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Aims Although axillary lymph nodes status, tumour size, hormonal-receptor status and histological grade at diagnosis are frequently used to orient the treatment of breast cancer patients, some tumours recur in patients with early stage disease. Pre-operative assessment of individual tumour characteristics, based on oncogenes and growth factors related to tumour growth, invasion or metastasis, may guide the treatment for patients with breast carcinomas. Methods We examine here the prognostic significance of cyclin D1, urokinase type plasminogen activator, vascular endothelial growth factor (VEGF), platelet-derived growth factor, and c-erbB2 expression in pre-operatively obtained fine-needle aspirates from breast carcinomas less than or equal to 3cm in size. Correlation between mRNA expression of these factors and clinicopathological characteristics was analysed. Results The level of c-erbB2 mRNA expression was significantly higher in tumours with lymph node metastases than in those without lymph node metastases. VEGF mRNA expression positively correlated with the degree of angiogenesis as quantitated by immunohistological staining with a CD31 monoclonal antibody. Conclusions Analysis of c-erbB2 and VEGF mRNA expression in fine-needle aspirates may be useful in assessing the malignant potential of individual breast carcinomas, leading to a pre-operative discrimination of a high-risk group.

The relationship between chromatically modulated stimuli and visual evoked potentials (VEPs) was considered. VEPs of normal subjects elicited by chromatically modulated stimuli were measured under several color adaptations, and their binary kernels were estimated. Up to the second-order, binary kernels obtained from VEPs were so characteristic that the VEP-chromatic modulation system showed second-order nonlinearity. First-order binary kernels depended on the color of the stimulus and adaptation, whereas second-order kernels showed almost no difference. This result indicates that the waveforms of first-order binary kernels reflect perceived color (hue). This supports the suggestion that kernels of VEPs include color responses, and could be used as a probe with which to examine the color visual system.

We developed an objective and quantitative method of mapping the human visual field with positron emission tomography (PET) and magnetic resonance imaging (MRI). The regional cerebral blood flow (rCBF) images were acquired with H/sub 2//sup 15/O-PET under visual fixation as well as under visual stimulation with flickering diodes arranged along the ring at 0/spl deg/, 3/spl deg/, 7/spl deg/, 14/spl deg/, 21/spl deg/, or 29/spl deg/ from the fixation point. After coregistration of PET and MR images, we extracted the surface of the calcarine cortex from the MR images and unfolded it to a two-dimensional (2-D) elliptic plane, on which the activated PET images were superimposed. Then we transformed the unfolded calcarine cortex into the visual field coordinates using the complex logarithmic function proposed by Schwartz. A large individual variation was observed in the retinotopical organization as well as in the morphology of the calcarine cortex. The formula was valid only within 15/spl deg/ from the center of the visual field. The constant parameter in the formula was estimated to be 1.5. The cortical linear magnification factor was 12.1, 2.8, and 1.6 at 0, 5, and 10/spl deg/, respectively. The areas of the central 10/spl deg/ and 40/spl deg/ in the visual field correspond to 50% and 81% of the calcarine surface, respectively.

This paper presents an extension for T1-weighted imaging of the ultra-fast MR imaging method with single-shot and time-unvarying gradient fields. A complete 2-D or 3-D Tr-weighted image can be obtained from two MR images with different inversion acquired by using time-unvarying gradient fields rather than the multiple excitations or the switching gradient fields as used in conventional methods. The principle, the pulse sequence, the strategy of selecting inversion period for producing an inversion recovery of magnetization, the data acquisition procedure, and the reconstruction algorithm are described. Finally, the simulation implemented is introduced. The method has the desirable features of the single-shot technique with time-unvarying gradient fields, including the potential for rapid acquisition, the simplicity of realization, and the elimination of probably harmful influences on patients due to the multiple excitations and the rapidly alternating gradient fields.

