Search

Background: It is unclear how effective recombinant thrombomodulin (rTM) treatment is in disseminated intravascular coagulation (DIC) during the perioperative period of gastrointestinal and hepato-biliary-pancreatic surgery. The current study aimed to evaluate the therapeutic outcomes of rTM for perioperative DIC. Methods: We enrolled 100 consecutive patients diagnosed with perioperative DIC after gastrointestinal surgery, and hepato-biliary-pancreatic including emergency procedures, between January 2012 and May 2021. Patients received routine rTM treatment immediately after DIC diagnosis. Then, the DIC, Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were calculated and used for evaluation. The outcomes of rTM treatment and the predictors of survival were evaluated. Results: The causative diseases of DIC were as follows: perforated peritonitis, n = 38; intestinal ischemia, n = 23; intra-abdominal abscess, n = 13; anastomotic leakage, n = 7; pneumonia, n = 7; cholangitis, n = 4; and others, n = 6. The 30-day mortality rate was 18.0%. There were significant differences in the platelet count (13.78 vs 10.41, P =.032) and the SOFA score (5.22 vs 9.89, P<.0001) at the start of DIC treatment between the survivor and non-survivor groups (day 0). The survivor group had a significantly lower DIC score (3.13 vs 4.93, P =.0006) and SOFA score (4.94 vs 12.14, P <.0001) and a higher platelet count (13.50 vs 4.34, P <.0001) than the non-survivor group on day 3. Conclusions: Comprehensive and systemic treatment is fundamentally essential for DIC, in which rTM may play an important role in the treatment of perioperative DIC. [ABSTRACT FROM AUTHOR]

Introduction: The bioimpedance spectroscopy (BIS) method is used in individual patients requiring body fluid volume measurement. In a hemodialysis facility, however, regular screening of body fluid volumes is also necessary. Such screening, by kinetic modeling, may become possible by calculating distribution volumes of urea and uric acid from regular blood test results. Objective: The aim is to compare uric acid distribution volumes with BIS-extracellular volume, urea distribution volume with BIS-total body water, and difference between urea and uric acid distribution volumes with BIS-intracellular volume. Methods: We reanalyzed stored blood test data of 53 hemodialysis patients obtained together with BIS data of the same patients in our previous study. Results: Significant correlations were found between urea distribution volume and total body water predicted by the BIS method, between uric acid distribution volume and extracellular volume predicted by the BIS method, and between the difference of uric acid distribution volume from urea distribution volume and intracellular volume predicted by the BIS method. In Bland-Altman analysis, comparison of each pair showed no systematic error. The mean difference between each pair was minimal. Conclusion: Fluid volumes in different body compartments can be estimated by kinetic modeling as well as by the BIS method. [ABSTRACT FROM AUTHOR]

Colorectal perforation is a serious disease with high mortality requiring emergency surgery. This study aimed to evaluate the role of the endotoxin activity assay (EAA) to assess the severity in patients admitted to the intensive care unit after emergency surgeries for colorectal perforations. Patients were divided into high (EAA ≥.4) and low (EAA <.4) groups based on the EAA levels, and the correlation between the EAA values and clinical variables related to the severity was evaluated. The SOFA scores were significantly higher in the high group than those in the low group. The high EAA value persisted even after 48 hours and extended the ICU length of stay. These results suggest that EAA may be a potential biomarker to assess severity and useful as one of the instrumental in predicting the outcomes for colorectal perforation patients. [ABSTRACT FROM AUTHOR]

Indocyanine green fluorescence imaging (ICG-FI)—a sensitive tool for detecting tumor localization in laparoscopic surgery—produces false positive results for benign liver tumors. This report is the first case of hepatic angiomyolipoma (HAML) treated laparoscopically with ICG-FI. We present the case of a 31-year-old woman with a liver tumor that was a 13-mm mass in the anterior superior segment. Though a benign tumor was suspected, malignant potential could not be ruled out. Therefore, minimally invasive laparoscopic resection using ICG-FI was planned. ICG, intravenously injected preoperatively, revealed the tumor's existence. Pure laparoscopic hepatectomy with ICG-FI was performed for excisional biopsy, during which the tumor was resected with adequate surgical margins, followed by histological confirmation of HAML. In conclusion, it is suggested that laparoscopic resection with ICG-FI is an effective minimal invasive surgery for tumors that are difficult to detect, such as HAML, leading to a safe surgical margin. [ABSTRACT FROM AUTHOR]

Background: Recently, virtual navigation system has been applied to hepatic surgery, enabling better visualization of intrahepatic vascular branches and location of tumor. Intraoperative ultrasonography (IOUS) is the most common form of image guidance during liver surgery. However, during laparoscopic hepatectomies (LH), IOUS has several limitations and its reliability has been poorly evaluated. The objective of this work is to evaluate VRCT (virtual real-time CT-guided volume navigation) during LH. This system aims to provide accurate anatomical orientation for surgeons enhancing the safety of LH. Methods: Twenty-seven hepatic neoplasms were resected laparoscopically at our institution under reference guidance of VRCT. During operation, electromagnetic tracking of the surgical instrument was used for navigating the direction of accurate liver transection. Results: Twenty-six (96.3%) of the 27 lesions (mean diameter 11 mm) were successfully performed under VRCT guidance. Average registration time was < 2 min. Average setup time was approximately 7 min per procedure. VRCT allows the surgeon to navigate liver transection with acceptable accuracy. The mean error was 12 mm. All surgical margins were negative and the mean histologic resection margin was 9 mm. Conclusions: VRCT-guided LH is feasible and provides valuable real-time anatomical feedback during hepatic resections. Advancement of such systems to improve accuracy might greatly compensate for the limitation of laparoscopic IOUS. [ABSTRACT FROM AUTHOR]

