Magnetic field induced enlargement of the regime of critical fluctuations in the classical superconductor V3Si from high-resolution specific heat experiments.

We present high-resolution specific heat data from a high-purity single crystal of the classical superconductor V(3)Si, which reveal tiny lambda-shape anomalies at the superconducting transition superimposed onto the BCS specific heat jump in magnetic fields of 2 T and higher. The appearance of these anomalies is accompanied by a magnetic-field-induced broadening of the superconducting transition. We demonstrate, using scaling relations predicted by the fluctuation models of the 3d-XY and the 3d-lowest-Landau-level (3d-LLL) universality class that the effect of critical fluctuations becomes experimentally observable due to of a magnetic field-induced enlargement of the regime of critical fluctuations. The scaling indicates that a reduction of the effective dimensionality due to the confinement of quasiparticles into low Landau levels is responsible for this effect.

Optical conductivity spectral anomalies in the off-center rattling system ß-Ba8Ga16Sn30.

We present optical conductivity studies of the type-I clathrate Ba8Ga16Sn30, using a terahertz time-domain spectrometer (0.3-3.0 THz). The lowest-lying spectral peak at 0.72 THz due to the Ba(2) ion's off-center vibration in the oversized cage shows a drastic and anomalous temperature dependence. Below about 100 K, the single broad peak splits into two subpeaks, and with further lowering of the temperature, the spectral shape of this so-called rattling phonon shows non-Boltzmann broadening to the point that the linewidth becomes comparable to the peak frequency. Whereas the initial splitting can be understood by assuming a multiwell anharmonic potential, the strong linewidth broadening toward low temperature cannot, since the Boltzmann factor generally sharpens the low-temperature spectra. The observed behavior suggests strong interaction between the local anharmonic phonons and other excitations.

Renal artery pseudoaneurysm occurring after laparoscopic partial nephrectomy.

Renal artery pseudoaneurysm (RAP) is rare, and has been reported after renal biopsy and percutaneous renal surgery. We report a case of RAP after laparoscopic partial nephrectomy for renal cell carcinoma.

Splenic artery steal syndrome in living donor liver transplantation: a case report.

Splenic artery steal syndrome (SASS) has only recently been recognized as a potential threat to transplanted livers. We report a case of SASS with progressive liver dysfunction that developed after living donor right lobe liver transplantation. SASS suspected by serial pre- and postoperative computed tomographic (CT) scans was diagnosed by celiac trunk angiography. It was successfully salvaged by splenic artery embolization. In this case, serial examinations of CT scans were useful to diagnose SASS. This case showed that portal hyperperfusion injury is a cause of liver graft dysfunction in SASS. The splenic artery embolization technique is a safe procedure that can be applied to treat such injury.

Endovascular therapy for massive haemothorax caused by ruptured extracranial vertebral artery aneurysm with neurofibromatosis Type 1.

Extracranial vertebral artery aneurysm is uncommon, and the common cause is penetrating trauma. Rupture of extracranial vertebral artery aneurysm into the thoracic cavity is extremely rare and fatal due to haemorrhagic shock by massive haemothorax. We report an intrathoracic rupture of the extracranial vertebral artery aneurysm with neurofibromatosis Type 1, successfully treated by coil and liquid embolisation.

A three-dimensional laminated paper model of the scaphoid from computed tomography.

PURPOSE: To describe a method of producing a life-sized three-dimensional (3D) solid model of a scaphoid bone by combining multidetector-row computed tomography (MDCT) volume data and rapid prototyping technique using thin paper as material, and to evaluate the dimensional accuracy of the experimental model. MATERIAL AND METHODS: We experimentally produced life-sized 3D solid models of 14 cadavers' scaphoid bones using high-resolution MDCT volume data, and evaluated the dimensional accuracy of the 3D solid models. RESULTS: The 3D solid model was almost perfectly produced in both size and shape (length, height, width, dorsal cortical angle, and landmarks of the scaphoid bone) compared to the real cadaver's scaphoid bone. In addition to accuracy, the cost and time for creating the model might be reasonable. CONCLUSION: This technique may be useful in assisting repair of scaphoid bone fracture.

