bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between daily survival rates of larval Japanese anchovy (Engraulis japonicus) and concentrations of copepod nauplii in the Seto Inland Sea, Japan
Authors: ZENITANI HIROMU , KONO NAOAKI , TSUKAMOTO YOUICHI
Published: August 2007

We attempted to estimate the survival rates of larval cohorts (3–15 mm in body length) of the Japanese anchovy Engraulis japonicus population in Hiuchi‐nada, Seto Inland Sea, Japan, and examined the relationship to their food availability. The survival rates were directly calculated from the change in larval density during the survey. The estimated daily survival rate ranged between 0 and 89% d−1, but increased with the increase in the mean concentration of small‐sized copepod nauplii (<100 μm in body length) sampled at 10 m depth. When the food concentration was higher than about 5 nauplii L−1, the daily survival rate of larval anchovy reached an asymptote of approximately 89% day−1. It might be possible to provide a framework for the forecast for larval abundance immediately prior to recruitment size (10–15 mm SL), based on larval abundance of the monitored size (3–8 mm SL) and the survival rate which is estimated from the concentration of small‐sized nauplii.
Interannual and interdecadal variability in juvenile coho salmon (Oncorhynchus kisutch) diets in relation to environmental changes in the northern California Current
Authors: BRODEUR RICHARD D. , DALY ELIZABETH A. , SCHABETSBERGER ROBERT A. , MIER KATHRYN L.
Published: August 2007

The feeding habits of juvenile coho salmon, Oncorhynchus kisutch, in the northern California Current were examined using samples from two different time periods (1980–85 and 1998–2003) of highly contrasting oceanographic conditions. The goal was to test the influence of interannual and interdecadal changes in taxonomic composition of prey, feeding intensity, and size spectra of teleost prey. Analyses were done for samples taken both early in the summer (June) shortly after the salmon enter the ocean, and also in late summer (September) following some ocean residency. Fish prey dominated coho salmon diets by weight during most years, but this trend was more pronounced during the 1980–85 sampling period. In terms of numerical composition, the diets were more variable on an interannual basis, but decapod larvae and euphausiids were important prey in most years. Pteropods and copepods were important prey during weak upwelling or El Niño years, whereas euphausiids were important during strong upwelling or otherwise highly productive years. Hyperiid amphipods comprised a substantial proportion of the diets only in 2000. Coho salmon showed highly significant differences in prey composition among years or between decades both in weight and numerical composition. The percentage of empty stomachs was highly variable by year in both June and September, but was significantly different only for September between decades. In contrast, an index of feeding intensity did not show many significant changes in either comparison. However, the relative size ratios for fish prey consumed were highly variable by year, and larger than average fish prey were consumed during 1998, leading to the highest feeding intensity observed.
Chlorophyll a variation in the Kuroshio Extension revealed with a mixed‐layer tracking float: implication on the long‐term change of Pacific saury (Cololabis saira)
Authors: YASUDA ICHIRO , WATANABE TOMOWO
Published: August 2007

Variation of chlorophyll a from March 2004 to July 2005 in the formation region of Subtropical Mode Water in the Kuroshio Extension was observed with a mixed‐layer tracking profiling float parking at around 40 m depth. Chlorophyll a concentration in the mixed‐layer is seasonally high from winter to early spring (January–April) even in the deep mixed layer; whereas during winter it tends to be lower for the corresponding deeper mixed layer. The chlorophyll a integrated over the winter mixed‐layer depth (MLD) increases with MLD for MLD <200 m and for MLD > 250 m the integrated chlorophyll a almost disappears, probably because of the large MLD exceeds in the critical depth with light limitation. These results suggest that the wintertime MLD influences the recruitment of Pacific saury (Cololabis saira) in the Kuroshio Extension because the wintertime food environment for larvae and juvenile of the Pacific saury could be better in the shallow wintertime MLD period of the 1950s and 1990s and worse in the deep MLD period of the 1970s and early 1980s.
Age‐specific reproductive success in a long‐lived bird: do older parents resist stress better?
Authors: ANGELIER FREDERIC , MOE BØRGE , WEIMERSKIRCH HENRI , CHASTEL OLIVIER
Published: August 2007

In many vertebrates, reproductive performance increases with advancing age but mechanisms involved in such a pattern remain poorly studied. One potential mechanism may be the hormonal stress response, which shifts energy investment away from reproduction and redirects it towards survival. In birds, this stress response is achieved through a release of corticosterone and is also accompanied by a decrease in circulating prolactin, a hormone involved widely in regulating parental cares.

It has been predicted that, when the value of the current reproduction is high relative to the value of future reproduction and survival, as it is expected to be in older adults, the stress response should be attenuated to ensure that reproduction is not inhibited.

We tested this hypothesis by measuring the corticosterone and prolactin responses of known‐age (8–36 years old) incubating snow petrels (Pagadroma nivea) to a standardized capture/handling stress protocol. We also investigated whether an attenuation of the stress responses will correlate with a lower occurrence of egg neglect, a frequently observed behaviour in snow petrels.

The probability of successfully fledging a chick increased from 6 years to 12 years before stabilizing after 12 years of age. Corticosterone response to stress was unaffected by age. Prolactin response to stress, however, was influenced clearly by age: in both sexes older breeders had higher stress‐induced prolactin levels than younger ones. This was due to an increasing attenuation of the prolactin response to stress with advancing age in females, and in males this was due to a probably higher intrinsic capacity of older males to secrete prolactin. Moreover, higher stress‐induced prolactin levels were correlated with a lower probability of neglecting the egg.

