Evaluation of Endoscopic Resection of Gastric Tumors Following Local Injections of HSE (Hypertonic Saline-Epinephrine Solution)

Abstract: The Endoscopic resection of gastric tumors following local injections of hypertonic saline-epinephrine solution (ERHSE) was performed on 72 lesions (69 patients) of gastric tumors at Yoyogi Hospital etc. from March, 1983, to December, 1989. These included 40 cases of adenoma, 31 cases of carcinoma, and one carcinoid tumor. The average length of the major axis of the endoscopically resected tumors was 12 ± 9 mm. The curative rate at the first attempt was 94% (64 of 68 lesions). The curative rate of the final procedure was 99% (67 of 68 lesions). This excluded 4 lesions in 3 patients in whom a follow-up examination was not possible. There was no relationship found between the final cure rate and the form and location of the lesions. Fifty four lesions were resected with one session of snare cautery; the average length of their major axis was 9 ± 6mm. The resection of 18 lesions was done piecemeal, and the average length of their major axis was 20 ± 10mm. A statistical significance was noted between the size of the lesions which could be resected with one session of snare cautery and those treated by the piecemeal method, but no difference was noted in the location of lesions for the two groups. The indication for ERHSE was assessed in accordance with the cases that resulted in piecemeal resection, those in which the first ERHSE left residual tumor tissues, and those with perforation. ERHSE could be performed with difficulty on lesions which were (1) on the sharply bending gasric wall, (2) observed only tangentially, (3) inadequately observed. These lesions were situated on the gastric fornix, cardia, and their vicinities, the gastric angulus, posterior wall and greater curvature of the gastric body, and anterior wall and lesser curvature of the middle to the upper gastric body.     

Does transrectal ultrasound guided eight‐core prostate biopsy improve cancer detection rates in patients with prostate‐specific antigen levels of 4.1–10 ng/mL?

BACKGROUND: To investigate retrospectively whether the eight-core biopsy method improves the prostate cancer detection rate when compared with the standard sextant biopsy method in patients with prostate specific antigen (PSA) levels of 4.1-10 ng/mL. MATERIAL AND METHODS: Of 437 patients whose PSA levels ranged from 4.1 to 10 ng/mL, 237 underwent a transrectal ultrasound guided sextant biopsy (sextant group), and 200 underwent an eight-core biopsy (eight-core group). Eight core samples were obtained from each of the far lateral regions in addition to the standard sextant biopsy cores. None of the patients had a previous history of prostate biopsy. RESULTS: Of the 237 patients in the sextant group, prostate cancer was detected in 47 patients (19.8%) and in 50 of the 200 patients in the eight- core group (25.0%). The rates of detection in the two methods were not statistically significant. However, in patients whose PSA density was less than 0.1 ng/mL per cc, the cancer detection rates in the sextant group and the eight-core group were 4.5% and 18.8%, respectively (P = 0.046). The morbidity and complications of the eight-core biopsy method were not notable. CONCLUSIONS: Only in patients with PSA levels of 4.1-10 ng/mL and density of less than 0.1 ng/mL per cc was the eight-core biopsy method an improvement on the sextant biopsy method in terms of prostate cancer detection rate. Accordingly, a number of cores greater than eight will be required to improve the cancer detection rates in patients with PSA levels of 4.1-10 ng/mL and PSA densities of more than 0.1 ng/mL per cc.     

Etiology of 19 infants with apparent life-threatening events: Relationship between apnea and esophageal dysfunction

There are various identifiable diseases or conditions that can cause apparent life-threatening events (ALTE; e.g. gastroesophageal reflux (GER) and seizures). Nineteen infants with ALTE (mean age: 4.3 months) were brought to our hospital between June 1986 and August 1991. The causes of these ALTE were investigated. Analysis of laboratory data, radiological studies and esophageal function tests led to the diagnosis of GER in six of 19 infants; pertussis in five; upper respiratory infection in three; vagotonia-like condition with esophageal dysfunction in two; laryngostenosis with cerebral palsy in two; choking on food or drink in two; and epilepsy in one infant. Two cases (one case of pertussis and one of vagotonia-like condition) were associated with GER. Some of the cases demonstrate that ALTE in infants may be induced by GER or some esophageal dysmotility. Further studies of ALTE are needed to ascertain how frequently GER or esophageal dysmotility is responsible for ALTE.     

搏动辅助血泵的设计构思与实践——从旋涡泵到罗叶泵

目的　由于国际市场供应的各种血泵价格过于昂贵 ,为降低其成本而不降低其质量 ,我们设计制作了旋涡泵和罗叶泵 ,以保持良好的血液流态 ,减少栓塞和溶血等并发症的发生率。　方法　为使血液在泵动周期中始终保持连续的流线和旋涡流态以充分冲洗泵体四周 ,同时避免湍流、再循环和潴流 ,旋涡泵设计为出入血口位于不同的平面上 ,并对泵血功能进行了测定。在血液流态、溶血试验等方面与通用血泵在模拟循环台中进行了比较。罗叶泵遵循相同的原理 ,泵体为拱顶形 ,其顶部有一锥形下凹伸入泵体内部 ,出入血管道相互交叉。由于泵体拱顶不对称 ,出血口高于入血口 ,在收缩期时血流盘旋上升 ,出血口处阻力小于入血口 ,排血更为迅速和彻底。　结果　旋涡泵在血液流态和溶血试验中与通用血泵比较 ,前者均优于后者。旋涡泵在 13次的绵羊实验中 ,最后 4只未经抗凝处理的绵羊 ,于平稳转流 14天后处死(其中 1条 2 1天 ) ,尸体解剖泵内、双肾内均无栓塞。罗叶泵已于 1999年应用于临床 ,成功抢救了 1例危重患者。结论　辅助循环血泵的设计 ,其连续的流线流态、避免湍流、血液潴留和再循环区是防止栓塞形成的关键     

Follicular development and induction of ovulation with human chorionic gonadotropin in the pregnant rat

Aims: The number of ovarian follicles and ovulations after human chorionic gonadotrophin (hCG) was given at various doses during pregnancy were investigated in rats.
Methods: On designated days of pregnancy, rats were injected with hCG at 13.00 hours and the number of ova were observed. The same rats were then killed at 13.00 hours the next day. The ovaries were cut into complete sections. All sections were observed and the size of each follicle was measured.
Results: The number of large (≥550 µm), healthy, non-atretic follicles (Graafian follicles) ranged from 1.5 to 11 during pregnancy. Ovulation was induced in rats at any stage of pregnancy with intramuscular injections of 40 or 50 IU hCG, but 10 IU had no effect and 20 or 30 IU had an incomplete effect. The number of ovulations after 40 IU hCG was 2–12 and there was not a significant difference between the number of ovulations and the number of large, healthy follicles at any point in the pregnancy.
Conclusion: Graafian follicles existed through the pregnancy. Results suggest that although hCG induces ovulation in large ovarian follicles (≥550 µm) during pregnancy, the responsiveness to hCG is lower than in recurrent estrus-stage rats. (Reprod Med Biol 2004; 3 : 201–204)