ノウホウナイ シュッケツ ニ トモナイ シンゴウ キョウド ノ コトナッタ タボウセイ ノウホウ オ テイシタ スイショウエキセイ ノウホウ センシュ ノ 1レイ

症例は33歳，女性．経時的に増大する膵体部嚢胞性病変を認めた．MRIではT1強調画像で低信号を呈する部位とT1強調画像で淡い高信号を呈する，信号強度の異なる大小不同の多房性嚢胞性病変を認め，MRCPおよび超音波内視鏡検査で主膵管拡張および腫瘍と主膵管との交通が疑われた．以上よりmixed typeの膵漿液性嚢胞腺腫を疑ったが粘液性嚢胞腺腫や膵管内乳頭粘液性腫瘍を否定できず，腹腔鏡下脾温存膵体尾部切除術を施行した．病理組織学的検査所見では卵巣様間質は認めず，主膵管交通も認めず，mixed typeの膵漿液性嚢胞腺腫と診断した．膵漿液性嚢胞腺腫は漿液性嚢胞液を有するが，異なった信号強度を呈する多房性嚢胞を有するものはまれである．今回われわれは，信号強度の異なった多房性嚢胞を呈した膵漿液性嚢胞腺腫の1例を経験したので報告する．A 33-year-old woman presented at our hospital with cystic tumor increased over time at pancreatic body. Magnetic resonance image revealed multilocular cysts with different signal intensities, which were mixed to low and slightly high intensities in T1 weighted image. Moreover, the connection of the cyst and main pancreatic duct was suspected by magnetic resonance cholangiopancreatography and endoscopic ultrasonography. We diagnosed as mixed-type serous cystadenoma, yet we could not contradict mucinous cystadenoma and intraductal papillary mucinous neoplasm. Therefore, we performed laparoscopic spleen preserved distal pancreatectomy. Histopathological findings revealed mixed-type serous cystadenoma, and the connection of the cyst and main pancreatic duct was not seen. Serous cystadenoma usually has serous discharge in the cyst and shows uniform signal intensity in the image findings. However, serous cystadenoma with different signal intensities in the multilocular cysts is relatively rare. We described a case of serous cystadenoma of the pancreas with different signal intensities in the multilocular cysts that was treated by laparoscopic surgery

ドウニュウ カガク リョウホウ ニテ コンチ セツジョ ガ カノウ トナッタ ケイブ ショクドウガン ノ 1レイ

　症例は50歳代，男性．咽頭痛，嚥下障害を主訴に近医受診し，上部消化管内視鏡検査にて頸部食道に1/4周性のtype3病変(squamous cell carcinoma)と食道胃接合部に0-IIa+IIc病変(adenocarcinoma)を指摘され，当院当科紹介となった．造影CT検査にて左頸部に原発巣と一塊となった腫瘤を認め，左総頸動脈及び気管への浸潤を認めた．精査の結果，頸部食道癌cT4bN2M0 cStageIVa，バレット食道腺癌cT1bN0M0 cStageIと診断し，切除不能局所進行食道癌であり導入化学療法の方針とした．DCF(Docetaxel/Cisplatin/5-Fluorouracil) 療法3コースで病変の縮小が得られ，頸部腫瘍は長径37mmから17mmとなり，総頸動脈の浸潤が解除されたため，根治術を行う方針とした．手術は咽頭喉頭食道全摘，頸部縦隔腹部リンパ節郭清，後縦隔経路遊離空腸付加胃管再建，腸瘻造設術を施行した．術中偶発症なく，手術時間846分，出血量670mLであった．病理組織学的検査では，頸部食道癌ypT4aN2M0 ypStegeIII，治療効果Grade 1b，バレット食道癌ypT1b-SM2N0M0 ypStageI，治療効果Grade 1aであった．術後経過は概ね良好で術後9日目より経口摂取を開始し，術後18日目に退院となった．　切除不能局所進行食道癌に対する標準治療は化学放射線療法であるが，近年，DCF療法による導入化学療法後の外科的切除の有用性が報告されている．今回，導入化学療法により根治切除可能であった頸部食道癌，食道腺癌の重複例を経験したため報告する．　A 58-year-old man with sore throat and dysphagia revealed type 3 lesion in cervical esophagus and 0-IIa+IIc lesion in esophagogastric junction on upper gastrointestinal endoscopy. Histopathologic examination of biopsy specimens showed squamous cell carcinoma at cervical esophagus and adenocarcinoma at esophagogastric junction. Computed tomography suggested that the large tumor in left neck infiltrated into the common carotid artery and trachea. According to these findings, we diagnosed locally advanced unresectable cervical esophageal cancer (cT4bN2M0, cStageIVa) and Barret’s esophageal adenocarcinoma (cT1bN0M0, cStageI), and decided to perform induction chemotherapy with Docetaxel, Cisplatin, and 5-Fluorouracil (DCF). After 3 courses of that, the primary tumor decreased from 37 mm to 17 mm as major axis and released infiltration into the common carotid artery. Therefore, we performed conversion surgery, pharyngolaryngectomy and total esophagectomy. Histopathological findings showed cervical esophageal cancer (ycT4aN2M0, ycStageIVa) and Barret’s esophageal adenocarcinoma (ycT1b-SM2N0M0, ycStageI). The postoperative course was uneventful, he resumed eating 9 days after surgery and was discharged 18 days after surgery.　Conversion surgery after induction chemotherapy for locally advanced unresectable esophageal cancer may contribute to radical resection and better clinical outcome

