Anterior tributaries of the portal vein at the superior margin of the pancreas Is “tunneling” procedure safe during pancreatic surgery?

Background. It is widely believed that using the “tunneling” procedure during pancreatoduodenectomy is a safe maneuver because the anterior tributaries of the portal vein (PV) are absent or very rare. Methods. The head of the pancreas with the duodenum and the common bile duct (CBD) was obtained from 22 autopsy cases. Three colors of silicon-polymerase dyes were injected into the pancreatic artery, PV, and bile duct. The tributaries of the PV at the superior margin of the pancreas were studied.     

The development of a multichannel electrode array for retinal prostheses

The development of a multielectrode array is the key issue for retinal prostheses. We developed a 10 × 10 platinum electrode array that consists of an 8-μm polyimide layer sandwiched between 5-μm polymonochloro-para-xylylene (parylene-C) layers. Each electrode was formed as a 30-μm-high bump by Pt/Au double-layer electroplating. We estimated the charge delivery capability (CDC) of the electrode by measuring the CDCs of two-channel electrode arrays. The dimensions of each electrode of the two-channel array were the same as those of each electrode formed on the 10 × 10 array. The results suggest that for cathodic-first (CF) pulses, 80% of electrodes surpassed our development target of 318 μC/cm², which corresponds to the charge density of pulses of 500 μs duration and 200 μA amplitude for a 200-μm-diameter planar electrode.     

Changes of Plasma Fibronectin in Patients Treated with Cryofiltration for an Extended Period

Abstract: The purpose of this study was to evaluate correlations between extra domain A fibronectin (EDA[+]FN) in plasma and the clinical course in cryofiltration for an extended period. Two patients with systemic lupus erythematosus (SLE), 1 with aortitis syndrome, 1 with ankylosis spondylitis, 1 with polymyositis, 1 with rheumatoid arthritis, and 1 with chronic rejection of a kidney graft, were regularly treated with cryofiltration for more than 3 years. The average level of EDA(+)FN in each year did not show significant change in clinically stable patients with aortitis syndrome, polymyositis, and SLE. In the patient with ankylosis spondylitis, the average level of EDA(+)FN in each year elevated, so cryofiltration was performed frequently. On the other hand, cryofiltration could not attenuate the progression in the juvenile rheumatoid arthritis patient. In the patient with chronic rejection of a kidney graft, kidney function without hemodialysis could be prolonged for 33 months by cryofiltration. The average level of EDA(+)FN elevated as the graft function got worse. Changes of average level of EDA(+)FN in plasma corresponded with changes in the clinical courses of patients with autoimmune disease and chronic rejection of a kidney graft. The EDA(+)FN level might give prognostic information and determine the interval of cryofiltration.     

Experimental study of paraplegia caused by spinal tumors: an animal model of spinal tumors created by transplantation of VX2 carcinoma.

BACKGROUND: Little is known about the mechanism of the paraplegia produced by metastatic spinal tumors, although the quality of life of patients with paraplegia caused by malignant tumors depends to a great extent on treatment of the paraplegia. We previously established an experimental model of malignant femoral tumors by transplanting VX2 carcinoma into the femur, and we have reported the efficacy of chemical embolic therapy, radiotherapy and hyperthermal therapy in treating the tumors in the model. PURPOSE: The purpose of the present study was to establish an animal model of metastatic spinal tumors by transplanting VX2 carcinoma into a pedicle and to analyze the mechanism of the paraplegia produced by metastatic spinal tumors. STUDY DESIGN: An experimental study. METHODS: VX2 carcinoma that had been successively transplanted to the thigh muscles of Japanese White rabbits in the Department of Orthopaedic Surgery of Kyorin University School of Medicine was used. The third lumbar vertebra of 37 healthy rabbits was exposed, and a piece of VX2 carcinoma was transplanted into a hole created in the pedicle with an air drill after transplantation. The animals were examined every other day. As soon as paraplegia developed, the animals were sacrificed, and the axial localization of the tumor was evaluated based on the surgical staging of the spinal tumor (SSST classification by Tomita). Roentgenographic, histological and angiographic studies were also performed. RESULTS: Twenty-two rabbits (60%) had paraplegia at the time of the final examination. Seventeen of them had complete paraplegia, and the other five had incomplete paraplegia. The average interval until incomplete paraplegia developed was 18.4+/-4.3 days, and the average interval until complete paraplegia developed was 30.0+/-4.3 days. The average proportion of the diameter of the spinal canal occupied by the tumor was 37.2+/-4.9% in the incomplete cases, and 70.6% in the complete cases. The radiographs revealed an osteolytic area in the pedicle and posterior border of the third lumbar vertebra in the rabbits with complete paraplegia, but no osteolytic areas were detected in the rabbits with incomplete paraplegia. According to the SSST classification, the lesions of all of the rabbits with paraplegia were classified as stage IV. Pathological studies revealed that the spinal cord generally exhibited degenerative change, especially at the site of tumor compression. No tumor cells had invaded the spinal cord. Microangiography showed a marked reduction in blood vessels in the gray matter of the spinal cord in the complete paraplegia in comparison with incomplete paraplegia. CONCLUSION: Our method succeeded in establishing a model of metastatic spinal tumors, because the natural history of the disease, including the anatomical location of the tumors and the imaging findings, was similar to the natural history in clinical cases. This model was useful for elucidating the pathogenetic mechanism of the paraplegia caused by metastatic spinal tumors.     

