bluuebunny/crossref_metadata_2025 huggingface dataset:
Pyrazolo[3,4-b]pyridine in heterocyclic synthesis: synthesis of new pyrazolo[3,4-b]pyridines, imidazo[1',2':1,5]pyrazolo[3,4-b]pyridines, and pyrido[2',3':3,4]pyrazolo[1,5-a]pyrimidines
Authors: Gad-Elkareem Mohamed A.M , Abdel-Fattah Azza M , Elneairy Mohamed A.A
Published: August 2007

Pyrazolo[3,4-b]pyridine derivatives 7 and 9 were synthesized via the reaction of 3-amino-1H-pyrazolo-[3,4-b]pyridine derivative 2 with ω-bromoacetophenones. Reaction of 7 and 9 with Ac2O afforded the imidazo[1',2':1,5]py razolo[3,4-b]pyridine derivative 8 and pyrazolo[3,4-b]pyridine derivative 10, respectively. Reaction of 2 with chloroacetonitrile followed by DMF-DMA gave imidazo[1',2':1,5]pyrazolo[3,4-b]pyridines 4 and 5, respectively. Acetyl acetone and 1,1-dicyano-2,2-dimethylthioethene were reacted with 2 to afford the pyrido[2',3':3,4]pyrazolo-[1,5-a]-pyrimidines 11 and 14, respectively. Also, 2 reacted with DMF-DMA to yield the formamidine 15, which in turn, reacted with active methylene reagents, yielding the corresponding pyrido[2',3':3,4]pyrazolo[1,5-a]pyrimidines 18 and 23a-23d.Key words: 1H-pyrazolo[3,4-b]pyridines, imidazo[1',2':1,5]pyrazolo[3,4-b]pyridines, pyrido[2',3':3,4]pyrazolo[1,5-a]pyrimidines.
A comparison of the energetic and topological properties of weak interactions in molecular organic crystals
Authors: Wolstenholme David J , Cameron T Stanley
Published: August 2007

Several molecular organic crystals [tetraphenylphosphonium squarate, bianthrone, and bis(benzophenone) azine] have been analyzed topologically following a multipole refinement of each compound. This has resulted in the complete characterization of all the weak interactions present in these systems (C-H···O, C-H···C, and C-Hδ+···δ+H-C). Correlations have been found to exist between the energetic and topological properties for each type of interaction. The coexistence of the three types of interactions provides a unique opportunity to examine their energetic differences and similarities. This examination can also be used to help understand the complex nature of C-Hδ+···δ+H-C type interactions, in particular those characterized as H–H bonds. All this leads to a better understanding of the role H–H bonds play in molecular organic crystals compared with other weak interactions such as hydrogen bonds and van der Waals interactions.Key words: energetics, multipole refinement, H–H bonds, hydrogen bonds.
Efficient preparation of chiral non-racemic sulfur compounds
Authors: Minville Joannie , Girardin Mélina , Spino Claude
Published: August 2007

p-Menthane-3-carboxaldehyde serves as an efficient chiral auxiliary in the preparation of chiral non-racemic S-alkylthiocarbamates or S-dithiocarbonates via the 3,3-sigmatropic rearrangement of the corresponding alkylthionocarbamates or xanthates. The transfer of chirality during rearrangement is complete, and the final products possess a chiral tertiary or quaternary carbon bearing sulfur. The rearranged products are then transformed into enantiopure cyclic or acyclic sulfur-containing products, depending on the means of clivage of the auxiliary. The synthesis of a potent MMP-13 inhibitor is presented.Key words: 3,3-sigmatropic rearrangement, p-menthane-3-carboxaldehyde, S-alkylthiocarbamate, S-dithiocarbonate, alkylthionocarbamate, xanthate, ring-closing metathesis.
ON SIKORA'S SPECTRAL SEQUENCES
Authors: BARNES DONALD W.
Published: August 2007

In his study of Poincaré duality of a space X acted on by a group G, Sikora uses three spectral sequences which he calls the Leray, the Leray–Serre and the Swan spectral sequences. I show that, if G is discrete and X is compact and Hausdorff, then the Alexander–Spanier cohomology versions of these three spectral sequences are isomorphic. If X is also HLC, then all versions of them are isomorphic.
DENSELY ORDERED BRAID SUBGROUPS
Authors: CLAY ADAM , ROLFSEN DALE
Published: August 2007

Dehornoy showed that the Artin braid groups Bn are left-orderable. This ordering is discrete, but we show that, for n > 2 the Dehornoy ordering, when restricted to certain natural subgroups, becomes a dense ordering. Among subgroups which arise are the commutator subgroup and the kernel of the Burau representation (for those n for which the kernel is nontrivial). These results follow from a characterization of least positive elements of any normal subgroup of Bn which is discretely ordered by the Dehornoy ordering.
ON THE TENSOR PRODUCT OF AN ORIENTED QUANTUM ALGEBRA WITH ITSELF
Authors: RADFORD DAVID E.
Published: August 2007

Let A be a finite-dimensional oriented quantum algebra over a field k There an oriented quantum algebra structure on A⊗A which is motivated by an algebra isomorphism of the quantum double D(A) with A⊗A when A has a factorizable Hopf algebra structure.

We describe and study the oriented quantum algebra structure on A⊗A and work it out in detail when A = M 2(k) is the algebra of 2×2 matrices over k and has the oriented quantum algebra structure which gives rise to the Jones polynomial. The resulting 16×16 braiding matrix gives rise to a non-trivial ambient isotopy invariant of oriented links.

