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Objective: To date, the actual prevalence of Skeletal muscle mass (SMM) loss by rigorous definition and its related factors have not been sufficiently surveyed in the community. We therefore examined the factors related to the reductions of skeletal muscle mass (SMM) in older adults. Design: Case-control study. Subjects: One hundred twenty four community-dwelling older adults aged ≥65 years participated. Measurements: Reductions of SMM were assessed by measuring difference between SMM at baseline and SMM 1 year later, by which participants were divided into three groups. Variables of the first tertile group, who had the greatest decrease in SMM, were compared with those of the second/third tertile groups. Variables included hight, weight, body mass index (BMI), maximal knee extension strength, grip strength, lower and upper muscle quality (UMQ), 5-m walking time (WT), timed up and go (TUG), food frequency questionnaire, mini nutritional assessment short form (MNA-SF), basic health checklist. A logistic regression analysis and classification and regression trees (CART) were used for multivariate analysis in order to extract variables that predicted reductions of SMM. Results: Significant differences were observed for age, SMM, UMQ, TUG, and WT between the first tertile and the second/third tertile groups, The CART analysis indicated that vitamin D intake UMQ and 5-m WT predicted significant decrease in SMM. Conclusion: The present study suggested a possibility that future reductions of SMM could be predicted by simple indices that may contribute to early detection of individuals at risk of developing sarcopenia in old age.

Graphical abstractDisplay Omitted We have developed and evaluated a PMMA-based gas sensor for monitoring VOCs.The sensor consists of a PMMA cantilever, a PVDF piezoelectric film and a PBD.The sensor had a resonant frequency of 341kHz and quality factor of 71.We examined the resonant frequency shift by setting up a VOC dilution flow system.The resonant frequency shifted when the sensor was exposed to toluene vapor. We have developed and evaluated a PMMA-based gas sensor to realize a low-cost sensor network system for monitoring VOCs (volatile organic compounds). The PMMA-based gas sensor consists of a PMMA (poly methyl methacrylate) cantilever, a piezoelectric film of PVDF (polyvinylidene fluoride), and a thin film of PBD (polybutadiene). We began by investigating the influence of PBD coating of a dynamic property of the PMMA cantilever in a higher order resonance mode under atmospheric pressure at room temperature. The PBD-coated PMMA cantilever had a resonant frequency of 341kHz and quality factor of 71 at the 4th flexural vibration mode. Next, we examined the change of resonance frequency in the presence of toluene vapor by setting up a gas sensor evaluation system equipped with a VOC dilution flow system, temperature-controlled chamber, oscillation circuit, and frequency counter. The resonant frequency shifted when the PMMA-based gas sensor was exposed to toluene vapor. The measured toluene sensitivity in the experiment was 0.02Hz/ppm.

We have developed and evaluated a Polymer-based VOC (volatile organic compounds) sensor module to realize a low-cost wireless sensor network system for environmental monitoring. The polymer-based VOC sensor module consists of a polymer- based VOC sensor, a sensing circuit, a transmitter and a receiver. The polymer-based VOC sensor composed polycarbonate (PC) cantilevers with PVDF (polyvinylidene fluoride) piezoelectric films. We examined the change of resonance frequency in the presence of VOC vapor by setting up a resonant sensor evaluation system equipped with a VOC dilution flow system and temperature-controlled chamber. The resonant frequency of polymer-based VOC sensor shifted significantly downward during the toluene, octane and ethanol exposure. The resonant frequency was converted to I2C output signal by I2C-I/F and transmitted to receiver

We investigated the size and mode dependencies of the resonance frequencies and quality factors of PMMA (polymethyl methacrylate) and PC (polycarbonate) cantilevers under atmospheric pressure in order to obtain fundamental data for polymer-based VOC (volatile organic compound) sensors. PMMA cantilevers and PC cantilevers are fabricated by hot embossing, bonding, and polishing techniques. Variations in the vibration mode result in large variations in the resonance frequencies and quality factors of these cantilevers. The measured resonance frequencies correlated well with the theoretical undamped resonance frequency of a flexural-vibrating cantilever. The measured quality factors varied from 10 to more than 100, depending on the vibration mode. A higher mode tended to exhibit a higher quality factor.

