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Primary appendiceal cancer is rare, and difficult to diagnose pre-operatively because lack of specific symptoms. This report presents a rare case of synchronous colon and appendiceal cancer. A 50-year-old man was referred to our hospital due to endoscopic submucosal resection (ESD) for early cecal cancer. ESD was performed, and the pathological examination revealed tubular adenocarcinoma with deep submucosal invasion. Laparoscopic ileocecal resection was performed as additional resection after ESD of cecal cancer. There were no obvious abnormalities around the ileocecal region in the preoperative examination. Postoperative pathological examination incidentally revealed a mucosal papillary adenocarcinoma of the appendix, with no residual lesion in the ESD scar. The patient was discharged on the seventh postoperative day. Synchronous appendiceal and colon cancer is extremely rare in past reports. Here, we report the case details and review previous case reports. [ABSTRACT FROM AUTHOR]

Gastroepiploic aneurysms are rare. We report the case of a 74-year-old man who presented with temporary loss of consciousness and abdominal pain. Computed tomography revealed a ruptured right gastroepiploic artery aneurysm. His vital signs improved after extracellular fluid infusion; hence, we performed transcatheter arterial embolization. There were no postoperative complications, and the patient was discharged on the 15th day of hospitalization. Ruptured abdominal aneurysms are often fatal and should be considered in patients with symptoms of anemia and abdominal pain. Currently, minimally invasive transcatheter arterial embolization had been designated as the preferred treatment option because of effectiveness in both diagnosis and treatment. Thus, we report a case of ruptured right gastroepiploic artery aneurysm treated by transcatheter arterial embolization, thereby preventing an emergency surgery. [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]

Background: We introduce a novel operative technique to dissect lymph nodes adjacent to the recurrent laryngeal nerve, referred to as the "native tissue preservation" technique. Using this technique, there was no damage to the recurrent laryngeal nerve, which is maintained in its anatomical position.Methods: From September 2016 to December 2018, minimally invasive esophagectomy was performed in the left lateral decubitus position in 87 patients with esophageal cancer. The native tissue preservation technique for lymphadenectomy around the recurrent laryngeal nerve was used, and all patients were evaluated for recurrent laryngeal nerve paralysis.Results: Minimally invasive esophagectomy was completed in all patients without conversion to thoracotomy. Although an extended lymphadenectomy was performed in all patients, there were no grade II or higher complications (Clavien-Dindo classification) and no incidence of recurrent laryngeal nerve paralysis.Conclusion: The native tissue preservation technique may reduce the incidence of recurrent laryngeal nerve paralysis after minimally invasive esophagectomy with radical lymph node dissection. [ABSTRACT FROM AUTHOR]

We have proposed and developed a new quadruped walking robot with a spherical shell, called "QRoSS". QRoSS is a transformable robot that can store its legs in the spherical shell. The shell not only absorbs external forces from all directions, but also improves mobile performance because of its round shape. In rescue operations at a disaster site, carrying robots into a site is dangerous for operators because doing so may result in a second accident. If QRoSS is used, instead of being carried in, robots are thrown in, making the operation safe and easy. We developed the QRoSS series and conducted basic experiments to verify performance, which includes landing, rising and walking through a series of movements. This paper reports details of a mechanical design to improve walking performance and development of the QRoSS V prototype model. We discuss the rising operation and performance of climbing over a high vertical step. [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]