Suppose that A is a finite-dimensional factorizable Hopf algebra over k and that the double D(A) has a ribbon element. Then the Hennings invariant of 3-manifolds is defined for D(A) and can be computed in a very natural way terms of an oriented quantum algebra structure on A⊗A. We supply details for future calculations which are developed in [2].
Association of PI3K-Akt signaling pathway with digitalis-induced hypertrophy of cardiac myocytes
Authors: Liu Lijun , Zhao Xiaochen , Pierre Sandrine V. , Askari Amir
Published: August 2007

Our previous studies on cardiac myocytes showed that positive inotropic concentrations of the digitalis drug ouabain activated signaling pathways linked to Na+-K+-ATPase through Src and epidermal growth factor receptor (EGFR) and led to myocyte hypertrophy. In view of the known involvement of phosphatidylinositol 3-kinase (PI3K)-Akt pathways in cardiac hypertrophy, the aim of the present study was to determine whether these pathways are also linked to cardiac Na+-K+-ATPase and, if so, to assess their role in ouabain-induced myocyte growth. In a dose- and time-dependent manner, ouabain activated Akt and phosphorylation of its substrates mammalian target of rapamycin and glycogen synthase kinase in neonatal rat cardiac myocytes. Akt activation by ouabain was sensitive to PI3K inhibitors and was also noted in adult myocytes and isolated hearts. Ouabain caused a transient increase of phosphatidylinositol 3,4,5-trisphosphate content of neonatal myocytes, activated class IA, but not class IB, PI3K, and increased coimmunoprecipitation of the α-subunit of Na+-K+-ATPase with the p85 subunit of class IA PI3K. Ouabain-induced activation of ERK1/2 was prevented by Src, EGFR, and MEK inhibitors, but not by PI3K inhibitors. Activation of Akt by ouabain, however, was sensitive to inhibitors of PI3K and Src, but not to inhibitors of EGFR and MEK. Similarly, ouabain-induced myocyte hypertrophy was prevented by PI3K and Src inhibitors, but not by an EGFR inhibitor. These findings 1) establish the linkage of the class IA PI3K-Akt pathway to Na+-K+-ATPase and the essential role of this linkage to ouabain-induced myocyte hypertrophy and 2) suggest cross talk between these PI3K-Akt pathways and the signaling cascades previously identified to be associated with cardiac Na+-K+-ATPase.
Dynamic blood pressure load and nephropathy in the ZSF1 (fa/facp) model of type 2 diabetes
Authors: Griffin Karen A. , Abu-Naser Mohammad , Abu-Amarah Isam , Picken Maria , Williamson Geoffrey A. , Bidani Anil K.
Published: August 2007

Diabetes and increased blood pressure (BP) are believed to interact synergistically in the pathogenesis and progression of diabetic nephropathy. The present studies were performed to examine if there were differences in BP load and/or protective renal autoregulatory capacity between the obese diabetic Zucker fatty /spontaneously hypertensive heart failure F1 hybrid (ZSF1) ( fa/ facp) rats and their lean controls. By ∼26 wk of age, ZSF1 ( n = 13) but not their lean controls ( n = 16) had developed substantial proteinuria (180 ± 19 vs. 16 ± 1.4 mg/24 h) and glomerulosclerosis (19 ± 2.4 vs. 0.6 ± 0.2%; P < 0.001). However, average ambient systolic BP by radiotelemetry (12–26 wk of age) was modestly lower in ZSF1 than in lean controls (130 ± 1.4 vs. 137 ± 1.7 mmHg, P < 0.002), although the 24-h BP power spectra showed a mild increase at frequencies <0.1 Hz in the ZSF1. Autoregulatory capacity under anesthesia in response to step changes in perfusion pressure between 100 and 140 mmHg was similarly well preserved in both ZSF1 and lean controls at 16–18 wk of age [autoregulatory indexes (AI) <0.1]. Similarly, differences were not observed for dynamic autoregulation in conscious rats [transfer functions between BP (input) and renal blood flow (output) using chronic Transonic flow probes]. Collectively, these data indicate that the pathogenesis of nephropathy in the ZSF1 model of type 2 diabetic nephropathy is largely independent of differences in systemic BP and/or its potential renal transmission. However, these data do not exclude the possibility that the diabetic milieu may alter the glomerular capillaries in the ZSF1, such that there is an enhanced local susceptibility to injury with even normal glomerular pressures.
Applicability of a segmental bioelectrical impedance analysis for predicting the whole body skeletal muscle volume
Authors: Tanaka Noriko I. , Miyatani Masae , Masuo Yoshihisa , Fukunaga Tetsuo , Kanehisa Hiroaki
Published: August 2007

This study aimed to test the hypothesis that a segmental bioelectrical impedance (BI) analysis can predict whole body skeletal muscle (SM) volume more accurately than a whole body BI analysis. Thirty males (19–34 yr) participated in this study. They were divided into validation ( n = 20) and cross-validation groups ( n = 10). The BI values were obtained using two methods: whole body BI analysis, which determines impedance between the wrist and ankle; and segmental BI analysis, which determines the impedance of every body segment in both sides of the upper arm, lower arm, upper leg and lower leg, and five parts of the trunk. Using a magnetic resonance imaging method, whole body SM volume was determined as a reference (SMVMRI). Simple and multiple regression analyses were applied to (length)2/ Z (BI index) for the whole body and for every body segment, respectively, to develop the prediction equations of SMVMRI. In the validation group, there were no significant differences between the measured and estimated SMV and no systematic errors in either BI analysis. In the cross-validation group, the whole body BI analysis produced systematic errors and resulted in the overestimation of SMVMRI, but the segmental BI analysis was cross-validated. In the pooled data, the segmental BI analysis produced a prediction equation, which involves the BI indexes of the trunk and upper thigh as independent variables, with a SE of estimation of 1,693.8 cm3 (6.1%). Thus the findings obtained here indicated that the segmental BI analysis is superior to the whole body BI analysis for estimating SMVMRI.
Aging potentiates the effect of congestive heart failure on muscle microvascular oxygenation
Authors: Behnke Bradley J. , Delp Michael D. , Poole David C. , Musch Timothy I.
Published: August 2007

