Electroretinography of short-wavelength-sensitive cones with a LED built-in electrode and its normal values

To record electroretinograms (ERG) produced by short-wavelength-sensitive cone mechanisms (SWS-cone ERG), the authors used three kinds (blue, green, and red) of light-emitting diode (LED) which were built into a contact lens electrode assembly. The LEDs were used as both stimulus and background light sources. ERG was recorded using blue LED after 10 min of yellow light adaptation produced by green and red LEDs. Duration of photo-stimulation was either 2 or 100 ms. ERG recorded in normal human subjects showed two positive waves with 2 ms photo-stimulation. Amplitude of the former positive wave (b1-wave) was attenuated when the luminance of yellow background increased, and the latter positive wave (b2-wave) was attenuated when the color of photo-stimulation was green or red. These findings suggest that middle-wavelength-sensitive and long-wavelength-sensitive cone mechanisms generated the former positive wave (b1-wave) and SWS-cone mechanisms generated the latter positive wave (b2-wave). Ratio of b2-wave-amplitude to b1-wave-amplitude with 2 ms photo-stimulation measured on 39 normal subjects ranged from 0.5 to 2.0. It was concluded that this three-colored LED built-in electrode was useful for recording SWS-cone ERG.     

Antigenicity of porcine cornea as xenograft

PURPOSE: To investigate the antigenicity of porcine corneal stroma as xenograft to man. METHODS: The localization of alpha-gal epitope in the porcine eye was determined using biotinylated Griffonia simplicifolia 1 isolectin B4. Porcine corneal stromal was inserted into corneal stromal pockets of cynomolgus monkeys. Immunohistochemistry was performed to analyze the immunological reaction in the monkey. RESULTS: Immunohistochemistry showed no alpha-gal epitope in the porcine cornea except for several keratocytes in the anterior-most part. Haze and keratic precipitates developed in two corneas out of three corneas that were followed up until 6 months after the surgery. In these two corneas, infiltrating cells included CD4+, CD8+, or HAM56+ cells, suggesting that haze and keratic precipitates were induced by cellular rejection to porcine corneal stroma. CONCLUSIONS: Porcine corneal stroma induces no hyperacute rejection but mild cellular rejection when transplanted in the cornea of cynomolgus monkeys.     

A prospective, Internet-based study of the effectiveness and safety of influenza vaccination in the 2001-2002 influenza season

The effectiveness of the influenza vaccine used in the 2001-2002 influenza season in Japan was investigated in a large-scale, geographically widely distributed, Internet-based study. Data were collected from 8841 of 9902 subjects registered by 38 clinics prior to the start of influenza season. Subjects were categorized into three groups by vaccination regimen: unvaccinated, vaccinated once, and vaccinated twice. Efficacy was also analyzed for three age groups: 0-15, 16-64, and 65-104 years. Influenza-like illness (ILI) was diagnosed according to Ministry of Health (MWH, Labor and Welfare in Japan) criteria. Laboratory-confirmed influenza cases were analyzed separately. The respective vaccine efficacy in the 0-15 years group for the one- and two-dose regimens was 67.6 and 84.5% for ILI and 54.0 and 79.8% for laboratory-confirmed influenza. Influenza vaccination was also shown to be effective in subjects 16-64 years. Vaccine effectiveness was not able to be determined for the over 65 years group, probably due to an insufficient number of infected patients. These results suggest that influenza vaccination is effective for children and adults and that a two-dose regimen is superior to a single dose in children 0-15 years.     

Comparison of I-123 IMP and Ga-67 citrate scintigraphy of malignant melanoma

I-123 iodoamphetamine (IMP) and Ga-67 scintigraphy of malignant melanoma were performed to compare the accumulation of these tracers regarding tumor diameter to determine the site of I-123 IMP accumulation and to evaluate the use of I-123 IMP and Ga-67 in postoperative follow-up. The studies involved 44 patients with a definite diagnosis of malignant melanoma during a 10-year period from April 1991 through March 2001. In this study a very high detection rate of 90.9% was obtained for primary foci with I-123 IMP. With Ga-67, the primary site detection rate was 25%. The results suggest that I-123 IMP is superior to Ga-67 with respect to the detection rate of primary site.     

