bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histopathological Analysis of the Factors Determining the Echogenicity of Gastric Carcinoma Visualized by Endoscopic Ultrasonography
Authors: SANO Shuichi , IKEDA Masahiro , FUJINO Masayuki A. , MOROZUMI Atsuro , YAMAMOTO Yasuyuki , SUZUKI Hiroshi 
Published: August 2007

Abstract: Endoscopic ultrasonography (EUS) reveals a variety of echo patterns in gastric carcinoma. We analysed the factors determining its echogenicity in 47 cases of advanced carcinoma. Echo levels were measured with a densitometer (Model PDM ‐5, Konishiroku, japan) on Polaroid films of ultrasonography. The echogenicity of a tumor (Et) was expressed as the value relative to those of the submucosal layer (EIII) and the proper muscle layer (EIV), (Et‐EIII)/(EIV‐EIII)=echogenicity index (EI). The amount of fiber was expressed as the ratio of the area of fibrosis measured with an image analyser (IBAS‐2000, Zeiss, Germany) on a preparation of Masson‐Trichrome staining. EI corresponded well to the echo levels graded by the conventional method of description and had a strong correlation with the amount of fiber (r =–0.621, p < 0.001) except in two cases of mucinous carcinoma. Scirrhous carcinoma had a significantly smaller El than medullary and intermediate carcinomas. It also had a significantly greater amount of fiber than the others. No significant difference was found in terms of both the EI and amount of fiber when the carcinoma were grouped according to their degrees of differentiation (well, moderate and poor) or their modes of infiltration (α, β and γ). The tumors with short, wave‐shaped “curly fiber” showed a greater EI than those with fine networks of fibers or thick bundles of fibers. Mucinous carcinoma and two cases of intermediate type carcinoma were included in the former group and scirrhous carcinoma was included in the latter group. In conclusion, the echo levels of gastric carcinoma visualized by EUS are mostly determined by the amount of fiber in the tumor, but are also modified to some extent by the shape and arrangement of those fibers. Scirrhous carcinoma can be distinguished from the other types based on its echo levels.
Multiple Microhamartomas of the Biliary Tract System (Von Meyenburg Complexes) with Multiple Liver Cysts — Diagnostic Imaging and Laparoscopic Findings —
Authors: TAMEDA Yukihiko , KOSAKA Yoshitane , SHIRAKI Katsuya , KIHIRA Takayuki , OHASHI Yohei , FUJIOKA Hiromichi , HAMADA Minoru , MIYAZAKI Mitsukazu , ITO Nobuyasu , TAKASE Kojiro , NAKANO Takeshi 
Published: August 2007

Abstract: We present two patients with multiple microhamartomas of the biliary tract (von Meyenburg complexes) with multiple liver cysts with special reference to their diagnostic imaging and laparoscopic findings. Case 1 was a 76‐year‐old male and case 2 was 51‐year‐old male, who was later found to have adenocarcinoma of the common bile duct as a complication. The characteristic findings of ultrasonography (US) were markedly heterogeneous and there was a severe hyperechoic pattern in the liver with small cystic lesions. Computed tomography (CT) demonstrated multiple low attenuation focal defects scattered throughout both lobes which showed no enhancement following the application of intravenous contrast medium.Laparoscopically, multiple whitish nodular or stellate‐shaped lesions, which were slightly depressed, and multiple small dark greenish cystic lesions of various sizes were scattered on the smooth surface of both lobes. Some dark greenish cystic lesions and whitish lesions were adjoining. A histological study of the whitish nodular lesions revealed a collection of proliferated and irregularly dilated bile ducts and ductules in a dense fibrous stroma. These findings are compatible with microhamartomas.These features are characteristic of this disease, and support the close association between liver cysts and microhamartomas. Our hypothesis is that a polycystic liver may result from cystic dilatation of microhamartomas.
Endoscopic US and Dynamic CT in Preoperative TN Staging of Esophageal Squamous Cell Carcinoma
Authors: FUJISHIMA Hiroshi , CHIJIIWA Yoshiharu , MARUOKA Akira , MISAWA Tadashi , NAWATA Hajime 
Published: August 2007

