ABSTRACT
PURPOSE: Choledochoduodenostomy (CDD) is performed to treat choledocholithiasis (CDL) cases where endoscopic stone removal is difficult. Recognizing CDD characteristics is important for CDL treatment planning. METHODS: A total of 116 patients, including 33 patients ≥ 80 years old (29 with previous total gastrectomy, 19 with previous distal gastrectomy, 20 with built-up stones, 19 with periampullary diverticulum, 10 with confluence stones, 8 with repetitive recurrent stones, 4 with hard stones, 3 with endoscopic retrograde cholangiography [ERC] not available due to lack of cooperation, 2 with a history of pancreatitis post-ERC, and 2 in whom ERC could not be performed due to a disturbed anatomy) underwent CDD for CDL. Postoperative complications and long-term outcomes were evaluated. RESULTS: The in-hospital mortality rate was 0%. The morbidity (grade ≥ IIIA according to the Clavien-Dindo classification) rates in the elderly (≥ 80 years old) and non-elderly (51-79 years old) patients were 3.0% (1/33) and 2.4% (2/83), respectively (p = 0.85). Long-term complications included cholangitis in eight (7%) patients, of which three cases were repetitive and seven had an operative history of total or distal gastrectomy. The incidence of postoperative cholangitis after total or distal gastrectomy was 15% (7/48), which was significantly higher than that involving other causes (1.5%, 1/68; p < 0.01). Two patients with cholangitis after total gastrectomy experienced early recurrence of lithiasis at 2 and 9 months after surgery. CONCLUSIONS: CDD is safe, even in elderly patients. However, a history of total gastrectomy or distal gastrectomy may increase the incidence of postoperative cholangitis.
Subject(s)
Cholangitis , Choledocholithiasis , Humans , Middle Aged , Aged , Aged, 80 and over , Choledocholithiasis/surgery , Choledocholithiasis/complications , Choledochostomy/adverse effects , Incidence , Treatment Outcome , Cholangiopancreatography, Endoscopic Retrograde , Cholangitis/epidemiology , Cholangitis/etiology , Retrospective StudiesABSTRACT
BACKGROUND: Blood group O of ABO blood group system is considered as a risk factor for various bleeding events, but the relationship with endoscopic treatment-associated bleeding has yet to be investigated. This study aimed to evaluate whether blood group O is associated with delayed bleeding after colorectal endoscopic resection. METHODS: This was a retrospective observational study based on medical records at four university hospitals in Japan. We reviewed the records for consecutive patients who underwent colorectal endoscopic resection from January 2014 through December 2017. The primary outcome was the incidence of delayed bleeding, defined as hematochezia or melena, requiring endoscopy, transfusion, or any hemostatic intervention up to 28 days after endoscopic resection. Multivariate logistic regression analysis was performed to adjust the impact of blood group O on the delayed bleeding. RESULTS: Among 10,253 consecutive patients who underwent colorectal endoscopic resection during the study period, 8625 patients met the criteria. In total, delayed bleeding occurred in 255 patients (2.96%). The O group had significantly more bleeding events compared with the non-O group (A, B, and AB) (relative risk, 1.62 [95% confidence interval, 1.24-2.10]; P < 0.001). In multivariate logistic regression analysis, blood group O remained an independent risk factor for the bleeding (adjusted odds ratio, 1.60 [95% confidence interval, 1.18-2.17]; P = 0.002). CONCLUSIONS: Blood group O was associated with an increased risk of delayed bleeding in patients undergoing colorectal endoscopic resection. Preoperative screening for ABO blood group could improve risk assessments.