Mixed adenoneuroendocrine carcinoma (MANEC) is defined as a tumor composed of both adenocarcinoma and neuroendocrine components. Here, we report the case of a 75-year-old woman with ampullary MANEC. She visited a physician with the chief complaint of dark urine and was diagnosed with advanced jaundice. Subsequently, she was referred to our hospital. Contrast-enhanced computed tomography scan revealed a neoplastic lesion measuring approximately 2 cm with a contrast effect at the duodenal papilla. Upper endoscopy showed a non-exposed tumor at the duodenal papilla. After biliary drainage, a subtotal stomach-preserving pancreaticoduodenectomy was performed. Histopathological examination revealed that the tumor components were composed of circular-to-oval atypical cells admixed with tubular adenocarcinoma tissue. These atypical cells were immunohistochemically positive for synaptophysin and diagnosed as neuroendocrine carcinoma with a Ki-67 labeling index of 63%. The patient was diagnosed with MANEC with a neuroendocrine carcinoma component of approximately 40%. The neuroendocrine carcinoma component had metastasized to the posterior pancreatic lymph nodes. Despite starting adjuvant chemotherapy with S-1, computed tomography revealed the presence of multiple liver metastases within 4 months after surgery. MANEC with neuroendocrine carcinoma is well known to have an extremely poor prognosis. Therefore, establishing a multidisciplinary therapy including chemotherapy is crucial. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to compare the clinical outcomes between laparoscopic partial liver resection and open partial hepatectomy for tumors in the posterosuperior segments.Methods: The clinical outcomes of patients who underwent either laparoscopic (n = 20) or open (n = 44) resection in segments 7/8 of the liver were initially evaluated. Because of disparities in the background characteristics, a case-matched study (1:1) was conducted. In addition, a comparative study of the patients who met the institutional criteria for laparoscopic partial hepatectomy was performed.Results: In the case-matched study, the laparoscopic technique required a longer operation time (p = 0.001), but was associated with less intraoperative blood loss (p = 0.021), a lower incidence of major complications (p = 0.014), higher levels of serum albumin on postoperative days 3 and 7 (p = 0.031 and p = 0.035), and earlier discharge (p = 0.001) than open resection. The results of the latter study were similar to those of the case-matched analysis.Conclusions: Laparoscopic partial hepatectomy was a feasible procedure for treating tumors in the posterosuperior segments without compromising oncological safety and yielded better short-term outcomes than open techniques. In addition, this study provides concrete selection criteria for laparoscopic partial hepatectomy for difficult lesions. [ABSTRACT FROM AUTHOR]

Purpose: The Frey procedure is an effective surgery for chronic pancreatitis (CP) patients who have pancreatic head lesions with dilation of the main pancreatic duct. However, pancreatic tail lesions can cause relapsing pancreatitis after the procedure. Therefore, additional distal pancreatectomy (DP) might complement the therapeutic effect of the Frey procedure in controlling inflammation of the pancreatic tail. The Frey procedure with DP (Frey + DP) is indicated for inflammatory lesions in the pancreatic head and tail. In this study, we assessed the usefulness of Frey + DP using the retrospective clinical data of our cases.Methods: The clinical outcomes were compared between CP patients who underwent the Frey procedure (N = 44) and Frey + DP (N = 13) from January 2005 to April 2016.Results: Frey + DP showed similarly good therapeutic effects to the Frey procedure with regard to the postoperative stay, morbidity, mortality, pain relief and nutrition, although the Frey + DP had a longer operative time, more bleeding and higher incidence of diabetes mellitus than the Frey procedure because of the additional DP. One patient in the Frey group received additional DP because of recurrent pain due to the tail lesion.Conclusion: Frey + DP can be a promising treatment for CP patients with pancreatic head and tail lesions. [ABSTRACT FROM AUTHOR]