Abstract: 〈Objective〉 The aim of this study was to assess the accuracy and limitations of endoscopic ultrasonography (US) and dynamic computed tomography (CT) in the preoperative evaluation of esophageal carcinoma.〈Methods〉 Endoscopic US and dynamic CT were performed preoperatively in 96 patients with an esophageal squamous cell carcinoma. The results were correlated with the histology of specimens resected from patients who had undergone subtotal esophagectomy with lymph node dissection.〈Results〉 According to the TN staging classification, endoscopic US was superior to dynamic CT for evaluating the depth of tumor infiltration (overall accuracy: EUS 75%, CT 35%) and in assessing regional lymph node metastases (overall accuracy: EUS 77%, CT 67%). However, the T4 stage was not accurately evaluated using endoscopic US in this study. Its specificity was high (97%) but its sensitivity was low (45%).〈Conclusions〉 We believe endoscopic US is the most accurate method for local tumor staging in esophageal carcinoma. A limitation to endoscopic US staging performed with current instruments was severe stenosis, as it would not permit passage of the instrument (25% of all cases in this study).
Acute Ulcers Induced in Canine Stomachs by Endoscopic Compressed Air Delivery of 25 mg NaCl
Authors: HOSHINO Teruo , KISHI Tadahiro 
Published: August 2007

Abstract: Endoscopic administration of 25 mg NaCl powder to target sites on the gastric mucosa of five dogs, using a compressed air delivery system developed by the author, was followed by observation of changes in the gastric mucosa. After 30 seconds, 1 minute, 2 minutes, 5 minutes and 10 minutes, the sprayed NaCl was washed away by endoscopic water spray, and the presence of submucosal bleeding was observed at the target sites. After 24 hours, ulcers in the gastric mucosa were recognized at sites at which the NaCl had been in contact for 2 minutes or more before being washed away. With one minute or less contact time between NaCl and the mucosa, erosion and redness were observed at the target sites. In a control study, however, no mucosal lesions occurred following identical spray of 25 mg lactose powder which was left in contact for 30 seconds, 1 minute, 2 minutes, 5 minutes and 10 minutes, and also 24 hours.Experimental gastric ulcers can be induced by endoscopic administration of a small amount of NaCl powder. The time of contact of NaCl on the gastric mucosa affected the induction of gastric mucosal damage. This method will be useful in the investigation of the direct effects of various drugs on the gastric mucosa.
Diagnostic System for Helicobacter pylori Urease Based on a pHsensitive Field Effect Transistor
Authors: KOHLI Yoshihiro , KATO Takuji , ITO Shigeji , MIYAZI Hideo , AZUMA Takeshi , NAGATA Kumiko , TSURUTA Hitoshi , MATSUI Satomi , OKA Keiko , NAKAMURA Michihiro 
Published: August 2007

Abstract:A rapid diagnostic system for Helicobacter pylori (H. pylori) was developed based on an urease analyser using a pH‐sensitive field effect transistor (pH‐FET). The system is composed of a solid‐phase capillary‐tube and a pH‐measuring cell. The solid‐phase tube, with an inner diameter 0.55 mm and coated with a monoclonal antibody against H. pylori's urease, was used to selectively capture the urease in endoscopically collected gastric mucus. The urease activity on the inner surface of the solid‐phase tube was measured by coupling it with ph‐FET in a pH measuring cell containing urea solution. Before immuno reaction in the solid‐phase, gastric mucus was diluted with a phosphate buffered saline containing 1% n‐octylglucoside, which was effective for accelerating the release of active urease from H. pylori's cells suspended in the sample solution. As a result of preliminary evaluations, it was found that the clinical sensitivity and specificity were 100 and 86%, respectively, using a bacteriological test as a reference.
Cystic Duct Stones Detected During Intraoperative Cholangiography in Laparoscopic Cholecystectomy
Authors: IDO Kenichi , KIMURA Ken , TANIGUCHI Yushi , KAWAMOTO Chiaki , ISODA Norio , SUZUKI Takanori , NAGAMINE Nobuhiko , IOKA Tatsuya , KUMAGAI Machio 
Published: August 2007