In young breeders, the combination of a robust corticosterone increase with a lower ability to maintain prolactin secretion during acute stress is probably one of the functional causes of their lower incubation commitment. We suggest that the ability to maintain a threshold level of prolactin during a stressful situation may be an important physiological mechanism involved in the improvement of reproductive performance with advancing age in long‐lived birds.
Effect of an evidence‐based education programme on ED discharge advice for febrile children
Authors: Considine Julie , Brennan Denise
Published: August 2007

Aims.  This study aimed to examine the effect of an educational intervention on discharge advice given to parents leaving the emergency department with a febrile child.

Background.  Childhood fever is a common reason to seek emergency care. Many children are discharged from the emergency department with fever as a significant component of their illness; therefore, it is vital that emergency department medical and nursing staff provide accurate and reliable information about childhood fever management.

Design.  A pre/post‐test design was used. The outcome measure was parental advice regarding paediatric fever management and the intervention for the study was an educational intervention for emergency department nursing staff that consisted of two tutorials. Data were collected using structured telephone interviews.

Results.  Data were collected from 22 families during the pretest period and 18 families during the post‐test period. The number of parents leaving the emergency department with no advice decreased by 48% (p = 0·002). Reports of written advice increased by 69·7% (p < 0·001) and there was a 38·4% increase in reports of verbal advice (p = 0·014). Parents leaving the emergency department with both written and verbal advice increased from 0 to 55·6% (p < 0·001). Reports of advice by nursing staff increased by 52% (p < 0·001) and there were significant increases in specific instructions related to oral fluid administration (22·7 vs. 77·8, p = 0·001) and use of antipyretic medications (27·2 vs. 77·8, p = 0·001).

Conclusion.  Evidence‐based education of emergency nurses improved both the amount and quality of discharge advice for parents of febrile children.

Relevance to clinical practice.  Parents and health care professionals alike need to better understand the physiological benefits of fever and the potential harmful effects of aggressive and often unwarranted treatment of fever.
An exploration of the smoking‐related health beliefs of older people with chronic obstructive pulmonary disease
Authors: Schofield Irene , Kerr Susan , Tolson Debbie
Published: August 2007

Aim.  To explore the smoking‐related health beliefs of older people with chronic obstructive pulmonary disease (COPD).

Background.  Globally, smoking is a major cause of COPD and symptoms present typically mid to later life. Substantial numbers of people with COPD continue to smoke even though smoking cessation is known to slow the rate of disease progression and prevent further deterioration in lung function. There is evidence to suggest that, although older long‐term smokers can successfully quit smoking with the help of specialist structured programmes, those with COPD find it more difficult to achieve sustained cessation. An understanding of the health beliefs of people with COPD will assist professionals to provide the most appropriate support with cessation attempts.

Design.  A secondary analysis of qualitative interview data.

Methods.  Twenty‐two current and former smokers with COPD who used the outreach service of an inner city hospital in Scotland were interviewed in their own homes using semi‐structured interviews which were transcribed verbatim. The main concepts of the Health Belief Model were used as an analysis framework.

Findings.  Interviews were carried out with 15 women and seven men with a median age of 68 years. Almost 90% lived in areas of the highest socio‐economic deprivation according to DEPCAT scores. Almost two‐thirds of the individuals in this study continued to smoke even though they largely perceived smoking as a threat to health. Individuals who continued to smoke cited various barriers to quitting smoking and all had, at some time, attempted smoking cessation. Over half were still attempting to quit. Cues to action came from external sources rather than increasing disease severity.

Conclusions.  Cessation is challenging and knowledge of a person's health beliefs is a prerequisite to supporting behaviour change.

Relevance to clinical practice.  Findings emphasize the need for frontline health professionals to reflect on their current practice with a view to providing sustained encouragement and support towards smoking cessation and relapse prevention for people with COPD.
Daily life after moving into a care home – experiences from older people, relatives and contact persons
Authors: Andersson Ingegerd , Pettersson Elisabet , Sidenvall Birgitta
Published: August 2007

Aims and objectives.  To describe older people's experiences of daily life at the care home after admittance with respect to their perceptions of participation in the decision to move. Furthermore, the aim was to study the experiences of their relatives and contact persons with respect to the daily life of the same residents.

Background.  When older persons move into a care home, the whole family often play an important part. Thus, it is interesting to study how newly admitted older people, their relatives and staff members experience daily life in a modern care home.

Methods.  Qualitative design. The participants comprised a purposive sample of 13 residents, recently admitted to a care home, 69–90 years old, both single living and married, both moving from their own homes and from different institutions. Interviews were carried out with the older people (n = 13), their relatives (n = 10) and contact persons (n = 11).

Results.  The majority of the residents reported satisfaction with care home living. The relatives were also satisfied, secure and appreciated the privacy and homely atmosphere of the flat. The disadvantage of one‐room flats was that the residents might have felt lonely. The relatives felt that the residents were bored, but few residents desired more activities, even if some of them longed for people to socialize with. For many older people, perhaps talking is the most important ‘activity’ at care homes. Concerning self‐determination, some residents did not find it satisfactory.