Congestive heart failure (CHF) is most prevalent in aged individuals and elicits a spectrum of cardiovascular and muscular perturbations that impairs the ability to deliver (Q̇o2) and utilize (V̇o2) oxygen in skeletal muscle. Whether aging potentiates the CHF-induced alterations in the Q̇o2-to-V̇o2 relationship [which determines microvascular Po2 (PmvO2)] in resting and contracting skeletal muscle is unclear. We tested the hypothesis that old rats with CHF would demonstrate a greater impairment of skeletal muscle PmvO2 than observed in young rats with CHF. Phosphorescence quenching was utilized to measure spinotrapezius PmvO2 at rest and across the rest-to-contractions (1-Hz, 4–6 V) transition in young (Y) and old (O) male Fischer 344 Brown-Norway rats with CHF induced by myocardial infarction (mean left ventricular end-diastolic pressure >20 mmHg for YCHF and OCHF). In CHF muscle, aging significantly reduced resting PmvO2 (32.3 ± 3.4 Torr for YCHF and 21.3 ± 3.3 Torr for OCHF; P < 0.05) and in both YCHF and OCHF compared with their aged-matched counterparts, CHF reduced the rate of the PmvO2 fall at the onset of contractions. Moreover, across the on-transient and in the subsequent steady state, PmvO2 values in OCHF vs. YCHF were substantially lower (for steady-state, 20.4 ± 1.7 Torr for YCHF and 16.4 ± 2.0 Torr for OCHF; P < 0.05). At rest and during contractions in CHF, the pressure driving blood-muscle O2 diffusion (PmvO2) is substantially decreased in old animals. This finding suggests that muscle dysfunction and exercise intolerance in aged CHF patients might be due, in part, to the failure to maintain a sufficiently high PmvO2 to facilitate blood-muscle O2 exchange and support mitochondrial ATP production.
Decoding a New Neural–Machine Interface for Control of Artificial Limbs
Authors: Zhou Ping , Lowery Madeleine M. , Englehart Kevin B. , Huang He , Li Guanglin , Hargrove Levi , Dewald Julius P. A. , Kuiken Todd A.
Published: August 2007

An analysis of the motor control information content made available with a neural–machine interface (NMI) in four subjects is presented in this study. We have developed a novel NMI–called targeted muscle reinnervation (TMR)—to improve the function of artificial arms for amputees. TMR involves transferring the residual amputated nerves to nonfunctional muscles in amputees. The reinnervated muscles act as biological amplifiers of motor commands in the amputated nerves and the surface electromyogram (EMG) can be used to enhance control of a robotic arm. Although initial clinical success with TMR has been promising, the number of degrees of freedom of the robotic arm that can be controlled has been limited by the number of reinnervated muscle sites. In this study we assess how much control information can be extracted from reinnervated muscles using high-density surface EMG electrode arrays to record surface EMG signals over the reinnervated muscles. We then applied pattern classification techniques to the surface EMG signals. High accuracy was achieved in the classification of 16 intended arm, hand, and finger/thumb movements. Preliminary analyses of the required number of EMG channels and computational demands demonstrate clinical feasibility of these methods. This study indicates that TMR combined with pattern-recognition techniques has the potential to further improve the function of prosthetic limbs. In addition, the results demonstrate that the central motor control system is capable of eliciting complex efferent commands for a missing limb, in the absence of peripheral feedback and without retraining of the pathways involved.
Slow Brain Potential and Oscillatory EEG Manifestations of Impaired Temporal Preparation in Parkinson's Disease
Authors: Praamstra Peter , Pope Paul
Published: August 2007

Performance in behavioral tasks is influenced by temporal expectations shaped by the temporal structure of the task. Such implicit temporal preparation is reflected in slow brain potentials and electroencephalographic oscillations and is attributed to interval timing mechanisms that probably depend on intact basal ganglia function. We investigated implicit timing in Parkinson's disease using a choice reaction task with two temporally regular stimulus presentation regimes, both including occasional deviant interstimulus intervals. Control subjects, but not patients, demonstrated temporal preparation in the form of an adjustment in time course of slow brain potentials to the duration of the interstimulus interval. However, in both groups, timing perturbations were accompanied by a slow brain potential amplitude drop at the time of expected stimulus occurrence, demonstrating intact representation of time in patients. In patients, oscillatory activity in beta and alpha bands showed attenuated preparatory desynchronization and reduced postmovement event-related synchronization, reflecting abnormal engagement and disengagement of sensorimotor and parietal areas. The results demonstrate profoundly deficient temporal preparation with preserved encoding of temporal information, a dissociation that may be explained by impaired dopamine-dependent motor learning. The results are discussed in the context of recent work on oscillatory activity in the basal ganglia.
A Central Pattern Generator Producing Alternative Outputs: Phase Relations of Leech Heart Motor Neurons With Respect to Premotor Synaptic Input
Authors: Norris Brian J. , Weaver Adam L. , Wenning Angela , García Paul S. , Calabrese Ronald L.
Published: August 2007

