Retroperitoneoscopic Nephrectomy for Treatment of a Case of Left Single Ectopic Ureter Accompanied by Dysplastic Kidney

We report the case of a 7-year-old girl with a single ectopic ureter who was treated with retroperitoneoscopic nephrectomy for a chief complaint of urinary incontinence. Preoperative CT showed a contrasted dysplastic kidney of 1cm in the renal fossa and a left ureteral opening into the vagina. Retroperitoneoscopic left nephrectomy was conducted with opening of the lateroconal fascia to enable identification of the dysplastic kidney. No intraoperative complications were encountered. Urinary incontinence improved immediately after surgery. This case shows that a retroperitoneal approach can be used in nephrectomy if the position of the kidney can be determined preoperatively

電子キーボードを活用した幼児の音楽セッションに関する研究

In these days, electronic keyboards are popularly used among people, as substitute of piano or as "a toy with keyboards". The aim of this study is to explore the potentiality of adopting these keyboards into music education in kindergardens, nursery schools, and utilizing them at the scene of rhythmic activities and music plays as it can be handled by ordinary child-care workers. In the study, we focused on four subjects, "rhythm", "tone", "optical navigation", "electronic keyboards+α". "Rhythm" indicated the practice of utilizing the rhythms built in keyboards, changeable rhythms and tempos and a start-stop button. "Tone" indicated the practice around tone, and "optical navigation" was that of utilizing luminous keyboards. In "electronic keyboards+α", other materials, e.g. cards, were utilized. On "rhythm", we invented some games and body movements, using the rhythms. It enabled us a new approach, that is, to invent infants' body movements derived from the rhythms of pop music, at the scene of rhythmic activities, though it had been said that it would be difficult for care workers who don't have technique for playing the piano and improvising. On "Tone", we made the practice of inventing games and "a picture book with sound effect" and enhancing images of music by using the sounds and songs. Especially, we found that the activity of making music and sound for picture books is possible for every care worker in their daily programme, because picture books can be always found in every kindergarten and nursery school and it can be converted to other instruments. On "Optical Navigation", we invented games, and performance of easy tunes, using the function of optical navigation. On "electronic keyboards+α", we adopted mainly playing cards as "+α". While keyboards as interface have been comprising the basis in music education as singing, an universal method for teaching electronic keyboards has not been established, because their modes will be inevitably changed to that of new models. Also in the practices stated above, each example was unique and additional tests would be possible only for the people who own the relevant model. However, we could propose the most appropriate way of utilizing electronic keyboards for infants. In addition, the card play on "electronic keyboards+α" became a chance for us to explore the contact point between music lessons and intellectual education system for infants, and it gave us some hints for constructing a new music learning system aiming for development of infants' thinking power, etc

小笠原諸島におけるムニンカケザトウムシの形態学的および遺伝学的研究

To clarify the morphological and phylogenetic differentiation of Bandona boninensis Suzuki 1974 in Chichi-jima Island of the Bonin (Ogasawara) group of Islands, we studied the external morphological characters and performed sequencing of the cytochrome c oxidase subunit I (COI) gene of mitochondrial DNA (mtDNA) and 28S rRNA of nuclear DNA (nrDNA). The sequences of COI and 28S rRNA were identical among the individuals of B. boninensis. These results suggest that B. boninensis experienced a rapid expansion of its distribution in Chichi-jima Island without undergoing any morphological and molecular differentiation.著者らは小笠原諸島の父島に生息するムニンカケザトウムシBandona boninensis の形態的および系統的分化を明らかにするために、父島の4 地点から採集を行い、体長、触肢腿節の長さ、背甲長および背甲幅、鋏角長、第1～4 脚の腿節長といった形態計測を実施し、ミトコンドリアDNA のCOI 領域および核DNA の28SrRNA 領域に基づく系統樹を作成した。その結果, ムニンカケザトウムシのCOI および28S において塩基置換は見られなかった。この結果は、ムニンカケザトウムシが父島内で系統的分化をほぼ起こしていないことを示す。また、採集を行った個体がすべて雌個体であったことから、これまでの報告の通り、父島においては単為生殖種として生息している可能性が高い