The mode dependences of resonance frequencies and quality factors in a PMMA (polymethyl methacrylate) cantilever and a PC (Polycarbonate) cantilever at atmospheric pressure are investigated to obtain fundamental data for polymer-based VOC (volatile organic compounds) sensors. The PMMA cantilever and the PC cantilever are fabricated using hot embossing, bonding and polishing techniques. The resonance frequencies and the quality factors are found to vary largely depending on the vibration mode. The measured resonance frequencies correlate well with the theory of undamped resonance frequency of a flexural-vibrating cantilever. The measured quality factors varied from less than 20 to more than 100 depending on the vibration mode. A higher mode tended to exhibit a higher quality factor. The highest quality factor of 100 was obtained on the 4th flexural mode in both the PMMA and PC cantilever.

The relationship between 9,10-ketol-octadecadienoic acid (KODA), GAs and jasmonic acid (JA) and flower bud formation influenced by fruit load in apples (Malus domestica Borkh.) was investigated. The endogenous KODA and JA concentrations in apical buds in plants subjected to flower thinning treatment (FTT), under which all flowers were removed were higher than those in plants subjected to heavy crop treatment (HCT), under which the number of leaves per fruit was adjusted to 20 from 60 to 120 days after full bloom (DAFB). In contrast, the gibberellic acid concentrations [total of gibberellin A1 (GA1) and gibberellin A4 (GA4)] in FTT plants were low compared with those in HCT plants. The result suggests that KODA and JA in contrast to GAs may have opposite effects on flower bud formation which is significantly influenced by fruit load in apples and that KODA and JA may also be associated with flower bud formation in apples.

伊勢神宮宮域林は20年ごとに神宮すべてを新造する式年遷宮に対し，木材を自給することを計画している。本研究では，システム収穫表をこの宮域林に適用し，持続可能かつ大径材生産に適した間伐計画を提案することを目的とした。システム収穫表には，Local Yield Table Construction System (LYCS) を使用し，伊勢神宮宮域林育林工程表と紀州地方ひのき林林分収穫表から成長モデルのパラメータを推定した。さらに，そのパラメータを用いたモデルを，35年生から100年生にかけて適用したところ，宮域林の平均樹高，平均胸高直径の成長の推移とよく適合した。これによって，低密度，長伐期施業という宮域林独自の施業体系において，多様な間伐計画に対応した収穫表の調製が可能となった。最後に，優良大径木生産に労働力・コスト削減を考慮に入れた間伐計画を策定し，この計画によって20年ごとの式年遷宮に大径材が持続的に供給可能であることがわかった。

The work was carried out to get information how to use wasted biomass, particularly waste woods, as a raw material for fine and advanced carbon products. A phenol-starch-formaldehyde resin was synthesized by using phenol of which one third was replaced by cornstarch as a model material for waste wood. The resin was spun, stabilized and finally carbonized at 900°C. A commercial novolac-type phenol-formaldehyde resin was used as a reference. There was no essential difference in the microscopic structures between the carbon fibers derived from the synthesized and the commercial resins, but the former resin showed some disadvantages against the latter: one is a poor spinnability to result in thick and irregular carbon fibers, and another one is the formation of macropores in the resulting carbon fibers, leading to low mechanical strength. These disadvantages are thought to be caused by the remaining MgO particles used as a neutralization agent in the synthesis of the resin. A possibility to achieve the final purpose is discussed briefly.

We have studied the photoluminescence (PL) properties of a GaAs/AlxGa1−xAs quantum well (QW) system containing three QWs with different thicknesses, in which the widest one (7.8 nm ) has an excited-subband exciton state located slightly below the barrier band edge. Using above-barrier excitation with a power density of about 10 W / cm 2 at 13 K , a strong PL emission peak appears on the high-energy side of the three PL peaks originating from the ground-state exciton transitions of the three QWs. This high-energy PL peak with an intensity comparable to the one of the other three peaks is located near an excited-subband (n=2) exciton state of the widest QW. By investigating the position dependence of the PL spectra across a 2-inch wafer, which exhibits a decreasing Al mole fraction x from the center to the edge, the PL intensity of the high-energy peak can be correlated with the one of the ground state in the widest QW. This correlation indicates that this high-energy PL peak is most likely related to the n=2 exciton state of the widest QW because of the energy alignment of the excited subband state relative to the barrier band edge.