Large cell neuroendocrine carcinoma (LCNEC) has an especially poor prognosis, and an effective therapeutic strategy has yet to be established. We have previously shown that the expressions of tropomyosin-related kinase B (TRKB) and brain-derived neurotrophic factor (BDNF) are high in LCNEC and that TRKB/BDNF signaling is involved in the proliferation, tumorigenesis, and invasive nature of LCNEC. Therefore, TRKB/BDNF signaling may offer a potential therapeutic target for LCNEC treatment. In the present study, we evaluated whether the TRKB tyrosine kinase inhibitor, k252a, has effects on tumor regression and relapse prevention on LCNEC, using a murine xenograft model. The LCNEC cell line and NCI-H810 cells were subcutaneously implanted into the flanks or intrathoracically injected into the bilateral pleural cavities of BALB/c nude mice. k252a significantly inhibited tumor volume, expression of matrix metalloproteinases and the formation of pleural dissemination by LCNEC. These results suggest that k252a has potential for tumor regression and relapse prevention in LCNEC. Since many patients with LCNEC suffer through the use of ineffective therapeutic strategies, a clinical trial using the TRKB inhibitor for LCNEC is urgently required.

Background. Angiogenesis is a prerequisite for tumor growth and metastasis. Tumor angiogenesis may be mediated by several angiogenic factors such as vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), transforming growth factor-α, and basic fibroblast growth factor. Methods. Differential mRNA expressions of VEGF, PDGF (A chain), transforming growth factor-α, and basic fibroblast growth factor in 32 primary invasive breast tumors were examined by reverse transcriptase-polymerase chain reaction. We analyzed relationships between mRNA expressions of these angiogenic factors and the degree of angiogenesis, tumor size, and metastasis. Quantification of angiogenesis was achieved by the immunohistochemical staining of endothelial cells with antibody to CD31. Results. VEGF and PDGF-A mRNAs were expressed more frequently in breast tumors than in nontumor breast tissues, whereas no difference was found in expression frequency of either transforming growth factor-α or basic fibroblast growth factor mRNA. Vascular counts in tumors correlated with each expression frequency of VEGF and PDGF-A mRNA. PDGF-A mRNA was expressed more frequently in tumors with lymph node metastasis than in those without metastasis. Conclusions. Expression of VEGF and PDGF mRNAs detected by reverse transcriptase-polymerase chain reaction in breast tumors correlates with tumor-related characteristics of angiogenesis and metastatic potential. Analysis of these mRNAs by reverse transcriptase-polymerase chain reaction may be useful for assessing the biologic behavior of a breast tumor before surgical treatment.

Peritoneal adhesions due to peritonitis make surgery more difficult and may cause complications. Clarifying the formation mechanism of peritoneal adhesions could help identify methods useful for their prevention. We cultured mesothelial monolayers on plates and microcarriers to simulate the parietal and visceral peritoneum, respectively. We then investigated the effects of lipopolysacchride (LPS) and tumor necrosis factor (TNF) on the homologous adhesion of these mesothelial monolayers. There was no adhesion of mesothelial monolayers in the control medium. When monolayers were cultured with endotoxin (LPS), approximately 90% of the microcarriers adhered to the mesothelial microplate. Adhesions occurred at LPS concentrations of 10 ng/ml and increased linearly in a dose-dependent manner. Kinetic studies revealed that the mesothelial adhesion appeared at 12 hr, and that 90% of the microcarriers were adherent after 24 hr. Open intercellular spaces were observed after a 24-hr treatment with LPS. Scanning electron microscopy revealed that the mesothelial cells adhered to the naked glass. LPS also caused increased permeability of the mesothelial monolayer. TNF did not cause any significant adhesion. Through our experiments we were able to develop an in vitro model of peritoneal adhesion using peritoneal mesothelial cell culture. Endotoxin caused an increase in homologous adhesion of peritoneal mesothelial monolayers, which may correspond to the initial stage of peritoneal adhesion formation in peritonitis.

