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Purpose The current state and effectiveness of abdominal ultrasonography (US) were investigated by reviewing statistical data for US of the kidney as part of complete medical screenings conducted at our institution between April 1994 and March 2004. Methods Among 4339 individuals with US findings, computed tomography (CT) was performed on 129 individuals at our institution. Among these individuals, US findings and CT diagnoses were compared and analyzed. Results US findings indicated renal tumors in 73 of the 129 subjects, and the breakdown of CT diagnoses for these 73 individuals was as follows: no lesion, n = 45 (61.6%); simple renal cyst, n = 13 (17.8%); complicated renal cyst, n = 5 (6.8%); suspected malignant tumor, n = 5 (6.8%); renal angiomyolipoma, n = 2 (2.7%); pelvic dilatation, n = 1 (1.4%); granuloma, n = 1 (1.4%); teratoma, n = 1 (1.4%). Magnetic resonance imaging (MRI) was performed on 4 of the 5 subjects with suspected malignant tumor, and surgery was performed in all 4 cases with suspected kidney cancer. Kidney cancer was histopathologically confirmed in 2 patients, resulting in a detection rate of 0.046% for kidney cancer by US as part of a complete medical screening. In the 2 patients with kidney cancer, differentiating cystic renal cell cancer from a renal cyst was not possible based on US findings alone in 1 patient, and no thorough examinations were performed in the 3 years leading up to surgery. Conclusions These results suggest that additional US and thorough examinations are necessary if a lesion cannot be confirmed as a simple renal cyst on initial US. Furthermore, to improve the skill levels of healthcare professionals who perform and interpret US, a feedback system should be established where data related to complete medical screenings are available to the personnel involved.  相似文献   
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Minimally invasive endoscopic surgery in the neck, first reported by Gagner in 1996, has been adopted by a number of other surgical specialties. We have developed new techniques for performing endoscopic enucleation lipoma. Using our new techniques, various complications, such as injury to nerves and vessels, are prevented. The technique generates cosmetically satisfying results. Expansion of minimally invasive surgery into the facial area will be enhanced by the future development of instruments for this area, and decrease operating time and hospital stay.  相似文献   
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Background

Necrotizing enterocolitis (NEC) is a disease known to cause injury to multiple organs including the liver. Liver regeneration is essential for the recovery after NEC-induced liver injury. Our aim was to investigate hepatic proliferation and progenitor cell marker expression in experimental NEC.

Methods

Following ethical approval (#32238), NEC was induced in mice by hypoxia, gavage feeding of hyperosmolar formula, and lipopolysaccharide. Breastfed pups were used as control. We analyzed serum ALT level, liver inflammatory cytokines, liver proliferation markers, and progenitor cell marker expression. Comparison was made between NEC and controls.

Results

Serum ALT level was higher in NEC (p < 0.05). The mRNA expression of inflammatory cytokines in the liver was also higher in NEC (IL6: p < 0.05, TNF-α: p < 0.01). Conversely, mRNA expression of proliferation markers in the liver was lower in NEC (Ki67; p < 0.01, PCNA: p < 0.01). LGR5 expression was also significantly decreased in NEC as demonstrated by mRNA (p < 0.05) and protein (p < 0.01) levels.

Conclusions

Inflammatory injury was present in the liver during experimental NEC. Proliferation and LGR5 expression were impaired in the NEC liver. Modulation of progenitor cell expressing LGR5 may result in stimulation of liver regeneration in NEC-induced liver injury and improved clinical outcome.

Level of evidence

Level IV.  相似文献   
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Objectives

Renal cell carcinoma (RCC) is characterized by a propensity for extension into the renal vein and inferior vena cava (IVC) and is associated with poor prognosis. BAP1 mutation, which occurs in about 15% of patients with clear cell RCC (ccRCC), also predicts poor prognosis. The aim of this study was to elucidate the association between BAP1 protein expression and clinicopathological outcomes in patients with nonmetastatic ccRCC with an IVC tumor thrombus (IVCTT).

Material and methods

Thirty-five patients with nonmetastatic ccRCC with an IVCTT who underwent radical nephrectomy and tumor thrombectomy at our institution from 1999 to 2010 were retrospectively evaluated. Immunohistochemical (IHC) analyses were performed for the expression of BAP1 protein, and the associations between the expression of BAP1 and clinical outcomes were assessed. Survival analyses were performed using the Kaplan-Meier method and log-rank test. Multivariate analyses of the associations between disease-free survival (DFS) and clinical variables including BAP1 protein expression, tumor size, Karnofsky performance status (KPS) score, and the extension level of the tumor thrombus were performed using a Cox proportional hazard model.

Results

The median follow-up time was 58.8 months (range: 2–130 months). The median age was 68 years (range: 37–80 years). The median size of the primary tumor was 9.6 cm (range: 3.0–15.0 cm). The IVCTT extended above and below the diaphragm in 10 (28.6%) and 25 (71.4%) patients, respectively. The KPS score was>80 in 23 patients (65.7%). BAP1 protein expression on IHC was positive in 24 cases (68.8%) and negative in 11 cases (31.2%). The median overall survival in cases with BAP1-negative and -positive tumor on IHC staining were 44.7 and 81.5 months, respectively (P = 0.052). BAP1-negative tumor on IHC staining was associated with a significantly shorter DFS than BAP1-positive tumor (median DFS = 10.0 vs. 26.0 months, respectively; P = 0.011). Multivariate analysis showed that only BAP1-negative tumor on IHC staining was significantly associated with shorter DFS (P = 0.004).

Conclusions

Patients whose tumors had loss of BAP1 protein expression were significantly associated with poor prognosis in patients with ccRCC with an IVCTT who underwent radical nephrectomy and tumor thrombectomy.  相似文献   
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