The central pattern generator (CPG) for heartbeat in leeches consists of seven identified pairs of segmental heart interneurons and one unidentified pair. Four of the identified pairs and the unidentified pair of interneurons make inhibitory synaptic connections with segmental heart motor neurons. The CPG produces a side-to-side asymmetric pattern of intersegmental coordination among ipsilateral premotor interneurons corresponding to a similarly asymmetric fictive motor pattern in heart motor neurons, and asymmetric constriction pattern of the two tubular hearts: synchronous and peristaltic. Using extracellular techniques, we recorded, in 61 isolated nerve cords, the activity of motor neurons in conjunction with the phase reference premotor heart interneuron, HN(4), and another premotor interneuron that allowed us to assess the coordination mode. These data were then coupled with a previous description of the temporal pattern of premotor interneuron activity in the two coordination modes to synthesize a global phase diagram for the known elements of the CPG and the entire motor neuron ensemble. These average data reveal the stereotypical side-to-side asymmetric patterns of intersegmental coordination among the motor neurons and show how this pattern meshes with the activity pattern of premotor interneurons. Analysis of animal-to-animal variability in this coordination indicates that the intersegmental phase progression of motor neuron activity in the midbody in the peristaltic coordination mode is the most stereotypical feature of the fictive motor pattern. Bilateral recordings from motor neurons corroborate the main features of the asymmetric motor pattern.
Heterogeneous Effects of Dopamine on Highly Localized, Voltage-Induced Ca2+ Accumulation in Identified Motoneurons
Authors: Kloppenburg Peter , Zipfel Warren R. , Webb Watt W. , Harris-Warrick Ronald M.
Published: August 2007

Modulation of synaptic transmission is a major mechanism for the functional reconfiguration of neuronal circuits. Neurotransmitter release and, consequently, synaptic strength are regulated by intracellular Ca2+ levels in presynaptic terminals. In identified neurons of the lobster pyloric network, we studied localized, voltage-induced Ca2+ accumulation and its modulation in varicosities on distal neuritic arborizations, which have previously been shown to be sites of synaptic contacts. We previously demonstrated that dopamine (DA) weakens synaptic output from the pyloric dilator (PD) neuron and strengthens synaptic output from the lateral pyloric (LP) and pyloric constrictor (PY) neurons. Here we show that DA modifies voltage-activated Ca2+ accumulation in many varicosities in ways that are consistent with DA's effects on synaptic transmission: DA elevates Ca2+ accumulation in LP and PY varicosities and reduces Ca2+ accumulation in PD varicosities. However, in all three neuron types, we also found varicosities that were unaffected by DA. In the PY neurons, we found that DA can simultaneously increase and decrease voltage-evoked Ca2+ accumulation at different varicosities, even within the same neuron. These results suggest that regulation of Ca2+ entry is a common mechanism to regulate synaptic strength in the pyloric network. However, voltage-evoked local Ca2+ accumulation can be differentially modulated to control Ca2+-dependent processes in functionally separate varicosities of a single neuron.
The Use of Prosthetic Stents in Tracheobronchial,Gastrointestinal, and Genitourinary Diseases
Authors: Edell Eric S. , Hughes Rollin W. , Oesterling Joseph E. , Cortese Denis A.
Published: August 2007

The concept of using a stent to maintain patency of a lumen is not new. As early as 1969, stents were
being investigated in the peripheral arterial system as a means of preventing restenosis after dilatation
by balloon angioplasty (Dotter, 1969). Since then, numerous reports have demonstrated the use
of stents in both the peripheral and coronary artery systems (Maass et al., 1982; Dotter et al., 1983;
Wright et al., 1985; Palmaz et al., 1987). Concomitant with the investigation of expandable endovascular
metal prosthesis has been the development of prosthetic devices for management of tracheobronchial,
gastrointestinal, and genitourinary diseases. We will review the use of endoscopically
placed prosthetic devices in the management of diseases affecting these systems.
Laparoscopic Surgical Staging of Stage I Primary SquamousCell Carcinoma of the Vagina
Authors: Childers Joel M. , Brzechffa Peter R. , Surwit Earl A.
Published: August 2007

Vaginal carcinoma is an uncommon malignancy and one of the few gynecologic malignancies that
is still clinically staged. Clinical staging, which can be difficult in some instances, is potentially inaccurate,
as it has been shown to be in early endometrial and ovarian carcinoma. In addition, clinical
staging can result in over‐ or undertreatment of the disease. The lack of standardization of treatment
further compounds the issue, particularly for patients with small‐volume disease. We report three patients
with grade 2 or 3 small‐volume primary squamous cell carcinoma of the vagina who underwent
pelvic lymph node sampling for staging purposes. Each patient had lesions small enough to be
considered for brachytherapy only. An average of 12 lymph nodes were removed with an average
operative time of 72 minutes. All procedures were performed on an outpatient basis, and there were
no intraoperative or postoperative complications. In one patient, teletherapy was added to the
brachytherapy because a microscopic focus of squamous cell carcinoma was discovered in an obturator
lymph node. Our initial experience indicates that laparoscopic sampling of lymph nodes in patients
with early vaginal carcinoma may be helpful in preventing undertreatment of these women.
Individualization of treatment can be accomplished quickly and safely on an outpatient basis, and
initiation of treatment is not delayed. We believe further evaluation of laparoscopic staging of primary
vaginal carcinoma is indicated.
Endoscopic Stenting and Sphincterotomy of the Minor Papilla in Symptomatic Pancreas Divisum: Results and Complications
Authors: Cohen Seth A. , Rutkovsky Frederick D. , Siegel Jerome H. , Kasmin Franklin E.
Published: August 2007

