Laparoscopic surgery for De Garengeot's hernia in a man after inguinal hernia surgery with a mesh plug: a case report and review of literature.

BACKGROUND: De Garengeot's hernia is a rare case of a femoral hernia that contains the appendix. Here we report a case of De Garengeot's hernia that occurred in a male patient who had a history of inguinal hernia surgery using a mesh plug. There were no reports of De Garengeot's hernia with a history of surgery for inguinal hernia, and the surgical question was whether we could successfully treat a patient with minimally invasive laparoscopic surgery using a mesh. CASE PRESENTATION: This case involved 75-year-old man with a history of right indirect inguinal hernia surgery using a mesh plug without on-lay mesh, who presented with a 5-day history of a right groin lump. Abdominal CT revealed an incarcerated appendix within the right femoral hernia and fluid collection around the appendix. Laparoscopic surgery was initiated and the incarcerated appendix was released with traction. There was no contamination around the appendix or the femoral ring, the appendix was removed, and the femoral hernia was repaired using mesh. Laparoscopic surgery was useful in first evaluating the inflammatory status of the appendix. As it was determined that there was little inflammation around the appendix and femoral ring, it was possible to repair the hernia using mesh. CONCLUSIONS: De Garengeot's hernias are rare and there is currently no standardized approach. Even if it is a recurrent hernia in the groin, laparoscopic surgery can be useful for diagnosis and treatment, but the use of mesh requires further careful consideration.

[A Case of Colostomy-Free and Long-Term Survival with 5-FU/CDDP for Local Recurrence of Anal Cancer after Chemoradiation Therapy].

We report a case of colostomy-free, long-term survival following 5-FU/CDDP for the local recurrence of anal cancer after chemoradiation therapy(CRT). The patient was a 48-year-old woman who was diagnosed with cStage ⅢA anal cancer. She was treated with CRT(5-FU/MMC plus 59 Gy)and achieved a complete response upon treatment completion. A local recurrence was detected on the left-side wall of her rectum after 6 months. We recommended abdominoperineal resection but the patient refused operation. The patient was treated with chemotherapy consisting of 5-FU(1,000mg/m / 2/day)on days 1-5 and CDDP(100mg/m / 2/day)on day 2. Grade 3 peripheral neuropathy appeared following the completion of 5 courses. Therefore, the dose was reduced to 60%. Twenty-five courses of this treatment were continued and chemotherapy was completed. The patient has been alive with no sign of recurrence for 6 years and 8 months from the initial treatment. CRT for anal cancer is becoming a standard therapy but local recurrence is possible. In these cases, abdominoperineal resection is required. Chemotherapy with 5-FU/CDDP in cases of recurrence can be a colostomy-free option.

[A Case of Resected Pancreatic Metastasis of Rectal Cancer after Multiple Resections of Metastatic Lesions].

A 71-year-old man underwent low anterior resection for rectal cancer 10 years prior. He underwent resection of liver metastasis once and that of lung metastases multiple times after the primary surgery. Computed tomography revealed a mass measuring 22mm in size in the pancreatic body 10 years after the rectal resection. We inspected it before surgery by performing EUS-FNA. On suspicion of metastasis of rectal cancer or primary pancreatic cancer, we performed distal pancreatectomy. The pancreatic tumor was diagnosed as metastasis of the rectal cancer. There were multiple metastases in the resected specimen that we were unable to indicate at the preoperative inspection. Resectable pancreatic metastasis from colorectal cancer is rare, but some patients with long-term survival have been reported. If a patient is tolerant to pancreatectomy and has no metastasis in other organs, the patient should be considered as a good candidate for pancreatectomy.

A Nearest Neighbor Classifier Employing Critical Boundary Vectors for Efficient On-Chip Template Reduction.

Aiming at efficient data condensation and improving accuracy, this paper presents a hardware-friendly template reduction (TR) method for the nearest neighbor (NN) classifiers by introducing the concept of critical boundary vectors. A hardware system is also implemented to demonstrate the feasibility of using an field-programmable gate array (FPGA) to accelerate the proposed method. Initially, k -means centers are used as substitutes for the entire template set. Then, to enhance the classification performance, critical boundary vectors are selected by a novel learning algorithm, which is completed within a single iteration. Moreover, to remove noisy boundary vectors that can mislead the classification in a generalized manner, a global categorization scheme has been explored and applied to the algorithm. The global characterization automatically categorizes each classification problem and rapidly selects the boundary vectors according to the nature of the problem. Finally, only critical boundary vectors and k -means centers are used as the new template set for classification. Experimental results for 24 data sets show that the proposed algorithm can effectively reduce the number of template vectors for classification with a high learning speed. At the same time, it improves the accuracy by an average of 2.17% compared with the traditional NN classifiers and also shows greater accuracy than seven other TR methods. We have shown the feasibility of using a proof-of-concept FPGA system of 256 64-D vectors to accelerate the proposed method on hardware. At a 50-MHz clock frequency, the proposed system achieves a 3.86 times higher learning speed than on a 3.4-GHz PC, while consuming only 1% of the power of that used by the PC.

Patterning of human dental arch wire blanks using a vector quantization algorithm.

We objectively and automatically classified arch wire blank forms represented by a series of facial surface points on tooth crowns in human adults with normal occlusions using a vector quantization algorithm on the basis of the generalized Lloyd algorithm. We investigated also the descriptive dental arch form parameters that were most effective in distinguishing the classified groups of dental arch wire blanks and examined if they were associated with specific anatomical traits. Dental casts, taken from 79 adults with complete dentitions, were laser scanned with a computer-assisted stereotaxic device. Coordinates of the tooth crown points (FA points) were measured for each dental arch expressed as a vector having positional elements in a series of 14 FA points and categorized into several codes (ie, patterns) according to the similarity of the quantized vector patterns. We found that classifying the dental arches into four patterns maximized the difference between arch wire blank patterns. The classified patterns were differentiated by a gradual broadening of the interarch widths posterior to the lateral incisor. The code with the narrowest arch had the longest coronal arch, whereas the code with the widest arch had the shortest coronal arch (P < .01). The interpremolar and intermolar basal arch widths determined for the code showing the widest arch were significantly greater than those for the code with the narrowest width (P < .01).

Analysis of Phenothrin and Its Metabolite 3-Phenoxybenzoic Acid (PBA) in Agricultural Products by GC and Ion-Trap GC/MS.

A sensitive method for analysis of phenothrin and its metabolite 3-phenoxybenzoic acid (PBA) in agricultural products by gas chromatography with electron capture detection (ECD-GC) and ion-trap gas chromatography/mass spectrometry (GC/MS) with chemical ionization (Cl) was investigated. After phenothrin in vegetables, fruits, potatoes, starches, and tea had been extracted with acetone, or in cereals and beans had been extracted with acetonitrile followed by Florisi! column chromatography, it was reextracted into n-hexane. PBA was determined by ECD-GC after esterification with hexafluoroisopropyl alcohol (HFIP) and diisopropylcarbodiimide (DIC). Phenothrin was determined by monitoring its molecular ion peak using ion-trap GC/MS and was confirmed by observing its spectral pattern. The detection limit for phenothrin by ECD-GC and ion-trap GC/MS by this method was 0.01 ppm. The detection limit for PBA by ECD-GC was 0.001 ppm. When phenothrin and PBA were added to samples at 0.2 and 1.0 ppm, the recoveries of phenothrin in each agricultural product ranged between 60.2 and 88.5% and those of PBA ranged between 37.8 and 89.5%. An actual-conditions surveillance analysis of six agricultural products imported from October to December 1994 indicated no phenothrin, but PBA was detected in all products.