Human and animal studies have revealed a stabilization of atherosclerotic plaques by statins. However, the stabilization of human carotid plaques has not been thoroughly described pathologically. This analysis explored the relationship between statin therapy and plaque stability in carotid endarterectomy (CEA) specimens. We analyzed specimens harvested between May 2015 and February 2017, from 79 consecutive patients presenting with > 70% carotid artery stenoses, of whom 66 were untreated (group 1) and 13 treated (group 2) with a statin. Immunohistochemistry was performed, using an endothelial specific antibody to CD31, CD34 and platelet derived growth factor receptor-β. The prevalence of plaque ruptures (P = 0.009), lumen thrombi (P = 0.009), inflammatory cells (P = 0.008), intraplaque hemorrhages (P = 0.030) and intraplaque microvessels (P < 0.001) was significantly lower in group 2 than in group 1. Among 66 patients presenting with strokes and infarct sizes > 1.0 cm3 on magnetic resonance imaging, the mean infarct volume was significantly smaller (P = 0.031) in group 2 (4.2 ± 2.5 cm3) than in group 1 (8.2 ± 7.1 cm3). The difference in mean concentration of low-density lipoprotein cholesterol between group 1 (121 ± 32 mg/dl) and group 2 (105 ± 37 mg/dl) was non-significant (P = 0.118). This analysis of plaques harvested from patients undergoing CEA suggests that statin therapy mitigates the plaque instability, which, in patients presenting with strokes, might decrease infarct volume. [ABSTRACT FROM AUTHOR]

Purpose: The lymphatic flow along the posterior gastric artery (PGA) is considered of possible clinical importance in terms of lymphatic metastasis; however, little is known about the lymph nodes (LNs) around this artery. The purpose of this study was to establish if LNs exist around the PGA and to evaluate their clinical implications.Methods: We examined the tissues surrounding the PGA from 21 cadavers to search for LNs. We also investigated the patterns of lymphatic metastases in patients who underwent surgery for gastric neoplasms at our institute to detect their presence along the PGA.Results: The PGA was identified in 11 cadavers, and LNs around the PGA were detected microscopically in 2 of these. Lymphatic metastasis directly to the LNs at the splenic artery without any metastases was regarded as skip metastasis along the PGA. Skip metastasis was found in two of ten patients who underwent surgery for remnant gastric cancer.Conclusions: The existence of LNs around the PGA was confirmed, and based on our findings, lymphatic metastasis through the PGA is possible in patients with remnant gastric cancer. [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]

Purpose: The aim of surgical intervention for chronic pancreatitis (CP) is to relieve symptoms and improve quality of life. However, the precise effect of surgery on the nutritional status of CP patients, which is often impaired by exocrine and endocrine pancreatic dysfunction, has not been elucidated. We conducted this study to evaluate whether Frey's procedure improves the nutritional status of CP patients. Methods: The nutritional status of 35 patients who underwent Frey's procedure for CP at our institute between April 2005 and December 2014, was assessed by the controlling nutritional status (CONUT) scoring before and 1 year after the surgery, and compared with that of seven CP patients who underwent pancreatoduodenectomy. The occurrence of postoperative hepatic steatosis was also monitored. Results: The nutritional status improved after Frey's procedure, but not after pancreatoduodenectomy. The median postoperative CONUT score after Frey's procedure was significantly lower than the preoperative score (1.0 ± 0.5 vs. 4.0 ± 2.5; p < 0.001). Conclusion: Frey's procedure is superior to pancreatoduodenectomy for improving the nutritional status of CP patients. [ABSTRACT FROM AUTHOR]

The patient was a 60-year-old man without any particular complaints, but he underwent abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) due to a fatty liver, which revealed two similar cystic lesions regarded as branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN) in the pancreatic body [BD-IPMN ( b), 16 mm in size] and tail [BD-IPMN ( t), 13 mm in size] without a 'high-risk stigmata' or 'worrisome features'. He subsequently received follow-up by MRCP every 6 months. Two years later, MRCP showed prominent dilation of the main pancreatic duct (MPD) and mural nodule formation within the dilated MPD adjacent to the BD-IPMN ( b). Distal pancreatectomy specimens revealed that the BD-IPMN ( b) was lined by low-papillary gastric mucinous epithelium with low-to-intermediate-grade dysplasia and involved the MPD, forming a malignant mural nodule showing pancreatobiliary-type IPMN. In contrast, the BD-IPMN ( t) was lined by flat, monolayer columnar gastric mucinous epithelium without atypia, which suggested the possibility of a 'simple mucinous cyst'. A genetic analysis showed KRAS mutation only in BD-IPMN ( b). Differences in the histological and genetic findings between two similar BD-IPMNs in the present case may suggest what kinds of examinations should be performed in patients with BD-IPMNs without any worrisome features. [ABSTRACT FROM AUTHOR]