Intraoperative ultrasonography is the golden standard method for evaluation of liver tumors during hepatectomy. However, in laparoscopic surgery, accurate assessment of tumors may be difficult, particularly if the lesion is located nearby the liver surface because of the challenges in handling the intraoperative ultrasound and the lack of tactile sensation. In this study, we demonstrate the preliminary results of examining the microvascular architecture of subcapsular hepatic tumors using laparoscopic narrow-band imaging (NBI) to distinguish between malignant and benign tumors. Thirty-five lesions were examined by NBI during laparoscopic hepatectomy for the presence of abnormal microvasculature on the liver surface in relation to hepatic tumors from January 2016 to August 2018. The microvascular findings were correlated with tumor localization and pathological diagnosis. The 35 examined nodules included 11 hepatocellular carcinoma, 18 colorectal liver metastasis, and six benign nodules. The mean tumor diameter was 26.3 (3-70) mm, and the distance from the liver surface to the tumor was 0.5 (0-5) mm. Microvessels on the liver surface were clearly visualized by NBI, consistent with malignant tumor localization. The tumors were thoroughly examined for the presence of three pathological microvascular features (enlargement, tortuosity, and heterogeneity). Abnormal microvascular patterns were found in 90.9% of hepatocellular carcinoma and 77.8% of colorectal liver metastasis, whereas neither normal sites nor benign lesions displayed microvascular abnormality. This study suggests that observing the microvessel image on the liver surface by NBI could be useful in tumor localization and differentiation between benign and malignant lesions. [ABSTRACT FROM AUTHOR]

Obesity is a positive predictor of surgical morbidity. There are few reports of laparoscopic cholecystectomy (LC) outcomes in obese patients. This study aimed to clarify this relationship. This retrospective study included patients who underwent LC at Showa University Northern Yokohama Hospital between January 2017 and April 2020. A total of 563 cases were examined and divided into two groups: obese (n = 142) (BMI ≥ 25 kg/m2) and non-obese (n = 241) (BMI < 25 kg/m2). The non-obese group had more female patients (54%), whereas the obese group had more male patients (59.1%). The obese group was younger (56.6 years). Preoperative laboratory data of liver function were within the normal range. The obese group had a significantly higher white blood cell (WBC) count (6420/μL), although this was within normal range. Operative time was significantly longer in the obese group (p = 0.0001). However, blood loss and conversion rate were not significantly different among the groups, neither were surgical outcomes, including postoperative hospital stay and complications. Male sex and previous abdominal surgery were risk factors for conversion, and only advanced age (≥ 79 years) was an independent predictor of postoperative complications as observed in the multivariate analysis. Although the operation time was prolonged in obese patients, operative factors and outcomes were not. Therefore, LC could be safely performed in obese patients with similar efficacy as in non-obese patients. [ABSTRACT FROM AUTHOR]

Purpose: Three-dimensional virtual endoscopy (3DVE) has the potential advantage of enhanced anatomic delineation and spatial orientation during laparoscopic procedures. In the present study, we aimed to evaluate the impact of 3DVE guidance in laparoscopic distal pancreatectomy (LDP). Methods: Thirty-eight patients presenting to our hospital with a variety of pancreatic tumors underwent preoperative computed tomography scanning to clearly define the major peripancreatic vasculature and correlate it with a 3DVE system (SYNAPSE VINCENT: Fujifilm Medical, Tokyo, Japan). This map served as the guide during preoperative planning, surgical education, and simulation and as intraoperative navigation reference for LDP. Operative records and pathological findings were analyzed for each procedure. Operative parameters were compared between the 38 patients in this study and 8 patients performed without 3DVE guidance at our institution. Results: The 3DVE navigation system successfully created a preoperative resection map in all patients. Relevant peripancreatic vasculature displayed on the system was identified and compared during the intervention. The mean blood loss in LDP performed under 3DVE guidance versus LDP without 3DVE was 168.5 +/- 347.6 g versus 330.0 +/- 211.4 g, p = 0.008 while and the operative time was 171.9 +/- 51.7 min versus 240.6 +/- 24.8 min, p = 0.001. Conclusions: 3DVE in conjunction with a "laparoscopic eye" creates a preoperative and intraoperative three-dimensional data platform that potentially enhances the accuracy and safety of LDP. [ABSTRACT FROM AUTHOR]

Highlights • IMF kernel is less attractive than MOX powder for those intending NED production. • Complex recovery process needed for IMF kernel declines its material attractiveness. • Massive IMF kernel decline attractiveness against imperfect but quick processing. • Fresh IMF kernel is regarded as irradiated fuel grade in material attractiveness. Abstract The impacts of chemical stability of inert-matrix-fuel (IMF) on the material attractiveness for states and non-state actors were evaluated in an open transuranic fuel cycle employing high temperature gas cooled reactors. The methodology for material attractiveness evaluation was developed to assess material attractiveness for states and treat IMF which is chemically inert for nitric acid solution. The material attractiveness was relatively assessed with physical properties of material in each of three discrete phases in the development of a nuclear explosive device. The material attractiveness assessment for non-state actors revealed that the non-irradiated TRISO fuel particle and IMF kernel for high temperature gas cooled reactors and the non-irradiated mixed oxide fuel (MOX) powder for MOX light water reactors were the most vulnerable targets in each fuel cycles. The TRISO fuel particle and IMF kernel would have less material attractiveness than the MOX powder because of their greater processing time and complexity. The material attractiveness assessment for states aiming concealed diversion revealed that the TRISO fuel particle and IMF kernel have less material attractiveness than the MOX powder, and are regarded as irradiated uranium fuel grade in the material attractiveness. [ABSTRACT FROM AUTHOR]

Purpose: Laparoscopic liver resection is increasingly used to treat patients with hepatic tumor. However, during laparoscopic resection, information obtained by palpation using laparoscopic forceps or from intraoperative ultrasonography is extremely limited, which may pose a risk for positive surgical margins. This study aimed to investigate the feasibility and clinical application of near-infrared (NIR) fluorescence imaging to guide laparoscopic liver resection of a liver tumor and secure the surgical margins.Methods: A preliminary study in 25 patients was conducted. NIR imaging was used intraoperatively during laparoscopic liver resection. The liver tumors were preoperatively labeled by intravenously injecting the patients with indocyanine green dye (0.5 mg/kg), an NIR fluorescence agent. During the surgical procedure, the PINPOINT Endoscopic Fluorescence Imaging System was used to assess the surgical margin by using real-time endoscopic high-definition visible and NIR fluorescence imaging.Results: All tumors were identified and resected laparoscopically by using the PINPOINT system, and all resections successfully secured the surgical margin. The pathological findings of all tumors indicated negative margins, defined as R0.Conclusions: This technique showed the potential to improve the intraoperative identification and demarcation of tumors. Its use could potentially reduce the number of positive resection margins. [ABSTRACT FROM AUTHOR]

The participating teams have developed Unmanned Ground Vehicles (UGV) and Unmanned Aerial Vehicles (UAV) with new technologies and tried to solve the complex problems of the missions using the above core technologies. In this issue, we will compile articles to introduce the state-of-the-art technologies of the disaster response robots of the Disaster category. We are pleased to announce the special issue on Disaster Response Robot - selected papers from the World Robot Summit 2020. [Extracted from the article]