Cytotoxic T cells have been implicated in the control of the progression of human melanoma. Most studies on human tumor T cell immunity have focused on the CD3+CD8+ cytotoxic T lymphocyte (CTL) phenotype; however, CD3+CD4+ CTL are important effector cells in other diseases and may also contribute to antimelanoma immunity. In this study we compared the functional activity of CD3+CD4+ and CD3+CD8+ CTL lines generated against autologous melanoma cells. CD8+ CTL had twofold higher cytotoxicity and serine esterase activity than CD4+ CTL. CD8+ CTL also were better binders to autologous melanoma cells. Binding of both CD4+ and CD8+ CTL to melanoma cells was significantly inhibited by ICAM-1 mAb. Interleukin-2 (IL-2) and IL-4 secretion was induced in both CD4+ and CD8+ CTL after stimulation by melanoma cells. A reverse transcriptase polymerase chain reaction performed on specific messenger RNA showed that both CD4+ and CD8+ CTL expressed IL-1, IL-2 and IL-4; CD4+ CTL also expressed interferon gamma (IFN). Both CTL phenotypes expressed receptors for IL-2 and IFN but only CD4+ CTL expressed the receptor for IL-4. Methods to augment CD4+ CTL growth were assessed using different combinations of cytokines. The combination of IL-2, IL-4 and IFN provided the optimal stimulation. Treatment of melanoma target cells with IL-4 and IFN enhanced CD4+ CTL recognition activity. CD4+ T cells are associated with antigen memory response and helper function, therefore activation of CD4+ CTL may be more beneficial with respect to long-term protective antimelanoma immunity.

Since the discovery of small non-coding RNAs, the analyses of microRNA (miRNA) expression patterns in human cancer have provided new insights into cancer biology. miRNA-21 has been suggested to be one of the miRNAs that have an important role in the development or biological behavior of a variety of malignancies, including pancreatic cancer. This study was conducted to evaluate the relationship between the expression of miRNA-21 and that of its molecular targets, programmed cell death 4 (PDCD4) and tissue inhibitor of metalloproteinase (TIMP3), in pancreatic ductal adenocarcinoma. The study included 65 pancreatic ductal adenocarcinomas and 5 normal pancreatic tissue specimens for comparison. The miRNA expression profiling of five selected pancreatic ductal adenocarcinomas and five normal pancreatic specimens was performed using a microarray platform, and was evaluated by a hierarchical clustering analysis. The miRNA most highly expressed in pancreatic ductal adenocarcinomas (ie, miRNA-21) was further assessed by quantitative real-time reverse transcription PCR (RT-PCR) assays in the 65 pancreatic ductal adenocarcinoma cases. The expression pattern of its molecular targets (eg, PDCD4 and TIMP3) in pancreatic ductal adenocarcinoma was examined immunohistochemically. In the microarray analyses, 28 miRNAs were upregulated in pancreatic ductal adenocarcinoma compared with normal pancreatic tissue, whereas 48 miRNAs were downregulated. miRNA-21 was the most significantly overexpressed miRNA in the pancreatic ductal adenocarcinomas analyzed, and was also highly expressed in 75% of the 65 pancreatic ductal adenocarcinomas examined by real-time RT-PCR. High miRNA-21 expression was correlated with a worse prognosis in the pancreatic ductal adenocarcinoma patients (P=0.045). The immunohistochemical expression patterns of PDCD4 (reduced nuclear staining pattern) and TIMP3 (downregulated expression) were significantly associated with both the upregulated miR-21 expression (P

Background Because surgery for esophagogastric junctional cancer (EGJC) occasionally requires a thoracotomy in addition to a laparotomy, surgery is associated with high mortality and morbidity rates. Therefore, minimally invasive surgery should be developed as an alternative to conventional open surgery. Methods We herein describe our first series of seven patients with EGJC who were treated by minimally-invasive surgery using thoracoscopy in addition to the laparoscopic procedure. During the thoracoscopic procedures, transection of the esophagus was performed at the cancer-free portion with a dissection of lower mediastinal nodes and a side-to-side Roux-en-Y esophagojejunostomy was made intrathoracically. Results In the seven patients treated using this procedure, the mean total length of the operation was 606 minutes and the mean number of retrieved lymph nodes was 58. No adverse events occurred intraoperatively and no failure in the intrathoracic esophagojejunostomy was observed, and favorable short-term results were obtained. Conclusions The described procedure for the treatment of patients with EGJC is a minimally invasive alternative to conventional open surgery that looks promising.

