Treatment outcome of laparoscopic surgery after self-expandable metallic stent insertion for obstructive colorectal cancer

International Journal of Clinical Oncology - We assessed the technical and oncological safety of self-expandable metallic stent (SEMS) insertion followed by laparoscopic colorectal surgery as a...     

Enucleation of the prostate: An anatomical perspective

Among transurethral surgery for benign prostatic hyperplasia (BPH), anatomical endoscopic enucleation of the prostate (AEEP) differs from conventional transurethral surgery as it adopts the same enucleation principle as open surgery. AEEP is known as an effective and safe surgical method. However, the learning curve is steep because the surgical anatomy is different from that of conventional transurethral surgery. If information on surgical anatomy related to enucleation is enriched and surgical standardisation is achieved, the learning curve will be shortened and AEEP will become more widespread. The concept of AEEP has been developed based on the surgical techniques obtained from holmium laser enucleation of prostate (HoLEP). The original surgical technique of HoLEP is a three-lobe technique. At the 12 o'clock position at the prostatic apex, the boundary of the prostate capsule is unclear. Separating anterior prostatic tissue from the prostatic capsule while preserving the sphincter in the apical area is one of the biggest challenges in AEEP. During the AEEP procedure, an accurate understanding of the surgical anatomy of the capsular plane, bladder neck, apical sphincteric area and blood vessels is important. In this article, literature on the anatomy related to enucleation in AEEP, mainly HoLEP, is reviewed and discussed.     

A novel age-related venous amyloidosis derived from EGF-containing fibulin-like extracellular matrix protein 1

Most intractable tissue-degenerative disorders share a common pathogenic condition, so-called proteinopathy. Amyloid-related disorders are the most common proteinopathies and are characterized by amyloid fibril deposits in the brain or other organs. Aging is generally associated with the development of these amyloid-related disorders, but we still do not fully understand how functional proteins become pathogenic amyloid deposits during the human aging process. We identified a novel amyloidogenic protein, named epidermal growth factor-containing fibulin-like extracellular matrix protein 1 (EFEMP1), in massive venous amyloid deposits in specimens that we obtained from an autopsied patient who died of gastrointestinal bleeding. Our postmortem analyses of additional patients indicate that EFEMP1 amyloid deposits frequently developed in systemic venous walls of elderly people. EFEMP1 was highly expressed in veins, and aging enhanced venous EFEMP1 expression. In addition, biochemical analyses indicated that these venous amyloid deposits consisted of C-terminal regions of EFEMP1. In vitro studies showed that C-terminal regions formed amyloid fibrils, which inhibited venous tube formation and cell viability. EFEMP1 thus caused a novel age-related venous amyloid-related disorder frequently found in the elderly population. Understanding EFEMP1 amyloid formation provides new insights into amyloid-related disorders occurring during the aging process. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Cephalometric evaluation of anterior open-bite nonextraction treatment, using multiloop edgewise archwire therapy

There are very few reports of extensive and detailed cephalometric investigations of nonextraction treatment changes for patients with anterior open bite. The purpose of this study was to evaluate changes in dentomaxillofacial morphology by way of lateral and oblique cephalograms of patients who had undergone multiloop edgewise archwire (MEAW) therapy for anterior open-bite correction. The subjects consisted of 21 Japanese female patients who received MEAW therapy without premolar extraction. The mean pre- and posttreatment ages were 16 years 9 months and 19 years, respectively. Lateral and oblique cephalograms were taken before and after treatment. Fifteen angular and 29 linear measurements were obtained from the lateral cephalograms; 17 angular and 20 linear measurements were obtained from the oblique cephalograms. Treatment changes were evaluated by the paired t-test. The upward and forward rotational changes of the mandible consequent to the use of the MEAWs and anterior vertical elastics were larger than the downward and backward rotational changes of the mandible, due to the extrusion of the posterior teeth by leveling and alignment. The uprighting and retrusion of the premolars and molars, and the extrusion, uprighting, and/or retrusion of the incisors and canines played important roles in the anterior open-bite nonextraction treatment by dint of the MEAW technique.     

A study on kinetic frictional properties in Begg/KB orthodontic appliances at posterior sites

In Begg and KB techniques, the kinetic frictional force generated between their characteristic orthodontic appliances at posterior sites and the orthodontic wire affects the efficiency of tooth movement. We compared the kinetic frictional force between the recent orthodontic appliances for posterior sites: the by-pass loop-KB buccal tube system (loop-KB tube system) and the conventional by-pass clamp-round buccal tube system (clamp-round tube system), and elucidated the frictional properties of the loop-KB tube system. We used 016"/018" round wires (016/018 round) and 022" × 016" ribbon wire (022 ribbon) with anchorage bend/curve applied. The results obtained were as follows:

Ultrasonic irrigation of a maxillary lateral incisor with perforation of the apical third of the root

We describe the successful use of a combination of nonsurgical root canal treatment and ultrasonic irrigation for collaborative management of a maxillary left lateral incisor with perforation of the apical third of the root. During the endodontic treatment procedure, the ultrasonically activated tip was used for intracanal irrigation. The area of perforation in the apical third of the root and the main root canal space were obturated with gutta-percha and root canal sealer, using a lateral condensation method. A follow-up clinical and radiographic examination at 5 years after treatment showed an asymptomatic tooth with excellent osseous healing.