Relevance to clinical practice.  Staff members must pay attention to residents’ need to talk with people. For many older people, talking is perhaps the most important ‘activity’ at care homes. Nurses must safeguard residents’ self‐determination. When residents are in control of their lives, they may become satisfied with time.
Bipolar gene flow in deep‐sea benthic foraminifera
Authors: PAWLOWSKI J. , FAHRNI J. , LECROQ B. , LONGET D. , CORNELIUS N. , EXCOFFIER L. , CEDHAGEN T. , GOODAY A. J.
Published: August 2007

Despite its often featureless appearance, the deep‐ocean floor includes some of the most diverse habitats on Earth. However, the accurate assessment of global deep‐sea diversity is impeded by a paucity of data on the geographical ranges of bottom‐dwelling species, particularly at the genetic level. Here, we present molecular evidence for exceptionally wide distribution of benthic foraminifera, which constitute the major part of deep‐sea meiofauna. Our analyses of nuclear ribosomal RNA genes revealed high genetic similarity between Arctic and Antarctic populations of three common deep‐sea foraminiferal species (Epistominella exigua, Cibicides wuellerstorfi and Oridorsalis umbonatus), separated by distances of up to 17 000 km. Our results contrast with the substantial level of cryptic diversity usually revealed by molecular studies, of shallow‐water benthic and planktonic marine organisms. The very broad ranges of the deep‐sea foraminifera that we examined support the hypothesis of global distribution of small eukaryotes and suggest that deep‐sea biodiversity may be more modest at global scales than present estimates suggest.
The California Hotspots Project: identifying regions of rapid diversification of mammals
Authors: DAVIS EDWARD BYRD , KOO MICHELLE S. , CONROY CHRIS , PATTON JAMES L. , MORITZ CRAIG
Published: August 2007

The high rate of anthropogenic impact on natural systems mandates protection of the evolutionary processes that generate and sustain biological diversity. Environmental drivers of diversification include spatial heterogeneity of abiotic and biotic agents of divergent selection, features that suppress gene flow, and climatic or geological processes that open new niche space. To explore how well such proxies perform as surrogates for conservation planning, we need first to map areas with rapid diversification —‘evolutionary hotspots’. Here we combine estimates of range size and divergence time to map spatial patterns of neo‐endemism for mammals of California, a global biodiversity hotspot. Neo‐endemism is explored at two scales: (i) endemic species, weighted by the inverse of range size and mtDNA sequence divergence from sisters; and (ii) as a surrogate for spatial patterns of phenotypic divergence, endemic subspecies, again using inverse‐weighting of range size. The species‐level analysis revealed foci of narrowly endemic, young taxa in the central Sierra Nevada, northern and central coast, and Tehachapi and Peninsular Ranges. The subspecies endemism‐richness analysis supported the last four areas as hotspots for diversification, but also highlighted additional coastal areas (Monterey to north of San Francisco Bay) and the Inyo Valley to the east. We suggest these hotspots reflect the major processes shaping mammal neo‐endemism: steep environmental gradients, biotic admixture areas, and areas with recent geological/climate change. Anthropogenic changes to both environment and land use will have direct impacts on regions of rapid divergence. However, despite widespread changes to land cover in California, the majority of the hotspots identified here occur in areas with relatively intact ecological landscapes. The geographical scope of conserving evolutionary process is beyond the scale of any single agency or nongovernmental organization. Choosing which land to closely protect and/or purchase will always require close coordination between agencies.
Lipopopeptidephosphoglycan from Entamoeba histolytica activates human macrophages and dendritic cells and reaches their late endosomes
Authors: VIVANCO‐CID H. , ALPUCHE‐ARANDA C. , WONG‐BAEZA I. , ROCHA‐RAMÍREZ L. M. , RIOS‐SARABIA N. , ESTRADA‐GARCIA I. , VILLASIS‐KEEVER M. A. , LOPEZ‐MACIAS C. , ISIBASI A.
Published: August 2007

Lipopopeptidephosphoglycan (LPPG) is a complex macromolecule from the surface of Entamoeba histolytica trophozoites. We analysed the interaction between LPPG and human macrophages and dendritic cells (DCs) and found that LPPG is internalized by these cells and activates them. The internalization process involves intracellular traffic from the cell membrane to late endosomes, as shown by co‐localization of LPPG with late endosomes marked with FITC‐dextran and LAMP‐1. LPPG‐activated DCs have increased expression of co‐stimulatory molecules CD80, CD86 and CD40 and produce pro‐inflammatory cytokines TNF‐α, IL‐8 and IL‐12. Taken together, these results show that LPPG activates antigen‐presenting cells and reaches intracellular compartments that are involved in antigen presentation.
Production of soluble recombinant proteins with Kell, Duffy and Lutheran blood group antigen activity, and their use in screening human sera for Kell, Duffy and Lutheran antibodies
Authors: Ridgwell K. , Dixey J. , Scott M. L.
Published: August 2007

summary The aim of this study was to show that soluble recombinant (sr) proteins can mimic blood group antigens and be used to screen human sera for blood‐group‐specific antibodies. The blood of all pregnant women and pretransfusion patients should be screened for blood‐group‐specific antibodies to identify and monitor pregnancies at risk of haemolytic disease of the foetus and newborn (HDFN), and to prevent haemolytic transfusion reactions. Current antibody screening and identification methods use human red blood cell panels, which can complicate antibody identification if more than one antibody specificity is present. COS‐7 cells were transfected to produce sr forms of the extracellular domains of the red blood cell membrane proteins that express Kell, Duffy or Lutheran blood group antigens. These sr proteins were used to screen for and identify anti‐Kell, anti‐Duffy or anti‐Lutheran blood‐group‐specific allo‐antibodies in human sera by haemagglutination inhibition and in solid‐phase enzyme‐linked immunosorbent assays (ELISAs). There is a positive correlation (correlation coefficient 0·605, P value 0·002) between antibody titre by standard indirect antiglobulin test (IAT) and signal intensity in the ELISA test. This work shows that sr proteins can mimic blood group antigens and react with human allogeneic antibodies, and that such proteins could be used to develop solid‐phase, high‐throughput blood group antibody screening and identification platforms.
Olivine‐spinifex basalt from the Tamba Belt, southwest Japan: Evidence for Fe‐ and high field strength element‐rich ultramafic volcanism in Permian Ocean
Authors: Ichiyama Yuji , Ishiwatari Akira , Koizumi Kazuto , Ishida Yoshito , Machi Sumiaki
Published: August 2007