Cerebral sinus thrombosis in patient with ulcerative colitis--case report.

Left transverse sinus thrombosis developed in a 27-year-old male with ulcerative colitis. The diagnosis was based on cerebral angiography and magnetic resonance (MR) imaging, the latter of which clearly delineated the intraluminal thrombus. Serial MR images demonstrated thrombus organization. The use of this method in the diagnosis of cerebral sinus thrombosis might reduce the need for cerebral angiography.     

Tumor histology in lymph vessels and lymph nodes for the accurate prediction of outcome among breast cancer patients treated with neoadjuvant chemotherapy

The present study investigated fibrotic foci (FFs), the grading system for lymph vessel tumor emboli (LVTEs), and the histological characteristics of nodal metastatic tumors that were significantly associated with the outcomes of 115 patients with invasive ductal carcinoma (IDC) who had received neoadjuvant chemotherapy. We compared the outcome predictive power of FFs, the grading system for LVTEs, and the histological characteristics of metastatic tumors in lymph nodes with the well-known clinicopathological characteristics of tumor recurrence and tumor-related death in multivariate analyses. The presence of FFs, as assessed by a biopsy performed before neoadjuvant chemotherapy, significantly increased the hazard rates (HRs) for tumor-related death in all the cases and in cases with nodal metastasis. The grading system for LVTEs, which was assessed using surgical specimens obtained after neoadjuvant chemotherapy, was significantly associated with increasing hazard rates (HRs) for tumor recurrence and tumor-related death in all the cases and in cases with nodal metastasis. Moderate to severe stroma in nodal metastatic tumors and five or more mitotic figures in nodal metastatic tumors were significantly associated with elevated HRs for tumor recurrence and tumor-related death among all the cases. These results indicated that FFs, the grading system for LVTEs, and the histological characteristics of tumor cells in lymph nodes play important roles in predicting the tumor progression of IDCs of the breast in patients treated with neoadjuvant chemotherapy. ( Cancer Sci  2009; 100: 1823–1833)     

Isolation and characterization of I5B2, a new phosphorus containing inhibitor of angiotensin I converting enzyme produced by Actinomadura sp

A new inhibitor of angiotensin I converting enzyme, I5B2, was isolated from the culture broth of Actinomadura sp. No. 937ZE-1. This compound contains N-methylvaline, tyrosine and 1-amino-2-(4-hydroxyphenyl)ethylphosphonic acid. The microorganism also produced another inhibitor, I5B1, which is identical with K-4 isolated from Actinomadura sp. as an antihypertensive agent.     

Induction of heme oxygenase-1 after hyperosmotic opening of the blood-brain barrier

The induction of the stress protein heme oxygenase-1 (HO-1) was studied in the rat brain after intracarotid administration of hyperosmolar mannitol. HO-1 was immunolocalized in fixed sections of brain 24 h to 7 days after injection. Immunoglobulin G (IgG) was immunolocalized in adjacent sections to demonstrate areas of breakdown of the blood–brain barrier. Induction of HO-1 was also evaluated by Western immunoblots, performed at 24 h after the insult. Immunofluorescent double labelling with monoclonal antibodies to HO-1 and either glial fibrillary acidic protein or the complement C3bi receptor was used to determine if glia/macrophages expressed HO-1. There was pronounced, widespread induction of HO-1 in the ipsilateral hemisphere and cerebellum by 24 h both by immunocytochemistry and by Western blots. This induction was markedly attenuated at later times. HO-1 was induced in astrocytes and microglia/macrophages in the ipsilateral hemisphere. In addition, the protein was induced in Bergmann glia and scattered microglia/macrophages in the cerebellum. The mechanism of induction of HO-1 in glia after opening of the blood–brain barrier could include exposure to heme proteins, denatured proteins and other plasma constituents known to induce HO-1. This glial induction may reflect a protective response of these cells.