A Case of Double Gallbladder with Adenocarcinoma Arising from the Left Hepatic Duct: A Case Report and Review of the Literature

Double gallbladder is a rare congenital biliary anomaly, but an accessory gallbladder arising from the left hepatic duct is a more remarkably rare congenital anomaly. We report a case of double gallbladder with adenocarcinoma and gallstones, which was preoperatively diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) and then confirmed by open laparotomy. A review of the literature is presented

Case Control Study in Diagnosis of Pancreatic Cancer: Using multiple-logistic regression

We determined 13 markers of pancreatic cancer which are used presently and tried quantitative combination assay of pancreatic cancer. Case-control study using the logistic regression showed the possibility of pancreatic cancer quantitatively. When the level of CA19-9 is more than Mean + 2S.D. (40 u/ml), the possibility of pancreatic cancer is 15 times higher than when the level is less than Mean + S.D .. In the case that the high-level of CA19-9 and α1-AT which are more than Mean + S.D., the possibility of pancreatic cancer is 30 times higher than the case that the level of CA19-9 and α1-AT are less than Mean + S.D. when both levels of CA19-9 and α1-AT are more than Mean + S.D .

Treatment for Osteoporotic Vertebral Fracture - A Short Review of Orthosis and Percutaneous Vertebroplasty and Balloon Kyphoplasty

The management of osteoporotic vertebral fractures (OVFs) in the elderly includes nonoperative treatment and vertebroplasty, but has not been established due to the diversity of patient backgrounds. The purpose of this study was to compare the impact of 3 treatment modalities for the management of OVF: orthotic treatment, percutaneous vertebroplasty (PVP), and balloon kyphoplasty (BKP). The method was based on an analysis of the latest RCTs, meta-analyses, and systematic reviews on these topics. No study showed a benefit of bracing with high level of evidence. Trials were found that showed comparable outcomes without orthotic treatment. Only 1 randomized controlled trial (RCT) showed an improvement in pain relief up to 6 months compared with no orthosis. Rigid and nonrigid orthoses were equally effective. Four of 5 RCTs comparing vertebroplasty and sham surgery were equally effective, and one RCT showed superior pain relief with vertebroplasty within 3 weeks of onset. In open trials comparing vertebroplasty with nonoperative management, vertebroplasty was superior. PVP and BKP were comparable in terms of pain relief, improvement in quality of life, and adjacent vertebral fractures. BKP does not affect global sagittal alignment, although BKP may restore vertebral body height. An RCT was published showing that PVP was effective in chronic cases without pain relief. Vertebroplasty improved life expectancy by 22% at 10 years. The superiority of orthotic therapy for OVF was seen only in short-term pain relief. Soft orthoses proved to be a viable alternative to rigid orthoses. Vertebroplasty within 3 weeks may be useful. There is no significant difference in clinical efficacy between PVP and BKP. Vertebroplasty improves life expectancy

The Effectiveness of Vertebral Height Restoration Based on the Vertebroplasty Procedure Used to Treat Osteoporotic Vertebral Fractures

Objective Whether the use of a balloon or stent in vertebroplasty for vertebral fractures, such as balloon kyphoplasty (BKP) or vertebral body stenting (VBS), actually contributes to the restoration of postoperative vertebral height is unclear. The aim of the current study was to compare the effectiveness of percutaneous vertebroplasty (PVP), BKP, and VBS in the correction of collapsed vertebrae in patients with painful vertebral fractures. Methods The cases studied involved 34 vertebrae in 28 patients treated with PVP, 43 vertebrae in 38 patients treated with BKP, and 20 vertebrae in 20 patients treated with VBS at Izinkai Takeda General Hospital. Changes in the vertebral height and local kyphosis angle were measured based on standing lumbar radiographs before and after surgery and were compared among the treatment groups. Results There were no differences in changes in the height of the anterior wall, middle body, or posterior wall of the treated vertebrae among the 3 treatment groups. The same was true for changes in the local kyphosis angle. The effectiveness of vertebral height restoration depended heavily upon preoperative vertebral instability in all the treatment groups. Correction loss due to balloon deflation effect or balloon sinking was noted with VBS or BKP. Conclusion BKP and VBS have the advantage of reducing the risk of extravertebral leakage of injected bone cement, but they have a disadvantage in that they are no more effective than PVP in restoring collapsed vertebrae despite the use of a balloon or metal stent

Litter carbon dynamics analysis in forests in an arid ecosystem with a model incorporating the physical removal of litter

金沢大学理工研究域自然システム学系Arid land afforestation could be a countermeasure for global warming, and a project for developing and evaluating techniques for arid land afforestation and reforestation has been carried out in Sturt Meadows near Leonora, Western Australia. As a part of this project, the litter carbon dynamics were investigated at three Acacia aneura forest sites, using a litter carbon model incorporating the physical removal of litter by winds, floods, etc. Based on the field observation data of above ground plant biomass, annual litter fall, existing amount of the litter, and also litter decomposition rate constants separately obtained for leaf litter and woody litter, we investigated the carbon flows at these forest sites, especially the annual amount of litter physically removed from the sites by floods or winds. As a result, it is estimated that annual physical removal of litter amounted to 59-75% of the annual litter fall, and the litter removal rate constants were from 0.38 to 0.55 year-1. Roughly one third to a half of the existing litter is removed annually from the sites. There was also a tendency that as the canopy coverage decreases, the litter removal rate constant increases. For this type of ecosystem, which is susceptible to the run-off of water and strong winds, we consider the taking into account of the physical removal of the litter is essential for analyzing the carbon dynamics in the ecosystem. © 2008 Elsevier B.V. All rights reserved

胆のう疾患のVIP神経

The immunocytochemical distribution of vasoactive intestinal peptide (VIP) was studied in healthy and diseased regions of the human gall bladder wall obtained after operation for cholelithiasis. Ganglionated plexuses containing VIP-like immunoreactive nerves and fibers were located in the subepithelial and muscle layer of the normal region, suggesting that VIP may exert gall bladder function, while such ganglionated plexuses were almost absent, being replaced by inflammatory cells and fibrotic tissue. This suggests that the lack of VIP may be one of the causes in the pathogenesis of gall bladder dysfunction in the case of cholelithiasis associated chronic cholecystitis