In this paper, the effects of oscillation amplitude on the aerodynamic derivatives of the thin rectangular cylinder with B/D = 13 and 150 were investigated. It was clear that the torsional amplitude affected strongly the aerodynamic derivatives H* 2 and A* 2 . This effect reduced the critical velocity of flutter by about 10%. The cause of this effect was investigated by the measurement of the unsteady surface pressure. This investigation made it clear that the variation of A* 2 is caused by the movement of the acting point of the resultant lift force. These results indicate that these effects cannot be disregarded for such a simple thin plate but for a real bridge girder with a more complex cross-section and with delicate aerodynamic control devices.

We have developed and evaluated polycarbonate (PC)-based dual cantilever sensors as part of a low-cost sensor network system for monitoring VOCs (volatile organic compounds). The PC-based dual cantilever sensor consists of a PC cantilever and a PBD (polybutadiene)-coated PC cantilever with PVDF (polyvinylidene fluoride) piezoelectric films. We began by investigating the size and mode dependences of resonant frequencies and quality factors of PC cantilevers and PBD-coated PC cantilever as output signal of PVDF piezoelectric film. Next, we examined the change of resonance frequency in the presence of VOCs vapor by setting up a resonance sensor evaluation system equipped with a dilution flow system, temperature-controlled chamber, oscillation circuit, and frequency counter. The resonant frequency of both PC cantilever and PBD-coated PC cantilever shifted significantly downward depending VOCs.

Summary By means of high performance liquid chromatography (HPLC) and gel permeation chromatography (GPC), the yields of the main reaction products and the polymeric portion formed in the reaction of guaiacylglycerol-β-guaiacyl ether (GG) under various acid-catalyzed conditions were quantified as a function of reaction time. Based on their forming sequence and reaction behavior, as well as their structural characteristics, an acid-catalyzed reaction mechanism of GG with phenol was proposed.

Birch wood meals, phenolated in the presence of sulfuric acid as catalyst, were compression-molded by using hexamethylenetetramine (HTMA) as a curing agent. The effect of combined phenol on the flexural strength and modulus of elasticity (MOE), Brinell hardness, and water resistance of the phenolated-wood-based moldings was studied. Moreover, on the basis of several factors, we examined the dynamic mechanical behaviour of the moldings using a dynamic mechanical thermal analyzer (DMTA). The flexural strength, MOE, hardness, and water resistance of the moldings were found to be controlled by the amount of combined phenol and at sufficient combined phenol levels were comparable to those of a commercial novolak-resin-based molding. Additionally, the DMTA studies showed that the temperature dependence of the dynamic elastic modulus (E') of phenolated-wood-based moldings depends greatly on the amount of combined phenol, filler content, HMTA content, molding temperature, moisture content, water-immersion test, heat-aging time, and frequency, and at sufficient combined phenol levels was comparable to that of the commercial novolak-resin-based material. It could also be stated that phenolated-wood-based moldings could be used safely within a temperature range of 75°C-165°C, depending upon the amount of combined phenol. Furthermore, the biodegradability of the phenolated-wood-based moldings was greater than that of a commercial novolak-resin-based molding.

Safe peritoneal access and gastric closure are the most important concerns in clinical applications of NOTES. Our past study demonstrated usefulness of the submucosal tunnel technique for safe peritoneal access and closure with endoclips. However, such closure is sometimes difficult and time-consuming. This study investigated the feasibility of fibrin glue for submucosal tunnel closure in a NOTES porcine model.In 10 female pigs each weighing 40 kg, transgastric peritoneoscopy was performed through a 60 mm-long submucosal tunnel created using the endoscopic submucosal dissection technique. After transgastric peritoneoscopy for 30 min, the submucosal tunnel was closed with endoclips in five pigs and fibrin glue in five pigs. After a 7 d follow-up period, the pigs were euthanized for post-mortem examination. Outcome measures included (a) technical feasibility of closure with endoclips versus fibrin glue, (b) clinical monitoring for 7 d, (c) follow-up necropsy at 7 d, and (d) histopathologic examination of the peritoneal access site.Transgastric peritoneoscopy with submucosal tunnel technique was successful in all pigs. Mean time required to close the mucosal incision site with fibrin glue was 1.6 ± 0.5 versus 19 ± 18.7 min with endoclips. All pigs survived well without complications. Necropsy revealed no peritonitis. There were no differences in transgastric peritoneal access sites between endoclips and fibrin glue. Histopathologic examination of the submucosal tunnel demonstrated wound healing with transmural fibrosis. No adverse effects from fibrin glue were noted.Compared with endoclips, the application of fibrin glue is easy and simple in the closure of transgastric peritoneal access in NOTES.