Purpose: Laparoscopic and thoracoscopic/laparoscopic hepatectomy is a safe procedure that has potential advantages over open surgery. However, deeply positioned liver tumors require expert laparoscopic and thoracoscopic/laparoscopic hepatectomy techniques. Using simulated preoperative three-dimensional virtual endoscopy (P3DVE) guidance, we demonstrate herein that a thoracoscopic approach (TA), thoracoscopic-laparoscopic approach (TLA), and laparoscopic approach (LA) are all feasible and safe routes for performing pure laparoscopic and thoracoscopic/laparoscopic resection of liver tumors located in the 4a, 7, and 8 liver subdiaphragmatic areas. Methods: Thirty-eight patients underwent laparoscopic and thoracoscopic/laparoscopic partial liver resection (TA 13 cases, TLA two cases, and LA 23 cases) of the subdiaphragmatic area at Showa University Hospital. All surgical approaches were preoperatively determined based on preoperative 3D virtual endoscopic simulation (P3DVES) visualization and findings using the image processing software SYNAPSE VINCENT. Results: Laparoscopic and thoracoscopic/laparoscopic liver resection was successfully performed for all cases under P3DVE instruction. The mean operative times using TA, TLA, and LA approaches were 193, 185, and 190 min, respectively. Mean blood loss during TA, TLA, and LA was 179, 138, and 73 g, respectively. No patients required conversion to open surgery, and there were no deaths, although there were three cases of Clavien-Dindo grade I in TA along with three cases of grade I and one case of grade II in LA. Conclusions: TA, TLA, and LA routes performed under P3DVE instruction are feasible and safe to perform for pure laparoscopic and thoracoscopic/laparoscopic liver resection in selected patients with lesions located in the hepatic subdiaphragmatic area. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 64-year-old male patient , who was diagnosed with cancer of the sigmoid colon. The patient underwent laparoscopic sigmoidectomy and liver resection for metastasis. The patient was placed in the supine position under general anesthesia for liver resection. It also cites the use of ultrasound and image fusion system for the detection of colon cancer.

The distribution function of relaxation time of distant-pair (DP), or nongeminate recombination is derived in an analytic form from the existing theories of DP recombination to analyse the data of quadrature frequency resolved spectroscopy (QFRS) of photoluminescence (PL) in a-Si:H with the competing recombination model. The distribution function has a single parameter of metastable carrier density n and yields too narrow QFRS spectrum to fit the experimental data. This is improved with introducing the fluctuation Δ of the electron localisation radius ae. The devised formula is demonstrated to predict the dependence of the DP recombination on the photogeneration rate and the defect density in the QFRS data of the high-quality and defective a-Si:H. (© 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [ABSTRACT FROM AUTHOR]

Background: Laparoscopic liver resection has recently gained wide acceptance for various liver tumors, thanks to advances in surgical techniques and devices. However, if the tumor is located in the subdiaphragmatic area of segments 7 and 8, resection is difficult. We demonstrate herein a novel technique for video-assisted thoracoscopic surgery hepatectomy (VATS-H) for liver tumors located in the subdiaphragmatic area. Methods: Five patients underwent VATS-H for a liver neoplasm. One port or two ports and two laparoscopic protectors were placed on the chest surrounding the tumor. Using intraoperative thoracoscopic ultrasonography (IOTU), the portion of the diaphragm located just above the tumor was cut and opened using laparoscopic coagulating shears. IOTU was performed on the liver surface, and the tumor margin was marked by electrocautery. For liver resection, microwave tissue coagulation or radiofrequency ablation was used for coagulation before liver transection and for coagulation of liver parenchyma during the transection. Results: The mean operating time was 137 min (range 95-185 min), and the mean operative blood loss was 43 g (range 0-200 g). No postoperative complications were encountered. Conclusions: VATS-H appears useful for resecting liver tumors located in the subdiaphragmatic area. [ABSTRACT FROM AUTHOR]

Technetium-99m-galactosyl human serum albumin (GSA) scintigraphy provides an accurate estimation of the hepatic functional reserve but is not applied after a hepatectomy. The aim of this study was to elucidate the natural course of the remnant hepatic functional reserve (RHFR) after hepatectomy by GSA scintigraphy. Eighty-six patients (partial hepatic resection, Hr0 = 46; sectionectomy, Hr1 = 21; bisectionectomy, Hr2 = 19) classified as Child–Pugh class A before the hepatectomy were enrolled, and GSA scintigraphy to detect HH15 (uptake ratio of the heart at 15 min to that at 3 min) and LHL15 (uptake ratio of the liver at 15 min to the liver plus the heart at 15 min) was performed periodically before and after the hepatectomy. HH15, LHL15, and the percentages of patients that recovered to the preoperative levels of these entities were estimated. In addition, hematobiochemical tests and the remnant liver volume were also periodically monitored. HH15 and LHL15 levels deteriorated until 2 months postoperatively (PO) after the procedure and subsequently recovered to the preoperative levels at 6 months PO in Hr0 patients. In Hr1 patients, but not in Hr2 patients, these levels also deteriorated until 3 months PO and had improved by 6 months after the surgery. Only 40% of the patients showed recovery to the preoperative levels by 6 months PO in the Hr0 group; furthermore, the percentage of patients who showed recovery to the preoperative levels by 6 months PO was under 40% in the Hr1 group and around 10% in the Hr2 group. However, the results of hematobiochemical tests and the remnant liver volume in all types of hepatectomies were rapidly normalized after the hepatectomy. Remnant hepatic functional reserve estimated by GSA scintigraphy revealed that a larger resected liver volume induced both more serious and continued remnant hepatic dysfunction in comparison to results shown by hematobiochemical tests, while the functional regeneration was also appreciably slower and more gradual in comparison to the volume regeneration. [ABSTRACT FROM AUTHOR]