Hemangiopericytoma in the sacrococcygeal space: a case report

<p>Abstract</p> <p>Introduction</p> <p>A hemangiopericytoma is a rare, soft-tissue tumor of vascular origin derived from a pericyte of Zimmerman, which is a modified smooth muscle cell that surrounds the small blood vessels. Hemangiopericytomas can occur wherever there are vascular capillaries. However, there are no previous reports of a hemangiopericytoma in the sacrococcygeal space.</p> <p>Case presentation</p> <p>We describe the first reported case of a hemangiopericytoma found in the sacrococcygeal space. A 47-year-old Japanese woman presented with a palpable tumor on the left side of her anus. Preoperative imaging indicated that the tumor was in the sacrococcygeal space without invasion of other organs. A complete resection was performed via a parasacral incision. The histological and immunohistochemical staining patterns supported the diagnosis of a hemangiopericytoma.</p> <p>Conclusion</p> <p>A complete resection without piecemeal excision is the best way to treat a hemangiopericytoma. Recognizing the presence of a hemangiopericytoma in the sacrococcygeal space requires appropriate surgery.</p

Moderately differentiated colorectal adenocarcinoma as a lymph node metastatic phenotype: comparison with well differentiated counterparts

<p>Abstract</p> <p>Background</p> <p>The differences between the metastatic property of moderately (Mod) and well (Wel) differentiated colorectal adenocarcinoma remain unclear. Since Mod is unable to form complete acini, therefore an epithelial-mesenchymal transition (EMT) can occur in that structure. Herein, we hypothesized that Mod metastasizes more easily than the Wel counterparts.</p> <p>Methods</p> <p>The medical records of 283 consecutive patients with Mod (n = 71) or Wel (n = 212) who underwent surgery were reviewed between January 1, 2001, and December 31, 2003, for actual 5-year overall survival. We examined the differences between the clinicopathological characteristics of the Mod and the Wel groups.</p> <p>Results</p> <p>The lymph node involvement (<it>p </it>< 0.0001), lymphatic permeation, venous permeation, depth of invasion, liver metastasis, and carcinomatous peritonitis were significantly higher in the Mod group in comparison to the Wel group. The independent risk factors by a logistic regression analysis for lymph node involvement were as follows: lymphatic permeation, liver metastasis, and Mod (<it>p </it>= 0.0291, Relative Risk of 1.991: 95% Confidence Interval: 1.073-3.697). A Kaplan-Meier survival curve showed that Mod had a trend towards a poor survival (<it>p </it>= 0.0517).</p> <p>Conclusion</p> <p>Mod metastasizes to the lymph nodes more easily in comparison to Wel. Therefore, patients with Mod may be considered the existence of lymph node involvement.</p

Feasibility study of immediate pharyngeal cooling initiation in cardiac arrest patients after arrival at the emergency room

AIM: Cooling the pharynx and upper oesophagus would be more advantageous for rapid induction of therapeutic hypothermia since the carotid arteries run in their vicinity. The aim of this study was to determine the effects of pharyngeal cooling on brain temperature and the safety and feasibility for patients under resuscitation. METHODS: Witnessed non-traumatic cardiac arrest patients (n=108) were randomized to receive standard care with (n=53) or without pharyngeal cooling (n=55). In the emergency room, pharyngeal cooling was initiated before or shortly after return of spontaneous circulation by perfusing physiological saline (5 °C) into a pharyngeal cuff for 120 min. RESULTS: There was a significant decrease in tympanic temperature at 40 min after arrival (P=0.02) with a maximum difference between the groups at 120 min (32.9 ± 1.2°C, pharyngeal cooling group vs. 34.1 ± 1.3°C, control group; P<0.001). The return of spontaneous circulation (70% vs. 65%, P=0.63) and rearrest (38% vs. 47%, P=0.45) rates were not significantly different based on the initiation of pharyngeal cooling. No post-treatment mechanical or cold-related injury was observed on the pharyngeal epithelium by macroscopic observation. The thrombocytopaenia incidence was lower in the pharyngeal cooling group (P=0.001) during the 3-day period after arrival. The cumulative survival rate at 1 month was not significantly different between the two groups. CONCLUSIONS: Initiation of pharyngeal cooling before or immediately after the return of spontaneous circulation is safe and feasible. Pharyngeal cooling can rapidly decrease tympanic temperature without adverse effects on circulation or the pharyngeal epithelium

Game-Tree Search Algorithm Based On Realization Probability

In games like chess, the node-expansion strategy significantly affects the performance of a gameplaying program. In this article we propose a new game-tree search algorithm that uses the realization probabilities of nodes for deciding upon the range of the search. The realization probability of a node represents the probability that the moves leading to the node will actually be played. Our algorithm expands nodes as long as the realization probability of a node is greater than the threshold