Although the involvement of cytomegalovirus (CMV) infections in the development of thrombotic microangiopathy (TMA) in HIV patients and transplant recipients has been reported, it is still controversial whether CMV itself can cause TMA. We report herein a rare case with rapid improvement of TMA by ganciclovir treatment in a patient who is neither HIV-positive nor a transplant recipient, suggesting a pathogenic role for CMV in TMA.

As the laparoscopic approach has become a popular gastric cancer treatment in Korea and Japan, the need for sharing current practices of surgeons who are experienced in laparoscopic gastric cancer surgery has increased.We sent a questionnaire on laparoscopic instruments, image documentation, preoperative evaluation, surgical indication, operative methods, and postoperative management to laparoscopic experts in Korea and Japan, and 24 (14 from Korea and 10 from Japan) responded.Endoscopic ultrasound and preoperative endoscopy-guided clipping are routinely employed, respectively, by 14 (58%) and 20 (83%) of the surgeons. Surgeons perform laparoscopy-assisted distal gastrectomy (LADG) based on varying indications. Five surgeons (21%) performed LADG only for cases of stage T1 cancer, 15 (63%) performed LADG on patients with less than T2 lesions, and 4 (17%) performed LADG on patients with less than T3 lesions. With regard to postoperative anastomosis, 18 surgeons (75%) preferred extracorporeal anastomosis and 6 (25%) preferred intracorporeal anastomosis. The mean postoperative hospital stay was 6.5 days in Korea and 10.1 days in Japan (P0.001).This survey can help to inform the current practice of laparoscopic gastric cancer surgery in Korea and Japan, where laparoscopic surgery is frequently performed.

Endoscopic mucosal resection (EMR) is now in clinical use for the management of small, early-stage gastric, carcinomas, although some patients are treated via laparotomy when the lesions are not suitable for, EMR due to their size, depth, and location. In many cases of invasive mucosal carcinoma with submucosal involvement, the regional lymph nodes along with the distal portion of the stomach must also be resected. In order to remove the whole resected specimen, a mini-laparotomy of appropriate length (5 cm) is performed which can be located at the optical port site after removing the laparoscope. By applying an abdominal wall elevator through the mini-laparotomy, direct vision is possible which facilitates resection of the regional lymph nodes and intestinal anastomosis. We describe our technique for laparoscopically assisted distal gastrectomy and present our early clinical results.

This paper provides the exciting factors and mechanism of rain-wind induced vibration of polyethylene-lapped cable of cable-stayed bridges and the aerodynamic countermeasure to suppress the vibration.

With about 1000-h of relativistic high-energy ion beams provided by Heavy Ion Medical Accelerator in Chiba, about 70 users are performing various biology experiments every year. A rich variety of ion species from hydrogen to xenon ions with a dose rate of several Gy/min is available. Carbon, iron, silicon, helium, neon, argon, hydrogen, and oxygen ions were utilized between 2012 and 2014. Presently, three electron cyclotron resonance ion sources (ECRISs) and one Penning ion source are available. Especially, the two frequency heating techniques have improved the performance of an 18 GHz ECRIS. The results have satisfied most requirements for life-science studies. In addition, this improved performance has realized a feasible solution for similar biology experiments with a hospital-specified accelerator complex.

A radioanalytical procedure has been developed for the determination of99Tc in environmental samples. The procedure consists of precipitation, solvent extraction, ion exchange, electrodeposition and radiation measurement. Rhenium was used as a non-isotopic carrier of99Tc. On the basis of 3σ counting error, the detection limits were 4.9·10−5 Bq/l, 7.4·10−3 Bq/kg wet and 7.4·10−2 Bq/kg dry for water, biota and soil samples, respectively. Sea water, seaweeds (brown algae) and soils were collected to evaluate the present levels of99Tc in Japan. The level of99Tc in sea water was ca. 1·10−4 Bq/l around Japan. Among the seaweeds (brown algae), Ishige okamurai showed the highest concentration of 5.8·10−2 Bq/kg wet tissue and the highest concentration factor of 583. The level of99Tc in the organic rich surface soil was ca. 1 Bq/kg dry soil in Fukuoka.