Background: The two-layer method (TLM) has recently been found to be superior to simple cold storage in University of Wisconsin (UW) solution as a means of pancreas preservation for islet transplantation. In this study, we investigated whether TLM would result in better hepatocyte function over UW cold storage and if it could be applied to hepatocyte transplantation. Materials and methods: Hepatocytes from male Sprague Dawley rat livers were isolated and divided into three groups: a non-preservation group (group 1), a 10-h preservation group (group 2), and a 24-h preservation group (group 3). Groups 2 and 3 were then divided into three subgroups: a group preserved by the TLM (subgroup a), a group preserved in UW solution (subgroup b), and a group preserved in water (subgroup c). Isolated hepatocytes were evaluated for cell yield, viability, and adenosine triphosphate level after preservation. Hepatocytes were either cultured or transplanted. Results: Although no differences in cell yield or morphological findings were observed between any of the groups, TLM significantly improved hepatocyte viability and adenosine triphosphate levels in comparison with UW cold storage. Albumin production or urea synthesis were significantly higher in subgroup 3a than in subgroup 3b at almost all time points. Surprisingly, after hepatocyte transplantation, the serum albumin level in subgroup 2a was significantly higher than in subgroup 2b at every time point. Conclusions: The results of this study demonstrated that liver preservation by the TLM before hepatocyte isolation might be beneficial and will be useful in the field of hepatotocyte transplantation. [Copyright &y& Elsevier]

In malignant hepatic neoplasm, anatomic resection could improve survival and limit complications from hepatectomy. Our purpose was to develop an intraoperative method for identifying segment and subsegment of the liver with high-sensitivity near-infrared fluorescence imaging. The subjects were 35 patients with hepatic malignant liver disease who received hepatectomy in 2006. The segments of liver method of identification that used infrared observation camera system termed Photo Dynamic Eye-2 (PDE-2) with indocianine green (ICG) for the patient with malignant liver tumor (hepatocellular carcinoma: 13 cases; metastatic liver cancer: 18 cases; intrahepatic cholangio carcinoma: 4 cases) were performed before liver resection. Although greenish stain of the liver surface after the injection of ICG via portal vein is not visible clearly without infrared observation camera system PDE-2, 1 minute after injection of ICG with fluorescent using infrared observation camera system PDE-2, demarcation of liver segment and subsegment was clearly detected. Ten minutes after injection of ICG with fluorescent using infrared observation camera system PDE-2, fluorescence of liver subsegment remained. Stained subsegment and segment of liver were identifiable in 33 (94.3%) of the 35 patients. There were no complications or side-effects related to the injection of patent blue dye. We demonstrated here that near-infrared fluorescence imaging system is a novel and reliable intraoperative technique to identify hepatic segment and subsegment for anatomical hepatic resection. [ABSTRACT FROM AUTHOR]

Aim: Hepatocyte transplantation is a potential alternative to whole organ liver transplantation. To realize this procedure, a hepatocyte bank system capable of supplying large numbers of hepatocytes must be established. We previously reported an easy method for cryopreserving hepatocytes using a microencapsulation technique. Here, we investigated how cryoinjury to microencapsulated hepatocytes could be avoided during cryopreservation. Methods: Hepatocytes from Sprague–Dawley rats were harvested in situ using a two-step ethylenediaminetetraacetic acid (EDTA)/collagenase digestion protocol. The cells were microencapsulated using alginate-poly L-lysine. The microencapsulated hepatocytes were put into vials and immediately immersed in liquid nitrogen. The growth of ice crystals in the vials containing the microencapsulated hepatocytes was observed using cryomicroscopy. The microencapsulated hepatocytes were sectioned for ultrastructural examination to investigate their intracellular conditions. Finally, total RNA was isolated from the cryopreserved microencapsulated hepatocytes and analyzed for hepatocyte nuclear factor (HNF) using reverse transcriptase polymerase chain reaction (RT–PCR) analysis. Results: Cryomicroscopy showed that the alginate microencapsulation technique protected the hepatocytes from physical damage caused by the growth of extracellular ice crystals. Ultrastructural examination revealed that the intracellular environment of the microencapsulated hepatocytes was maintained. The RT–PCR analysis additionally suggested that the alginate gel also maintained the HNF level. Conclusion: Our microencapsulation technique protects hepatocytes from cryoinjury. This novel technique could be utilized by hepatocyte banks. [ABSTRACT FROM AUTHOR]

Background: Hepatocyte transplantation (HTx) has progressed significantly, but widespread application remains slow because of the shortage of donor hepatocytes. Many sources of hepatic cells have been proposed as alternatives to isolated hepatocytes, but primary isolated hepatocytes continue to be the best source for liver cell-based therapy. To expand the donor pool, we focused on steatotic liver as a new cell source for HTx because numerous steatotic livers are discarded as unsuitable for orthotopic liver transplantation. This study investigated the efficacy of steatotic hepatocyte transplantation (SHTx) using steatotic liver in a rat model. Materials and methods: Hepatocytes were isolated from obese and lean Zucker rats. Hepatocytes from each group were cultured to analyze the function of steatotic hepatocytes. Hepatocytes from each group were also transplanted into the spleens of Nagase analbuminemic rats (NARs) to investigate the efficacy of SHTx. Results: In the in vitro experiment, a real-time reverse-transcription polymerase chain reaction assay showed that albumin and several hepatocyte nuclear factors were highly expressed in both groups. Morphologically, the steatotic hepatocytes were positive for albumin, and an enzyme-linked immunosorbent assay showed no significant differences between the two groups except for albumin production after 5 d of culture. In the in vivo experiment, the transplanted steatotic hepatocytes in the spleens of Nagase analbuminemic rats were positive for albumin and periodic acid-Schiff staining. Surprisingly, an enzyme-linked immunosorbent assay showed no significant differences in the serum albumin levels between the two groups throughout the study period. Conclusions: We have demonstrated that steatotic hepatocytes are a potential new cell source for HTx therapy. [Copyright &y& Elsevier]

We developed an online system for estimating dietary nutritional content. It also had the function of assessing the accuracy of the participating dieticians and ranking their performance. People who wished to have their meal estimated (i.e. clients) submitted images of their meal taken by digital camera to the server via the Internet, and dieticians estimated the nutritional content (i.e. calorie and protein content). The system assessed the accuracy of the dieticians and if it was satisfactory, the results were sent to the client. Clients received details of the calorie and protein content of their meals within 24 h by email. A total of 93 dieticians (71 students and 22 licensed practitioners) used the system. A two-way analysis of variance showed that there was a significant variation (P=0.004) among dieticians in their ability to estimate both calorie and protein content. There was a significant difference in values of both calorie (P=0.02) and protein (P<0.001) estimation accuracy between student dieticians and licensed dieticians. The estimation accuracy of the licensed nutritionists was 85% (SD 10) for calorie content and 78% (SD 17) for protein content. [ABSTRACT FROM AUTHOR]