Subject(s)
Blood Group Antigens , Colorectal Neoplasms , Gastrointestinal Hemorrhage/epidemiology , Gastrointestinal Hemorrhage/etiology , Humans , Postoperative Hemorrhage/epidemiology , Postoperative Hemorrhage/etiology , Retrospective Studies , Risk FactorsABSTRACT
An 88-year-old patient had undergone endoscopic stenting for the treatment of acute cholangitis caused by choledocholithiasis. After a year and two months, he presented with cholangitis caused by common bile duct stones that formed a stent-stone complex. Another stent was observed adjacent to the old stent;however, the cholangitis relapsed in a short term. Thus, we planned to remove as many stones as possible. These stones were not free-floating and had affected the bile duct. Endoscopic mechanical lithotripsy was attempted;however, it failed. He was successfully treated using peroral cholangioscopy and electrohydraulic lithotripsy. After three months, he developed cholangitis because of the recurrence of choledocholithiasis. After removing as many stones as possible and performing endoscopic stenting, he was followed up as an outpatient. He had no symptoms for seven months after the procedure.
Subject(s)
Choledocholithiasis , Gallstones , Lithotripsy , Aged, 80 and over , Cholangiopancreatography, Endoscopic Retrograde , Choledocholithiasis/diagnostic imaging , Choledocholithiasis/surgery , Gallstones/diagnostic imaging , Gallstones/surgery , Humans , Male , Stents , Treatment OutcomeABSTRACT
OBJECTIVES: Upper gastrointestinal endoscopy is mostly performed under sedation and has a low yield of relevant gastric lesions in patients without alarm symptoms. Simpler screening tests such as capsule endoscopy could be helpful, but gastric visualization is insufficient with the current passive capsules. A magnetically guided gastric capsule was prospectively evaluated in patients with routine indications for gastroscopy. METHODS: A total of 189 symptomatic patients (105 male; mean age 53 y) from 2 French centers subsequently and blindly underwent capsule and conventional gastroscopy by 9 and 6 examiners, respectively. The final gold standard was unblinded conventional gastroscopy with biopsy under propofol sedation. Main outcome was accuracy (sensitivity/specificity) of capsule gastroscopy for diagnosis of major gastric lesions, defined as those lesions requiring conventional gastroscopy for biopsy or removal. RESULTS: Twenty-three major lesions were found in 21 patients. Capsule accuracy was 90.5% [95% confidence interval (CI), 85.4%-94.3%] with a specificity of 94.1% (95% CI, 89.3%-97.1%) and a sensitivity of 61.9% (95% CI, 38%-82%). Accuracy did not correlate with lesion location, gastric luminal visibility, examiner case volume, or examination time. Of the remaining 168 patients, 94% had minor and mostly multiple lesions; the capsule made a correct diagnosis in 88.1% (95% CI, 82.2%-92.6%), with gastric visibility and lesion location in the proximal stomach having significant influence. All patients preferred capsule gastroscopy. CONCLUSIONS: In a prospective and strictly blinded study, magnetically guided capsule gastroscopy was shown to be feasible in clinical practice and was clearly preferred by patients. Improvements in capsule technology may render this technique a future alternative to gastroscopy.
Subject(s)
Capsule Endoscopy/methods , Early Detection of Cancer/methods , Gastroscopy/methods , Magnetics/methods , Stomach Neoplasms/diagnosis , Biopsy , Capsule Endoscopes , Capsule Endoscopy/instrumentation , Early Detection of Cancer/instrumentation , Equipment Design , Feasibility Studies , Female , Gastroscopy/instrumentation , Humans , Magnetics/instrumentation , Male , Middle Aged , Patient Preference , Predictive Value of Tests , Prognosis , Prospective Studies , Stomach Neoplasms/pathologyABSTRACT
Coffee aroma, with more than 600 components, is considered as one of the most complex food aromas. Although electronic noses have been successfully used for objective analysis and differentiation of total coffee aromas, it is difficult to use them to describe the specific features of coffee aroma (i.e., the type of smell). This is because data obtained by electronic noses are generally based on electrical resistance/current and samples are distinguished by principal component analysis. In this paper, we present an electronic nose that is capable of learning the wine related aromas using the aroma kit "Le Nez du Vin," and the potential to describe coffee aroma in a similar manner comparable to how wine experts describe wine aroma. The results of our investigation showed that the aromas of three drip coffees were more similar to those of pine and honey in the aroma kit than to the aromas of three canned coffees. Conversely, the aromas of canned coffees were more similar to the kit coffee aroma. In addition, the aromatic patterns of coffees were different from those of green tea and red wine. Although further study is required to fit the data to human olfaction, the presented method and the use of vocabularies in aroma kits promise to enhance objective discrimination and description of aromas by electronic noses.