The benefits of adjuvant chemotherapy for completely resected non-small cell lung cancer (NSCLC) have been demonstrated using mainly cisplatin (CDDP)-based chemotherapeutic regimens. However, treatment-related deaths sometimes occur. Therefore, the development of a safer regimen is necessary.The patients were randomized to either carboplatin (CBDCA) area under the curve (AUC) 3 and paclitaxel (PTX) 90 mg/m(2) (PCb arm) or CBDCA (AUC3) plus gemcitabine (GEM) (1000 mg/m(2)) (GCb arm) every 2 weeks for 8 cycles after surgery. The primary endpoint was the compliance with the regimen, while the secondary endpoints were safety and toxicity.A total of 75 patients were enrolled in a multi-institutional study. Twenty-one out of 39 patients (54%) in the PCb arm and 25 of 36 patients (69%) in the GCb arm completed 8 cycles, and 59% in the PCb arm and 81% in the GCb arm completed ≥6 cycles. The predominant toxicity was neutropenia. Non-hematological adverse effects were infrequent and no treatment-related death was registered. The estimated disease-free survival and overall survival at 2 years were 70.8% and 66.3% in the PCb and 91.4% and 79.1% in the GCb arm, respectively.This adjuvant bi-weekly scheduled chemotherapy resulted in good compliance in both arms, and the regimen was feasible, with acceptable levels of toxicity in completely resected Japanese NSCLC patients. Therefore, these regimens represent a new treatment option suitable for outpatients with completely resected NSCLC.

Adjuvant chemotherapy improves the prognosis of patients with non-small cell lung cancer (NSCLC) after a complete resection despite unacceptable toxicity and low compliance.A total of 67 patients were enrolled in a multi-institutional study. The patients received chemotherapy with carboplatin (CBDCA) area under the curve of 3 and paclitaxel (PTX) 90 mg/m(2) every 2 weeks for six cycles after surgery.Fifty patients (74.6%) completed all cycles of therapy. The presence of grade 3 and 4 toxicities of neutropenia were 13.4, and 3.0%, respectively. Non-haematological adverse effects were infrequent and no treatment-related death was registered. The estimated disease-free survival and overall survival at 2 years were 89.0% and 88.8%, respectively.A bi-weekly schedule of CBDCA and PTX as adjuvant chemotherapy showed an acceptable toxicity and favourable feasibility in Japanese NSCLC patients after complete tumor resection. Consequently, it is desirable to validate this regimen in a future randomized clinical trial.

The VIO soft-coagulation system is a new device for tissue coagulation in which the output voltage is automatically regulated. We evaluated the safety and efficacy of this system for major pulmonary resection of lung cancer.We used bipolar VIO soft-coagulation for major pulmonary resection in 68 patients with primary lung cancer using the following three surgical procedures: (1) coagulation of the tissues around lobar vessels and bronchus; (2) fissure dissection; (3) lymph node dissection. The dissection in those steps was performed with both bipolar VIO soft-coagulation forceps and scissors. Results were analyzed with special reference to intraoperative complications, blood loss, and postoperative morbidity. The data in this study (VIO group) were compared with those of 78 lung cancer patients who underwent surgery using conventional electrocautery (CE group).The operations in this series included 60 lobectomies, 1 bilobectomy, 1 pneumonectomy, and 6 segmentectomies. With the VIO soft-coagulation system, coagulation of tissues around the lobar pulmonary vessels without injury to the pulmonary vessels or bronchus was effective. The mean blood loss in the VIO group was 90.6 g (range 5-595 g), which was significantly lower than that in the CE group (mean 141.0 g, range 5-700 g) (P = 0.014). Postoperative morbidity rates in the VIO and the CE group were 11.7% and 17.9%, respectively.The VIO soft-coagulation system is safe and feasible for major pulmonary resections in patients with lung cancer.

The effect of interferon-gamma (IFN-gamma) on the interaction between tumor cells and mesothelial cell layers was studied from the aspect of changes in mesothelial permeability. Mesothelial permeability was assessed as the percentage diffusion of radiolabeled albumin across the mesothelial cell sheets on Matrigel-coated filter cup assemblies. When lined gastric carcinoma cells (KATO-III) were seeded on the confluent mesothelial cell layers, the fine cobblestone appearance of the cell sheet was disrupted and mesothelial permeability significantly increased. The increase in permeability was suppressed by the addition of as little as 1 U/ml of IFN-gamma. The effect of IFN-gamma was observed when either the conditioned medium of tumor cells alone or the IFN-gamma-resistant tumor cells, K-562, was placed onto the mesothelium. The cobblestone appearance of the cell sheet was relatively well preserved in the presence of IFN-gamma. In contrast, IFN-alpha did not suppress tumor-induced mesothelial permeability. These results suggest that IFN-gamma has the potential to protect the human mesothelial cell layers against tumor cells.