The article presents the formulas of quadrature frequency resolved spectroscopy (QFRS) on the upconversion photoluminescence (UCPL) of rare-earth (RE) doped materials on the general M-level model. The formulas are derived in matrix-equation form with the first-order perturbation on the rate equations at the M energy-levels of RE ion. The QFRS spectra for three different UCPL processes, i.e., the excited state absorption (ESA), energy transfer upconversion (ETU) and photon avalanche (PA) via cross relaxation process (CRP) in a particular case of M = 3 are demonstrated with the respective salient features of the excitation power dependence. We have measured the QFRS on the UCPL ( S → I ) by systematically varying Er-doping in GeGaS chalcogenide glass from 0.01 to 0.5 at.% as well as 975 nm excitation power. Thereby the relaxation rates k at the intermediate level I , k at the top level S and ETU parameter w are determined as a function of Er concentration. The UCPL dynamics on the basis of the formulas for the 3-level model is interpreted in terms of the determined parameters. [ABSTRACT FROM AUTHOR]

The paper addresses the quadrature frequency resolved spectroscopy (QFRS) on the red ( F → I ) upconverted photoluminescence (UCPL) as well as the green ( S → I ) UCPL of Er in GeGaS chalcogenide glasses at the pump wavelength 975 nm. On the basis of the perturbed rate equations for the generally accepted 5-level model of the green and red UCPLs of Er, we have derived the formulas for the QFRS on the green and red UCPLs of the two differently Er-doped samples. Adopting the respective formulas as model functions for the nonlinear regressions on the QFRS data of both the UCPLs, we have determined the relevant parameters such as relaxation rates at the four excited levels, the excited absorption cross section and energy transfer parameters. Thereby the differences of UCPL dynamics between the green and red UCPLs as well as between the two differently Er-doped GeGaS samples are interpreted in terms of the determined parameters. [ABSTRACT FROM AUTHOR]

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]

Loop colostomy prolapse is associated with an impaired quality of life. Surgical treatment may sometimes be required for cases that cannot be closed by colon colostomy because of high-risk morbidities or advanced disease. We applied the Altimeter operation for patients with transverse loop colostomy. The Altemeier operation is therefore indicated for rectal prolapse. This technique involves a simple operation, which includes a circumferential incision through the full thickness of the outer and inner cylinder of the prolapsed limb, without incising the abdominal wall, and anastomosis with sutures using absorbable thread. We performed the Altemeier operation for three cases of loop stomal prolapse. Those patients demonstrated no postoperative complications (including obstruction, prolapse recurrence, or hernia). Our findings suggest that this procedure is useful as an optional surgical treatment for cases of transverse loop colostomy prolapse as a permanent measure in patients with high-risk morbidities or advanced disease. [ABSTRACT FROM AUTHOR]