Abstract:During intraoperative cholangiography, cystic duct stones were diagnosed in 79 of 898 consecutive patients (8.8%) who underwent laparoscopic cholecystectomy over a 45‐month period. The stones were successfully removed laparoscopically. In addition, it should be mentioned that the stones were identified and retrieved before the cholangiography was started in all but 8 of the 79 cases. Of these 79, only 27 cases (34.2%) had been diagnosed as having cystic duct stones preoperatively by intravenous cholangiography and/or endoscopic retrograde cholangiography. From the results obtained, it can be concluded that intraoperative cholangiography is mandatory to detect unsuspected retained stones not only in the common duct but also in the cystic duct during laparoscopic cholecystectomy, and also provides vital information as to biliary anatomic variations, the proximity of the cystic duct to the common duct, and the confirmation of inadvertent bile duct injury.
A Case of Massive Hepatic Necrosis (Scarred Liver) with Elevated α‐Fetoprotein and Seroconversion from HBe Ag to HBe Ab
Authors: WATANABE Makoto , SAKAI Shino , SATO Shuichi , FUKUDA Ryo , AKAGI Shuji , KOHGE Naruaki , KUSHIYAMA Yoshinori , FUKUMOTO Shiro 
Published: August 2007

AbstractA 39‐year‐old male with general malaise visited our clinic with high levels of aminotransferases (AST 776 IU/1, ALT 1,069 IU/I) and a prolonged prothrombin time. Serum‐fetoprotein (AFP) level was markedly elevated (2,214 ng/ml) and human hepatocyte growth factor (hHGF)was also high (0.81 ng/ml). Hepatocellular carcinoma was found to be negative from imaging techniques. AFP bands separated by lectin affinity electrophoresis had a benign pattern. Laparoscopic diagnosis was scarred liver and histologically massive hepatic necrosis with a strongly positive AFP stain. Levels of hHGF and AFP fell into a normal range after treatments with glucagon‐insulin and prostaglandin Ei. At second laparoscopy, regenerated nodules were confirmed by improved staining with Indocyanine Green. Hepatocyte regeneration was also histologically proven with a weakly positive AFP stain. The proliferating cell nuclear antigen (PCNA) was stained, and hepatocytes with PCNA positive nuclei were not seen at the time of the first laparoscopy, whereas hepatocytes with PCNA positive nuclei were found to be many at the time of the second laparoscopy. Seroconversion from HBe Ag to HBe Ab was observed 4 months after the maximum rise of AFP (6,341 ng/ml), when levels of ALT and DNA polymerase were within normal ranges.This is a patient with a marked rise in his serum level of AFP in association with seroconversion from HBe Ag to HBe Ab, and the elevation of AFP in the present case was thought to reflect severe liver injury with concomitant regenerative activities of injured hepatocytes rather than simple hepatocyte regeneration after hepatic necrosis was resolved.
Laparoscopic Findings of Metastatic Laryngeal Carcinoma of the Liver Histologically Simulating Hepatocellular Carcinoma
Authors: SATO Shuichi , WATANABE Makoto , AKAGI Shuji , KOHGE Naruaki , SAKAI Shino , FUKUMOTO Shiro 
Published: August 2007

