Anomalous arterial supply to the gallbladder from the superior mesenteric artery: angiography and computed tomography findings in two cases

The arterial supply of the gallbladder usually arises from the right hepatic artery. Other origins include the left, proper, and common hepatic arteries. We report cases of the cystic artery arising from the superior mesenteric artery and arising from the dorsal pancreatic artery originating in turn from the superior mesenteric artery, as demonstrated by angiography and computed tomography.     

Development of variable pitch factor scanning for multislice computed tomography

RATIONALE AND OBJECTIVES: The latest multislice computed tomography (MSCT) scanners permit the chest and abdomen to be scanned continuously. However, conventionally, it has been necessary to perform scanning twice using different pitch factors for the cardiac and abdominal regions. We have developed a new scanning technique known as variable pitch factor scanning, in which the table speed is changed during scanning to obtain continuous images from the heart to the abdomen in a single scan, and have evaluated its physical characteristics. MATERIALS AND METHODS: A bead phantom, a comb phantom, and a gold wire placed at an angle were scanned using a 64-row MSCT scanner. The variation in the spatial resolution and continuity of images in the body axis direction because of changes in the pitch factor were evaluated. RESULTS: Because reconstruction taking the cone angle into consideration was employed, the spatial resolution in the body axis direction was unchanged and the continuity of images in the body axis direction was maintained at a certain level even when the pitch factor was changed. CONCLUSION: Variable pitch factor scanning is a useful technique for obtaining continuous images from the heart to the abdomen in a single scan.     

Fos expression in the brainstem nuclei evoked by nasal air-jet stimulation in rats

BACKGROUND: Noxious stimulation of the nasal mucosa may induce protective reflexes in the upper airway in rats. Previously, we have reported that nasal air-jet stimulation increases the activities of the laryngeal muscles in decerebrate cats; however, the neuronal mechanism of this phenomenon still is not clarified. METHODS: After the application of nasal air-jet stimulation for 2 hours, we investigated the distribution of Fos-positive cells (FPCs) throughout the medulla compared with sham-operated rats using Fos immunoreactivity. RESULTS: FPCs in the spinal trigeminal nucleus, the parvocellular reticular nucleus, and the nucleus of the solitary tract were more frequent than the sham-operated rats. CONCLUSION: These results suggest that the afferents induced by air-jet stimulation were conveyed to these FPCs and that some of these cells might participate in the augmentation of laryngeal muscle activities during nasal air-jet stimulation.     

Lansoprazole ameliorates intestinal mucosal damage induced by ischemia-reperfusion in rats

AIM:To investigate the protective effect of lansoprazoleon ischemia and reperfusion(I/R)-induced rat intestinalmucosal injury in vivo.METHODS:Intestinal damage was induced by clampingboth the superior mesenteric artery and the celiac trunkfor 30 rain followed by reperfusion in male Sprague-Dawleyrats.Lansoprazole was given to rats intraperitoneally 1 hbefore vascular clamping.RESULTS:Both the intraluminal hemoglobin and proteinlevels,as indices of mucosal damage,significantlyincreased in I/R-groups comparion with those of sham-operation groups.These increases in intraluminal hemoglobinand protein levels were significantly inhibited by the treatmentwith lansoprazole at a dose of 1 mg/kg.Small intestineexposed to I/R resulted in mucosal inflammation that wascharacterized by significant increases in thiobarbituric acid-reactive substances(TBARS),tissue-associatedmyeloperoxidase activity(MPO),and mucosal content of ratcytokine-induced neutrophil chemoattractant-1(CINC-1).These increases in TBARS,MPO activities and CINC-1 contentin the intestinal mucosa after I/R were all inhibited bypretreatment with lansoprazole at a dose of 1 mg/kg.Furthermore,the CINC-1 mRNA expression was increasedduring intestinal I/R,and this increase in mRNA expressionwas inhibited by treatment with lansoprazole.CONCLUSION:Lansoprazole inhibits lipid peroxidation andreduces development of intestinal mucosal inflammationinduced by I/R in rats,suggesting that lansoprazole mayhave a therapeutic potential for I/R injury.     

Survival after surgical treatment of early gastric cancer: surgical techniques and long-term survival

Background and aims Recent results from long-term follow-up of a large number of patients who have undergone gastric resection for early gastric cancer (EGC) have not yet been fully evaluated.Patients and methods A total of 848 patients who had undergone gastric resection for EGC (262 female, 586 male; mean age 58.0 years; range 20–86 years) were studied with respect to surgical technique, long-term survival and prognostic factors on the basis of current TNM classification.Results Death related to recurrence occurred in only eight patients (0.9%). Hematogenous metastasis to the liver or bone represented the most common pattern of recurrence, developing in six of the eight recurrences (75%). The 5-year and 10-year cancer-related survival rates were 98.6% and 94.8%, respectively. The 5-year and 10-year overall survival rates were 95.2% and 85.0%, respectively. Lymph node metastasis represented an independent prognostic factor when analyzed on the basis of cancer-related survival.Conclusion The present findings indicate that long-term survival of patients who undergo gastric resection for EGC is extremely good and that lymph node metastasis represents an independent prognostic factor when analyzed according to cancer-related survival. Future developments for the treatment of EGC are expected to improve quality of life for patients after gastric resection.     

Reconstruction of jugular and portal blood flows using remodeled great saphenous vein grafts

Remodeled great saphenous vein grafts were used to reconstruct both jugular and portal veins. The great saphenous vein was split longitudinally and sutured side-to-side to construct a vessel twice the diameter and one half the length of the original vessel. This graft was used with good results for reconstruction of the jugular veins in a patient after a bilateral neck dissection for tongue cancer and for a portal vein in a patient after resection for cancer in the head of the pancreas.     

Revascularization with the branched graft in middle aortic syndrome

A case of middle aortic syndrome which was thought to be the thoracoabdominal type of Takayasu's disease was successfully treated with the branched graft bypass. Patient was a 23 year-old woman with hypertension and abdominal pain. The preoperative angiography revealed aortic stenosis from the celiac axis to the left renal artery. The operative procedures were as follows; patient was positioned in supine with her left shoulder and arm raised. Eighth intercostal thoracotomy and midline laparotomy was performed with the thoracoabdominal incision. The branched graft was made previously with woven Dacron (phi 18 mm) and three EPTFEs (phi 8mm). The woven Dacron of the graft was used for the bypass from the descending thoracic aorta to the infrarenal abdominal aorta, and the branched EPTFEs of the graft were used for the bypasses to the common hepatic artery, the superior mesenteric artery and the right renal artery in this order. The bypasses were placed along the anatomical courses in the retroperitoneal space. Postoperatively, the blood pressure dropped and the abdominal pain disappeared. The plasma renin activity decreased and the renal function improved. Two months after operation the bypasses were patent by the angiography and now six months after operation she has returned to her social life healthily. The approach to the aorta and its abdominal branches by thoracotomy and laparotomy and bypass with the three branched graft was useful for middle aortic syndrome.