Abstract  Permian basalt showing typical spinifex texture with >10 cm‐long olivine pseudomorphs was discovered from the Jurassic Tamba accretionary complex in southwest Japan. The spinifex basalt occurs as a river boulder accompanied by many ferropicritic boulders in a Permian chert‐greenstone unit. Groundmass of this rock is holocrystalline, suggesting a thick lava or sill for its provenance. Minor kaersutite in the groundmass indicates a hydrous magma. The spinifex basalt, in common with the associated ferropicritic rocks, is characterized by high high field strength element (HFSE) contents (e.g. Nb = 62 ppm and Zr = 254 ppm) and high‐HFSE ratios (Al2O3/TiO2 = 3.9, Nb/Zr = 0.24 and Zr/Y = 6.4) unlike typical komatiites. The spinifex basalt and ferropicrite might represent the upper fractionated melt and the lower olivine‐rich cumulate, respectively, of a single ultramafic sill (or lava) as reported from the early Proterozoic Pechenga Series in Kola Peninsula. Their parental magma might have been produced by hydrous melting of a mantle plume that was dosed with Fe‐ and HFSE‐rich garnet pyroxenite. The spinifex basalt is an evidence for the Pechenga‐type ferropicritic volcanism taken place in a Permian oceanic plateau, which accreted to the Asian continental margin as greenstone slices in Jurassic time.
Variation of crustal thickness in the Philippine Sea deduced from three‐dimensional gravity modeling
Authors: Ishihara Takemi , Koda Keita
Published: August 2007

Abstract  Crustal thickness of the northern to central Philippine Sea was gravimetrically determined on the simple assumption of four layers: seawater, sediments, crust and lithospheric mantle, with densities of 1030, 2300, 2800 and 3300 kg/m3, respectively. As for the correction of the regional gravity variation, a 15 km difference of the lithospheric thickness with a density difference of 50 kg/m3 against the asthenosphere below between both sides of the Kyushu‐Palau Ridge was taken into consideration. Mantle Bouguer anomalies were calculated on the assumption of constant crustal thickness of 6 km, and then the crustal thickness was obtained by three‐dimensional gravity inversion method. The results show occurrence of thin crust areas with a thickness of approximately 5 km in the southern part and at the western margin of the Shikoku Basin and also of thick crust areas in the northwestern and northeastern parts of the Parece Vela Basin. We suggest that these are because of the variation of magma supply at the time of sea floor spreading in the Shikoku and Parece Vela Basins, which is possibly related to the variation of spreading rate and enhanced magmatism near the past arc volcanic fronts. The results further show the occurrence of crust thinner than 5 km in the northeastern part of the West Philippine Basin, of crust thicker than 15 km in the Amami Plateau, the Daito and Oki‐Daito Ridges, and also in the northern part of Kyushu‐Palau Ridge, whereas the southern part of the Kyushu‐Palau Ridge the crust is thicker than 10 km. It was also inferred that small basins in the Daito Ridge province have the thinnest oceanic crust of less than 5 km in the Kita‐Daito Basin.
The pH Measurement of Fasting Gastric Juice in Acute Gastric Mucosal Lesions
Authors: ITO Go , KANEKO Eizo , SAKAKIBARA Terue , TAKEUCHI Yasushi , KITAHARA Hirofumi , KOBASHI Hiroshi , ARAKI Atsushi , TOKUNAGA Tadashi , HASEGAWA Jun , KOBAYASHI Nagaharu , INOUE Kiyoshi
Published: August 2007

Abstract: Fasting gastric juice acidity was assessed to elucidate its role in the cause of acute gastric mucosal lesions (AGML). Gastric juice was aspirated through an auxiliary endoscopic channel during routine endoscopic examinations, and its pH was measured with a glass electrode PH meter. The pH of 100 cases with AGML (acute hemorrhagic erosions (AHE), acute gastric ulcer and acute hemorrhagic gastritis), and 586 cases with other ulcerative or inflammatory lesions were compared with the gastric juice pH in 1775 endoscopically normal subjects. The pH value was classgied into four acid groups: Hyperacidity (pH < 1.4), Normoacidity (1).5 < pH < 2.0), Hypoacidity (2).1 < pH <4.0) and Anacidity (4). 1 < pH). In cases with AHE, a signifcant hyperacidity was recognized both in the periods preceding and just after the onset. This hyperacidity was followed by signgicant anacidity, and thereafter a return to normoacidity. These pH changes coincided well with endoscopic appearances; preceding stage‐hypernormacidity, black‐slough stage—hyperacidity, white‐slough stage‐anacidity and scarring stage‐;normoacidity. These results suggest that an elevation of gastric acidity etiologically relates with the formation of AGML, especially Shin.
Combined Non‐Surgical Treatment with Transileocolic Obliteration and Endoscopic Injection Sclerotherapy for Esophageal and Gastric Varices
Authors: TORIYA Hiroshi , MAESHIRO Kensei , YOSHIMURA Sigeaki , SHIRAI Zentaro , ARIMA Sumitaka , SHIMURA Hidehiko , OYAMA Youichi , NAKAOKA Kouichi , KOKAWA Hiroshi , TOKUMITSU Hideo , SAKAGUCHI Seigo , OKUMURA Makoto , OKAZAKI Masatoshi
Published: August 2007

