Technical Progress in Single-Incision Laparoscopic Cholecystectomy in Our Initial Experience

Single-incision laparoscopic cholecystectomy (SILC) has rapidly spread throughout the world because of its low invasiveness and because it is a scarless procedure. Various surgical methods of performing SILC are present in each institute; however, it is necessary to develop a standardized procedure that we can perform safely, such as the conventional 4-port laparoscopic cholecystectomy (LC). The SILC experiment in our institute was started by use of the commercial SILS Port and changed from a 3-port method via an umbilicus to a 2-port method to improve some problems. Although none of the conversions to conventional 4-port LC and also none of the complications such as bile duct injury occurred in each method, the 2-port method functioned best and was also economical. However, it is most important to adopt strict criteria and select the patients suitable for SILC to demonstrate SILC safety same as 4-port LC

Responses to depressive symptom items exhibit a common mathematical pattern across the European populations

The theoretical distribution of responses to depressive symptom items in a general population remains unknown. Recent studies have shown that responses to depressive symptom items follow the same pattern in the US and Japanese populations, but the degree to which these findings can be generalized to other countries is unknown. The purpose of this study was to conduct a pattern analysis on the EU population’s responses to depressive symptom items using data from the Eurobarometer. The Eurobarometer questionnaires include six depressive symptom items from the 12-item General Health Questionnaire. The pattern analysis revealed that, across the entire EU population, the ratios between “score = 2” and “score = 1” and between “score = 3” to “score = 2” were similar among the six items and resulted in a common pattern. This common pattern was characterized by an intersection at a single point between “score = 0” and “score = 1” and a parallel pattern between “score = 1” and “score = 3” on a logarithmic scale. Country-by-country analyses revealed that the item responses followed a common characteristic pattern across all 15 countries. Our results suggest that responses to depressive symptom items in a general population follow the same characteristic pattern regardless of the specific country

DNA double-strand break induction in Ku80-deficient CHO cells following Boron Neutron Capture Reaction

<p>Abstract</p> <p>Background</p> <p>Boron neutron capture reaction (BNCR) is based on irradiation of tumors after accumulation of boron compound. ¹⁰B captures neutrons and produces an alpha (⁴He) particle and a recoiled lithium nucleus (⁷Li). These particles have the characteristics of high linear energy transfer (LET) radiation and have marked biological effects. The purpose of this study is to verify that BNCR will increase cell killing and slow disappearance of repair protein-related foci to a greater extent in DNA repair-deficient cells than in wild-type cells.</p> <p>Methods</p> <p>Chinese hamster ovary (CHO-K1) cells and a DNA double-strand break (DSB) repair deficient mutant derivative, xrs-5 (Ku80 deficient CHO mutant cells), were irradiated by thermal neutrons. The quantity of DNA-DSBs following BNCR was evaluated by measuring the phosphorylation of histone protein H2AX (gamma-H2AX) and 53BP1 foci using immunofluorescence intensity.</p> <p>Results</p> <p>Two hours after neutron irradiation, the number of gamma-H2AX and 53BP1 foci in the CHO-K1 cells was decreased to 36.5-42.8% of the levels seen 30 min after irradiation. In contrast, two hours after irradiation, foci levels in the xrs-5 cells were 58.4-69.5% of those observed 30 min after irradiation. The number of gamma-H2AX foci in xrs-5 cells at 60-120 min after BNCT correlated with the cell killing effect of BNCR. However, in CHO-K1 cells, the RBE (relative biological effectiveness) estimated by the number of foci following BNCR was increased depending on the repair time and was not always correlated with the RBE of cytotoxicity.</p> <p>Conclusion</p> <p>Mutant xrs-5 cells show extreme sensitivity to ionizing radiation, because xrs-5 cells lack functional Ku-protein. Our results suggest that the DNA-DSBs induced by BNCR were not well repaired in the Ku80 deficient cells. The RBE following BNCR of radio-sensitive mutant cells was not increased but was lower than that of radio-resistant cells. These results suggest that gamma-ray resistant cells have an advantage over gamma-ray sensitive cells in BNCR.</p

Laparoscopic Repair of a Ventral Hernia Using Composix E/X Dual Mesh at a Single Institution.