Pancreas divisum has been postulated as a cause of acute pancreatitis and a chronic pain syndrome in a small subgroup of patients and can be treated with endoscopic dorsal pancreatic duct stent placement
and minor papilla sphincterotomy. Twenty patients (9 with at least one attack of idiopathic pancreatitis,
and 11 with severe pancreatic‐type pain) were treated endoscopically. Dorsal duct stents
were placed in 19 patients with subsequent needle knife sphincterotomy of the minor papilla over
the stent. Clinical response was judged by comparison of symptoms (using a 0‐to‐l0 scale and the
patient′s overall assessment). The symptom score improved from 9.3 to 5.1 in the pancreatitis group
and from 9.3 to 5.7 in the pain group. A good clinical response was observed in 3 of 7 patients in the
pancreatitis group and in 6 of 11 in the pain group at a mean follow‐up of 22 months. Complications
of sphincterotomy were limited to pancreatitis in 6 patients (29%), 5 mild and 1 moderate according
to published criteria. No patient required more than 4 days hospitalization. Two of 39 stents migrated
into the pancreas, and another stent fractured and remained lodged in the pancreas. Eight of 9 patients
evaluated demonstrated new morphologic duct changes on follow‐up pancreatograms.
Endoscopic stenting and sphincterotomy of the minor papilla are feasible and may be effective in
some patients with pancreas divisum but carries a significant complication rate. The subjective improvement
in patients with chronic pain warrants further controlled study.
An Improved Colonoscopy Preparation Method and its Acceptability by Patients
Authors: Tsuruoka Masanori
Published: August 2007

The author presents an improved method of preparation for colonoscopy that involved no dietary
limitation on the patient until the day of the examination and that was shown by a randomized questionnaire
evaluation to earn good patient tolerance and acceptance. Patients were given 10 mg of cisapride
and 75 mg of sodium picosulfate before sleep on the day preceding the examination, and 50
g of magnesium citrate powder (MP) in 1,200 mL lukewarm water before the examination. It was
divided into 600‐mL portions and ingested slowly during two 30‐minute periods. Ninety‐five percent
of patients classified the taste of a magnesium citrate powder laxative as palatable in the questionnaire
given immediately after the procedure. Concerning the quantity, 79.4% replied that it was
tolerable, 17.3% considered it somewhat excessive, and 3.3% replied that it was barely tolerable. No
patient classified it as intolerable. Symptoms after taking laxatives and lukewarm water such as abdominal
pain, nausea and abdominal fullness were observed in 3.8%, 4.4% and 5.6%, respectively,
whereas there were no symptoms in 79% of patients. Body weight and serum K level showed a tendency
to decrease, whereas the serum Mg level showed an increase before and after colonoscopy.
The quality of colonic cleansing evaluated by colonoscopy was excellent, good, or fair in a total of
93.3%. No adverse effects were observed. It was concluded that this method is a clinically beneficial
and well‐tolerated preparation for colonic examinations.
Thoracoscopic Surgical Treatment of SpontaneousPneumothorax: Selection of Surgical Therapy According toThoracoscopic Findings
Authors: Sugamura Y. , Jibiki M. , Ikari H. , Nakamura T. , Kawabe H. , Ishibashi T. , Kunizaki T.
Published: August 2007

We report our experience with thoracoscopy used for the treatment of spontaneous pneumothorax
and idiopathic emphysematous bullae. Fifty‐one patients with pneumothorax were admitted to the
hospital and received a pleurography and CT scanning before thoracoscopy. End‐GIA resection or
end‐loop ligation were used alone or in combination, with or without laser coagulation. Only one patient
developed recurrent pneumothorax, whereas another required repeated resection. Our results
indicate that surgical treatment of pneumothorax using thoracoscopy results in a rapid expansion of
the lung, minimum postoperative pain, early hospital discharge, and return of normal activity.
Endoscopic Findings of Early Stage Vocal Fold Cancer
Authors: Kitzing Peter
Published: August 2007

To describe early cancerous and precancerous lesions of the laryngeal vocal folds as well as of the
most common differential diagnoses, based on a series of microlaryngoscopic photographs. Some
introductory remarks about terminology and the classification of epithelial lesions of the vocal folds
are included. The paper ends with some comments as to the management of epithelial thickenings
(or leukoplakias) of the vocal folds. Malignancy should be suspected as long as it has not been ruled
out by histologic diagnosis on adequate biopsies, which is the only way to correctly evaluate the character
of such lesions. Precancerous lesions should be controlled by regular follow up examinations
as carefully as invasive carcinomas (posttreatment), because there is a high tendency for recurrences
or for later development of malignancy in these cases.
Diagnostic Thoracoscopy
Authors: Janssen Julius P. , Postmus Pieter E. , Van Mourik Johan C. , Cuesta Miguel A.
Published: August 2007

Since the introduction of video‐imaging and endoscopic surgical interventions, there is a worldwide renewed interest in thoracoscopy. However, thoracoscopy for diagnosis of pleural and pulmonary
disease has been performed for more than 30 years. An overview is presented here of the results and
experiences in the past 3 decades of thoracoscopy for diagnosis of pulmonary and pleural disease.
Thoracoscopy is a simple and safe method to obtain a diagnosis in case of pleural effusion, pleural
mass, or interstitial lung disease. In most cases, it can be performed under local anaesthesia.
Intrafascial Supracervical Hysterectomy Without Colpotomyand Transuterine Mucosal Resection by Pelviscopy andLaparotomy
Authors: Mettler Liselotte , Alvarez-Rodas Erick , Lehmann-Willenbrock Enrique , Lüttges Jutta , Semm Kurt
Published: August 2007