Tumor cells attach, degrade, and migrate through basement membranes as they metastasize. Laminin, a major glycoprotein of basement membranes, promotes the metastatic activity of tumor cells by stimulating the attachment and migration of the cells and their secretion of collagenase IV. We have identified a synthetic peptide of 19 amino acids (Cys-Ser-Arg-Ala-Arg-Lys-Gln-Ala-Ala-Ser-Ile-Lys-Val-Ala-Val-Ser-Ala-Asp -Arg) from the sequence of the A chain of laminin that increases experimental metastases of the lungs by murine melanoma cells. The peptide is active when injected either intravenously or intraperitoneally. The peptide increased collagenase IV activity, a key enzyme in the breakdown of basement membranes, to the same extent as laminin. This peptide represents an active site on laminin for promotion of the metastatic phenotype and generates a probe for studying the regulation of malignant activities.

In addition to its role in the adult mammalian nervous system as an inhibitory neurotransmitter, gamma-aminobutyric acid (GABA) is involved in the proliferation, differentiation, and migration of several kinds of cells including cancer cells. GABA is synthesized predominantly from glutamate by glutamate decarboxylase and exerts its effects via ionotropic GABA(A) receptors and/or metabotropic GABA(B) receptors. In this review, the current state of knowledge regarding the role of the GABAergic system in peripheral nonneuronal cell proliferation is described, and recent advances in elucidation of the mechanisms leading to cell proliferation are discussed.

Juzen-Taiho-To (JTT) is a Japanese herbal medicine that has been administered mainly to patients weakened by long illness. Currently, it has also been used for cancer patients and showed antitumor effects that have been reported as phagocytosis enhancement, cytokine induction and antibody production. In this study, we examined the effect of oral administration of JTT in mice on the immunological restoration of the liver, especially focused on natural killer (NK) T-cell induction. Mice were grouped to receive JTT or placebo orally for a period of 1, 3 and 7 days. After sacrifice, the liver tissue was fixed, embedded and stained with hematoxylineosin and some antibodies by common staining methods. Transmission electron microscope (TEM) observation was also carried out. Although the JTT-treated mice had the same appearance as the non-JTT-treated mice, their livers were infiltrated by massive mononuclear cells, some of which were aggregated in clusters. Immunohistochemical staining revealed that there was abundant cytokine expression of interleukin (IL)-12 and massive infiltration of mononuclear cells with large granules in the liver of JTT-treated mice. Oral administration of JTT may induce the expression of IL-12 and be followed by immunological restoration such as NK T-cell induction in liver

In the radio link design of cellular CDMA system, system capacity has been estimated with the uniform traffic distribution condition so far. In many cases, however, actual traffic in a service area is not distributed uniformly. Therefore, this paper discusses the up link capacity of the cellular CDMA system applied in a service area with tapered traffic distribution condition. The analytical result shows that the system capacity is degraded according to the degree of traffic concentration to the service area center. It is also suggested that the cell size change in inverse to the degree of traffic concentration is effective to mitigate the system capacity degradation

Radiative recombination properties of excitons have been investigated for a GaAs quantum well confined by barriers with an energy gap slightly larger than the energy of the first excited (n = 2) subband exciton. The low-temperature photoluminescence (PL) spectra show a surprisingly intense emission line higher in energy and intensity than the ground-state exciton band. This high-energy PL line remains prominent for excitation power densities between 0.01 and 10 W/cm/sup 2/. It can be clearly discriminated from the barrier emission using PL excitation (PLE) spectra and calculations of the subband energies. The picosecond PL dynamics reveal that the high-energy PL line exhibits a decay time of 0.77 ns at 20 K, which is much longer than the expected carrier relaxation time. These results indicate that the high-energy PL line can be ascribed to the exciton population of the first excited subband, which is stabilized for certain barrier injection conditions due to the exciton-parity forbidden relaxation (from n - 2 to n = 1 excitons) pathway.

For an Acrobat Robot which is a small humanoid robot, our purpose is to make it jump vertically toward a horizontal bar. In order to realize efficient jump, it is important to set a step input timing according to the response of the input by PD control. This validity is confirmed by a simulation with simplified 3 link model and an experiment using Acrobat Robot.