Rationale: Since the hypofunction of the N-methyl-D-aspartate (NMDA) receptor is known to be involved in the pathophysiology of schizophrenia, the enhancement of NMDA receptor function through glycine modulatory sites is expected to be a useful approach for the treatment of schizophrenia. Objectives: We investigated the efficacy of a glycine transporter 1 (GlyT1) inhibitor that potentiates NMDA receptor function by increasing synaptic glycine levels in animal models for cognitive dysfunction and negative symptoms, both of which are poorly managed by current antipsychotics. Results: A newly synthesized GlyT1 inhibitor, 3-chloro-N-{(S)-[3-(1-ethyl-1H-pyrazol-4-yl)phenyl][(2S)-piperidin-2-yl]methyl}-4-(trifluoromethyl)pyridine-2-carboxamide (TASP0315003) significantly improved cognitive deficit induced by MK-801 in the object recognition test in rats. Likewise, TASP0315003 significantly improved MK-801 impaired cognition in the social recognition test in rats and also enhanced social memory in treatment-naïve rats. In addition, repeated phencyclidine (PCP) treatment reduced the social interaction of paired mice, which may reflect negative symptoms such as social withdrawal, and both acute and sub-chronic treatment with TASP0315003 reversed the reduction in social interaction induced by PCP. Moreover, TASP0315003 additionally exhibited an antidepressant effect in the forced swimming test in rats. In contrast, TASP0315003 did not affect spontaneous locomotor activity or rotarod performance and did not induce catalepsy, indicating that TASP0315003 does not cause sedation or motor dysfunction, which is sometimes observed with the use of current antipsychotics. Conclusions: These results suggest that GlyT1 inhibitors including TASP0315003 may be useful for the treatment of cognitive dysfunction and the negative symptoms of schizophrenia without having undesirable central nervous system side effects. [ABSTRACT FROM AUTHOR]

Laparoscopic surgery for this disease is not widely spread due to difficulties in its procedure. We started a laparoscopic procedure for this disease since 2011, and the robotic surgery since 2012. The aim of this study is to assess early results of these procedures. We have operated seven cases from September 2011 through December 2013. First two cases were performed by laparoscopic procedure, and following cases were done by robotically assisted surgery. Of these cases, the perioperative outcome and short-term postoperative morbidity were evaluated. Their average age was 43.6 years old (20-64 years old), and male-female ratio was 2:5. Todani classification was type 1 in all cases. The operation time was 321 min in laparoscopic cases, while 489 min in robotic surgery cases. One case of robotic surgery developed postoperative intestinal obstruction of the biliary limb, requiring laparoscopic adhesiolysis. Pancreatic fistula and anastomotic leakage have not been observed. The robotic surgery for the congenital dilatation of the bile duct is feasible and is a theoretically useful option, especially for hepatico-jejunostomy. On the other hand, the limitation of energy devices, high running cost, and time consumption remain questionable. [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]

Objective: Human resistin is expressed strongly in monocytes or macrophages rather than in adipocytes and may play a pivotal role in inflammation. We hypothesize that resistin levels are elevated in patients with Kawasaki disease (KD) in the acute phase and may be associated with the disease severity. Design and subjects: Serum resistin concentrations were measured in 44 Japanese children with KD and 17 age-matched healthy children. All the KD patients were given both aspirin and a single dose of intravenous immunoglobulin (IVIG). Results: The serum resistin levels at baseline in KD children were significantly higher than those in controls [33.0 (21.6-45.3) vs. 14.8 (12.4-18.6) ng/mL, P < 0.001]. After IVIG therapy, serum resistin levels were significantly decreased to normal control levels. No significant difference in baseline resistin levels was found between the high-risk group and the low-risk group of coronary artery aneurysms. Conclusions: We confirmed that resistin was an acute inflammatory protein, but its concentrations were unlikely to predict the prognosis of disease in acute KD patients. [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]

In this paper, we present the results of the wideband quadrature frequency-resolved spectroscopy (QFRS) of the electric-field ( F) effects on photoluminescence (PL) in a-Si:H: the recombination of geminate electron-hole pairs including excitons is quenched by an electric field, whereas that of nongeminate or distant pairs (DP) is enhanced. The quenching of the geminate recombination at intermediate temperatures is interpreted in terms of the classical Onsager theory. On the other hand, the enhancement of the DP recombination is explained using the effective temperature in diffusion-limited recombination. [ABSTRACT FROM AUTHOR]