Between September 1991 and December 1993, 253 patients were operated on using the Classical
Intrafascial SEMM (Serrated Edged Macro Morcellator) Hysterectomy (CISH) technique. One hundred
fifty‐two patients were assigned to pelviscopic CISH and 101 to laparotomic CISH. Uterine
leiomyomas with menstrual disorders and pressure symptoms topped the list of indications with 61%.
In all cases, initially transuterine mucosal resection and coring of the cervicouterine cylinder were
carried out followed by the intrafascial supracervical dissection of the uterus. The size of the uterus
played a decisive role in selecting the cases for CISH technique either by pelviscopy or laparotomy.
The cervicouterine mucosal cylinders were cored using the Calibrated Uterine Resection Tool
(CURT). Cervical thickness and diameters were measured preoperatively by transvaginal sonography
for facilitating the use of a specific‐sized CURT. After removal of this cylinder, hemostasis in
the area was secured by coagulating with an endocoagulation device. The advantage of this technique
is that the pelvic floor integrity remains intact, and because uterine arteries and ureters were
not touched, the so called “complication zone” is thus avoided.The histological findings are in agreement with the indications, the leiomyomas and leiomyomas
with adenomyosis being the most frequent pathology. The histologic analysis showed that in all cases
the squamocolumnar transformation zone was totally removed. There were 11 (4.4%) complications,
promptly identified and treated without further problems.The value of the Classical intrafascial supracervical hysterectomy without colpotomy including
the resection of transformation zone speaks for itself, because there is less physical stress and recovery
is quick. However, it has yet to prove its value as compared with other techniques for hysterectomy
for specific indications.
Electronic Endoscopy in Endoscopic Mucosal Resection(EMR) of Gastric Cancer
Authors: Kawaguchi Minoru , Misaka Ryouichi , Yamada Michiru , Midorikawa Shouko , Sanji Tetuya , Shinohara Satoshi , Morita Shigefumi , Handa Yutaka , Ohno Hiroyuki , Saitou Yasuhiko , Yosida Hajime , Takase Masahisa , Saitou Toshihiko
Published: August 2007

The role in which electronic endoscopy plays is important in EMR. It is useful in diagnosis and treatment of gastric cancer from a clinical viewpoint. EMR with use of electronic endoscopy allows better
coordination between the operator and assistants, and thus improves the results further.
Laparoscopic Presacral Neurectomy in the Treatment ofPrimary Dysmenorrhea
Authors: Chu K. K. , Chen E. P. , Chang S. D. , Soong Y. K.
Published: August 2007

Sixty‐one laparoscopic presacral neurectomies were performed in Chang Gung Memorial Hospital, Keelung Center over a 1‐year period for patients with primary dysmenorrhea who failed to respond
to medical management. Eighty‐three percent (50) had complete relief of pain, 10% (6) had significant relief, 3.5% (2) had moderate relief, and 3.5% (2) had no relief from their dysmenorrhea at their first menstruation after the procedure. One vascular complication requiring laparotomy occurred. Average total operation time was 24 minutes, and the average hospital stay was 2 days. Six months
follow‐up was done in 35 patients with complete symptom relief, and all reported continued relief
of menstrual pain. The efficacy of laparoscopic presacral neurectomy for the pain relief of primary
dysmenorrhea is justified in this report.
Severe Bronchomalacia in a 65‐Year‐Old Man Treated WithStent Insertion Instead of Surgical Bronchoplasty
Authors: Sutedja Tom G. , de Graaf Jan C. , Schramel Franz M. , Van Kralingen Klaas W. , Postmus Pieter E.
Published: August 2007

Bronchomalacia in adults is rare. A case is reported here of a 65‐year‐old man with severe cough and mucostasis, caused by a benign bronchomalacia of the ventral wall of the left main bronchus. This
was treated successfully with the insertion of a silicone Dumon stent as an alternative to surgical
bronchoplasty.
Crohn′s Disease and Urinary Bladder Mass
Authors: Bales Gregory T. , Straus, Francis H. , Gerber Glenn S.
Published: August 2007

The presence of a bladder mass in a patient with inflammatory bowel disease poses a diagnostic
dilemma. We present the case of a 26‐year‐old male with a bladder mass who had not previously
been diagnosed with Crohn′s disease. Initial biopsies of the bladder mass were consistent with inflammatory
changes, but superficial transitional cell carcinoma could not be reliably excluded.
Subsequent evaluation confirmed the presence of Crohn′s disease with bladder involvement, and the
patient underwent bowel resection and partial cystectomy. Pathologic evaluation demonstrated
Crohn’s disease and no evidence of malignancy. Accurate differentiation of benign and malignant
bladder masses in patients with inflammatory bowel disease may be difficult and requires cooperation
between pathologists and clinicians.
A Unique Case of Adenoid Cystic Carcinoma of theLeft Main Bronchus
Authors: Kobayashi Toshiaki , Konaka Chimori , Shibanuma Hiroyuki , Serizawa Hiromi , Ebihara Yoshirou , Kato Harubumi
Published: August 2007

A unique case of adenoid cystic carcinoma of the left main bronchus is reported.
Video Assisted Thoracic Surgery for Indeterminate Pulmonary Nodules
Authors: Albright Janet L. , MacArthur Rick I. , Swain Julie A. , Tran Alan T. , Little Alex G.
Published: August 2007

The approach to patients with indeterminate pulmonary nodules is poorly defined. Should every pulmonary nodule be biopsied, is needle biopsy adequate, and other questions are challenges. Video assisted
thoracic surgery or thoracoscopy has added a new diagnostic possibility which is evaluated in
this paper. Fifty‐five patients underwent thoracoscopy for diagnosis of a solitary pulmonary nodule.
There were few complications and mortality was zero. A definitive diagnosis was obtained in all patients,
although one required a second thoracoscopic wedge resection and 10 required conversion to
an open thoracotomy.As discussed in the paper, thoracoscopy provides the opportunity for safely establishing a definitive diagnosis in all patients with solitary nodules and the authors believe will become a standard part
of the evaluation of these patients.
Endoscopic Management of Pancreatic Pseudocysts
Authors: Dohmoto M. , Rupp K. D.
Published: August 2007

Recently, endoscopic interventional procedures were introduced for nonsurgical therapy of symptomatic pancreas pseudocysts. We reported 25 patients treated by endoscopic retrograde pancreas
drainage (ERPD), endoscopic cystogastrostomy (ECG), or endosopic cystoduodenostomy (ECD).