Abstract: Wideband quadrature frequency resolved spectroscopy (QFRS) expanded from 2ns to 160s revealed that the triple-peaked lifetime distribution observed in the photoluminescence (PL) of a-Si:H consists of the well-known double-peak structure and a newly identified third component. By the exploring dependence of the lifetime distribution on the generation rate G, temperature T, PL emission energy E PL, PL excitation energy E X and external magnetic field, the former is assigned to excitonic recombination and the latter to distant-pair (DP) or nongeminate recombination. The DP component gives the same sublinear G and T dependence as light-induced electron spin resonance (LESR) results. The present paper also shows that the residual PL decay in a-Si:H persists for more than 104 s, which corresponds the DP component and agrees with the LESR results. The residual PL decay reveals that the DP recombination kinetics is monomolecular at low T and low G. [Copyright &y& Elsevier]

There is a strong demand for efficient rescue techniques and devices in preparation for large-scale earthquakes. in this study we aim to develop a robot that focuses on the efficient search for survivors. We think that efficient rescue operation is achieved when many people can work using the rescue tools at the same time. Therefore, we believe that rescue tools are snore important than expensive and specialized robots. in this paper we report on the pneumatic-drive expandable arm "Slime Scope ", which has a search device, such as a CCD camera, at the end of the pneumatically controlled expandable arm. This can drive stably in environments that have much debris, no electric power and no wireless communication. [ABSTRACT FROM AUTHOR]

Abstract: Recent studies have demonstrated that the transplantation of bone marrow cells following diabetes induced by streptozotocin can support the recovery of pancreatic β-cell mass and a partial reversal of hyperglycemia. To address this issue, we examined whether the c-Met/hepatocyte growth factor (HGF) signaling pathway was involved in the recovery of β-cell injury after bone marrow transplantation (BMT). In this model, donor-derived bone marrow cells were positive for HGF immunoreactivity in the recipient spleen, liver, lung, and pancreas as well as in the host hepatocytes. Indeed, plasma HGF levels were maintained at a high value. The frequency of c-Met expression and its proliferative activity and differentiative response in the pancreatic ductal cells in the BMT group were greater than those in the PBS-treated group, resulting in an elevated number of endogenous insulin-producing cells. The induction of the c-Met/HGF signaling pathway following BMT promotes pancreatic regeneration in diabetic rats. [Copyright &y& Elsevier]

Catalytic antibody 2B generated by immunization with N-methyl mesoporphyrin as hapten catalyzes the insertion of a cupric ion into mesoporphyrin. To identify amino acid residues essential for the catalytic activity, we studied effects of various amino acid-reactive reagents on the catalytic activity. The reagents reactive to Arg, Tyr and carboxyl-containing residues inactivated the antibody and mesoporphyrin protected notably the antibody from the inactivation. These results indicated that Arg, Tyr and carboxyl-containing residues are situated in or near the substrate-binding site of the antibody and that some of them would be essential for the catalytic activity. The modified Arg and Tyr residues in the inactivation were quantified in connection with the residual activity. As the result, it was shown that three Arg and one Tyr residues are modified to lead the inactivation. Kinetic analysis indicated that the antibody loses the catalytic activity by modification of one carboxyl-containing residue. In order to find candidates for the modified residues, we performed modeling of the variable domain of the antibody. The model showed that the modified residues are Arg L54, Arg H94, Arg H95, Tyr L91 and Asp H96, and suggested that Arg H95, Tyr L91 and Asp H96 residues would stabilize the transition state of mesoporphyrin in the antibody-mediated reaction. [Copyright &y& Elsevier]

The aim of the present study was to clarify the role of the metabotropic glutamate 5 (mGlu5) receptor subtype in the development of rewarding effect induced by a prototypicalµ-opioid receptor agonist morphine in the mouse. In the conditioned place preference paradigm, intracerebroventricular (i.c.v.) administration of a selective mGlu5 receptor antagonist, 2-methyl-6-(phenylethynyl)-pyridine (MPEP), attenuated the morphine-induced rewarding effects. Using immunoblot analysis, we confirmed that the increased level of protein kinase Cγ (PKCγ) isoform was observed in the limbic forebrain of ICR mice conditioned with morphine. Here we found for the first time that the treatment with MPEP significantly inhibited the up-regulation of PKCγ isoform in the limbic forebrain of mice showing the significant place preference. Furthermore, it should be mentioned that the protein level of mGlu5 was significantly increased in membrane preparations of the limbic forebrain obtained from morphine-conditioned mice compared to those from saline-conditioned mice. As well as the result from the immunoblot analysis, we demonstrated using the receptor binding assay that the number of mGlu5 receptors in the mouse limbic forebrain was significantly increased by morphine conditioning. The present data provide direct evidence that the activation of mGlu5 receptor linked to the increased PKCγ isoform in the mouse limbic forebrain is implicated in the development of rewarding effect of morphine. [ABSTRACT FROM AUTHOR]

The present study was designed to investigate whether endoplasmic inositol 1,4,5-trisphosphate (IP3) receptor-mediated intracellular signaling pathway could be involved in the morphine-induced antinociception in the mouse. An intracerebroventricular (i.c.v.) pretreatment with xestospongin C (10–100 pmol per mouse, i.c.v.), a membrane permeable and selective antagonist for IP3 receptor, produced a dose-dependent reduction in the supraspinal antinociceptive effect produced by i.c.v. administration of morphine (0.3–10 nmol). In addition, the dose-response curve for morphine-induced antinociception was significantly shifted to the right by i.c.v. pretreatment with xestospongin C at 100 pmol. In the present study, we confirmed that the IP3R1 mRNA in opisthonos (opt) heterozygote mice was approximately 50% reduced as compared to that in wild-type mice. Under these conditions, a significant antinociception produced by subcutaneous (s.c.) injection of morphine (5 mg/kg) observed in wild-type mice was markedly reduced in opt heterozygote mice. These findings suggest that IP3 receptor-, especially type 1 IP3 receptor-mediated intracellular signaling pathway may be implicated in the expression of antinociceptive effect induced by morphine in mice. [Copyright &y& Elsevier]

To find applicability of tin/tin contacts to connectors used in communication systems requiring high reliability electrical connection, damp heat cycle tests have been carried out and the accelerated degradation characteristics of the tin/tin contact have been compared with those of the gold/gold and gold/tin contacts. The results are as follows. (1) The contact resistance of the tin/tin contact is close to that of the gold/gold contact and it was found to be a tellable contact in high reliability connectors for the first 20 insertions. (2) In the tin/tin contact, the worn-off area is smaller and the apparent contact area is larger than in the gold/tin contact. These factors contribute to the stability of the contact resistance and are basis for contact resistance in the tin/tin contact is more stable than in the gold/tin contact. From these results it is found that the tin/tin contact can be used in high reliability connectors within the range of a few insertions. [ABSTRACT FROM AUTHOR]