The feasibility of F/sub 2/ lithography (VUV lithography) was discussed positively from a viewpoint of optical materials and mask materials. The laser durability of CaF/sub 2/ and new materials for the F/sub 2/ mask substrate are discussed.

We demonstrate the imaging of buried features in a microstructure—a tiny hole in an aluminum thin film covered by a chromium layer—with nanometer lateral resolution using a transient temperature distribution restricted to within ~0.5 µm of the sample surface. This is achieved by mapping photothermally induced megahertz surface vibrations in an atomic force microscope. Local thermal probing with megahertz-frequency thermal waves is thus shown to be a viable method for imaging subsurface thermal features at submicron depths. ©2003 American Institute of Physics.

Summary form only given. ArF lithography (wavelength 193 nm) is expected to start its mass-production stage at this time. It will cover the 100 nm resolution node and will extend to near 80 nm. F2 lithography (wavelength 157 nm) is expected to come next; it is the technology that realizes both high throughput (comparable to ArF) and high resolution below 70 nm at the same time. F2 exposure tools have similar structure to ArF tools; but there are significant differences in optics, materials and mechanical structures.

We evaluated and characterized the mouse scratching behavior using a new apparatus, MicroAct. Scratching behavior was evoked in ICR and BALB/c mice by compound 48/80, passive cutaneous anaphylaxis or repeated hapten application. Under the present experimental condition, MicroAct detected consecutive scratching behavior (events) consisting of 3 or more beats. Although the detecting standard of MicroAct was not identical to that of an observer, the number of events detected by MicroAct and by an observer were almost comparable with each other. Frequency of events, total scratching time and total number of beats detected by MicroAct increased depending on the intensity of the causing stimuli for scratching. In contrast, the duration of each event and the number of beats in each event increased only slightly, but the scratching speed was almost constant. The present results demonstrate that MicroAct is a useful tool for evaluating mouse scratching behavior. Mouse scratching behavior seems to have a relatively fixed pattern and the causing stimulus increases mainly in the frequency of event without affecting the scratching speed.

Gastric cancer has been successfully treated by both endoscopic and open surgery, while early-stage gastric cancer with some risk of lymph node metastasis is managed with laparoscopic surgery. The principle of treatment of gastric cancer is to perform a complete resection of the lesion with safe and appropriate procedures based on disease stage. Three types of laparoscopic surgery have been reported: laparoscopy-assisted distal gastrectomy (LADG); laparoscopic local resection with the use of aT-fastener; and intragastric mucosal resection. In local resection, there is a possibility that past of the lesion or lymph node metastases may remain. D2 lymph node dissection requires a longer operative time and technical difficulties causing postoperative complications may be encountered. At present, LADG is the preferred choice of treatment in patients with early-stage gastric cancers due to the acceptable length of surgery and simple lymph node harvesting. For the wider application of minimally invasive surgery, numerous advances in operative procedures, including hand-assisted surgery and sentinel node navigation surgery, are required, along with technical developments for more accurate diagnosis to offer ideal treatment for each stage of gastric cancer.

A 45 year-old male underwent lower left third molar extraction under intravenous sedation. During the surgical extraction of the mandibular left impacted third molar using a high-speed air-turbine drill, the patient complained of compression at the level of the right breast without any abnormal vital signs. Radiological investigation and CT scan showed a picture of bilateral, subcutaneous and mediastinal emphysema involving the bilateral face, neck and pectoral area. Following the antibiotic therapy, the drainage was performed through bilateral pectoral incisions by thoracic surgery. The patient recovered within two days and underwent the completion of this surgery under general anesthesia one month later.

Since 1991, laparoscopic surgery has been applied to treat the patient with gastrointestinal malignancies. Surgery seems to be a very useful modality from the viewpoint of curability. Nevertheless, stress due to surgical procedures induces physiological responses in clinical settings. In laparoscopic surgery, intensity of surgical stress is less than that in open surgery, and physiological response involving the immunological depression after laparoscopic surgery is also less than that after open surgery, while the mesothelium on the peritoneal surface is injured with the presence of both positive intraperitoneal pressure and CO2 gas. These physiological responses as systemic effects and the wound healing responses as local effects after laparoscopic surgery may modulate the growth, invasion, and metastasis of the remnant malignancies. Various studies have been reported to clarify these effects of pneumoperitoneum. We review, herein, the literature and our preliminary results with regard to the modulation on the behavior of the malignant cells after the laparoscopic surgery.