The positions of Stark levels have been determined, using a step-by-step procedure, in the 4I9/2 and 4F3/2 manifolds of Nd3+ ions from absorption and photoluminescence measurements in the 12–293 K temperature range. This data has been used to calculate the emission cross-section for which the maximum value turns out to be ∼2.3 × 10−20 cm2. The radiative recombination time, calculated using Judd–Ofelt analysis, of the 4F3/2 manifold is in close vicinity to the experimentally determined times that were measured by the conventional decay of PL after interruption of excitation and by QFRS. Moreover, the peak time defined by QFRS is independent of temperature. Therefore, the dominant relaxation mechanism from the 4F3/2 excited manifold of Nd3+ ions in GaLaS glass is believed to be by radiative emission. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the usefulness of postmortem computed tomography (PMCT) in detecting causes of sudden death in infants and children. Our subjects were 15 nontraumatically deceased patients (nine boys and six girls, ranging in age from 20 days after birth to 12 years old, mean age 1.6 years), who had been in a state of cardiopulmonary arrest on arrival at our hospital. PMCT was performed within 2 h after certification of death: head (15 cases), chest (11 cases), and abdomen (12 cases). Blood was collected from 11 of the patients at the time of cardiopulmonary resuscitation. An autopsy was conducted on two. PMCT did not show any traumatic changes indicating child abuse. It was difficult to presume the cause of death with PMCT alone, but the cause of death in 14 of 15 cases could be presumed by combining information from their medical history, clinical course before death, PMCT findings, laboratory data, and bacterial culture. The remaining subject was classified as cause unknown. The causes of sudden death in infants and children were detected at a high rate when we comprehensively investigated the PMCT and other examination findings. [ABSTRACT FROM AUTHOR]

In a 64-year-old man who had been treated with prednisolone (PSL) and 6-mercaptopurine (6MP) for a long period, for ulcerative colitis (UC), hepatocellular carcinoma (HCC) was detected incidentally. The UC was in remission with these medications. After he had been taking these medications for about 8 years, HCC was detected by computed tomography (CT), done for the evaluation of an other disease. Blood chemistry examination results were normal, except that the protein induced by vitamin K antagonist (PIVKA)-II level was 7940 AU/ml. We performed resection of liver segment V. With comparative genomic hybridization, chromosomal aberrations were recognized; these were gains of 1q, 3ptel-21, 8p12, and 22q11.23–22q13.1. Generally, HCC is associated with hepatitis virus infection in most cases, but in this patient, the HCC was not related to hepatitis C virus (HCV) or HBV. It is presumed that this case was related to the immunosuppressive therapy for UC and was associated with the gains of 1q, 3p, and 8p. [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]

The regulation of liver regeneration after partial hepatectomy (PHx) is complex and involves many different cytokines. We investigated the role of one of these, transforming growth factor-β1 (TGF-β1), an inhibitor of liver regeneration, in a Wistar male rat model, in which anti-TGF-β1 antibody was injected immediately or 24 h after 70% PHx. Livers from treated animals contained an increased number of cells in S phase, according to 5-bromo-2′-deoxyuridine (BrdU) labeling 36 h after PHx. Antibody administration 24 h after PHx resulted in the highest peak of proliferation; moreover, peak MIB-5 labeling was also observed at that time. However, neither residual liver-weight-to-body-weight ratios nor regeneration rates differed significantly between any of the animals. Therefore, we also measured levels of serum TGF-β1 and hepatocyte growth factor (HGF; an activator). With antibody administration at 0 or 24 h, TGF-β1 levels were diminished at 24 or 36 h as compared with levels in control rats, but then rebounded, reaching a delayed peak at 48 or 72 h after PHx, respectively. Interestingly, there were also similar trends in HGF levels. These results indicate that TGF-β1 may inhibit the G1 checkpoint, and serum TGF-β1 concentration may influence HGF to regulate liver regeneration and to maintain homeostasis of proliferation after PHx. [ABSTRACT FROM AUTHOR]