The anomalously low vertical excitation energy from the ground state to the lowest excited triplet state (T1) is predicted for SiH2FCHCH2 (4.6 eV) by the quantum chemical calculation using ab initio MP3/3-21+G*//HF/3-21+G* molecular orbital methods. The steric effect of the fluorine which alters the symmetry of the molecule is considered to be responsible for the low-lying T1 state.

The energy distributions of the occupied surface states of GaAs(001) surfaces with several kinds of surface superstructure are measured using photoemission yield spectroscopy. The surfaces are prepared by molecular beam epitaxy. The surface states are found to change in both distribution and density depending on the surface superstructure and the surface preparation conditions. It is concluded that not all observed surface states originate ordered surface atomic structures.

消化器外科領域では肝臓の血行が慢性, あるいは急性に障害された病態を治療対象としたり, または手術などで直達的に操作することが少なくない.本論文では消化器外科の診療, または研究で比較的多く遭遇すると思われる, 1) 肝動脈結紮, あるいは門脈結紮時の肝循環, 2) 腸間膜静脈結紮, 3) 肝動脈結紮下部分的門脈動脈血化 (arterialization of the portal vein with the hepatic artery ligated), 4) 門脈圧亢進症の血流, などについてのコンピュータ・シミュレーション・モデルを構築し, 肝循環動態を汎用simulator PSpiceでシミュレーションした.肝循環を観察する主な要因, すなわち動脈圧, 肝内血管抵抗, 腹部内臓あるいはシャントの血管抵抗などを病的状態または手術操作を想定して変化させると, 診療上問題になる病態をシミュレーションできる.

Laparoscopic gastrectomy is widely used as minimally invasive surgery for gastric carcinoma. Billroth I or Roux-en-Y reconstruction is commonly performed after laparoscopic distal gastrectomy (LDG). Roux-en-Y reconstruction after LDG is one of the best methods for reconstruction of the alimentary tract when Billroth I reconstruction is difficult. There are few reports of intracorporeal Roux-en-Y reconstruction after LDG because of the technical difficulties of such a procedure. In particular, in the case of a very small gastric remnant, gastrojejunostomy using endoscopic linear staplers becomes more complicated. We developed a new technique for intracorporeal Roux-en-Y reconstruction: a modified stapling technique to allow the gastrojejunostomy to be made on the stomach transecting line that is applicable even when the residual stomach is very small. Roux-en-Y reconstruction with our modified technique was performed in six patients. There was no intraoperative complication or conversion to minilaparotomy or conventional celiotomy in any patient. Oral intake was easy and adequate after surgery. The present Roux-en-Y reconstruction procedure is feasible. Herein we describe an intraabdominal Roux-en-Y reconstruction with a modified stapling technique after LDG.

Endoscopic thymectomy is commonly used for treatment of myasthenia gravis (MG) patients due to its relatively low invasiveness. However, the long-term effects of endoscopic thymectomy have not been fully evaluated.To assess the long-term effects of extended infrasternal mediastinoscopic thymectomy (IMT) in MG patients and compare them with those of extended transsternal thymectomy (TT).Among 24 MG patients without thymoma who underwent thymectomy in our Institute between January 1997 and December 2000, 14 patients who received IMT and 10 who received TT were enrolled in the present study. Quantitative myasthenia gravis (QMG) score and anti-acetylcholine receptor antibody (anti-AChR) titers were evaluated before and at five years after surgery.After five years, QMG scores were reduced from 6.6 to 1.8 (p0.01) in the IMT group, and from 7.6 to 2.7 (p0.01) in the TT group. The anti-AChR titers were reduced from 75.2 to 40.1 (p=0.027) in the IMT group, and from 224 to 61.3 (p=0.020) in the TT group.These data suggest that the long-term therapeutic effect of IMT is equivalent to TT, and is thus suitable for the treatment of MG patients.