Minilaparotomy may be independently associated with reduction in inflammatory responses after resection for colorectal cancer

OBJECTIVES: A minilaparotomy approach (skin incision less than 7 cm) to resection of colon cancer is technically feasible, but objective data supporting its benefit are scarce. The aim of this study was to clarify whether minilaparotomy is independently associated with a reduction in the acute inflammatory response after resection of colorectal cancer. DESIGN: Thirty-one patients who underwent surgical resection of colorectal cancer using minilaparotomy or conventional laparotomy were included in this nonrandomized prospective study. Inflammatory responses were evaluated with serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels. RESULTS: In both the minilaparotomy and conventional laparotomy groups, serum IL-6 and CRP levels significantly increased 24 h after the operation (1POD) compared to preoperative levels (p < 0.0001 and p < 0.0001, respectively). Median serum levels of IL-6 and CRP in the minilaparotomy group were significantly lower at 1POD versus the conventional group (p = 0.0066 and p = 0.0033, respectively). Multivariate analyses showed that a smaller increase in serum IL-6 or CRP levels at 1POD [less than 75th percentile (112.9 or 10.6 mg/ml, respectively)] was independently related to only minilaparotomy. CONCLUSIONS: These data in this nonrandomized trial suggest that minilaparotomy may be independently associated with reduced inflammatory responses in colorectal cancer resection.     

General anesthesia for disabled patients undergoing dental treatment in a general hospital

BACKGROUND: General anesthesia for dental treatment in disabled patients may present particular problems, especially when it is done in a general hospital, compared with specialized dental hospitals. METHODS: We surveyed 24 patients who underwent dental treatment under general anesthesia in our institution during the last decade. RESULTS: Electrocardiography or chest x-ray photography was not obtained in 8 patients owing to lack of patients' cooperation. Slow induction with sevoflurane was selected in 5 patients, because intravenous cannulae could not be placed owing to their rejection. Nasotracheal intubation was performed in all patients, but no difficulty in intubation was documented. As postoperative complications, we observed convulsion in one patient and muscle rigidity in another, but no critical troubles related to circulatory or respiratory status. In patients who were treated for more than ten teeth, we observed differences in age, body weight, duration of anesthesia, maximum concentration of sevoflurane administered during anesthesia, and use of postoperative analgesics compared with the other patients. CONCLUSIONS: We found particular problems of anesthesia for disable patients undergoing dental treatment in a general hospital, and suggest that information on numbers of teeth to be treated is helpful.     

Sling suspension of the liver in donor operation: a gradual tape-repositioning technique

BACKGROUND: To control bleeding in the deeper parenchymal plane in right hepatectomy, Belghiti et al. (J Am Coll Surg 2001;193:109) proposed a liver-hanging maneuver using a sling passed between the anterior surface of the inferior vena cava (IVC) and the liver parenchyma. We applied this technique in donor operations in which a hepatic parenchymal transection should be performed before dividing the feeding or draining vessels for the graft. METHODS: After passing a tape between the liver and the IVC, the lower tip of the tape is pulled up behind the hepatic hilum to enable effective traction of the dorsal part of the liver. To preserve significant middle hepatic vein (MHV) tributaries in right-liver graft, the tape is gradually repositioned behind the veins, and parenchymal transection is completed before dividing the venous tributaries. Congestion of the graft is minimal until harvest. In right hepatectomy with the MHV, the tape is switched behind the MHV to preserve the MHV. RESULTS: Since March 2000, this technique has been used in 71 consecutive donor operations, including 37 right hepatectomies without the MHV, 8 right hepatectomies with the MHV, 20 left hepatectomies with the caudate lobe, and 6 right lateral sectorectomies. Taping behind the liver was successful in all but one donor (98.6%). There were no major complications related to this procedure. CONCLUSIONS: This new approach to the sling suspension of the liver with a gradual tape manipulation facilitated the suspending action and was useful in four types of donor operation. These techniques are feasible in most living donors and are recommended as basic procedures to enhance the safety of the donor and the quality of the graft.     

Correlation between lymph node micrometastasis and histologic classification of small lung adenocarcinomas,in considering the indication of limited surgery

The validity of limited surgery for lung carcinomas have not been clearly established. Several reports suggest that not only tumor size but also the histological findings may be of importance in this role. By conducting immunohistochemical examinations of lymph node micrometastases from small lung adenocarcinomas, we considered the suitability of limited surgery for especially localized bronchioloalveolar carcinoma (LBAC) without active fibroblastic proliferation (Noguchi's histologic classification types A and B). In this study, we enrolled 54 patients with lung adenocarcinoma smaller than 2 cm in diameter. Lymph node involvement was demonstrated in 11 (20.4%) patients. Lymph node micrometastasis was present in 11 (25.6%) of the 43 patients at pN0 disease. However, 13 patients with LBAC without active fibroblastic proliferation (types A and B) had neither lymph node involvement nor micrometastasis. Our results indicate that limited pulmonary resection may be acceptable procedure for LBAC without active fibroblastic proliferation.