Although there have been studies of the effects of pneumoperitoneum on the peritoneal cavity, we still do not know whether the morphologic changes to the peritoneum are different for pneumoperitoneum vs laparotomy. Using scanning electron microscopy, we examined the murine peritoneum after pneumoperitoneum vs laparotomy and compared the changes.Forty-five mice were anesthetized with diethyl ether and divided into seven groups. Pneumoperitoneum was established at 5 mmHg for 30 min with carbon dioxide (CO(2)) (n = 9), helium (n = 9), and air (n = 9). One group underwent laparotomy for 30 min (n = 9), and a control group underwent anesthesia only (n = 3). CO(2) pneumoperitoneum was further established at 10 mmHg for 30 min (n = 3) and at 5 mmHg for 60 min (n = 3). After the procedures, the peritoneum was resected from the mesenterium of the small intestine in each animal and examined by scanning electron microscope for morphologic changes of the mesothelial cells.Bulging up of the mesothelial cells was evident immediately after pneumoperitoneum, whereas detachment of the mesothelial cells was present immediately after laparotomy. Bulging up of the mesothelial cells was reduced at 24 h after CO(2) pneumoperitoneum and fully resolved at 72 h in all pneumoperitoneum groups, whereas the mesothelial cells remained detached at 72 h in the laparotomy group. Intercellular clefts were found immediately after helium pneumoperitoneum and were present at 24 h and 72 h after helium pneumoperitoneum, but they were not seen after air pneumoperitoneum and were only evident after CO(2) pneumoperitoneum at 10 mmHg. Depression of the mesothelial cell surface was observed when pneumoperitoneum lasted 60 min.Morphologic peritoneal alterations after pneumoperitoneum differed from those after laparotomy and were influenced by the type of gas, amount of pressure, and duration of insufflation. These peritoneal changes after pneumoperitoneum may be associated with a specific intraperitoneal tumor spread after laparoscopic cancer surgery.

Substance P-immunoreactivity in neurons projecting to the spinal cord was examined using retrograde tract-tracing method combined with immunohistochemical techniques in chickens. Many small substance P-immunoreactive neurons were densely clustered in the midline area in the rostral midbrain, the rostromedian area (80% of the neurons in the rostromedian area). Some of these substance P-immunoreactive neurons in the rostromedian area (about 20% of substance P-immunoreactive neurons) were retrogradely labeled by small injections of wheat germ agglutinin conjugated horseradish peroxidase into the central part of the lumber segments including the intermediomedial nucleus, suggesting the projections from the rostromedian area to the lower spinal preganglionic regions. From the present data and mammalian previous studies, it was suggested that the midline area in the midbrain has fiber connections with the regions related autonomic functions, and all of which exhibit substance P-immunoreactivity.

The aim of this study was to evaluate the subjective bowel function after low anterior resection and sigmoid colectomy and to clarify the clinicopathologic factors influencing postoperative bowel habits.Eighty-six patients who underwent low anterior resection and sigmoid colectomy replied to the questionnaire which consisted of 8 categories of bowel symptoms. The patients were divided into 2 groups: good bowel function showing less than half of symptoms (4) and poor bowel function showing more than half of symptoms (or = 4).After low anterior resection, patients were often complicated with incomplete evacuation (75%), bowel movement at night (60%), defecation more than twice a day (46%), and soiling (27%). The mean number of defecation/day and frequency of patients with night stools was significantly higher after low anterior resection than sigmoid colectomy (2.81 vs. 2.18, P0.05; and 60% vs. 29%, P0.05). Poor bowel function after low anterior resection was frequent in patients with high ligation of the inferior mesenteric artery (82%, P0.05), injury to the pelvic autonomic nerve (82%, P0.05), and blood transfusion; while poor bowel function after sigmoid colectomy was frequent in patients with resected colon measuring 25 cm or more (81%, P0.05).These results indicate that poor bowel function after low anterior resection is associated with high ligation of the inferior mesenteric artery and injury to the pelvic autonomic nerve; while poor bowel function after sigmoid colectomy correlates with length of the resected colon. Less aggressive surgery is needed to preserve good bowel function.