ERPD was performed in 9 patients by placement of a 5 Fr. or 7 Fr. endoprosthesis transpapillary
into the cyst or the main pancreatic duct. ECG was carried out in 10 cases, in 7 of these, a double pigtail
catheter was additionally inserted. Three patients suffering from pseudocysts of the pancreas head
were treated by ECD. In a further 3 cases, ERPD and ECG were combined.

All patients reported a dramatic reduction of pain with a simultaneous increase of appetite and
body weight. The drainage tubes were removed after disappearance of symptoms, and abnormal clinical
and endoscopic findings within 2 to 12 months. In 4 cases, a recurrence of the cyst was found 10
and 22 months later, in 3 cases the endoprostheses had to be renewed because of catheter occlusion
or dislocation. 2 patient underwent surgical treatment after insufficient endoscopic drainage due to
haemorrhage or recurrence.

Endoscopic treatment of pancreatic pseudocysts yielded good results with low rates of recurrence
and complications. According to our experiences we think endoscopic interventional techniques will
oust surgery from its present dominant position in the next years.
Relationship Between Percutaneous Transhepatic Cholangioscopy Findings and Pattern of Carcinomatous Spread in the Bile Duct
Authors: Sato M. , Maetani I. , Ohashi S. , Ogawa S. , Anzai T. , Hoshi H. , Yoshioka H. , Igarashi Y. , Sakai Y.
Published: August 2007

To clarify the relationship between percutaneous transhepatic cholangioscopic findings such as papillogranular
surface and vascular dilation, which are reportedly characteristic of carcinoma, and the
pattern of spread for bile duct carcinomas, we compared endoscopic photographs with histological
features of biopsy specimens in 57 regions of specimens from 35 patients with malignant stenosis of
the bile duct. Regions with a papillogranular surface were associated with noninvasive mucosal carcinomas
and papillary proliferation of superficial epithelia significantly more often than regions without
such a surface (P<0.0001). The sensitivity and specificity of the papillogranular surface to
noninvasive mucosal carcinoma was 79 and 95%, respectively, that of papillary proliferation of superficial epithelia was 100 and 98%, respectively. Regions with vascular dilation were associated
with invasive carcinoma significantly more often than regions without vascular dilation (P<0.0001).
The sensitivity and specificity of vascular dilation to invasive carcinoma were 90 and 86%, respectively.
Results indicate that a papillogranular surface is related to noninvasive mucosal carcinomas
while vascular dilation is related to invasive carcinomas. However, a papillogranular surface was
even more closely related to papillary proliferation of superficial epithelia.
Endoscopic Retrograde Cholangiopancreatography Treatment of Cholecystitis: Possible? Yes; Practical??
Authors: Siegel Jerome H. , Kasmin Franklin E. , Cohen Seth A.
Published: August 2007

Classically, until now, the management of cholecystitis has consisted of immediate and judicious
clinical assessment of the affected patient, interpolating into the assessment of the physical findings
and results from appropriate laboratory, x‐ray, and scanning techniques (sonography and scintigraphy)
to formulate a clinical impression. Usually, after the diagnosis has been established, the patient
is subjected to a cholecystectomy, although the timing of the surgery may vary depending on the
clinical condition of the patient. Alternatives to this management (cholecystectomy, medical management)
scheme have been suggested, but these are dependent upon the clinical condition ofthe patient
and considerations of risks. Percutaneous drainage of the gallbladder or cholecystostomy is
sufficient enough to provide drainage, relieve obstruction, and the consequences of infection, i.e.,
sepsis, and prevent perforation. A contributory role of endoscopic retrograde cholangiopancreatography
(ERCP) in this schema has not been a consideration. An ERCP is rarely employed for therapy
(or diagnosis) when cholecystitis is suspected but it might assume a more significant role if it is considered
an efficacious alternative in specific conditions. We have had the unusual experience of managing
11 patients with cholecystitis employing ERCP and its therapeutic modalities, i.e.,
sphincterotomy, selective cannulation of the cystic duct, and relieving obstruction of that structure
by catheter displacement of an obstructing stone. Endoscopic techniques providing decompression
of the gallbladder are described, and the feasibility of utilizing endoscopic procedures for treatment
of cholecystitis will be given consideration.
Clinical Experience With a New Type of Rhino‐Larynx Electronic Endoscope PENTAX VNL‐1530
Authors: Kawaida Masahiro , Fukuda Hiroyuki , Kohno Naoyuki
Published: August 2007

We observed recordings of pictures obtained from patients with diseases of the larynx by using a new type of rhino‐larynx electronic endoscope, PENTAXVNL‐1530 connected to a video processor, PENTAX
EPM‐3300 (Asahi Optical Co., Ltd.). The electronic endoscope differs from the fiberoptic endoscope
in that it contains a small light‐sensitive charge coupled device (CCD) chip that is attached
to the tip of the endoscope. This electronic endoscope has the smallest CCD camera of 5.1 mm in diameter,
in the tip portion, and can be passed through the nasal passage into the laryngeal cavity. The
dynamic image provided by this system is superior to that obtained by a flexible laryngofiberscope
in resolution of the detail.The system with this electronic endoscope was introduced and some clinical cases were presented.
Endoscopy of Nasopharyngeal Cancer
Authors: Burkey Brian B. , Ossoff Robert H.
Published: August 2007