Abstract:A 77‐year‐old male was admitted to the department of Oto‐rhino‐laryngology of our hospital in 1989 with hoarseness due to laryngeal cancer. It was well treated with X‐ray irradiation and could not be detected by computed tomography (CT) and Gallium (87Ga) scintigraphy at the time of his discharge from hospital, and his hoarseness also subsided.In November 1992, he noticed the hoarseness again with a gradual worsening. On admission to the same department, multiple space occupying lesions were detected in right lobe of the liver by abdominal ultrasonography (US) and CT. When he was transferred to our department, a US‐guided aspiration biopsy showed a pathohistology mimicking hepatocellular‐carcinoma with a multiple restiformation. Laparoscopy revealed multiple yellowish white flat lesions with an irregular margin, and aimed biopsy was performed to one of these lesions. Histology mimicked hepatocellular carcinoma with a few keratinocytes and a coiled structure and these were consistent with a diagnosis of metastatic epidermoid carcinoma.This is the first case report regarding laparoscopic observation of metastatic epidermoid carcinoma originating in the larynx.
Experience with Percutaneous Electronic Choledochoscopy
Authors: SHINOHARA Yasushi , FUKUDA Sadao , TAKEDA Kazuya , TAKEI Kazuo , HORIBE Toshiya , KAKUTANI Hiroshi , KAWAI Takashi , NIIDO Teitetsu , IKEDA Hajimu , SAITOH Toshihiko 
Published: August 2007

Abstract:Experience with percutaneous choledochoscopy using a prototype electronic choledochoscope (Pentax ECN‐1530) is presented herein. This electronic endoscope is 5.3 mm in outside diameter at the tip and has a forceps channel 2.0 mm in diameter. The outside diameter is 0.4 mm larger, while the forceps channel diameter is 0.2 mm smaller, than that of the conventional fiberoptic choledochoscope (FCN‐15X) produced by the same company. Although the new electronic choledochoscope could be inserted through a 16 Fr in size fistula, we considered an 18 Fr fistula to be preferable for insertion without resistance. Various types of accessory equipment for endoscopic treatment, such as an electrohydraulic Shockwave lithotriptor (EHL) and an Nd‐YAG laser, could be used without difficulty. The electronic choledochoscope was useful for examining bile duct carcinoma invasion to the hepatic side and evaluating the efficacy of various multi‐modal treatments, as it provided observation of the bile duct mucosa in great detail due to a very clear dynamic image. Moreover, endoscopic treatment was also greatly facilitated because it provided a clear view on a large, bright monitor screen for the surgeons. We therefore believe that this new electronic choledochoscope is very useful for the accurate diagnosis and treatment of biliary diseases.
Diagnosis of the Depth of Advanced Gastric Cancer Invasion by Endoscopic Ultrasonography
Authors: CHONAN Akimichi , FUJITA Naotaka , MOCHIZUKI Fukuji , YUKI Toyohiko , ISHIDA Kazuhiko , INOUE Shigeru , NODA Yutaka , KOBAYASHI Go , KMURA Katsumi , MATSUNAGA Atsuo , ANDO Masao , TOMINAGA Gen , NOMURA Mikiko , YAGO Akira , CHIBA Masaki , KISARA Norihiro 
Published: August 2007

Abstract:Preoperative endoscopic ultrasonography (EUS) was performed in 272 patients with advanced gastric cancer who underwent gastrectomy between December 1986 and December 1993. We divided the subjects into two groups: group A consisted of patients whose stomachs were filled with water for the EUS examination (water‐filling method: 1986.12–1992. 10) and group B of patients in whom EUS was performed with the water‐filled balloon compression method (balloon‐compression method) in addition to the water‐filling method (1992.11–1993. 12). A comparative study of EUS diagnostic efficacy, as regards the depth of invasion, was made between group A and group B. The following results were obtained:1) In group A, the depth of invasion of mass‐forming type carcinoma was accurately diagnosed by EUS in 59.3% of patients with mp cancer, in 28.8% of those with ss cancer, in 78.8% of those with se cancer, and in 83.3% of those with si cancer. The accuracy rate in diagnosing the depth of invasion of wall‐thickening type carcinoma was 46.2% in patients with mp cancer, 68.0% in those with ss cancer, 59.1% in those with se cancer, and 66.7% in those with si cancer.2) In group B, the depth of invasion of mass‐forming type carcinoma was accurately diagnosed by EUS in 70.6% of patients with mp cancer, in 68.4% of those with ss cancer, in 92.3% of those with se cancer, and in 100% of those with si cancer. The accuracy rate in diagnosing the depth of invasion of wall‐thickening type carcinoma was 75.0% in patients with mp cancer, 72.7% in those with ss cancer, 76.5% in those with se cancer, and 100% in those with si cancer.3) These results suggest that the diagnostic efficacy of EUS utilizing both the balloon‐compression method and the water‐filling method is greater, as regards the depth of advanced gastric cancer invasion, than EUS utilizing only the water‐filling method.
Laparoscopic Cholecystectomy in Patients with Previous Gastrectomy
Authors: HAKEEM Rachit , KANO Nobuyasu , YAMAKAWA Tatsuo , ISHIKAWA Yauro , ISHIYAMA Junji , KASUGAI Hisashi , REY Sammuel , MIYAJIMA Nobuyoshi , OTAKI Shuji 
Published: August 2007

