (EPO) and its receptor (EPOR) are crucial for the proliferation, survival, and terminal differentiation of erythroid progenitors, it remains to be elucidated whether EPOR-unique signaling is required for erythropoiesis. To address this issue, human granulocyte-macrophage colony-stimulating factor (hGM-CSF) receptor (hGMR)-transgenic mice and heterozygous EPOR mutant mice were crossed by in vitro fertilization. In methylcellulose clonal culture of fetal liver (FL) cells of generated hGMR-expressing EPOR(-/-) embryos at embryonic day (E) 12.5 of gestation, hGM-CSF stimulated erythroid colony formation under serum-containing and serum-free conditions. Analysis of globin expression in individual erythrocyte-containing colonies formed from E12.5 FL cells showed that hGM-CSF supports primitive and definitive erythropoiesis even in EPOR(-/-) embryos. In comparison of activities between hGM-CSF and EPO in hGMR-expressing EPOR(+/+) embryos, the 2 substances supported the formation of similar numbers of erythroid colonies in clonal culture of E12.5 FL cells; enhanced adult, but not embryonic, globin synthesis; and induced increase of GATA-1 expression and decrease of erythroid Kruppel-like factor and cMyb expression in the FL cells. On the other hand, in E8.0 yolk sac erythropoiesis, both substances had a similar effect on erythroid colony formation, but hGM-CSF induced an increase of beta-major globin expression, while EPO did not. All together, the results of the present study demonstrated that hGM-CSF can stimulate the proliferation and differentiation of primitive and definitive erythroid cells independently of EPOR signal if they express hGMR, and the activity is comparable to that of EPO in definitive, but not primitive, erythropoiesis.
Animals↗
Identification and characterization of an output neuron from the oscillatory molluscan olfactory network.
Synchronous oscillations in olfactory systems have been thought to play critical roles in encoding olfactory information. However, their role in determining behavior is unknown. As a first step toward understanding the decoding process of coherent oscillation, we looked for a neuron in the terrestrial slug Limax marginatus that receives output signals from the procerebrum (PC), which is the olfactory center of Limax. We identified a neuron in the metacerebrum that extends its neurites into both the PC and the metacerebrum, and named it the metacerebro-procerebral neuron (MPN). The MPN exhibited a membrane potential oscillation that was synchronous with the local field potential oscillation in the PC. When we cut the PC off, the membrane potential oscillation of the MPN disappeared. Numerous varicosities were found on the neurites in the metacerebrum, while no varicosities were found on the neurites inside the PC. From these morphological and physiological results, we conclude that the MPN is an output neuron from the PC. The MPN also receives monosynaptic inputs from the superior and inferior tentacle nerves. The MPN thus may receive olfactory information from two pathways, one directly from the sensory organ and the other by way of the PC, possibly functioning to integrate them.
Animals↗
DNA mediated immunization with encoding the nucleoprotein gene of porcine transmissible gastroenteritis virus.
The immune response to a naked plasmid DNA encoding the nucleoprotein (N protein) of porcine transmissible gastroenteritis virus (TGEV) was investigated in this study. A complementary DNA of the entire N gene was amplified by RT-PCR, and inserted into a mammalian expression vector (pcDNA3.1) to construct a recombinant plasmid (pcDNA/N). To evaluate the immunogenicity of the construct, BALB/c mice were intramuscularly immunized with different doses (50, 100 and 200 microg/mouse) of pcDNA/N twice at a 5-week interval. An optimal antibody response was achieved with 100 microg of pcDNA/N. The response lasted at least 11 weeks after primary immunization. By western blotting analysis, the antibodies specifically recognized a 47 kDa protein corresponding to the viral N protein, but they did not reveal neutralizing activity against infectious TGEV in vitro. Immunoglobulin G2a was predominant among these antibodies, which was indicative of Th1 type cell activation in pcDNA/N immunized mice. Moreover, spleen cells from these mice showed stronger immune responses than those from live vaccine or parental vector immunized mice. These results suggest that the construct can elicit both humoral and cell-mediated immune (CMI) responses against TGEV N protein in mice.
Animals↗
Opposing effects of anti-activation-inducible lymphocyte-immunomodulatory molecule/inducible costimulator antibody on the development of acute versus chronic graft-versus-host disease.
The functional role of inducible costimulator (ICOS)-mediated costimulation was examined in an in vivo model of alloantigen-driven Th1 or Th2 cytokine responses, the parent-into-F(1) model of acute or chronic graft-vs-host disease (GVHD), respectively. When the Ab specific for mouse ICOS was injected into chronic GVHD-induced mice, activation of B cells, production of autoantibody, and development of glomerulonephritis were strongly suppressed. In contrast, the same treatment enhanced donor T cell chimerism and host B cell depletion in acute GVHD induced host mice. Blocking of B7-CD28 interaction by injection of anti-B7-1 and anti-B7-2 Abs inhibited both acute and chronic GVHD. These observations clearly indicate that the costimulatory signal mediated by CD28 caused the initial allorecognition resulting in the clonal expansion of alloreactive T cells, whereas the costimulatory signal mediated by ICOS played a critical role in the functional differentiation and manifestation of alloreactive T cells. Furthermore, treatment with anti-ICOS Ab selectively suppresses Th2-dominant autoimmune disease.
Acute Disease↗