Abstract: Clinical results associated with the combined treatment of endoscopic injection sclerotherapy (EIS) followed by transileocolic obliteration (TIO) for esophageal of gastric varices were evaluated in 31 patients. Twenty patients underwent emergency treatment, and 11 underwent non‐ememgency treatment. No fatal complications developed after this combined treatment.
Endoscopic Diagnosis of Early Malignant Lymphoma of the Stomach
Authors: MISUMI Atsunobu , YOSHINAKA Ichiro , HARADA Kazunori , MURAKAMI Akitoshi , KAKO Hirofumi , HONMYO Ubehiko , OHSHIMA Shigeki , SUGIYAMA Makio , SUKO Hironobu , SUKO Shuji
Published: August 2007

Abstract: The findings and results obtained by endoscopies and direct vision biopsies carried out in 13 patients with early primary gastric lymphoma, were compared with those of 8 patients with RLH, 28 with depressed type of early gastric carcinoma, and 10 patients with benign gastric ulcers, to deal with problems inherent to endoscopic diagnosis of early primary gastric lymphoma

The first endoscopy attained a correct diagnosis in only 1 patient (7.7%) but in 7 patients (53.8%) with the final endoscopy. Endoscopic features of early gastric lymphoma characteristically yielded a cobblestone appearance and reticulated erosion when they were compared with that of RLH, early carcinoma and benign ulcer. Furthermore, early gastric lymphoma presented ill demarcated margins associated with discoloration of the mucosa more frequently comparing with that of early gastric carcinoma. Also, hemorrhage, lustrous nodules, regulalr and white‐coated ulcer were the findings more frequently seen in early gastric lymphoma but redness was less frequent in early gastric carcinoma. Dye endoscopies provided a more detailed appearance of the lesion and margins than conventional endoscopies. In addition, dye endoscopies made visible the lesions that were not visible by conventional endoscopies, in areas repelling dye solution.

In this paper, the importance to pay an attention to the endoscopic findings described above and an application of dye endoscopy was emphasized for detection of an early gastric lymphoma.
Clinical Evaluation of Endoscopic Ultrasonogrphy in Diagnosis of Submucosal Tumor of the Upper Alimentray Tract
Authors: MATSUMOTO Jun , NAKASHIO Kazuaki , YOSIKAWA Junichi , TANAKA Keizo , SHIBUE Tadashi
Published: August 2007

Abstract: The usefulness and the problems of endoscopic ultrasonograpy (EUS) in the diagnosis of submucosal tumors (SMT) of the upper alimentary tract were evaluated in this study. EUS was carried out in 86 cases with SMT of the stomach. Tumors of 13 cases was confirmed histologically (leiomyoma in 7 cases, leiomyosarcoma in one, lipoma in 2, gastric cyst in one, aberrant pancreas in one and Schwannoma in one case). In only one out of 22 cases with SMT of the esophagus, the tumor was surgically resected and a pathological examination revealed leiomyoma

EUS was useful in estimating the histological origin of SMT by observation of the relationship between the location of the tumor and each layer in the gastric or esophageal wall. However, it was imposible to differentiate leiomyoma from leiomyosarcoma in myogenic tumors through the echoic pattern of the tumor by EUS alone at the present time.

EUS was also useful in distinguishing the cause of extragastric compression showing similar findings with SMT, which could not be clarified by X‐ray or endoscopic examination. In fact, organs compressing the stomach were easily clarified by EUS. It was decided that EUS should be performed in all cases whenever there is any doubt of SMT existing after an X‐ray or endoscopic examination.
Ascending Colon Stenosis:A Rare Presentation of Perforated Appendicitis
Authors: KAKEI Nobuyuki , MIKI Kazumasa , KIMURA Masayoshi , ICHINOSE Masao , HOSHINO Etsuo , SANO Junjiro , KAWAMURA Norio , TASHIRO Takao , MATSUSHIMA Masashi , KUROKAWA Kiyoshi , HASHIMOTO Daijo , IDEZUKI Yasuo
Published: August 2007

Abstract: Described is a 49‐year‐old Japanese male who developed an ascending colon stenosis secondary to perforated appendicitis. The patient was examined at our hospital because of an abdominal pain and the presence of a firm mass in the right flank. A barium enema and colonoscopic examination revealed an ascending colon stenosis with multiple nodular elevations. On laparotomy, an inflammatory mass, originating from a ruptured appendix, was found adhered to the cecum and the ascending colon. Thus, a right hemicolectomy was performed. Microscopic examination revealed a periappendiceal abscess with marked submucosal fibrosis and lymphoid hyperplasia of the ascending colon and cecum.

