First clinical experience with IVR-CT system in the emergency room: Positive impact on trauma workflow

Recently, computed tomography (CT) has gained importance in the early diagnostic phase of trauma care in the emergency room. We implemented a new trauma workflow concept with CT in our emergency room that allows emergency therapeutic intervention without relocating the patient. Times from patient arrival to CT initiation, CT end, and definitive intervention were significantly shorter with our new protocol than were those with the conventional CT protocol. Our new workflow concept, which provides faster time to definitive intervention, appears to be effective

Structural and Expressional Alterations of Episomal and Integrated Human Papillomavirus Type 16 in Precancerous Lesions and Carcinomas of the Cervix.

HPV infection has long been implicated in the development of cervical car-cinoma. We have analyzed the HPV 16 genome structure and expression of the viral mRNA in cervical intraepithelial neoplasias (CINs) and cervical car-cinomas by using modified polymerase chain reaction (PCR) methods. Genome structure has been determined by PCR using multi-primer sets which are located in each open reading frames and then these results have been compared with the physical state of the viral DNA determined by two-dimensional electrophoresis. Furthermore, we have analyzed the expression of HPV 16 mRNA and genome structure using DNA and RNA simultaneously extracted from CINs and cervical carcinomas using PCR and reverse transcription (RT-) PCR. Our data showed that the DNA regions from the El to Ll region were delet-ed in two of three CINs containing episomal HPV 16 and three out of seven cervical carcinomas containing integrated HPV 16. However, the E6/E7 region was conserved in all the HPV 16-positive samples. RT-PCR analysis has determined the presence of mRNA species which could encode the E6, E6*I, E6*II, E7, E2, E2 ? C, E1^E4, E1^E2 ? C, E4, E2 ? C-E5 and L2 proteins. The overall results of DNA and mRNA analyses in cervical lesions indicated that the expression patterns of the early and late transcripts studied were not specifically related to the grade of malignancy and the physical state or the deletion of the viral genome. Furthermore, alterations in the splicing pat-terns of HPV 16 transcripts may not be involved in tumor progression

The Double Polymerase Chain Reaction with Consensus Primers Permits Rapid and Sensitive Detection of Genital Human Papillomavirus Oncogenes

We have developed a sensitive procedure for the detection of relatively low copy numbers of multiple genital human papillomaviruses (HPVs) using the polymerase chain reaction (PCR). HPV DNAs were detected by agarose gel electrophoresis and ethidium bromide staining after 2 rounds of PCR amplification (double PCR) with outer and inner consensus primer pairs for HPV-6, 11, 16, 18, 31, 33, 52, and 58. The detection limit of this method (i. e., 10?? copy of HPV DNA per cell in 1 μg cell DNA) was sufficient for analysis of cervical intraepithelial neoplasia (CIN) specimens. Overall prevalence rate of HPV was 100% in 20 cases of CIN specimens. HPV typing by restriction enzyme analysis revealed that HPV-16 sequence was present in 11 cases, HPV-18 in 1 case, HPV-31 in 4 cases, HPV-33 in 1 case, HPV-52 in 2 cases, HPV-58 in 3 cases, and an unidentified type(s) in 3 cases. There were 4 cases of mixed infections. This procedure obviates the use of hybridization- based for-mat for identification of at least 8 types of HPV sequences present in a small fraction of cells within a heterogeneous population

成人T細胞白血病/リンパ腫のクローン構成を評価する新規方法の開発

長崎大学学位論文 [学位記番号]博（医歯薬）甲第1308号 [学位授与年月日]令和3年3月3

Assessment of the Initial Diagnostic Accuracy of a Fragility Fracture of the Sacrum: A Study of 56 Patients

Study Design Retrospective study. Purpose To investigate the clinical manifestations of a fragility fracture of the sacrum (FFS) and the factors that may contribute to a misdiagnosis. Overview of Literature The number of patients diagnosed with FFS has increased because of extended life expectancy and osteoporosis. Patients with FFS may report nonspecific symptoms, such as back, buttock, groin, and/or leg pain, leading to a misdiagnosis and a delay in definitive diagnosis. Methods Fifty-six patients (13 males and 43 females) with an average age of 80.2±9.2 years admitted to the hospital for FFS between 2006 and 2021 were analyzed retrospectively. The following patient data were collected using medical records: pain regions, a history of trauma, initial diagnoses, and rates of fracture detection using radiography, computed tomography (CT), and magnetic resonance imaging (MRI). Results Forty-one patients presented with low back and/or buttock pain, nine presented with groin pain, and 17 presented with thigh or leg pain. There was no history of trauma in 18 patients (32%). At the initial visit, 27 patients (48%) were diagnosed with sacral or pelvic fragility fractures. In contrast, 29 patients (52%) were initially misdiagnosed with lumbar spine disease (23 patients), hip joint diseases (three patients), and buttock bruises (three patients). Fracture detection rates for FFS were 2% using radiography, 71% using CT, and 93% using MRI. FFS was diagnosed definitively using an MRI with a coronal short tau inversion recovery (STIR) sequence. Conclusions Some patients with FFS have leg pain with no history of trauma and are initially misdiagnosed as having lumbar spine disease, hip joint disease, or simple bruises. When these clinical symptoms are reported, we recommend considering FFS as one of the differential diagnoses and performing lumbar or pelvic MRIs, particularly coronal STIR images, to rule out FFS