As data centers have become increasingly important in recent years their operational management must attain higher efficiency and reliability. Moreover, the power consumption of a data center is extremely large, and it is anticipated that it will continue to increase, so energy saving has become an urgent issue concerning data centers. In the meantime, the environment of the server rooms in data centers has become complicated owing to the introduction of virtualization technology, the installation of high-heat density information and communication technology (ICT) equipment and racks, and the diversification of cooling methods. It is very difficult to manage a server room in the case of such a complicated environment. When energy-saving measures are implemented in a server room with such a complicated environment, it is important to evaluate "temperature risks" in advance and calculate the energy-saving effect after the measures are taken. Under those circumstances, in this study, two prediction models are proposed: a model that predicts the rack intake temperature (so that the temperature risk can be evaluated in support of energy-saving measures implemented in the server room) and a model that evaluates the energy-saving effect (in relation to a baseline). Specifically, the models were constructed by using machine learning. The first constructed model evaluates the temperature risk in a verification room in advance, and it was confirmed that the model can evaluate the risk beforehand with high accuracy. The second constructed model—"baseline model" hereafter—supports energy-saving measures, and it was confirmed that the model can calculate the baseline (energy consumption) with high accuracy as well. Moreover, the effect of proposal process of energy-saving measures in the verification room was verified by using the two proposed models. In particular, the effectiveness of the model for evaluating temperature risk in advance and that of a technology for visualizing the energy-saving effect were confirmed. [ABSTRACT FROM AUTHOR]

In this study, we developed new bending modules and pneumatic self-excited valves. In a previous study, we developed a planar flexible-deformation mobile robot that combines multiple bending modules. The robot moves by a traveling wave, which is periodically generated by pressurizing air to the bending modules. Further, it can move in every direction by simultaneously combining the two directional traveling waves. However, problems such as air leakage from the bending module that constitutes the moving object and the influence of the moving operation owing to the tubes comprising the flow path were identified. To address these problems, new bending modules have been developed. To address air leak issues, we verified the materials used in the bending modules and developed an injection mechanism. To reduce the number of externally connected tubes, we developed new bending modules that could include multiple internal flow paths. In addition, because the mobile robot moves owing to the generation of traveling waves, it is a low-grade operation. However, this requires multiple solenoid valves and electronic circuits. This is useful if traveling waves can be generated by simply supplying air using a pneumatic self-excited valve. In this study, we developed bending modules with multiple internal channels and a pneumatic self-excited valve that utilizes the snap buckling of leaf springs used in the mobile robot. [ABSTRACT FROM AUTHOR]

Data centers (DCs) are becoming increasingly important in recent years, and highly efficient and reliable operation and management of DCs is now required. The generated heat density of the rack and information and communication technology (ICT) equipment is predicted to get higher in the future, so it is crucial to maintain the appropriate temperature environment in the server room where high heat is generated in order to ensure continuous service. It is especially important to predict changes of rack intake temperature in the server room when the computer room air conditioner (CRAC) is shut down, which can cause a rapid rise in temperature. However, it is quite difficult to predict the rack temperature accurately, which in turn makes it difficult to determine the impact on service in advance. In this research, we propose a model that predicts the rack intake temperature after the CRAC is shut down. Specifically, we use machine learning to construct a gradient boosting decision tree model with data from the CRAC, ICT equipment, and rack intake temperature. Experimental results demonstrate that the proposed method has a very high prediction accuracy: the coefficient of determination was 0.90 and the root mean square error (RMSE) was 0.54. Our model makes it possible to evaluate the impact on service and determine if action to maintain the temperature environment is required. We also clarify the effect of explanatory variables and training data of the machine learning on the model accuracy. [ABSTRACT FROM AUTHOR]

• Proliferation resistance evaluation of an inert matrix fuel (IMF) in the transuranic nuclear fuel cycle (NFC) of a high temperature gas cooled reactor (HTGR). • Impacts of chemical stability of IMF and fuel irradiation on the proliferation resistance. • Study shows scope for a more reasonable, cost-effective, and reduced safeguards inspection frequency to manage the fresh IMF block with a high proliferation resistance. The proliferation resistance (PR) of an inert matrix fuel (IMF) in the transuranic nuclear fuel cycle (NFC) of a high temperature gas cooled reactor is evaluated relative to the uranium and plutonium mixed-oxide (MOX) NFC of a light water reactor using PRAETOR code and sixty-eight input attributes. The objective is to determine the impacts of chemical stability of IMF and fuel irradiation on the PR. Specific material properties of the IMF, such as lower plutonium content, carbide ceramics coating, and absence of 235U, contribute to enhance its relative PR compared to MOX fuel. The overall PR value of the fresh IMF (an unirradiated direct use material with a one-month diversion detection timeliness goal) is nearly equal to that of the spent MOX fuel (an irradiated direct use nuclear material with a three-month diversion detection timeliness goal). Final results suggest a reduced safeguards inspection frequency to manage the IMF. [ABSTRACT FROM AUTHOR]

• A roadmap for licensing of HTGR cogeneration systems is presented. • Major features and examples of HTGR safety standards are described. • A test plan using the HTTR to support the establishment of safety standards and safety analysis methods is shown. High temperature gas-cooled Reactor (HTGR) is expected to extend the use of nuclear heat to a wider spectrum of industrial applications such as hydrogen production, high efficiency power generation, etc., due largely to high temperature heat supply capability as well as inherent safe characteristics. Japan Atomic Energy Agency has been conducting research and development with a central focus on the utilization of High Temperature engineering Test Reactor (HTTR), the first HTGR in Japan, towards the realization of industrial use of nuclear heat. On the basis of licensing experience through the HTTR construction, JAEA initiated an activity to establish an international safety standard for licensing of commercial HTGR cogeneration systems fully taking into account safety features of HTGRs. This paper explains a roadmap towards licensing of commercial HTGR cogeneration systems. A test plan using the HTTR to support the establishment of safety standards and safety analysis methods is also presented. [ABSTRACT FROM AUTHOR]