Abstract: This study was designed to assess outcome, morbidity and mortality in patients with a previous history of gastrectomy who underwent laparoscopic cholecystectomy at Teikyo University Hospital at Mizonokuchi.From May 1990 through April 1995, 18 patients who had an upper midline incision from previous gastric surgery underwent attempted or successful laparoscopic cholecystectomy. Previous gastric operations included subtotal gastrectomy with Billroth l/ll anastomosis for ulcer diseases and total gastrectomy with jejunal interposition for gastric cancer. Preoperative ultrasound was done in all cases, ERCP in nine cases and drip infusion cholangiography in three cases to assess and evaluate the biliary system. Intraoperative cholangiography was done in the latter eight cases. Laparoscopic cholecystectomy was successful in all but one patient who had severe adhesions necessitating conversion to an open cholecystectomy. Overall results were very similar in patients with and without a previous history of gastric surgery who underwent laparoscopic cholecystectomy at this institution. It was also found that intraoperative difficulties and a prolonged operative time did not correlate with the nature of the previous operation, but rather with the severity of adhesions identified during surgery.Although the number of cases in this study was very small, the results indicate that if the surgeon is experienced and well prepared patients with a previous history of gastrectomy can also undergo laparoscopic cholecystectomy safely and with maximum benefit. We conclude that these patients should not be denied the advantages of laparoscopic cholecystectomy. A trial laparoscopic procedure is warranted although the conversion rate to open cholecystectomy may be high.
Experimental and numerical studies on dynamic crack growth in layered slate rock under wedge impact loads: part II – non‐plane strain problem
Authors: ALAM M. R. , MUNASWAMY K. , SWAMIDAS A. S. J. 
Published: August 2007

ABSTRACTDynamic crack propagation in non‐plane strain (or 3D) slate blocks under wedge impact loads was investigated numerically in this part of the paper. A parabolic‐shaped crack trajectory was taken into consideration to model the crack propagation in slate blocks for analyzing the impact splitting of layered slate rock. Major and minor axes of the parabola were determined from the condition of equal mode I stress intensity factors (SIFs) along the crack front. Mode I SIFs were determined for experimental breaking loads for each increment of crack growth in a manner similar to that mentioned in part I of this paper. These values were compared with the plane strain material fracture toughness value obtained from experimental studies and very good agreement was obtained between them, for the case of actual load applied on the specimen. Numerical analysis of a field problem, i.e., separation of a large‐sized slate slab from the rock strata in a slate quarry using wedge impacting, was also carried out in this paper. It can be observed that a large magnitude of load is required to break large‐sized slate blocks; but this load is applied through a number of smaller load‐capacity actuators‐in‐parallel, requiring large power capacity for the hydraulic pumps. However, this required power could be reduced considerably if the load applied on the line of hydraulic actuators is cascaded across the (line of) actuators (starting from centrally placed actuators) with a small time delay (equal to the initial crushing time in slate rock).
Repeat retroperitoneal lymph‐node dissection after chemotherapy for metastatic testicular germ cell tumour
Authors: Willis Susan F. , Winkler Mathias , Savage Philip , Seckl Michael J. , Christmas Timothy J. 
Published: August 2007