Large intestinal stenosis is a rare complication of appendicitis, and there have been only a few reported cases involving the ascending and sigmoid colon, and the rectum. In these cases, however, the polypoid lesions as seen in our case have never been described. In reviewing the literature, we found only two other cases in which a coarse or a polypoid lesion, similar to our case, was noted in the cecum, though the mucosal change was localized and luminal stenosis did not occur. Thus, when a patient with an ascending colon stenosis is encountered, a possibility of periappendiceal abscess must be kept in mind.
Gastric Cancer Developing in a Patient with Chronic Lymphocytic Leukemia with Massive Gastrointestinal Involvement
Authors: MATSUHASHI Nobuyuki , URABE Akio , OHNISHI Shin , OHNISHI Mayumi , KONDO Yukio , SUGANO Kentaro , TAKAKU Fumimaro
Published: August 2007

Massive infiltration of neoplastic lymphocytes caused a variety of gross gastrointestinal manifestations in a 71‐year‐old patient with chronic lymphocytic leukemia (CLL). These included plaque‐like elevations in the esophagus, convoluted gyrus‐like folds in the stomach, and many polypoid lesions in the stomach and duodenum. No gross lesions were noted in the large intestine. Four years later, systemic chemotherapy reduced the gastrointestinal involvement, but a papillary elevation grew at the gastric angle, which was shown to be an early cancer on histological examination. Gastrointestinal involvement in CLL and second cancers associated with CLL are reviewed, with special reference to the possible relationship between CLL and gastric cancer.
Endoscopic Retrospective Study on Gastric Malignant Lymphoma—with Special Reference to the Appearance of the Initial Lesion—
Authors: AMANO Yuji , ISHIHARA Shunji , TAKATORI Yoshimasa , IMAOKA Tomonori , WATANABE Makoto , FUKUMOTO Shiro
Published: August 2007

An endoscopic retrospective study was performed on five lesions in four patients with gastric malignant lymphoma, in order to elucidate the characteristics of the initial lesion and the growth process of these lymphomas.

In case 1 (protruding type of malignant lymphoma), an area of small macular redness and a shallow ulcer, which had neither a surrounding elevation due to edema nor the circumscribed redness caused by regenerative epithelium, were observed 23 and 11 months before, respectively, when a cobblestone appearance, indicative of early lymphoma of the stomach, was found. A shallow ulcer was also recognized in the initial stage of the disease in case 2 (giant rugal type). Discolored and lustrous granules were observed as a first endoscopic finding in cases 3 and 4 (ulcerative type). These endoscopic findings were thought to be key findings indicative of gastric malignant lymphoma in the initial stage. For the early diagnosis of gastric malignant lymphoma, a careful follow‐up with a skillfully performed biopsy, i. e. an exactly aimed biopsy using large, sharp‐edged forceps, should be carried out if the findings described above are once observed.
Benign Strictures of the Intrahepatic Bile Ducts Managed with Percutaneous Transhepatic Cholangioscopy: A Case Report
Authors: KUBOTA Yoshitsugu , SEKI Toshihito , YAMAGUCHI Takashi , KUNIEDA Kouji , TANI Kazuhiro , KIN Hideyuki , MIZUNO Takako , SAMESHIMA Yoshiko
Published: August 2007

Benign strictures of the intrahepatic bile ducts were detected, by percutaneous transhepatic cholangioscopy combined with forceps biopsies, in a patient who presented symptoms suggesting cholangitis. The patient was successfully treated by non‐operative stricture dilation techniques, with the aid of cholangioscopy. In this paper, the usefulness of percutaneous transhepatic cholangioscopy for the management of benign biliary strictures is discussed.
Gallbladder Cancer Laparoscopy
Authors: WATANABE Makoto , TAKESHITA Masahiro , TAKATORI Yoshimasa , UEKI Kazunori , UMEKAWA Yasuhiro , HIRAKAWA Hiroyasu , FUKUMOTO Shiro , SHIMADA Yoshihiro
Published: August 2007

The role of laparoscopy in the diagnosis of gallbladder cancer was evaluated. Fifteen patients who were suspected of having gallbladder cancer, following physical examination, laboratory tests, and imaging techniques, received laparoscopy at our clinic, and the laparoscopic findings and histologies were analyzed. Five patients in whom the gallbladder was observed were laparoscopically confirmed as having gallbladder cancer, and in 2 of these cases metastases to the liver were observed. Among the 10 patients in whom the gallbladder could not be observed, metastases to the liver and the peritoneum were observed in 6 and 4 cases, respectively. In 3 cases neither the gallbladder nor metastases to other visceral organs could be observed. Thus, the qualitative rate of laparoscopic diagnosis was 80% (12/15 cases). Five cases (42%) among the 12 cases in which laparoscopy suggested gallbladder cancer, were histologically confirmed after biopsy specimens were obtained. Only one of these cases was diagnosed by direct forceps biopsy of the gallbladder wall.
A Clinicopathological Study of IIa +IIc Type Early Colorectal Cancer with Massive Submucosal Invasion
Authors: OKAMURA Shozo , ASAI Toshio , YAMAGUCHI Hatsuhiro , HAMAJIMA Eiji , KATOH Tadashi , SHIMODAIRA Masaya , ITOH Hisayoshi
Published: August 2007

Abstract: The authors investigated clinical data and pathological findings of eight cases of IIa+IIc type early colorectal cancer which showed minimal invasion in the mucosal laver, but massive invasion in the submucosal layer (deep invasion type). The average age of these 8 patients was 57.8 years (6 out of 8 cases were between 55 and 61‐years‐old). 6 patients were males; 2 were females. Five patients were asymptomatic with a positive reaction for fecal occult blood; the other 2 had anal bleeding. All but 1 patient were diagnosed as having the IIa+IIc type of cancerous lesion, by barium enema examination and colonoscopy. Five patients had lesions in the sigmoid colon, 2 had lesions in the rectum, and 1 had a lesion in the ascending colon. The maximum lesion diameters ranged from 5 to 25 mm, averaging 15.9 mm. Six lesions were less than 20 mm in maximum diameter; 3 of these were less than 10 mm. Pathologically, 5 cases were moderately differentiated adenocarcinoma, 2 were well differentiated adenocarcinoma, and one was poorly differentiated adenocarcinoma. None of the lesions had a coexisting adenomatous component. The incidence of lymph node metastasis was considerably higher than expected (2 out of 8 cases) for early invasive colorectal cancer.