Preoperative portal vein embolization with a mixture of gelatin sponge and iodized oil: efficacy and safety.

PURPOSE: To evaluate whether portal vein embolization (PVE) using a mixture of gelatin sponge (GS) pieces and iodized oil is safe and effective in inducing hypertrophy of the future liver remnants (FLR). MATERIAL AND METHODS: PVE was performed in 14 patients (eight male and six female, mean age 65 years, range 35-81 years) diagnosed with malignant liver tumor before surgery, whose FLR volumes were judged too small to allow for safe resection. Liver volume change, biochemical data change, complications related to PVE, and postoperative complications were retrospectively evaluated. RESULTS: PVE was successful in all patients, and there were no procedural complications. Absolute FLR volume and FLR/total liver volume (TLV) ratio increased by 102 cm3 and 8% (mean values), respectively. Planned hepatectomies were cancelled in three patients due to extrahepatic metastasis or bile duct infection. Five of the 11 patients (45%) who underwent hepatectomies had major postoperative complications. However, complications due to hepatic failure were not seen. In 10 patients, except one whose outcome was fatal outcome, the mean hospitalization days with and without major complications were 73 and 33 days, respectively. CONCLUSION: PVE using a mixture of GS and iodized oil seems to be effective and safe in inducing hypertrophy of the FLR.

[Congenital and acquired esophagobronchial fistula].

We report a case of a patient with repeated intractable pneumonia due to congenital and acquired esophagobronchial fistula that was relieved by surgery. The patient was a 69-year-old female, who had repeatedly developed pneumonic symptoms since December 2000. It was found that she had a fistula from an esophageal diverticulum into the right bronchus and was diagnosed with congenital esophagobronchial fistula (Braimbridge classification type I). The patient was not relieved with conservative treatment and the diverticulum and fistula were subsequently excised. Considering the complications, lobectomy was not performed. In postoperative esophagraphy, a second fistula was found at a different site that was then removed during a second surgery. This fistula operation was formed a posteriori based on the conditions around the fistula. We had difficulty with the diagnosis and treatment. However, the patient had a good outcome With surgical treatment. A review of the relevant literature is also presented.

Endovascular therapy for abdominal pseudoaneurysms: analysis from technical and clinical aspects.

PURPOSE: To clarify the factors of outcomes by endovascular therapy for abdominal pseudoaneurysm (PSA) from both technical and clinical aspects. MATERIAL AND METHODS: Sixteen patients with PSAs underwent embolization. Embolic methods were classified into two groups: proximal and distal embolization (PDE) and proximal embolization alone (PE). The patients were classified into four groups by shock index. Pre-embolization hemoglobin (Hb) level and decrease in Hb level were evaluated. Outcomes were classified into two groups: successful recovery and failure despite successful PSA embolization. RESULTS: There were no statistical differences in success, recurrence, and complication rate, and outcomes between the two embolic methods. There was a statistically significant correlation between the grades of shock indices and outcomes (P<0.05). There was no statistical difference between the Hb levels and outcomes. CONCLUSION: Outcomes were not dependent on the embolic methods. Shock index reflecting clinical status may be a simple predictor of outcome. PSA should therefore be treated by optimal embolic methods as quickly as possible to avoid rupture.

Acinar cell carcinoma of the pancreas showing finger-print-like zymogen granules by electron microscopy: immunohistochemical study.

A rare case of finger-print-like zymogen granules shown by electron microscopy is reported. The patient was a 75-year-old man who was histologically and ultrastructurally confirmed to have acinar cell carcinoma of the pancreas. Frozen section and postmortem examination revealed that the tumor was made up of solid nests of cells resembling the appearance of normal pancreatic acini, showing polygonal cells which had round or oval nuclei, and rare mitotic figures. Zymogen-like granules, shown by eosinophilic granular staining, were abundant in the cytoplasm. Electron microscopy showed that the tumor cells were closely packed, occasionally forming small intercellular spaces resembling pancreatic acini (microtubules). The cytoplasm contained characteristic zymogen granules with dark-to-medium electron density, measuring 660 nm +/-213 SD in diameter. The granules of medium density were large, and showed finger-print-like patterns. Investigation of more cases is necessary to identify whether these finger-print-like patterns are an important factor in the genesis of acinar cell carcinoma.