ビニルシランの励起状態の電子構造とプラズマ反応性の相関について検討した。MNDO分子軌道法による二中心結合エネルギーと局在化分子軌道エネルギーの計算結果から,最低励起状態では,オレフィン結合のπ部分が開裂し,第二励起状態では,Si-C結合が伸びて弱くなることが示唆された。特に三重項励起状態において,その傾向が強い。最低励起三重項状態への励起エネルギーは,他の励起状態よりかなり低く,ビニルシランの化学反応を誘起する励起エネルギーを低エネルギー側に絞れば,この励起状態を経由する反応がかなり選択的に起こることが予測される。高周波プラズマによるグロー放電分解の実験結果は,この計算による予測によく対応した。生成薄膜のXPSおよびIRスペクトルから,低パワーにおいてはオレフィン結合のπ部分の開裂により炭素骨格が形成され,パワーを上げていくとSi-C結合の切断が起こり,C/Si比を連続的に変化させてa-Sic膜を形成することができた。

Optical properties of living tissues have not been well established even today, and biooptic instrumentations have to be based on empirical formulae. In order to examine optical properties of the tissue having pulsating blood perfusion, we investigated the relation between optical density (defined as O.D.) of whole blood and hematocrit by transmission spectrophotometry. We used Waseda mock circulatory system that simulates blood circulation in the tissue. It was found that with increasing light path length, O.D. per unit light path length due to scattering and absorption effect, tended to become constant in each hematocrit. For wavelengths of 660, 805 and 940 nm, the relations between O.D. of whole blood and hematocrit predicted by Twersky's equation, Loewinger's equation and photon diffusion equation fitted to the data obtained. Meanwhile, for 1300 nm, the relation predicted by Loewinger's equation gave the best fit to the data

A tonometer is used to measure ocular pressure either by shooting a short blast of compressed air onto the cornea or by applying pressure directly to the cornea. At present, the tonometer is the primary instrument available for measuring ocular pressure. However, measuring ocular pressure by such means can either frighten or injure the patient. We propose an improved method of measuring ocular pressure in which the tonometer is applied over the patient's closed eyelid for several seconds. The sensor part of the newly developed tonometer contains a bimorph type transducer and weighs only 28.7 (g). When the sensor is placed on the eyelid and the transducer is vibrated by altering the applied voltage, the current flowing through the transducer changes in relation to the ocular pressure. Ocular pressure can thus be determined based on the current flowing through the system. During measurement, patients are generally unaware of the vibrations of the sensor and report no pain.

s / The Breast 24 S3 (2015) S21–S75 S51 2400 mg per day on days 1 to 21 every 28 days. Fulvestrant combined with capecitabine was administered as 2nd, 3rd, or 4th regimen of MBC following progression of fulvestrant monotherapy in 3 patients, and it was administered as 2nd or 4th regimen following progression of other regimens without fulvestrant in 2 patients. Fulvestrant combined with capecitabine was administered as 2nd, 3rd, or 4th regimen of MBC following progression of fulvestrant monotherapy in 3 patients, and administered as 2nd or 4th regimen following progression of other regimens without fulvestrant in 2 patients. Chemotherapy was an initial treatment in 1 patient with stage IV disease. Best responses were as follows. Partial response (PR) and stable disease (SD) were observed in 3 and 2 patients, respectively. Time to progression (TTP) was 15 months in 1 patient; however, 4 were censored in TTP analysis (3, 4, 7, and 13 months). No grade 3 or 4 adverse events were observed in fulvestrant combined with capecitabine regimen. Grade 2 palmarplantar erythrodysesthesia was observed in 2 patients, in one of whom the dose of capecitabine was reduced. No other grade 2 adverse events were observed. Our retrospective study indicates that fulvestrant combined with capecitabine is effective and well tolerated for patients with ER-positive, HER2-negative MBC. Further analyses will be needed in a prospective study setting.

Medical capsule devices such as video capsule endoscopes are finding increasing use in clinical applications. At present, technologies capable of measuring capsule position and detecting a bleeding in the digestive tract at the same time have not yet been established. The present study aims to develop a small wireless position and bleeding detection sensor. The sensor position are measured by using the phenomenon of mutual induction and Newton's law. Electromotive forces induced in the sensor are modulated to FM signals using an astable multivibrator, and the signals are passed directly through living tissue at low current and then demodulated by detectors on the surface of the body. A prototype sensor was developed and evaluated in vitro. The sensor was capable of accurately measuring capsule position up to 500 (mm) from the primary coils with an accuracy of 5 (mm), and detecting 0.5 cc blood in 500 cc physiological saline.