Laparoscopic total gastrectomy (LTG) for remnant gastric cancer (RGC) requires advanced techniques due to severe postoperative adhesions and anatomic changes. We performed LTG in 2 patients with RGC using intraoperative indocyanine green (ICG) fluorescence imaging. Both cases previously underwent distal gastrectomy with Billroth-I reconstruction for gastric cancer and were subsequently diagnosed with early-stage gastric cancer of the remnant stomach. Indocyanine green (2.5 mg/body) was administered intravenously during surgery. The liver and common bile duct were clearly visualized during surgery using near-infrared fluorescence laparoscopy, and the adhesions between the hepatobiliary organs and remnant stomach were safely dissected. Laparoscopic total gastrectomy was successfully performed without complications, and the postoperative course was uneventful in both cases. Intraoperative real-time ICG fluorescence imaging allows clear visualization of the liver and common bile duct and can be useful in LTG for RGC with severe adhesions. [ABSTRACT FROM AUTHOR]

Solid pseudopapillary neoplasm (SPN) of the pancreas has generally been regarded as a low-grade malignant tumour that preferentially develops in young women and can have a good prognosis with surgery. Among the few patients who have died from metastatic SPN are mostly those whose tumours harbour an undifferentiated component characterized by diffuse sheets of cells with increased nuclear atypia and proliferative index. We herein report a case of an aggressive, fatal, solid pseudopapillary neoplasm (SPN) of the pancreas in a 63-year-old woman complaining of epigastric pain. Despite having undergone surgical resection for a 10 cm pancreatic mass and multiple liver metastases, the patient later died due to uncontrollable metastases 36 months after the initial surgery. Histological examination showed that the tumour displayed unusual high-grade malignant features, showing diffuse sheets of cells with increased nuclear atypia and proliferative activity, along with conventional low-grade malignant features. The tumour was subsequently recognized as an SPN with foci of high-grade malignant transformation according to the 2010 World Health Organization classification. Immunohistochemical studies revealed that p16-RB pathway alterations contributed to the high-grade malignant transformation. The present case report suggests the necessity for developing diagnostic and treatment methods targeting p16 and RB for high-grade variants of SPN. [ABSTRACT FROM AUTHOR]

Solid pseudopapillary neoplasm (SPN) of the pancreas has generally been regarded as a low-grade malignant tumour that preferentially develops in young women and can have a good prognosis with surgery. Among the few patients who have died from metastatic SPN are mostly those whose tumours harbour an undifferentiated component characterized by diffuse sheets of cells with increased nuclear atypia and proliferative index. We herein report a case of an aggressive, fatal, solid pseudopapillary neoplasm (SPN) of the pancreas in a 63-year-old woman complaining of epigastric pain. Despite having undergone surgical resection for a 10 cm pancreatic mass and multiple liver metastases, the patient later died due to uncontrollable metastases 36 months after the initial surgery. Histological examination showed that the tumour displayed unusual high-grade malignant features, showing diffuse sheets of cells with increased nuclear atypia and proliferative activity, along with conventional low-grade malignant features. The tumour was subsequently recognized as an SPN with foci of high-grade malignant transformation according to the 2010 World Health Organization classification. Immunohistochemical studies revealed that p16-RB pathway alterations contributed to the high-grade malignant transformation. The present case report suggests the necessity for developing diagnostic and treatment methods targeting p16 and RB for high-grade variants of SPN. [ABSTRACT FROM AUTHOR]

Background: Cell therapy, such as hepatocyte transplantation (HTx), is promising for the treatment of metabolic liver diseases or as a bridge to orthotopic liver transplantation in patients with fulminant liver failure. However, one of the limitations of this therapy is the shortage of donors. The present study aims to investigate whether the two-layer method (TLM) of cold preservation with oxygenation improves the viability and activity of hepatocytes from rat donation after cardiac death (DCD) donors compared with results obtained with the University of Wisconsin (UW) solution. Moreover, we evaluated the hepatocyte function after culture or transplantation into the spleen. Materials and Methods: We used male Sprague-Dawley rats for this study. The DCD model was induced by phrenotomy after injecting heparin. We assigned rats based on warm ischemia times of 15 and 30 min to groups S and L, respectively. Each group (n = 5) was then subdivided as follows: (1) group S: not preserved (S/N), preserved by TLM for 3 h (S/TLM3) and 12 h (S/TLM12), and in the UW solution for 3 h (S/UW3) and 12 h (S/UW12), and (2) group L: not preserved (L/N), preserved by TLM for 3 h (L/TLM3) and 12 h (L/TLM12), and in the UW solution for 3 h (L/UW3) and 12 h (L/UW12). The cell viability and function of isolated DCD hepatocytes were analyzed for culture or HTx into the spleen. Results: The viability and ATP levels of DCD hepatocytes significantly improved after TLM compared with the values after preservation in cold UW solution in group S/N (p < 0.059). The levels of albumin production and urea synthesis by hepatocytes after culture were significantly higher in groups S/TLM3 and S/TLM12 than in groups S/UW3 and S/UW12 (p < 0.05), respectively. Further, serum albumin levels after HTx were also markedly higher in groups S/TLM3 and S/TLM12 than in groups S/UW3 and S/UW12. The morphological features revealed that cultured and transplanted hepatocytes remained clearly viable and maintained an expression for specific hepatic function, such as the production of albumin and glycogen. Conclusion: This novel method of oxygenated cold preservation of DCD livers can expand the hepatocyte donor pool for HTx and establish a wider application of this developing technique. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We quantitatively measured the smiles of a child with autism spectrum disorder (ASD-C) using a wearable interface device during animal-assisted activities (AAA) for 7 months, and compared the results with a control of the same age. The participant was a 10-year-old boy with ASD, and a normal healthy boy of the same age was the control. They voluntarily participated in this study. Neither child had difficulty putting on the wearable device. They kept putting on the device comfortably through the entire experiment (duration of a session was about 30-40 min). This study was approved by the Ethical Committee based on the rules established by the Institute for Developmental Research, Aichi Human Service Center. The behavior of the participants during AAA was video-recorded and coded by the medical examiner (ME). In both groups, the smiles recognized by the ME corresponded with the computer-detected smiles. In both groups, positive social behaviors increased when the smiles increased. Also, negative social behaviors decreased when the smiles increased in the (ASD-C). It is suggested that by leading the (ASD-C) into a social environment that may cause smiling, the child's social positive behaviors may be facilitated and his social negative behaviors may be decreased. [ABSTRACT FROM AUTHOR]