ABSTRACT
INTRODUCTION: Successful access to the papilla and cannulation of the desired duct can be technically challenging. A novel second-generation multi-bending backward-oblique viewing duodenoscope (2nd M-D scope) was developed to overcome this difficulty. The aim of the present study was to evaluate the utility of 2nd M-D scope during biliary ERCP. MATERIAL AND METHODS: This was a retrospective review of 53 patients with native papilla who underwent biliary ERCP with the 2nd M-D scope. RESULTS: Biliary cannulation and interventional procedures were successfully completed in all patients. In two of these patients, ERCP was initially attempted with a conventional single bending duodenoscope, but biliary cannulation was unsuccessful; one had Billroth-I gastrectomy, and the other had a Type III choledochal cyst. However, with the 2nd M-D scope, biliary cannulation and interventional procedures were successfully achieved. Finally, in nine patients, upward or downward angulation of the proximal bending portion in addition to the distal bending portion was used during ERCP, and the operator's comments demonstrated that it was helpful for obtaining an appropriate en face view to look up to the papilla and facilitate successful biliary cannulation. CONCLUSION: The newly developed 2nd M-D scope could safely facilitate biliary cannulation in selected patients during ERCP.
Subject(s)
Catheterization/methods , Cholangiopancreatography, Endoscopic Retrograde/instrumentation , Cholangiopancreatography, Endoscopic Retrograde/methods , Duodenoscopes , Pancreatic Ducts , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
Several in vivo studies suggest that nanoparticles (smaller than 100 nm) have the ability to reach the brain tissue. Moreover, some nanoparticles can penetrate into the brains of murine fetuses through the placenta by intravenous administration to pregnant mice. However, it is not clear whether the penetrated nanoparticles affect neurogenesis or brain function. To evaluate its effects on neural stem cells, we assayed a human neural stem cell (hNSCs) line exposed in vitro to three types of silica particles (30 nm, 70 nm, and <44 µm) and two types of titanium oxide particles (80 nm and < 44 µm). Our results show that hNSCs aggregated and exhibited abnormal morphology when exposed to the particles at concentrations = 0.1 mg/mL for 7 days. Moreover, all the particles affected the gene expression of Nestin (stem cell marker) and neurofilament heavy polypeptide (NF-H, neuron marker) at 0.1 mg/mL. In contrast, only 30-nm silica particles at 1.0 mg/mL significantly reduced mitochondrial activity. Notably, 30-nm silica particles exhibited acute membrane permeability at concentrations =62.5 µg/mL in 24 h. Although these concentrations are higher than the expected concentrations of nanoparticles in the brain from in vivo experiments in a short period, these thresholds may indicate the potential toxicity of accumulated particles for long-term usage or continuous exposure.
Subject(s)
Nanoparticles , Neural Stem Cells/drug effects , Silicon Dioxide/pharmacology , Titanium/pharmacology , Cell Line , Humans , Mitochondria/drug effects , Nestin/genetics , Nestin/metabolism , Neural Stem Cells/cytology , Neural Stem Cells/metabolism , Neurofilament Proteins/genetics , Neurofilament Proteins/metabolism , Silicon Dioxide/chemistry , Titanium/chemistryABSTRACT
Electronic noses have the benefit of obtaining smell information in a simple and objective manner, therefore, many applications have been developed for broad analysis areas such as food, drinks, cosmetics, medicine, and agriculture. However, measurement values from electronic noses have a tendency to vary under humidity or alcohol exposure conditions, since several types of sensors in the devices are affected by such variables. Consequently, we show three techniques for reducing the variation of sensor values: (1) using a trapping system to reduce the infering components; (2) performing statistical standardization (calculation of z-score); and (3) selecting suitable sensors. With these techniques, we discriminated the volatiles of four types of fresh mushrooms: golden needle (Flammulina velutipes), white mushroom (Agaricus bisporus), shiitake (Lentinus edodes), and eryngii (Pleurotus eryngii) among six fresh mushrooms (hen of the woods (Grifola frondosa), shimeji (Hypsizygus marmoreus) plus the above mushrooms). Additionally, we succeeded in discrimination of white mushroom, only comparing with artificial mushroom flavors, such as champignon flavor and truffle flavor. In conclusion, our techniques will expand the options to reduce variations in sensor values.
