Availability of a remote online hemodynamic monitoring system during treatment in a private dental office for medically high-risk patients

The importance of systemic management to prevent accidents is increasing in dentistry because co-morbid illnesses in an aging society and invasive surgical procedures are increasing. In this prefecture, a new medical system called the remote online hemodynamic monitoring system (ROHMs) was started in 2001. Eight private dental offices participated in this trial. When dental practitioners feel the risk of a dental procedure, they can contact via ROHMs to this hospital. Then, the hemodynamic data (blood pressure, heart rate, ECG, SpO2, and RPP) of the patient in the clinic can be transmitted here via the internet, and the images and the voice can be transmitted as well. The availability of this system was assessed in 66 patients (98 cases). The most frequent complications were hypertension, heart disease, and diabetes mellitus. Systemic management included monitoring during the dental procedure (71.4%), checking vital signs after an interview (15.3%), and monitoring under sedation (13.3%). There were 35.7% of all cases where an unscheduled procedure was necessary for the systemic management. Based on a questionnaire, the majority of the patients felt relieved and safe. This system creates a situation where a specialist is almost present during the procedure. This system will provide significant assistance for future medical cooperation for risk management

Autoimmune Pancreatitis Accompanied by Cholecystitis, Periaortitis and Pseudotumors of the Liver

A variety of extrapancreatic lesions have been associated with autoimmune pancreatitis (AIP), and these lesions can be difficult to diagnose. We report a patient referred to Shizuoka Cancer Center with the diagnosis of a possible biliary carcinoma with liver metastasis who was shown to have AIP accompanied by pseudotumors of liver. Clinical imaging revealed diffuse enlargement of the head of the pancreas with irregular narrowing of the main pancreatic duct and inferior common bile duct, multiple liver masses, mediastinal lymphadenopathy, and thickening of the wall of the gallbladder and abdominal aorta. Cytology and biopsy from the pancreaticobiliary tract was negative for malignancy. Serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA19-9) levels were in the normal range, but soluble interleukin 2 receptor (sIL2R), IgG4 and antinuclear antibody were abnormally high (sIL2R: 2,550 U/ml; IgG4: 764 mg/dl). Corticosteroid therapy was effective and these abnormal findings all improved. This case demonstrates the clinical importance of AIP accompanied by other systemic disorders in the differential diagnosis of patients with a pancreatic mass lesion

Dispersion-Flocculation Behavior of Fine Lead Particles in an Organic Solvent

Methyl ethyl ketone (MEK) is a good solvent for polyvinyl chloride (PVC) and it has been proposed for use in PVC recycling. In the recycling process, fine particles of 3PbOÁPbSO 4 ÁH 2 O, used as a thermal stabilizer in PVC products, are dispersed and not dissolved in the solvent. To establish methods for removing of 3PbOÁPbSO 4 ÁH 2 O particles from the solvent, factors affecting the dispersion-flocculation behavior of the particles in MEK were investigated. The zeta potential and particle distribution of 3PbOÁPbSO 4 ÁH 2 O particles in MEK solutions containing known amounts of H 2 O were measured. Above 5 vol%H 2 O in MEK solutions, the zeta potential of 3PbOÁPbSO 4 ÁH 2 O particles approached zero and the flocculation of particles was achieved. In addition, it was found that Pb 2þ and Cl À affect the zeta potential of the particles. These results indicate that the dispersion-flocculation behavior of lead particles can be influenced by the concentration of H 2 O, Pb 2þ , and Cl À in MEK

Pancreatic stellate cells derived from human pancreatic cancer demonstrate aberrant SPARC-dependent ECM remodeling in 3D engineered fibrotic tissue of clinically relevant thickness