We cloned the cDNA and genes of two different types of CC chemokine from Japanese flounder Paralichthys olivaceus. The genes were designated JFCC1 and JFCC2. The JFCC1 cDNA encoded 91 amino acid residues. The JFCC1 gene has a size of 1.9 kb and consists of three exons and two introns. Two types of JFCC2 mRNA, corresponding to genes designated JFCC2-1 and JFCC2-2, were detected by reverse transcription–polymerase chain reaction in several organs, although fully spliced mRNA was not detected. The sizes of JFCC2-1 and -2 were 1.9 kb and 1.8 kb, respectively. JFCC2-1 consists of three exons and two introns and JFCC2-2 consists of two exons and one intron, although the coding regions of the two genes are identical. Because the JFCC2 gene has uncommon properties and an uncommon expression pattern, we suggest that it is a pseudogene. Southern blot hybridization and the characterization of BAC clones indicated that both the JFCC1 and JFCC2 genes exist as multicopy genes in the Japanese flounder genome. JFCC1 and JFCC2 genes were expressed in several organs including peripheral blood leukocytes (PBL) and kidney. The two forms of JFCC2 mRNA were also encountered in these cells. Expressions of JFCC1 and JFCC2 genes were upregulated after stimulation with concanavalin A/phorbol myristate acetate and lipopolysaccharide, compared with normal PBL. [ABSTRACT FROM AUTHOR]

High magnetic field dependence of lifetimes of methylene-chain-linked radical ion pairs (RIPs) generated by photo-induced electron transfer from zinc(II) porphyrin to viologen has been confirmed in aqueous acetonitrile using a pulse magnet–laser flash photolysis apparatus. In the case of a short methylene chain it was first revealed that the dependence was definitely different from that for a long one, and was characterized by a reversal in the dependence. In addition to a long lifetime independent of the magnetic field, RIP in fields above 7 T exhibited short lifetimes that depended on the field. These results were interpreted not only by spin–lattice (longitudinal) relaxation but also by spin–spin (transverse) relaxation in RIPs. [ABSTRACT FROM AUTHOR]

Background. In fulminant hepatic failure (FHF), the ability of surviving hepatocytes to proliferate is diminished. Therefore, it is important that medical therapy cause no further impairment of liver regeneration. In FHF, intracranial hypertension secondary to brain edema is the most common cause of brain injury and death and glycerol is used in some countries to treat this complication. Glycerol has been long known to suppress the growth of various cell types. We therefore decided to examine the effect of glycerol on hepatocyte proliferation in vitro and in vivo in rats subjected to partial (2/3) hepatectomy. Additionally, we investigated the effect of glycerol on the proliferation of HepG2 cells.Materials and methods. Mitogen-induced primary rat hepatocytes were cultured in a hormonally defined Dulbecco''s modified Eagle''s medium containing increasing amounts of glycerol (0.5, 1.0, 2.0, 4.0%). HepG2 cells were cultured in minimal essential medium/10% FBS. After 2 days, HepG2 cells were exposed to glycerol (1.0–2.0–4.0%) and harvested after 48 h. Control dishes contained no glycerol. Cell proliferation was measured by the incorporation of [3H]thymidine and/or bromodeoxyuridine (BrdU). In vivo, Sprague–Dawley rats were subjected to standard partial 2/3 hepatectomy and assigned to intraportal administration of either 400 μl of glycerol or saline. Rats were killed after 1, 2, 3, 5, and 7 days. Liver weight/body weight ratio and BrdU uptake were measured.Results. In all cultures tested, glycerol suppressed the growth of cells in a dose-dependent manner. In vivo, a single intraportal dose of glycerol slowed the liver regenerative response.Conclusions. This study demonstrated that glycerol has a potent growth-inhibitory effect on hepatocyte proliferation in vivo and in vitro. Remarkably, glycerol inhibited the proliferation of liver cancer cells as well. The results of this study have important clinical implications. [Copyright &y& Elsevier]

• Progesteron receptor (PgR) is associated with insulin-production. • PgR and insulin colocalize in pancreatic neuroendocrine tumors. • PgR might contribute cell growth inhibition in insulinomas. Progesterone receptor (PgR) inhibits cell proliferation in pancreatic neuroendocrine neoplasms (PanNEN). In non-neoplastic pancreas, loss of PgR induces β-cell proliferation and insulin production. However, detailed association between PgR and insulin producing PanNENs is poorly understood. Insulin, proinsulin, and PgR were immunolocalized in 82 PanNENs (54 non-functioning PanNENs: NF-PanNENs and 28 insulinomas). The status of immunoreactivity was compared to the clinicopathological factors of the patients. Immunoreactivity was also confirmed by employing the double-immunohistochemistry. These results were also compared with those in non-neoplastic Langerhans islets. PgR immunoreactivity was significantly higher in insulinomas than that in NF-PanNENs (p < 0.001). Insulin and proinsulin immunoreactivity was also detected in 20 (37 %) of (single cell) insulin positive NFs (Inspos-NF-PanNEN), in which PgR expression was higher than in insulin negative NF-PanNENs (Insneg-NF-PanNEN, p = 0.03). The ratio of PgR-insulin double positive cells to overall insulin positive cells, as well as PgR-proinsulin double positive cells to proinsulin positive cells, was detected to the same degree in insulinoma (PgR-insulin 70 %, PgR-proinsulin 66 %), Inspos-NF-PanNENs (PgR-insulin 65 %, PgR-proinsulin 68 %) and normal islet (PgR-insulin 80 %, PgR-proinsulin 72 %). PgR and insulin expressing cells colocalize in tumor cells of the PanNENs regardless of the hormone-related symptoms of the patients. Inhibitory effect of PgR on tumor cells might be associated with the favourable clinical outcome of insulinoma patients. [ABSTRACT FROM AUTHOR]

Urinary incontinence is one of the common complications after radical prostatectomy along with inguinal hernia. Artificial urethral sphincter implantation is widely accepted as a treatment option. We report two surgical cases of inguinal hernia after artificial urethral sphincter implantation for urinary incontinence following radical prostatectomy. In Case 1, since the device went through the inguinal canal, adhesion around the pubis was extremely hard. In Case 2, the device was placed on the ventral side of the rectus abdominis muscle, so it was operable almost as normal. In each case, the surgical procedure was considered carefully after confirming the location of the device by preoperative computed tomography and ultrasonography. Hernia repair was successfully performed using the Lichtenstein method. There are few reports regarding surgical repair of inguinal hernia following artificial urinary sphincter implantation. Preoperative image and appropriate choice of approach could facilitate safe and secure surgery. [ABSTRACT FROM AUTHOR]