Subject(s)
Agaricales/metabolism , Biosensing Techniques/methods , Electronic NoseABSTRACT
A technique for rapid detection of pathogenic microorganisms is essential for the diagnosis of associated infections and for food safety analysis. Aeromonas hydrophila is one such food contaminant. Several methods for rapid detection of this pathogen have been developed; these include multiplex polymerase chain reaction assays and the colony overlay procedure for peptidases. However, these conventional methods can only be used to detect the microorganisms at high accuracy after symptomatic onset of the disease. Therefore, in the future, simple pre-screening methods may be useful for preventing food poisoning and disease. In this paper, we present a novel system for the rapid detection of the microorganism A. hydrophila in cultured media (in <2 h), with the use of an electronic nose (FF-2A). With this electronic nose, we detected the changes of volatile patterns produced by A. hydrophila after 30 min culture. Our calculations revealed that the increased volatiles were similar to the odours of organic acids and esters. In future, distinctive volatile production patterns of microorganisms identified with the electronic nose may have the potential in microorganism detection.
Subject(s)
Aeromonas hydrophila/isolation & purification , Culture Media/chemistry , Electronic Nose , Aeromonas hydrophila/growth & development , Algorithms , Gases/metabolism , Time Factors , VolatilizationABSTRACT
BACKGROUND: Passive video capsule endoscopy is the criterion standard for small-bowel exploration but cannot be used for the large gastric cavity. We report the first blinded comparative clinical trial in humans comparing a magnetically guided capsule endoscope (MGCE) and a conventional high-definition gastroscope. OBJECTIVE: To assess the potential of gastric examination with a guided capsule. DESIGN: Blinded, nonrandomized comparative study. SETTING: Single endoscopy center. METHODS: The trial involved 61 patients included in a blinded capsule and gastroscopy comparative study. MGCE examination was performed 24 hours after patients had undergone gastroscopy. To remove food residue or mucus, patients drank 900 mL of water in 2 portions. Then to provide the air-water interface required by the guidance system, they drank 400 mL of water at 35°C. RESULTS: Visualization of the gastric pylorus, antrum, body, fundus, and cardia was evaluated as complete in 88.5%, 86.9%, 93.4%, 85.2%, and 88.5% of patients, respectively. Of gastric lesions, 58.3% were detected by both gastroscopy and MGCE at immediate assessment and review of recorded data. Capsule examination missed 14 findings and gastroscopy missed 31 findings seen with MGCE. Overall diagnostic yield was similar for both modalities. LIMITATION: Pilot study. CONCLUSIONS: Diagnostic results were similar for the 2 methods. After some technical difficulties related to gastric expansion or presence of mucus had been overcome, this study opened a new field for noninvasive gastric examination in countries where high gastric cancer incidence demands a screening tool.