Desmoplasia is a hallmark of pancreatic cancer and consists of fibrotic cells and secreted extracellular matrix (ECM) components. Various in vitro three-dimensional (3D) models of desmoplasia have been reported, but little is known about the relevant thickness of the engineered fibrotic tissue. We thus measured the thickness of fibrotic tissue in human pancreatic cancer, as defined by the distance from the blood vessel wall to tumor cells. We then generated a 3D fibrosis model with a thickness reaching the clinically observed range using pancreatic stellate cells (PSCs), the main cellular constituent of pancreatic cancer desmoplasia. Using this model, we found that Collagen fiber deposition was increased and Fibronectin fibril orientation drastically remodeled by PSCs, but not normal fibroblasts, in a manner dependent on Transforming Growth Factor (TGF)-β/Rho-Associated Kinase (ROCK) signaling and Matrix Metalloproteinase (MMP) activity. Finally, by targeting Secreted Protein, Acidic and Rich in Cysteine (SPARC) by siRNA, we found that SPARC expression in PSCs was necessary for ECM remodeling. Taken together, we developed a 3D fibrosis model of pancreatic cancer with a clinically relevant thickness and observed aberrant SPARC-dependent ECM remodeling in cancer-derived PSCs

Prediction of acid mine drainage formation and zinc migration in the tailings dam of a closed mine, and possible countermeasures

Acid mine drainage (AMD), the very acidic and highly contaminated leachate generated in closed/abandoned mines, is commonly managed by neutralization to raise the pH and precipitate most of the heavy metals. Although effective, this approach does not generate any product of economic value, so it is very costly and unsustainable in the long-term. Unfortunately, there are currently no effective alternatives to neutralization, and one way to improve the sustainability of this process is to reduce the volume of AMD generated and/or the concentration of heavy metals. The tailings dam investigated in this study is located in northern Hokkaido, Japan. Detailed characterization of borehole core samples showed that even after almost 40 years of exposure to the environment, the tailings still contain pyrite (FeS2) and substantial amounts of copper (Cu) and zinc (Zn). Reactive-transport modeling using Visual MODFLOW predicted that AMD quality would likely continue to deteriorate with time and that treatment should be continued for at least 1,000 years. The model also predicted that a barrier with low permeability installed downstream of the tailings dam or ground sealing techniques for recharge reduction could lower the volume of AMD and concentration of Zn from the site

Surgery for pulmonary aspergillosis

Surgery for pulmonary aspergillosis was evaluated in 20 patients who underwent surgery. These included pulmonary aspergillosis in 17, bronchial aspergillosis in 2 and pleural aspergillosis in 1, respectively. The operative procedures were mainly lobectomy and segmentectomy except for one in whom fenestration was carried out. With advances in development of drugs such as fluconazole and miconazole, surgical outcome was improved without any operative death related to surgery as far as healthy polmonary tissues are preserved. Nevertheless, it is emphasized that severity of preexisting disorder should be precisely assessed prior to surgery

CEA in Esophageal Cancer Tissues

The presence of carcinoembryonic antigen (CEA) was assessed in cancer tissues of 53 patients with esophageal carcinoma. Positive rates of CEA staining in tissues were 81.1%. Well differentiated carcinomas tended to be well stained. The survival time in positive tissue CEA patients was longer than that in negative one. The measurement of a presence of tissue CEA is of help to judge the prognosis

Availability of Low Potassium UW Solution for a 24 Lung

A comparative study of preservation solution was made in a 24 hour storaged donor lung between original UW (University of Wisconsin) solution (k = 120mEq/l) and Low potassium UW (k = 30mEq/l) solution. Preservation of a donor lung with low potassium UW solution was superior to that with original UW solution in terms of static compliance and pulmonary vascular resistance. In conclusion, the use of low potassium UW solution is of great value to storage a donor lung

Surgery for Traumatic Injury of the Trachea and Bronchus

Surgery for traumatic disruption of the trachea and the bronchus was evaluated with respect to the surgical outcome in three with tracheal injury and four with bronchial injury. In this series, the results were satisfied except for one who underwent delayed operation. Experience seems to indicate that the primary care to ensure security of air way is of great value in life-saving and guarantee of the outcome including pulmonary function following surgery. In conclusion, it is emphasized that the fortuitous result and preservation of pulmonary function are mandatory for pertinent treatment with expediously precise diagnosis