Fast skeletal muscle isoforms exhibit the highest incorporation level into myofibrils and stress fibers among members of myosin alkali light chain isoform family.

Isoproteins of myosin alkali light chain (LC) were co-expressed in cultured chicken cardiomyocytes and fibroblasts and their incorporation levels into myofibrils and stress fibers were compared among members of the LC isoform family. In order to distinguish each isoform from the other, cDNAs of LC isoforms were tagged with different epitopes. Expressed LCs were detected with antibodies to the tags and their distribution was analyzed by confocal microscopy. In cardiomyocytes, the incorporation level of LC into myofibrils was shown to increase in the order from nonmuscle isoform (LC3nm), to slow skeletal muscle isoform (LC1sa), to slow skeletal/ventricular muscle isoform (LC1sb), and to fast skeletal muscle isoforms (LC1f and LC3f). Thus, the hierarchal order of the LC affinity for the cardiac myosin heavy chain (MHC) is identical to that obtained in the rat (Komiyama et al., 1996. J. Cell Sci., 109: 2089-2099), suggesting that this order may be common for taxonomic animal classes. In fibroblasts, the affinity of LC for the nonmuscle MHC in stress fibers was found to increase in the order from LC3nm, to LC1sb, to LC1sa, and to LC1f and LC3f. This order for the nonmuscle MHC is partly different from that for the cardiac MHC. This indicates that the order of the affinity of LC isoproteins for MHC varies depending on the MHC isoform. Further, for both the cardiac and nonmuscle MHCs, the fast skeletal muscle LCs exhibited the highest affinity. This suggests that the fast skeletal muscle LCs may be evolved isoforms possessing the ability to associate tightly with a variety of MHC isoforms.

Partial hepatectomy of marmoset: clinical and pathological effects and utility in microsomal enzyme analysis.

Liver biopsy based on a partial hepatectomy technique (shearing) was performed in 10 common marmosets (Callithrix jacchus). This is a preliminary study to evaluate the effects of drugs on hepatic microsomal enzymes: cytochrome P-450 and T4 uridine diphosphate glucuronyl transferase (T4-UDPGT), by comparing post-treatment values with pre-treatment values individually with a limited number of animals. The effects of the biopsy on clinical findings and liver pathology were evaluated during the first 5 post-surgical weeks. Although the plasma aspartate aminotransferase (AST) activities tended to decrease from 1 to 4 weeks post-surgery, no abnormality was noted in clinical sign, body weight, the hematocrit value or other blood chemical values. At necropsy, adhesion of the sheared site of the liver to the parietal peritoneum or the small intestine was evident in 2 of the 4 marmosets. Microscopic examination revealed focal fibrosis in the liver, but it was localized around the sheared site. Based on the above results, it was concluded that liver biopsy must be performed more than one month before administration of the drug to be tested. The biopsy samples and the whole liver samples obtained at autopsy were subjected to analysis of microsomal protein content, cytochrome P-450 content and T4-UDPGT activity. In comparison with the values from the whole liver samples, those from the biopsy samples showed no significant difference. Furthermore, there was a significant correlation rather than difference between matched values. This suggested that partial hepatectomy is a useful method for obtaining pretreatment values in liver biochemistry to evaluate the effects of drug-treatment in individual animals.

Limited pancreatectomy: significance of postoperative maintenance of pancreatic exocrine function.