Subject(s)
Capsule Endoscopes , Gastroscopes , Gastroscopy/instrumentation , Stomach Diseases/pathology , Stomach/pathology , Abdominal Pain/etiology , Adult , Aged , Female , Gastroesophageal Reflux/etiology , Humans , Magnetics , Male , Middle Aged , Pilot Projects , Single-Blind Method , Stomach Diseases/complications , Stomach Diseases/diagnosis , Young AdultABSTRACT
OBJECTIVE: Autoimmune pancreatitis (AIP) is often misdiagnosed as pancreatic carcinoma (PC) despite recent advances in imaging tests. The aim of the study was to evaluate whether the quantitative perfusion analysis using software "Time intensity curve" with contrast-enhanced harmonic EUS (CH-EUS) facilitate the differentiation of AIP from PC. METHODS: Consecutive patients with focal AIP and pancreatic carcinoma who underwent CH-EUS from January 2009 to September 2010 were analyzed. CH-EUS was performed with intravenous administration of an ultrasonographic contrast (Sonazoid) and electronic radial echoendoscope. The graph of time intensity curve (TIC) for pancreatic mass was generated to depict the changes in signal intensity over time within the region of interest (ROI). ROI was placed to cover an area with a pancreatic mass lesion. Based on the analysis of TIC, base intensity before injection (BI), peak intensity (PI), time to peak, and maximum intensity gain (MIG: PI-BI) were calculated. RESULTS: Eight patients with focal AIP and twenty-two patients with PC were evaluated by TIC. PI and MIG of mass lesion of AIP were significantly higher than that of PC (21.4 dB vs. 9.6 dB, 17.5 vs. 6.6). Receiver operating characteristics analysis yielded an optimal MIG cutoff value of 12.5 with high sensitivity and specificity. CONCLUSION: Pancreatic mass lesions of AIP and PC exhibited markedly different patterns with the TIC. This novel diagnostic modality using TIC generated by CH-EUS might offer an opportunity to improve accuracy in the differential diagnosis between pancreatic mass lesion of AIP and PC.
Subject(s)
Autoimmune Diseases/diagnostic imaging , Carcinoma/diagnostic imaging , Endosonography/methods , Pancreatic Neoplasms/diagnostic imaging , Pancreatitis/diagnostic imaging , Signal Processing, Computer-Assisted , Aged , Aged, 80 and over , Contrast Media , Diagnosis, Differential , Female , Ferric Compounds , Humans , Image Interpretation, Computer-Assisted/methods , Iron , Male , Middle Aged , Oxides , Pancreatitis/immunology , ROC Curve , Retrospective Studies , Time FactorsABSTRACT
OBJECTIVE: There is no comparative study of electronic radial endoscopic ultrasonography (ER-EUS) and electronic curvilinear EUS (EC-EUS). The aim of this study was to compare the accuracy of ER-EUS and EC-EUS for detecting pancreatic malignancies. METHODS: This was a retrospective review of the patients who had EUS assessment from September 2008 to December 2011 for suspicious pancreatic tumors. Sensitivity, specificity, and area under the ROC curve to detect pancreatic malignancies were calculated and compared between the ER-EUS and EC-EUS cohort. The final diagnosis of pancreatic malignancy was based on pathology, or the consensus of patient's clinical course and multimodal imaging tests. RESULTS: Two hundred twenty-one patients were included and divided into two cohorts: ER-EUS (n = 139) and EC-EUS (n = 82) cohorts. With propensity score matching method, 70 cases in each cohort were selected for the comparison. There was no significant difference in sensitivity, specificity, and area under the ROC curve to detect pancreatic malignancy between ER-EUS and EC-EUS cohort (88.5 vs. 100%, 88.6 vs. 90.9%, 0.8855 vs. 0.9545). CONCLUSION: ER-EUS and EC-EUS provided similar accuracy for the detection of pancreatic malignancies. In view of similar diagnostic results of ER-EUS and EC-EUS for the detection of pancreatic malignancy, and the advantage of being able to perform FNA with EC-EUS, EC-EUS may be the preferred choice.
Subject(s)
Carcinoma/diagnostic imaging , Endosonography/instrumentation , Neuroendocrine Tumors/diagnostic imaging , Pancreatic Neoplasms/diagnostic imaging , Aged , Area Under Curve , Carcinoma/diagnosis , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Female , Humans , Male , Middle Aged , Neuroendocrine Tumors/diagnosis , Pancreatic Neoplasms/diagnosis , Predictive Value of Tests , Propensity Score , ROC Curve , Retrospective Studies , Statistics, NonparametricABSTRACT
As olfactory perceptions vary from person to person, it is difficult to describe smells objectively. In contrast, electronic noses also detect smells with their sensors, but in addition describe those using electronic signals. Here we showed a virtual connection method between a human nose perceptions and electronic nose responses with the smell of standard gases. In this method, Amorphophallus titanum flowers, which emit a strong carrion smell, could objectively be described using an electronic nose, in a way resembling the skill of sommeliers. We could describe the flower smell to be close to that of a mixture of methyl mercaptan and propionic acid, by calculation of the dilution index from electronic resistances. In other words, the smell resembled that of "decayed cabbage, garlic and pungent sour" with possible descriptors. Additionally, we compared the smells of flowers which bloomed on different dates and at different locations and showed the similarity of odor intensities visually, in standard gas categories. We anticipate our assay to be a starting point for a perceptive connection between our noses and electronic noses.