Nasopharyngeal cancer (NPC) is a unique disease with increasing interest for many physicians due to its unusual etiology, histology, and epidemiology. The recent era of fiberoptic endoscopy now provides the clinician with better tools for the screening, diagnosis, staging, and follow‐up of NPC. The
use of high resolution flexible and rigid nasopharyngoscopy gives the physician an opportunity for
a more sensitive examination in a higher proportion of patients. Ultimately, this will allow for earlier
diagnosis of NPC, and improved prognosis and better quality of life for the patients with this disease.
Also, by allowing the clinician to perform directed biopsies of the nasopharynx under local
anesthesia, fiberoptic nasopharyngoscopy allows a less morbid and more cost‐effective approach towards
this disease, including screening protocols in certain high risk regions of the world.
Endoscopic CO2‐Laser Surgery for Vocal Cord Cancer
Authors: Czigner J. , Sávay L.
Published: August 2007

A retrospective study is reported on endoscopic CO2‐laser microsurgery in 69 patients with histologically verified early vocal cord cancer. A flexible nasopharyngolaryngoscope (STORZ Co) was used for preoperative assessment and occasionally for postoperative follow‐up.

Six years of experience with this technique have led to endoscopic cordectomy, previously not accepted as a therapeutic method alone, but which has become the favored method with use of the CO2
laser endoscopically. Laser surgery as a therapeutic endoscopic procedure provided successful treatment
of early vocal cord cancer in 59 (86%) of the 69 patients. The initial success rate together with
“salvage” treatment modalities reached 96% (66/69 patients).

Endoscopic laser surgery resulted in a decrease in voice intensity and phonatory duration from
near normal to mildly abnormal. Voice preservation succeeded in 97% of all patients. Thus, the data
demonstrate that endoscopic laser surgery is a useful modem method of therapeutic endoscopy for
early vocal cord carcinoma.
Bronchoscopy of Lung Cancer
Authors: Hauck R. W. , Emslander H. P.
Published: August 2007

Lung cancer is a leading cancer site in men and women with a high incidence and mortality rate. Most
patients are diagnosed when the disease has already spread. An early, detection and immediate and
accurate histological or cytological diagnosis are essential for a hopeful outcome. In most patients,
bronchoscopy is the method of choice in establishing a suspected lung neoplasm. With the rigid and
flexible method, two complementary techniques are available. The methods bear a very low mortality
rate if sufficient monitoring and resuscitative instrumentation is available. Rigid bronchoscopy
offers the possibility of obtaining large biopsy specimens from the tumorous tissue and provides an
effective tool in the control of major haemorrhage. However, it cannot be used for the inspection of
further peripherally located parts of the bronchial system and needs general anaesthesia. In contrast,
the flexible method can be quickly and readily performed at practically any location using portable
equipment. Bronchi can be inspected up to the 8th order and with bronchial washing, forceps biopsy,
brush biopsy and fluorescence bronchoscopy techniques with a high diagnostic yield are available.
This holds true, especially if these sampling techniques are used as complementary methods.
Endoscopic Balloon Dilatation of Benign EsophagealStricture—A Nonhazardous Procedure?
Authors: Ekberg Olle , Borgström Anders , Fork Frans-Thomas , Lövdahl Eje
Published: August 2007

Balloon dilatation of benign esophageal strictures has been widely used since its introduction. We
have performed 224 dilatation procedures in 52 patients. Dilatation was done as an outpatient procedure.
Strictures were due to reflux esophagitis in 25 patients, anastomatic stenosis in 6, achalasia
in 5, complications of sclerotherapy in 5, corrosive lesions in 3, and long‐standing nasogastric intubation
in 2. The cause was unknown in 6 cases. The intention was to dilate all strictures up to 20 mm.
Three major complications occurred, and one of these patients died. The risk of perforation seems
to be higher after repeated procedures than during the first one.
Photodynamic Therapy for Superficial Esophageal CancerUsing an Excimer Dye Laser
Authors: Mimura Seishiro , Otani Toru , Okuda Shigeru
Published: August 2007

In order to improve the therapeutic effectiveness of photodynamic therapy with Photofrin II and laser light for superficial esophageal cancer, we employed an excimer dye laser instead of an argon dye
laser. Eight superficial esophageal cancer lesions (7 cases) were treated. Of these 8 lesions, 6 were
cured by initial treatment, while one lesion required another treatment. The final rate of cure was
88% (7/8).
Clinical Experience of Laser Angioplasty for the Cardiovascular Disease
Authors: Okada Masayoshi , Yoshida Masato , Tsuji Yoshihiko
Published: August 2007

In recent years, lasers are being utilized in cardiovascular surgery. Since the 1980′s we have investigated angioplasty using an Argon laser for patients with obstructive arterial diseases. This technique aims to open the obstructive arterial lumen. Based on the excellent results of experimental studies, the technique has been clinically applied. Laser angioplasty was carried out in 84 patients with stenotic or obstructive lesions occluding more than 75% of peripheral and coronary arteries angiographically. They consisted of 74 cases with intermittent claudication and 10 cases with angina pectoris. Laser angioplasty for the peripheral arterial disease was performed under local anesthesia in the inguinal region under angioscopic guidance. On the other hand, laser coronary angioplasty was simultaneously undertaken at the time of coronary artery bypass grafting for a patient with multiple coronary stenoses. The initial success rate by laser angioplasty for the peripheral artery was 91% in the stenotic lesions and 71% in the obstructive lesions. The cumulative patency rate was 94% in the stenotic lesions and 83% in the occlusive lesions. A follow‐up study of 66 months was carried out for patients with clinical success, excluding the cases where an angiogram showed occlusion within 1 week after laser angioplasty. Consequently, excellent long‐term results could be clinically obtained. Based on the satisfactory results in the peripheral artery, coronary laser angioplasty was employed in 10 patients with angina pectoris. There were no complications by laser. Thus, the feasibility of laser application was apparently confirmed and laser angioplasty might be recommended for patients with atherosclerotic changes, especially for small arteries.