OBJECTIVESTo examine the operative findings, histopathology and clinical outcome of patients undergoing repeat retroperitoneal lymph node dissection (RPLND) after initial chemotherapy and RPLND (PC‐RPLND) for metastatic testicular germ cell tumour (GCT), as a small proportion relapse or have residual disease after incomplete resection in the lung, retrocrural or pelvic nodes, and retroperitoneum.PATIENTS AND METHODSBetween September 1992 and May 2006, 359 patients had PC‐RPLND under the care of one surgeon, 54 of which were repeat procedures. We compared the long‐term outcome between those having primary and those having repeat PC‐RPLND.RESULTSThe median (range) time from original to repeat surgery was 2.4 (0.25–26.5) years, and the median follow‐up after the repeat procedure was 5.8 (0.08–12.9) years. There was no difference in survival between patients requiring only one PC‐RPLND and those having a repeat procedure (P = 0.592). The most frequent sites of recurrent disease were: behind the great vessels/para‐aortic areas (38, 46%), in the suprahilar region (18, 18%), in the retrocrural area (16, 19%), in the pelvic nodes (10, 12%) and in the lung (one, 1%). The most common pathological findings in the repeat PC‐RPLNDs were differentiated teratoma (19, 35%), malignant teratoma undifferentiated (nine, 17%), adenocarcinoma (eight, 15%) and necrotic tissue (five, 9.2%).CONCLUSIONAlthough a small proportion of patients with metastatic GCT might require repeat PC‐RPLND, there is no difference in survival between this group and those having one PC‐RPLND. However, to avoid cancer recurrence and reoperation, it is crucial that the first PC‐RPLND is careful and complete, preferably done in a centre with expertise in this procedure.
Role of Rho‐kinase in contractions of ureters from rabbits with unilateral ureteric obstruction
Authors: Turna Burak , Cinar Mehtap G. , Canda Abdullah E. , Orhan Elif C. , Tiftik Nalan R. , Nazli Oktay , Buyukafsar Kansu 
Published: August 2007

OBJECTIVETo investigate the expression of two isoforms of Rho‐kinase (ROCK) and its functional role in the pathophysiological control of smooth muscle contraction in rabbits with unilateral ureteric obstruction (UUO).MATERIAL AND METHODSLeft UUO was created in 14 rabbits and eight other rabbits (controls) had sham operations. After 2 weeks all the rabbits were killed. Ureteric strips suspended in an organ bath were used for functional studies and the effects of Y‐27632, a specific inhibitor of Rho‐kinase, on spontaneous contractions and electrical field stimulation (EFS; 50 V, 1 ms, 16 Hz, for 20 s), carbachol‐ (10−7–10−4m), phenylephrine‐ (10−7–10−4m) and KCl‐ (50 mm) induced contractions were analysed. Western blotting was used to determine expression levels of Rho‐kinase protein in the ureters of UUO and control rabbits.RESULTSIn the functional analysis, the contractions induced by EFS, KCl, phenylephrine and carbachol in the ureteric strips from rabbits with UUO were significantly greater than those from the control rabbits. Y‐27632 considerably suppressed the ureter contractile responses in both UUO and control rabbits. Western blot analysis showed that both ROCK‐1 and ROCK‐2 proteins were expressed in the rabbit ureter. In accordance with the functional studies, the expression levels of both ROCK‐1 and ROCK‐2 were significantly greater in the ureters of UUO rabbits than in the controls.CONCLUSIONSY‐27632 suppressed ureteric contractions in the rabbits with UUO. Western blot analysis also confirmed greater expression levels of ROCK‐1 and ROCK‐2 in the ureters of UUO rabbits. It is important to elucidate by which mechanisms the Rho‐kinase pathway affects ureteric function after obstruction.