Subject(s)
Amorphophallus/chemistry , Biomimetics/instrumentation , Computer Graphics , Conductometry/instrumentation , Flowers/chemistry , Gases/analysis , Nose , Electronics/instrumentation , Equipment Design , Equipment Failure Analysis , Signal Processing, Computer-Assisted/instrumentation , Transducers , User-Computer InterfaceABSTRACT
The greater omentum is the largest depot of visceral fat, and recent studies implicate removal of omental fat as a therapeutic option for metabolic syndrome (MS). This study evaluated the technical feasibility of reducing omental fat by using ultrasound-assisted liposuction (UAL) in porcine models. We removed as much omental adipose tissues as possible with a novel ultrasonic aspirator specifically designed for visceral liposuction that was inserted into the peritoneal cavity via the bilateral hypochondrial trocars. The greater part of the omental surface was emulsified and suctioned within 12.4 ± 9.2 (mean ± SD) min. In the survival study, all animals survived for two weeks without clinically evident complications following UAL. Histological examinations confirmed a substantial reduction in omental fat in pigs subjected to UAL. In conclusion, the pilot animal study conducted here demonstrated the technical feasibility of omental liposuction. UAL thus has potential as a relatively non-invasive liposuction approach to treat MS by selectively reducing the visceral fat content of the greater omentum.
Subject(s)
Intra-Abdominal Fat/surgery , Lipectomy/methods , Omentum/surgery , Ultrasonic Therapy/methods , Animals , Feasibility Studies , Female , Peritoneal Cavity , Pilot Projects , Survival Rate , SwineABSTRACT
INTRODUCTION: We developed a new offset-tip papillotome to facilitate biliary cannulation and reduce the incidence of unintended contrast injection into the pancreatic duct during ERCP. The aim of the present retrospective cohort study was to evaluate the utility of the novel offset-tip papillotome in achievement of biliary cannulation, and prevention of unintended contrast injection into the pancreatic duct during ERCP, compared with a standard straight-tip catheter. MATERIAL AND METHODS: Patients with native papilla who required biliary ERCP were retrospectively reviewed. Biliary ERCPs were performed by two experienced endoscopists using either the offset-tip papillotome or a standard catheter. Patients in whom ERCP involved fellows in training were excluded. RESULTS: Eighty-five patients were included and divided into two cohorts: The offset-tip papillotome (OT; n = 40) and the standard straight-tip cohort (ST; n = 45). Biliary cannulation success rates in OT and ST cohort were 92.5% and 88.9%, respectively. The frequency of unintended contrast injection into the pancreatic duct and time to biliary cannulation of the OT cohort during biliary cannulation were significantly less than those of the ST cohort (0.56 vs. 1.65 times and 103.3 vs. 287.9 seconds). CONCLUSION: The novel offset-tip papillotome could reduce the incidence of unintended contrast injection into the pancreatic duct and the time to biliary cannulation.