Our results suggest that the deep invasion type of early colorectal cancers (which probably arise de novo) are, though small as a rule, considered to have great potential to be malignant.
A Clinical Study on Colitis Found during Total Colonoscopy Screening for Colorectal Cancer
Authors: IKUMA Hitoshi , MITSUSHIMA Toru , NAGATANI Kyohei , ARIMA Nobuyuki , YOKOTA Toshihiro , MINAMIHARA Yoshikazu , TSUDA Sumio , OHASHI Shigeki , TANOUE Yoichi , HOJO Atsushi , YOKOUCHI Keiji , ABE Yosuke , KOKUBO Takeshi
Published: August 2007

Abstract: Colitis was found in 302 out of 5803 patients (5.2%) who underwent colonoscopy for the first time. Unclassified colitis (with slight edema, hemorrhage etc.) accounted for 89.1 % of these cases. Most of the colitis (93 cases, 40.1 %) was found to affect the sigmoid colon, followed, in order of decreasing frequency, by the rectum, cecum, transverse colon, descending colon and ascending colon. A comparison of the percentage revealed that of colitis found in two groups which were given different pre‐treatments, 80 out of 3280 cases (2.4%) were found among those examinees pre‐treated by the modified Brown method (B‐method), while 152 out of 2513 cases (6.0%) were found in those pre‐treated by the PEG oral lavage method (P‐ method). About 40% of the diagnosed colitis cases were free from symptoms (diarrhea, abdominal pain, etc.); the results of the guaiac test on their stool samples were negative. We hypothesized that, in these cases, signs of colitis were actually pretreatment‐induced artifacts. No significant differences were found among groups with regard to sex and age, nor was the fraction of colitis cases represented by artificial colitis significantly different between pre‐treatment groups.
Evaluation of Endoscopic Naso‐biliary Drainage Established without Endoscopic Sphincterotomy for Malignant Obstructive Jaundice
Authors: NAKATSU Toshiaki , HIRABAYASHI Shuko , NISHIOKA Mikio
Published: August 2007

Abstract: Endoscopic naso‐biliary drainage (ENBD) without endoscopic sphincterotoyny (ES) was carried out using 7.2 Fr naso‐biliary tubes in 36 patients with malignant obstructive jaundice. The success rate of this method was SO .4% (37/16 cases). The effectiveness of ENBD without ES in terms of lowering total bilirubin values was good or excellent in 24 out of 29 cases (82.8%). Complications were observed in 1 out of 37 cases (10.8%);fortunately, none were as severe as perforation or bleeding. After ENBD established without ES serum amylase levels increased makcdly in 7 cases (17.9%), but these increases were transient and decveased vapidly.

Endoscopic internal bilio‐duodenal drainage established without ES was also successfully performed, using 10 or 12 Fr endoprosthetic tirbes, in 6 cases of malignant obstructive jaundice. Amylase levels after this procedure did not show any significant elevation. This fact suggests that compression of the pancreatic orifice by the naso‐biliary tube dose not cause hyperamylaseynia.

Endoscopic biliary drainage established without ES is an effective, safe, and simple method which can be applied to patients with malignant obstructive jaundice.
The Double Contrast Method by Endoscopic Transpapillary Catheterization in the Gallbladder
Authors: HIRABAYASHI Shuko , NAKATSU Toshiaki , NISHIOKA Mikio
Published: August 2007

Abstract: Endoscopic transpapillary catheterization in the gallbladder was attempted in 18 cases and double contrast images of the gallbladder was successfully obtained in 10 cases. In a case with a polypoid lesion, its edge and surface were nicely delineated by this method, but it was still hard to distinguish it from malignant lesions. Precise identification of tiny stones which will be easily missed by conventional ERC was made using this method. As for technology obtaining good cholecystgrams, sufficient aspiration of bile was considered to be important. Our experience with this quite new technique suggested that this method is effective in making an accurate diagnosis of gallbladder diseases. We named it double contrast images of the gallbladder by endoscopic transpapillary catheterization in the gallbladder (ETCG).
A Case of Extensive Gastrointestinal Involvement of Malignant Lymphoma Associated with Early Gastric Carcinoma
Authors: KAKEI Nobuyuki , MIKI Kazumasa , KIMURA Masayoshi , SANO Junjiro , ICHINOSE Masao , HOSHINO Etsuo , KAWAMURA Norio , TASHIRO Takao , MATSUSHIMA Masashi , KUROKAWA Kiyoshi
Published: August 2007

Abstract: Described is a 59 year old Japanese man With malignant lymphoma involving the stomach, duodenum, terminal ileum, colon and rectum, who developed early gastric carcinoma. Repeated gastroduodenoscopy revealed various appearances of the gastrointestinal involvement in malignant lymphoma, such as giant folds, polypoid lesions, and ulcerations, in addition to a depressed lesion of early gastric carcinoma. Colonoscopy also showed multiple polypoid lesions throughout the large bowel. Though the gastrointestinal involvement in malignant lymphoma is not rare, diffuse multiple polypoid lesions in the entire large bowel as seen in our case have rarely been endoscopically described.

