Citoarhitektura humanog paraventrikularnog jedra

Introduction. The significance of this research in terms of structure and biochemical processes in PVN contributes to further understanding of vital physiological processes from delivery and stress to delicate chemical processes that keep the hypothalamo-hypophysial axis in balance. Conclusion. Comparative studies of the human hypothalamus with the hypothalamus of other mammals enable further research, especially pharmacological and physiological ones. These are made possible with the aid of highly sophisticated equipment for examination of neurophysiological features of the brain.Ovim člankom smo želeli da ukažemo na važnost paraventrikularnog jedra pokazujući novije podele ćelijskih podgrupa, kao i podele prema hemijskom sastavu proteina koji se nalaze u njemu. Fiziološka uloga hipotalamo-hipofiznog kompleksa je svakako uslovljena njegovim vezama sa drugim delovima mozga, kao i hemijskim supstancijama od kojih zavisi prenos signala. Uvođenjem savršenijih tehnika u razvojno-neurobiološka istraživanja, možemo da pratimo i poredimo mnoge delove mozga, pa i paraventrikularno jedro s istim jedrima drugih sisara, a time omogućimo lakši rad na eksperimentalnim modelima fiziološko-farmakoloških i drugih istraživanja

Implementation of endoscopic submucosal dissection in Europe: survey after ten ESD expert training workshops 2009 – 2018

Background and aims Transfer of ESD technique for early gastrointestinal cancer from Japan requires expert-supervised experimental training before unsupervised implementation of clinical ESD. Aims To evaluate unsupervised implementation of ESD-intention-to-treat (-ITT). Methods ESD Workshops (in-vivo porcine model) lasted 3.3 days including one day theory for 177 participants from 135 Western referral centers. A questionnaire was sent to the senior participant of all 135 centers. Design Cross-sectional questionnaire survey. Main outcome measurements Performance, organ distribution, severe adverse events of ESD-ITT. Results Feedback was received from 113 centers (84%), i.e. 73 (54%) ESD centers and 40 centers (30%) with zero ESD; 10 (7%) had published ESD; no feedback from 12 (9%) centers with unknown status. Altogether, 83 centers (61.5%) perform ESD: 21 (16%) had >150 ESD (professional category), 33 (24%) had 31-150 ESD (competent category), and 29 (21.5%) had ≤ 30 ESD (initial learning category). Most implemented ESD centers (91%, 72 of 79) were analyzed: Centers on initial learning (420 ESD) compared to centers with >30 ESD (5676 ESD) performed en-bloc ESD in 64% vs. 84%, hybrid-ESD in 26% vs.11% and piecemeal-EMR in 10% vs. 5.2%. Majority of ESD (66-68%) were in colorectum, overall with low risk (30-day mortality 0.03%, surgical repair 3.5% vs. 1.7%) and satisfactory outcome (oncosurgery 7.4% vs. 5.2%, local recurrence 1.5% vs. 0.3%). Conclusions Beyond guideline recommendations, unsupervised implementation of ESD was successful in colorectum with step-up approach. Now, Western ESD centers have to aim for professional (i.e. >80%) curative ESD

Surveillance after Colorectal Polypectomy : Comparison Between Japan and U.S.

Background: Recently, early detection and early treatment of the colorectal cancer have been enabled by the improvement of endoscopic diagnosis and introduction of new techniques. In Japan, although Japan Polyp Study is running, there is no standard strategy concerning the post-polypectomy colonoscopic surveillance yet. Post-polypectomy colonoscopic surveillance is so far entrusted to each institute or each gastroenterologist at present. Material and method To analyze the present states of the surveillance after polypectomy in Japan, we performed questionary survey and compared them with the results in U.S. and U.S.Multisociety Task Force on colorectal Cancer. A simple random sample of 132 doctors who engaged in a digestive organ disease in plural institutes was obtained. Result: Many doctors recommend surveillance every around 1 year regardless of the kind of the polyp. Doctors in Japan tend to recommend postpolypectomy colonoscopic surveillance more frequently than that recommended U.S. Multisociety Task Force on colorectal Cancer. Furthermore in all types of polyps except for 12 mm tubular adenoma with high grade dysplasia, the majority of doctors in Japan recommend post-polypectomy colonoscopic surveillance more frequently than American doctors. Significant difference was found in surveillance of hyperplastic polyp among doctors with 1 to 5 years experience and those with more than 6 years. Conclusion: It has been shown that surveillance intervals varies substantially in each doctor. The agreement of the surveillance program in Japan is necessary to standardize the strategy for the post-polypectomy surveillance of the colon

Efficacy of a Novel Narrow Knife with Water Jet Function for Colorectal Endoscopic Submucosal Dissection

Backgrounds. With respect to the knife’s design in colorectal endoscopic submucosal dissection (ESD), diameter, water jet function, and electric power are important because these relate to efficient dissection. In this study, we analyzed a novel, narrow ball tip-typed ESD knife with water jet function (Flush knife BT-S, diameter: 2.2 mm, length: 2000 mm, Fujifilm Co., Tokyo, Japan) compared to a regular diameter knife (Flush knife BT, diameter: 2.6 mm, length: 1800 mm). Methods. In laboratory and clinical research, electric power, knife insertion time, vacuum/suction amount with knife in the endoscopic channel, and water jet function were analyzed. We used a knife 2.0 mm long for BT-S and BT knives. Results. The BT-S showed faster mean knife insertion time (sec) and better vacuum amount (ml/min) compared to the BT (insertion time: 16.7 versus 21.6, p<0.001, vacuum amount: 38.0 versus 14.0, p<0.01). Additionally, the water jet function of the BT-S was not inferior. In 39 colorectal ESD cases in two institutions, there were mean 4.7 times (range: 1–28) of knife insertion. Suction under knife happened 59% (23/39) and suction of fluid could be done in 100%. Conclusions. Our study showed that the narrow knife allows significantly faster knife insertion, better vacuum function, and effective clinical results