Introduction: Although abdominal ventral hernias are common, there is still no consensus regarding the most appropriatetechnique to be used for surgical repair. We herein present our initial experiences of laparoscopic ventral herniorrhaphy to repairabdominal ventral hernias.Patients: From April 2007 to March 2009, four patients were assigned to recieve laparoscopic ventral hernia repair. The operativetechnique was demonstrated. Additionally clinical factors, including operative time, length of hospital stay, complications,and recurrence rates, were evaluated.Results: All of the patients were successfully treated laparoscopically without conversion to open laparotomy. The median operativetime was 107.5 (range 75 - 130) minutes and the mean length of hospital stay was 13 (range 5 -19) days. There wereno significant complications or hernia recurrences during a follow-up period of 36 months ( median, 28 - 42 ).Conclusion: Laparoscopic repair of abdominal ventral hernias may therefore be a feasible option with a great potential to bothimprove treatment outcomes and reduce surgical morbidity

Comparative Study of Human Hematopoietic Cell Engraftment into Balb/c and C57BL/6 Strain of Rag-2/Jak3 Double-Deficient Mice

Immunodeficient mice are becoming invaluable tools in human stem cell and tumor research. In this study, we generated Rag-2/Jak3 double-deficient (Rag-2−/−Jak3−/−) mice with a C57/BL6 and Balb/c genetic background and compared the human lymphohematopoietic cell engraftment rate. Human cord blood-derived CD34+ hematopoietic stem cells were successfully engrafted into Balb/c Rag-2−/−Jak3−/− mice; however, the engraftment rate was far lower in C57/BL6 Rag-2−/−Jak3−/− mice. Transplantation of human peripheral blood mononuclear cells resulted in the same tendency. Thus, a Balb/c background offers superior engraftment capacity than a C57/BL6 background and provides an attractive model for human hematopoietic cell engraftment

Laparoscopic Management of Omental Torsion Secondary to Inguinal Hernia: Report of a Case

Omental torsion is a rare cause of acute abdomen. The clinical symptoms can mimic other acute abdominal disorders, and therefore manypatients are often diagnosed during a laparotomy performed under a presumptive diagnosis of appendicitis, cholecystitis and so on. Recent advancesin diagnostic modalities has made it possible to determine the correct preoperative diagnosis of omental torsion, and the chances oftreating this rare condition are therefore expected to increase. Laparoscopic surgery has been used extensively for various emergent disorders;however, the laparoscopic management of omental torsion might be troublesome for most surgeons. A case of omental torsion secondary toinguinal hernia is herein reported, where a huge torted omentum was successfully managed laparoscopically. It was useful to hang up thepedicle of the congested and fragile omentum with polyester tape to manage it atraumatically. Moreover this device made it easy to removeof the specimen through a 4-cm minilaparotomy

Small Mucinous Cystic Neoplasm of the Pancreas Successfully Detected and Resected by a Laparoscopic Approach: Report of a Case

Incidentally detected small pancreatic cyst is a therapeutic challenge. As these lesions include a spectrum of pathologies ranging from benignlesions to malignant mucinous tumors, it is important to differentiate potential malignant mucinous cystic neoplasms (MCN) from others.However, a definitive diagnosis might be difficult, since computed tomography (CT) and magnetic resonance imaging (MRI) cannot depict themorphologic features characteristic of small MCN.This report presents a case of a small pancreatic cyst incidentally detected during medical check-up for inguinal hernia. Although the preoperativediagnosis was uncertain with CT and MRI, the diagnosis of MCN was strongly suspected because the majority of MCN tend to oftenoccur in elderly women and the most common locations are in the pancreatic tail. Laparoscopic ultrasonography (LUS) was employed to obtaina correct diagnosis, and it showed a 16 mm cyst with characteristic features indicating a diagnosis of MCN. The patient underwent alaparoscopic distal pancreatectomy and the diagnosis of MCN was confirmed histopathologically. In conclusion, LUS allowed a timely curativeresection of a small MCN in this case