Medical capsule devices such as video capsule endoscopes are finding increasing use in clinical applications. At present, technologies capable of measuring capsule position in the digestive tract have not yet been established. The present study aims to develop a small wireless position sensor capable of measuring capsule position based on the phenomenon of mutual induction. Currents into primary coils are adjusted to maintain electromotive force induced in secondary coils at a constant level. Electromotive forces induced in the secondary coils are modulated to FM signals using an astable multivibrator, and the signals are passed directly through living tissue at low current and then demodulated by detectors on the surface of the body. A prototype wireless sensor was developed and evaluated in vitro. The sensor was capable of accurately measuring capsule position up to 500 (mm) from the primary coils with an accuracy of 5 (mm). Miniaturization of the sensor is necessary for commercialization.

ejd.2013.2031 Auteur(s) : Sei-ichiro Motegi smotegi@gunma-u.ac.jp, Akihiko Uchiyama, Osamu Ishikawa Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan Transient acantholytic dermatosis (TAD), also known as Grover's disease, is a rare acquired skin disease, which is histologically characterized by intraepidermal acantholysis [1]. Pruritic papules and papulovesicular eruptions are typically observed over the trunk and extremities [...]

We propose a novel algorithm for voxel-by-voxel compartment model analysis based on a maximum a posteriori (MAP) algorithm. Voxel-by-voxel compartment model analysis can derive functional images of living tissues, but it suffers from high noise statistics in voxel-based PET data and extended calculation times. We initially set up a feature space of the target radiopharmaceutical composed of a measured plasma time activity curve and a set of compartment model parameters, and measured the noise distribution of the PET data. The dynamic PET data were projected onto the feature space, and then clustered using the Mahalanobis distance. Our method was validated using simulation studies, and compared with ROI-based ordinary kinetic analysis for FDG. The parametric images exhibited an acceptable linear relation with the simulations and the ROI-based results, and the calculation time took about 10 min. We therefore concluded that our proposed MAP-based algorithm is practical.

This paper describes a deformable organ model suited for a real-time surgical simulation system. This proposed organ model allows us to perform surgical maneuvers such as pressing, pinching, various incisions, resection and to show the deformation of the inner structures such as blood vessels on our system. At the same time, we have been developing a VR cockpit suited for virtual surgery and tele-surgery. Using our cockpit, our system allows us to provide the users with an environment closely resembling the open surgery situation.

The goal of our study is to develop a data fusion system, which enables surgeons to easily visualize the inner structures of elastic organs during open surgery. We chose the liver as the focus of this study due to its easily deformable nature and complex vascular structures. To do so, we propose using preoperative data and supplementary intraoperative data. We captured a sequence of liver surface data for the intraoperative data by using trinocular stereo and we applied them to the preoperative 3D model's surface. Then, we modified the model to fit the intraoperative liver condition and portrayed the model's inner structures. With this method, we could establish this system.

We have aimed to develop a virtual surgery system that realizes the performance of surgical maneuvers on elastic organs and to construct an elastic organ model known as sphere-filled model. In this paper we describe a new method of deforming volumetric data in real time by using sphere-filled model. As well we modified this model to take the interference between soft tissue and rigid tissue to consideration. Furthermore basic surgical maneuvers (pushing, pinching and incision) and connection with force feedback device are realized on this model similarly to our surface model.

We have developed a new three-dimensional (3D) endoscopic ultrasound system (EUS) with convex scanning echoendoscope to diagnose and navigate for endoscopic puncture using the 3D image. To detect the position of the probe and to monitor the shape of the scope inside the body, we use a fiber optic tracking system which is shaped like a ribbon (Shapetape, Measurand Inc.). The fiber optic tracking system could measure bend and twist at each position of the ribbon. The position of the tip of the echoendoscope is allotted to a 2D image, and the system can reconstruct and visualize a 3D image in real-time. We have reported results of our experimental studies and animal studies.

We excised a bronchogenic cyst causing recurrent laryngeal nerve palsy using thoracoscopic surgery. A 28-year-old woman presented after the sudden onset of hoarseness, and laryngoscopic examination showed left vocal cord palsy. Computed tomography and magnetic resonance imaging showed a cystic mass, 4 cm in diameter, in the aortopulmonary window. Thoracoscopic examination revealed that the mass was adhered to the recurrent laryngeal nerve below the aortic arch. We extirpated the cyst via thoracoscopy without any injury to the nerves or major blood vessels. This case illustrates the benefits of thoracoscopic surgery for providing good visualization of the perineural structures and as a safe surgical treatment for a cystic mass in the aortopulmonary window.