The mechanisms whereby hepatocytes in the normal liver can be primed for replication following partial hepatectomy (PHx) are poorly understood. To determine whether "shear stress," which is induced by acute portal hypertension after PHx, is involved in liver regeneration, we studied liver regeneration in rats with splenic transposition (SPT) in which we can minimize the postoperative elevation of portal pressure. Rats underwent 70% PHx following splenic transposition or sham surgery and were killed at various time points to measure portal pressure and other factors. In the control groups, the portal pressure was significantly increased immediately after surgery, peaking at 48 h, and returning to near the preoperative levels by 168 h after PHx. In the SPT group, although portal pressure increased immediately, it decreased to the control levels 6 h after PHx and thereafter repeatedly increased. Tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels peaked at 24 and 6 h after PHx, respectively. Proliferative cell analysis was done using MIB-5 antibody, and there were no significant differences between the two groups. Furthermore, liver weight was restored in the same way in both groups. Taken together, the results suggest that an immediate increase in portal pressure is necessary for the initiation of liver regeneration. [ABSTRACT FROM AUTHOR]

The principal aim of this study was to show how an autonomous mobile robot can acquire the optimal action to avoid moving multiobstacles through interaction with the real world. In this paper, we propose a new architecture using hierarchical fuzzy rules, a fuzzy evaluation system, and learning automata. By using our proposed method, the robot autonomously acquires finely tuned behavior which allows it to move to its goal and avoid moving obstacles by using the steering and velocity control inputs simultaneously. We also show experimental results which confirm the feasibility of our method. [ABSTRACT FROM AUTHOR]

To clarify the factors influencing the concentrations and distribution of metal elements in the lung, we analyzed the following 8 metals in the 5 lung lobes of 17 autopsied urban dwellers by flame or flameless atomic absorption spectrometry: aluminum (Al), cadmium (Cd), chromium (Cr), nickel (Ni), lead (Pb), manganese (Mn), copper (Cu), and Zinc (Zn). The arithmetic mean value (in micrograms of metal per gram of dry weight) calculated for five lobar metal concentrations in each subject ranged from 80 to 681 for Al, from 0.34 to 3.41 for Cd, from 0.41 to 12.7 for Cr, from 0.22 to 1.93 for Ni, from 0.15 to 1.47 for Pb, from 0.64 to 2.36 for Mn, from 2.84 to 7.24 for Cu, and from 40.7 to 77.6 for Zn. The eight metals were classifiable into two groups on the basis of the interindividual and interlobar concentration variations. The first group, consisting of Cu and Zn, was characterized by smaller interindividual variations (coefficient of variation, CV < 30%) and smaller inter lobar variations (mean CV < 15%). Their levels were not affected significantly by sex, smoking habits, or possible occupational exposure to metal-containing dust. In contrast, the second group, consisting of Al, Cd, Cr, Ni, Pb, and Mn, exhibited larger interindividual variations (CV > 45%) and larger interlobar variations (mean CV > 25%). Concentrations of these metals, except for Cd, tended to be higher in the upper lobes than in the lower lobes. The concentrations of Al and Cr were significantly higher in men than in women. Smoking significantly elevated the levels of Cr, Cd, Ni, and Pb, and the concentrations of Al, Cr, Ni, and Mn were higher in subjects with possible occupational exposure to metal-containing dust than in those without such exposure. However, the interlobar distribution patterns of the metals did not seem to be influenced by sex, smoking habits, or occupational exposure to metal-containing dust. [ABSTRACT FROM AUTHOR]