Subject(s)
Cholangiopancreatography, Endoscopic Retrograde/methods , Common Bile Duct/pathology , Pancreatic Ducts/pathology , Pancreatitis/surgery , Sphincterotomy, Endoscopic/methods , Aged , Catheterization/methods , Feasibility Studies , Female , Humans , Male , Middle Aged , Pancreatitis/diagnosis , Retrospective Studies , Statistics, NonparametricABSTRACT
BACKGROUND: Small-bowel lesions responsible for obscure GI bleeding are often accompanied by vascular abnormalities. Image-enhanced capsule endoscopy could be advantageous in detecting these abnormalities. OBJECTIVE: To evaluate the image representation performance of the contrast capsule. DESIGN: Feasibility study. SETTING: University hospital. PATIENTS AND INTERVENTIONS: Consecutive patients with obscure GI bleeding swallowed the contrast capsule. MAIN OUTCOME MEASUREMENTS: Image representation performance of the contrast capsule and the appearance of small-bowel lesions in image-enhanced capsule endoscopy. RESULTS: Twenty patients (16 males and 4 females) underwent capsule endoscopy during the study period. Small-bowel abnormality was detected, including 5 cases of multiple erosions or ulcers, 1 case of Peutz-Jeghers syndrome, and 1 case of angiectasia. The contrast capsule visualized the lesions with high vascularity in a dark green color with a strong color contrast compared with the surrounding normal mucosa, which appeared as a brownish color. LIMITATIONS: Small, single-center, nonrandomized study. CONCLUSION: This feasibility study demonstrated the image representation characteristics of the contrast capsule. The diagnostic yield of this technology should be investigated in a future randomized trial.
Subject(s)
Capsule Endoscopy/methods , Gastrointestinal Hemorrhage/diagnosis , Gastrointestinal Hemorrhage/etiology , Image Enhancement/methods , Adult , Aged , Capsule Endoscopy/instrumentation , Color , Feasibility Studies , Female , Humans , Image Enhancement/instrumentation , Intestines/blood supply , Light , Male , Middle Aged , Stomach/blood supplyABSTRACT
BACKGROUND: The advent of natural orifice transluminal endoscopic surgery (NOTES) has accelerated the development of new technology in the field of GI endoscopy. Various suturing devices or multitasking platforms are expected to be valuable for endoluminal surgery as well as for NOTES. OBJECTIVE: To evaluate a new multitasking platform in performing endoscopic full-thickness resection (EFTR). DESIGN: Bench-top comparison study. SETTING: Research laboratory study of 10 ex vivo porcine models. INTERVENTION: Ten EFTRs (5 with a double-channel endoscope vs 5 with a new multitasking platform) assisted with percutaneous gastric lifting. Each group was given the task of resecting a full-thickness specimen of the gastric wall including a pseudolesion 10 mm in diameter with an effective margin. MAIN OUTCOME MEASUREMENTS: Outcome measurements included time to perform the procedure, accuracy of the resection, and efficiency for the task. Accuracy was assessed according to variability of the surgical margin and misalignment between the mucosal layer and the seromuscular layer. Efficiency was assessed according to the duty ratio, which is the percentage of time spent for the main purposes compared with the total procedure time. RESULTS: Mean diameter of the specimen was not significantly different between the groups. All other assessment items were significantly superior in group B to those in group A (P < .05). LIMITATIONS: Ex vivo animal model study. CONCLUSION: We were able to perform EFTR procedures precisely and effectively by using a new multitasking platform compared with use of a conventional endoscope in a porcine model. A multitasking platform developed for NOTES procedures would be useful for advanced endoluminal surgery such as endoscopic submucosal dissection or EFTR as well as NOTES.