Video capsule endoscopes are partly applied to clinical use. However, measurement technologies of capsule position in the digestive tract are not established yet. Therefore, the purpose of this study is to develop three-dimensional position sensor which can measure capsule position in the digestive tract. Three coils are arranged perpendicular in the capsule. The sensor generates electromotive force induced by magnetic field generator placed outside of a living body. By measuring induced electromotive force, we can calculate the distance between the sensor and the magnetic field generator. Although wireless is an ideal method for position measurements of capsule endoscope, this sensor is connected to computer through a thin cable because of electric power requirement.

We have been developing a virtual surgery system that is capable of simulating surgical maneuvers on elastic organs. In order to perform such maneuvers, we have created a deformable organ model using a sphere-filled method instead of the finite element method. This model is suited for real-time simulation and quantitative deformation. Furthermore, we have equipped this model with a sense of touch and a sense of force by connecting it to a force feedback device. However, in the initial stage the model became problematic when faced with complicated incisions. Therefore, we modified this model by developing an algorithm for organ deformation that performs various, complicated incisions while taking into account the effect of gravity. As a result, the sphere-filled model allowed our system to respond to various incisions that deform the organ. Thus, various physical manipulations that involve pressing, pinching, or incising an organ's surface can be performed. Furthermore, the deformation of the internal organ structures and changes in organ vasculature can be observed via the internal spheres' behavior.

Background Although endoscopic surgical procedures are popular in various fields, reports on its use in gastric surgical procedures are limited. This study was designed to review our initial experience with laparoscopic gastric surgical techniques to evaluate indications and surgical results. Study design We undertook a retrospective analysis of 100 patients (66 men and 34 women, mean age 63 years) who underwent laparoscopic gastric surgical procedures between 1995 and 2001. Procedures performed were distal gastrectomy (n = 76), wedge resection (n = 20), and intragastric surgical procedures (n = 4). Patients were divided into two groups according to the date of the procedure, from the earliest to the most recent. Results There were 85 patients with gastric cancers, 14 submucosal tumors, and 1 duodenal ulcer. In 8 cases conversion was made to an open surgical procedure. Operation times required for distal gastrectomy, wedge resection, and intragastric surgical procedures were 330 ± 69, 144 ± 34, and 298 ± 106 min, and blood loss was 354 ± 251, 56 ± 94, and 33 ± 58 g, respectively. Complications included transient anastomotic stenosis (n = 5), leakage (n = 4), and bleeding (n = 1) after distal gastrectomy, and bleeding (n = 1) after intragastric surgical procedures. There were no complications after wedge resection. Comparing the first and second halves of the series, the percentage of distal gastrectomy significantly increased from 66% to 86% (p = 0.02) and the number of dissected lymph nodes at this procedure increased from 20 ± 13 to 33 ± 17 (p Conclusions Laparoscopic gastric surgical procedures are safe and feasible for early gastric cancers and submucosal tumors. Technical advances in lymph node dissection have made distal gastrectomy a leading and increasingly popular laparoscopic procedure for early gastric cancer.

The aim of this study is to propose a scatter correction method based on a statistical model of mixture Gaussian Model (MGM) that has robust capability for information extraction and can make smaller in size of PET data stored. Clustering algorithm based on MGM is applied to extract scatter component. MGM assumed that measured data are sum of unknown components that statistical characteristic is Gaussian. MGM was applied to three different implementations of one-, two-, and three-dimensional projection data. Good extraction performance and reduction of the amount of data are archived.

The aim of this study is to visualize glucose metabolism in the brain using PET dynamic data and the proposed clustering analysis (CAKS). PET can give the glucose metabolism using /sup 18/F-FDG. Voxel-based analysis is not practical because of the bad noise property in voxel-based PET data and a large number of voxels. In CAKS, PET data are clustered to improve reliability in estimation and calculation speed. In CAKS, voxels whose concentration history in tissue time activity are similar, are gathered before parameter estimation using a statistical clustering algorithm based on the mixture Gaussian model, then the averaged time course is used for parameter estimation. As a result, physiologically acceptable images on the glucose metabolism were obtained in ten minutes.