Microfluidic Separation of Blood Cells Based on the Negative Dielectrophoresis Operated by Three Dimensional Microband Electrodes

A microfluidic device is presented for the continuous separation of red blood cells (RBCs) and white blood cells (WBCs) in a label-free manner based on negative dielectrophoresis (n-DEP). An alteration of the electric field, generated by pairs of slanted electrodes (separators) that is fabricated by covering parts of single slanted electrodes with an insulating layer is used to separate cells by their sizes. The repulsive force of n-DEP formed by slanted electrodes prepared on both the top and bottom substrates led to the deflection of the cell flow in lateral directions. The presence of gaps covered with an insulating layer for the electric field on the electrodes allows the passing of RBCs through gaps, while relatively large WBCs (cultured cultured human acute monocytic leukemia cell line (THP-1 cells)) flowed along the slanted separator without passing through the gaps and arrived at an edge in the channel. The passage efficiency for RBCs through the gaps and the arrival efficiency for THP-1 cells to the upper edge in the channel were estimated and found to be 91% and 93%, respectively

Particle Patterning Based on Positive Dielectrophoresis Using a Scanning Microelectrode

Positioning and patterning of polystyrene particles on a silicon nitride (SiN) membrane with a microhole array has been demonstrated by positive dielectrophoresis (p-DEP). A chamber with an SiN membrane with the well-aligned microholes as the bottom substrate was positioned on an indium-tin-oxide (ITO) electrode with a 1 mm space between the bottom substrate and the ITO electrode. The chamber and the space were filled with water and a suspension of particles (10 µm diameter) in water, respectively. An AC electric signal was then applied to a microelectrode positioned at 10 µm above the SiN membrane, while the ITO electrode was connected to the ground. Particles present in the space between the SiN membrane and ITO electrode gradually moved toward the lower surface of the SiN membrane directly under the microelectrode owing to the strong electric field generated on and in localized microholes and accumulated at this position to form aggregates. For particles of 3 µm diameter, one particle was deposited in each hole (2 µm diameter) in the region directly under the microelectrode. The horizontal movement of the microelectrode gave rise to the formation of a line pattern of particles along the trail of the microelectrode because of the shift of the region with the strong electric field. These demonstrations could be applicable to arranging the particles at desired positions and in desired holes, and form particle patterns with highly flexible designs

Simple Detection of Surface Antigens on Living Cells by Applying Distinct Cell Positioning with Negative Dielectrophoresis

We report the fabrication of two different cell patterns based on negative dielectrophoresis (n-DEP) and apply it to simple and rapid distinction of cells with specific surface antigens from a cell population. The DEP device for cell manipulation comprised a microfluidic channel with an upper indium tin oxide (ITO) electrode and a lower ITO-interdigitated band array (ITO–IDA) electrode modified with an antibody. Cells immediately accumulated on the surface in the gap area between both bands of the ITO–IDA electrode by n-DEP upon AC voltage between the upper ITO and both lower bands. Switching of the applied band electrode voltage resulted in the removal of accumulated cells to form another pattern because of the formation of a different electric field pattern in the device. Modifying the ITO–IDA surface with the antibody inhibited the removal of the cells with a specific surface antigen for irreversible capture by immunoreactions during the first accumulation. In this study, we targeted the CD33 surface antigen expressed on human promyelocytic leukemia cells (HL-60). The time required for the assay was substantially short: 60 s for forcing and 60 s for separating the unbound cells. Furthermore, the present method does not require pretreatment such as target labeling or washing of unbound cells. Moreover, the use of the swing technique considerably improved cell binding to the antibody-modified surface for cells with a specific surface antigen. The distinct integration of cells with n-DEP in the high conductivity medium provided higher cell binding efficiency compared to that obtained in our previous study (Hatanaka, H.; Yasukawa, T.; Mizutani, F. <i>Anal. Chem.</i>, <b>2011</b>, <i>83</i>, 7207–7212) without loss of rapidity and simplicity