Subject(s)
Gastric Mucosa/surgery , Gastroscopes , Gastroscopy/instrumentation , Stomach/surgery , Animals , Statistics, Nonparametric , Swine , Time and Motion StudiesABSTRACT
Steroid biosynthesis is initiated with transportation of cholesterol along with steroidogenic acute regulatory protein (StAR) into the mitchondria and is achieved with several steroidogenic enzymes. It has been reported that Ca(2+) channel blockers (CCBs), such as azelnidipine, efonidipine and nifedipine, suppress the biosynthesis of aldosterone and cortisol, but the overall effects of CCBs on steroid biosynthesis remain to be clarified. The present study was designed to evaluate the effects of CCBs on the expression of steroidogenic enzymes and the production of adrenal androgen, dehydroepiandrosterone sulfate (DHEA-S) that has anti-atherosclerotic actions. NCI-H295R human adrenocortical carcinoma cells and HepG2 human hepatoma cells were cultured for 24 hours with or without a CCB (amlodipine, efonidipine, nifedipine, azelnidipine R(-)-efonidipine, verapamil or diltiazem). HepG2 hepatoma cells were used to confirm the effects of CCBs on the expression of StAR. In fact, efonidipine and nifedipine increased the expression of StAR in HepG2 cells. Efonidipine and nifedipine, but not other examined CCBs, also increased the N(6), 2'-O-dibutyryladenosine 3',5'-cyclic monophosphate (dbcAMP)-induced StAR mRNA, which reflects the action of adrenocorticotropic hormone, and efonidipine and R(-)-efonidipine enhanced the dbcAMP-induced DHEA-S production in NCI-H295R adrenocortical carcinoma cells. Therefore, efonidipine and nifedipine might increase the expression of StAR and, in turn, efonidipine enhanced the dbcAMP-induced DHEA-S production, independent of Ca(2+) channel blockade. These results indicate that such effects are not associated with Ca(2+) influx. Moreover, only efonidipine enhanced the angiotensin II-induced expression of StAR mRNA (P < 0.01 vs. angiotensin II alone). In conclusion, efonidipine might exert an additional action beyond anti-hypertensive actions.
Subject(s)
Adrenocortical Carcinoma/metabolism , Calcium Channel Blockers/pharmacology , Dehydroepiandrosterone Sulfate/metabolism , Dihydropyridines/pharmacology , Nitrophenols/pharmacology , Adrenocortical Carcinoma/genetics , Angiotensin II/pharmacology , Bucladesine/pharmacology , Cell Line, Tumor , Diltiazem/pharmacology , Dose-Response Relationship, Drug , Gene Expression Regulation, Neoplastic/drug effects , Humans , Hydrocortisone/biosynthesis , Organophosphorus Compounds/pharmacology , Phosphoproteins/genetics , Phosphoproteins/metabolism , RNA, Messenger/genetics , RNA, Messenger/metabolism , Verapamil/pharmacologyABSTRACT
BACKGROUND: Compared to two-dimensional cultures, three-dimensional (3D) cultures have many advantages in cancer studies. Nevertheless, their implementation is unsatisfactory. This study aimed to develop an anchorage-dependent 3D culture model for colorectal cancer research. MATERIALS AND METHODS: Human HCT116, DLD-1 and SW620 colorectal cell lines were cultured in a gelatin sponge, and its applicability for morphological examination was studied. RESULTS: The resulting specimens were suitable for scanning electron microscopy, transmission electron microscopy, and immunohistochemical examination. HCT116 formed smaller structures and migrated through the pores of the sponge. DLD-1 formed larger structures with tight cell-to-cell adhesion. SW620 also formed large structures but small clustered cells tended to attach to the anchorage more favorably. Immunohistochemical staining demonstrated phosphorylated yes-associated protein (YAP) localized near the attachment site in HCT116 cells. CONCLUSION: Because the gelatin sponge provided suitable anchorage and the cultured cells formed distinguishable 3D structures, this method may be useful for further colorectal cancer research.
Subject(s)
Adaptor Proteins, Signal Transducing/metabolism , Cell Culture Techniques/methods , Colorectal Neoplasms/pathology , Gelatin/chemistry , Tissue Scaffolds/chemistry , Transcription Factors/metabolism , Cell Adhesion , Cell Line, Tumor , Cell Movement , Cell Proliferation , Cell Survival , Colorectal Neoplasms/metabolism , HCT116 Cells , Humans , Phosphorylation , YAP-Signaling ProteinsABSTRACT
The reaction of enynes with acetyl-masked aldoses in the presence of a rhodium(I) catalyst resulted in cyclocarbonylation, thus avoiding the direct use of carbon monoxide, to afford bicyclic cyclopentenones. In rhodium catalysis, aldoses serve as a carbon monoxide equivalent by donating their carbonyl moieties on the acyclic aldehyde form to enynes. A variety of aldoses, including D-glucose, D-mannose, D-galactose, D-xylose, and D-ribose, can be used as a carbonyl source. Using the method, a wide variety of enynes were cyclocarbonylated in 22-67% yields. An asymmetric variant also proceeded with moderate to high enantioselectivity.