Ischemia reperfusion injury (IRI) during liver-metastasis resection for treatment of colon cancer may increase the risk of further metastasis. Peroxisome proliferator-activated receptor-γ (PPARγ) activation has been observed to exert a protective effect against IRI and IRI-induced metastasis of hepatocellular carcinoma. The present study aimed to investigate the effect of the PPARγ agonist pioglitazone on tumor metastasis and liver injury following IRI in a mouse model of colon cancer. Pioglitazone (30 mg/kg weight) was administered orally 1.5 h before and 2 h after the initiation of ischemia and was orally administrated daily to mice from day 0–21. SL4-cancer cells expressing red fluorescent protein (SL4-RFP) (1 × 106) were injected into the spleen. Fifteen minutes after injection, the hepatoduodenal ligament was clamped with a vessel clip, and released 5 min later. Liver, blood and tumor samples were taken from mice in order to determine if inflammation was induced by IRI. The effect of pioglitazone on liver metastasis was assessed. Furthermore, the effect of pioglitazone to control the inflammatory response during IRI progression was examined. Liver metastasis along with MMP-9 activation and the production of inflammatory cytokines were resistant to pioglitazone. Our results indicate that liver metastasis and associated inflammation in mice were resistant to pioglitazone. [ABSTRACT FROM AUTHOR]

This paper describes development of a mobile robot using semicircular wheels on uneven terrain. It performs the crawl gait on flat ground without changing potential energy and the butterfly gait to climb over debris. We also used crawl gait to perform turning motion. The butterfly gait is used to climb over high steps. Turning motion is achieved not only by creating a difference in angular velocity between the wheels on both sides, but also by keeping the crawl gait. We achieved continuous movement from turning motion to pivot turning. We conducted an experiment on the movement and turning motion on flat ground using crawl gait. [ABSTRACT FROM AUTHOR]

A 3-month-old male infant with intracranial hemorrhage attributable to a vitamin K deficiency is reported. Vitamin K2 was administered orally at birth and then at 5 days and 1 month of age. Oral antibiotics were also given 2 days before the onset of bleeding. Although the incidence of intracranial hemorrhage resulting from vitamin K deficiency has decreased since the introduction of vitamin K2 prophylaxis, spontaneous intracranial hemorrhages are still being reported in infants. We suggest that vitamin K prophylaxis is needed especially for breast-fed infants and for those undergoing antibiotic therapy. [ABSTRACT FROM AUTHOR]

Unlabelled: A 15-year-old girl with common variable immunodeficiency contracted hepatitis C, which progressed to liver cirrhosis and finally to hepatic failure 5 years later. Since she was agammaglobulinaemic, hepatitis C virus (HCV) infection was diagnosed on the basis of HCV-RNA detection. Quantification of her sera showed high levels of HCV-RNA (more than 10(7) copies of RNA/mL), which implied active viral replication. There were no other hepatotoxic factors except HCV infection. The initial liver biopsy at 16 years of age and the autopsy confirmed a rapid progression in liver histopathological change over 4 years.Conclusion: Contrary to the widely held view of a benign short-term prognosis in paediatric hepatitis C, progressive fatal liver disease can develop in some patients with HCV infection. Such a rapid progression of liver injury provides the rationale for antiviral therapy in at least certain high risk groups of these children. Hepatitis C may progress rapidly in an immune deficiency condition. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor in response to the article "Prevalence of CMV Infection in Severe Refractory Ulcerative and Crohn's colitis," by M. Cottone, G. Pietrosi, G. Martorana et al. in the 2001 issue.

A 15-month-old female infant with nystagmus, gait disturbance, diminished reflexes, ophthalmoplegia, and facial paresis was diagnosed as having Fisher syndrome. Magnetic resonance imaging revealed a transient, high-signal-intensity lesion on the left side of the cerebellum on T2-weighted images. The ataxia of Fisher syndrome is not compatible with polyneuritis, but can be explained by a cerebellar lesion, as seen in this case. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at the International Conference on Optical and Optoelectronic Properties on materials and applications in optics, optoelectronics and photonics is presented. Most of the researchers and scientists who attended had actively participated in the two parallel sessions and the short workshop. The conference was sponsored by the Charles Darwin University, Australian Research Council's Nanotechnology Network, Springer Wile and many more.