The coexistance of malignant lymphoma and gastric carcinoma in our case might be only a coincidence, though some reports of an increasing incidence of second tumors in patients with malignant lymphoma have been published. Further consideration will be needed as to the relationship between malignant lymphoma and the occurence of a second malignancy.
The Specificity of the Penetrating and the Superficial Spreading Types of Early Gastric Cancer—Classification of Early Gastric Cancer Using the Interactive Image Analysis System—
Authors: HIRAYAMA Daisuke , FUJIMORI Takahiro , SATONAKA Kazuhiro , NAKAMURA Tetsuya , GOTOH Akinobu , TOKUDA Yoshio , TERAMOTO Tadahisa , KITAZAWA Souhei , HORIO Mitsuzou , MAEDA Sakan , ARAO Mototsugu , NAGASAKO Kou
Published: August 2007

Abstract: Specific types of early gastric cancer were investigated in accordance with the cancer surface area and the degree of penetration by means of quantitative measurements of the surface area of early gastric cancer using the interactive image analysis system.

The results indicated a significant correlation between the surface area and the penetration depth in ordinary early gastric cancer. However these correlations were not observed in both well and poorly differentiated adenocarcinoma cases of the so‐called PEN and SUPER types, which showed a significant specificity when compared with ordinary early gastric cancer. The PEN and SUPER types of early gastric cancer also exhibited various clinicopathological characteristics, and it was suggested that the poorly differentiated PEN type might be the initial lesion of a linitis plastica type gastric cancer.

Examination of the conditions of the mucosa surrounding the cancer revealed a difference between the PEN and the SUPER types, and this suggested that the environment at the site of a cancer growth influences the type of growth and the spread of early gastric cancer.
Clinico‐pathological Evaluation of Repeated Intratumoral Injection Therapy of OK‐432 for Inoperable Gastric Carcinomas
Authors: OCHIAI Masahiro , FUNABIKI Takahiko , AMANO Hiroshi , FUJITA Shinji , KAMEI Katsuhiko , FUTAWATARI Hisatomo
Published: August 2007

Abstract: Fifteen patients with inoperable gastric cancer underwent repeated intratumoral injections of OK‐432, a streptococcal preparation, through an endoscope. Seven patients showed a reddened tumor surface following the initial two or three injections, and in most of these a remarkable change in configuration followed. Two of these patients showed complete macroscopic disappearance of the tumor and three had a marked reduction, while eight patients in who no color change initially appeared later showed no or minor morphological changes. Finally, five among fifteen patients showed excellent local responses, and rate of effectiveness was estimated as 33.3%. There seemed to be no correlation between the effectivity and the patient's background factors. In ten patients for who serial histological findings were obtained by biopsy, inflammatory cellular infiltration to the tumor parenchyma had apparently increased. Among these, plasma cell was predominant in five patients, while lymphocytic predominancy was seen in three and neutrophil predominancy was seen in two patients. The rate of effectiveness was the highest in the plasma cell dominant patients. The systemic immunological responses were determined by measuring skin tests for delayed hypersensitivity and phytomitogen blastogenesis which failed to reveal a significant enhancement of the reactivity except in the case of the PPD skin test. In terms of the survival rate, there was no significant difference between these patients and patients who were otherwise treated. However, among the patients who received injections of OK‐432, a prolonged survival rate was obtained in patients with a good local response compared with those who had a poor response or no response.
Acute Gastric Mucosal Lesion in the Aged
Authors: KATSUBE Takao , OGAWA Kenji , ISHIKAWA Shinya , INABA Shunzo , NARITAKA Yoshihiko , YAGAWA Hirokazu , HAGA Shunsuke , KAJIWARA Tetsuro , KAMEI Fumie , KOKUHO Michiko , OI Itaru , KATAYAMA Osamu , ICHIOKA Shisho
Published: August 2007

Abstract: Over a period of 3 years between August 1985 and July 1988, 110 patients (male/female ratio, 64: 46, age range 22–89 years, mean 48.1 years) were diagnosed endoscopically as having acute gastric mucosal lesion (AGML). These patients were divided into an elderly group (60 years or more, 26 patients) and a younger group (less than 60 years, 84 patients). The chief complaint, the precipitating factors, the location of the lesion, the disease type, the background gastric mucosa and the state of bleeding were compared between the groups. AGMLs in elderly patients were found to have the following characteristic features. The chief complaints included hematemesis and melena, and oral drugs were the precipitating factor in many patients. The lesion often occurred in the body or whole area of the stomach, and was found to be relatively rare in the vestibule. An acute gastric ulcer was the most frequent clinical finding. The background gastric mucosa was rated C‐II or more severe in most cases. Overt bleeding was present in many cases, requiring endoscopic hemostasis.
Effects of Endoscopic Injection Sclerotherapy for Esophageal Varices on the Reflux Prevention Mechanisms of the Lower Esophageal Sphincter
Authors: SUZUKI Satoshi , FUJITA Rikiya , TAKAHASHI Hiroshi , FUJITA Yasuyuki , SUGATA Fumio
Published: August 2007

Abstract: Lower esophageal sphincter pressure (LESP) was measured before and after endoscopic injection sclerotherapy (EIS) in 41 patients with esophageal varices in order to evaluate the effects of the therapy on the reflux prevention mechanisms. LESP was measured by the infusion method before, upon completion of EIS and 6 months after EIS. The magnitude of the decreases in LESP were significantly greater in patients who had ulcers following EIS than in those who did not. A close correlation was noted between the incidence of clinical symptoms of reflux esophagitis (such as heartburn and retrosternal pain), ulcer formation and decreases in LESP. This finding suggests that ulcer formation by EIS affects the reflux prevention mechanisms of the lower esophageal sphincter. However, disorders of the lower esophageal sphincter seem, transient and also reversible because decreases in LESP recovered and the patients' clinical symptoms improved within 6 months of the EIS.