This study attempted to clarify whether limited pancreatectomy (duodenum-preserving total pancreatic head resection [DPTPHR], or medial pancreatectomy [MP], maintain pancreatic exocrine function more than conventional pancreaticoduodenectomy (Whipple) or pylorus-preserving pancreaticoduodenectomy (PPPD). A total of 125 patients (18 with Whipple, 71 with PPPD, 13 with DPTPHR, and 23 with MP) were studied. Fecal chymotrypsin and p-type amylase, and pancreatic function diagnostant (PFD) tests were used for evaluation. There were no differences in preoperative background. Pancreatic function was seen to be significantly lower after surgery than before surgery in patients who underwent the Whipple procedure and PPPD (P < 0.05), but there was no difference between pre- and postoperative pancreatic function in patients who underwent DPTPHR and MP. Postoperative pancreatic function was shown to be significantly worse in Whipple procedure and PPPD patients than in those with DPTPHR and MP (P < 0.05). Patients who underwent the Whipple procedure and PPPD showed significantly lower pancreatic function than patients who underwent DPTPHR and MP (P < 0.05). There was no difference in pancreatic function between patients who underwent DPTPHR and those with MP. DPTPHR and MP, both of which preserve the entire duodenum, maintain pancreatic function more than the Whipple procedure and PPPD.

Significance of three-field lymphadenectomy for carcinoma of the thoracic esophagus based on depth of tumor infiltration, lymph nodal involvement and survival rate.

BACKGROUND: Significance of three-field lymhpadenectomy for carcinoma of the thoracic esophagus was examined retrospectively based on depth of tumor infiltration, lymph nodal involvements and long-term survival. METHODS: One hundred and fifty-two consecutive patients who underwent curative esophagectomy for thoracic carcinoma invading to submucosa (pT1) or deeper layers of the esophageal wall from 1983 to 1996 were examined. Sixty-six patients underwent three-field lymphadenectomy (3F) and 86 underwent two-field lymphadenectomy (2F). Survival curves were compared between 3F and 2F after stratifications according to depth of tumor infiltration, the number of positive nodes (0, 1 to 4, 5 or more), and positive intrathoracic recurrent nerve-chain nodes. RESULTS: Overall 5-year survival rate for 3F was 43.8%, while it was 30.2% for 2F (p = 0.07). In 41 patients with pT1 cancers, the 5-year survival rate for 3F was 55.7%, while it was 41.4% for 2F (p = NS). In patients with cancers invading to muscularis propria (pT2), the 5-year survival rate for 3F was 49.4%, while it was 30.7% for 2F (p = 0.06). In patients with tumors invading to adventitia, there was no significant difference. In patients with one to four positive nodes, the 5-year survival rates for 3F was 50.1%, while it was 24.1% for 2F (p = 0.01). There was no significant difference in the subgroups with no positive nodes and five or more. In subgroups with positive recurrent nerve-chain nodes, the 5-year survival rate for 3F was 27.9%, while it was 0% for 2F (p = 0.01). CONCLUSIONS: Significance of three-field lymphadenectomy was found in patients with one to four positive nodes or positive intrathoracic recurrent nerve-chain nodes.

Variations of the extensor indicis muscle and tendon.

Variations of the extensor indicis muscle were examined in 164 hands from 86 Japanese cadavers. Anomalous cases exhibiting supernumerary muscles or tendons were found in 22 hands. These variations were classified into four types: type 1, an additional tendon slip from the extensor indicis tendon; type 2, an extensor indicis radialis or extensor pollicis et indicis accessorius; type 3, an extensor medii proprius with or without extensor medii brevis; and type 4, an extensor indicis radialis and extensor medii proprius. The extensor medii proprius was the most common variation, followed by extensor indicis radialis. There were no clear differences in incidence of variations between men and women or between right and left hands. When variations were bilateral, both sides were identical or similar in type.

FK506 and cyclosporin A inhibit stem cell factor-dependent cell proliferation/survival, while inducing upregulation of c-kit expression in cells of the mast cell line MC/9.

Murine mast cell proliferation and maturation are regulated by two distinct cytokines, interleukin-3 (IL-3) and the c-kit ligand, stem cell factor (SCF). In this study using cells of the mouse mast cell line, MC/9, the effects of two immunosuppressants, FK506 and cyclosporin A (CsA), were investigated. Withdrawal of IL-3 from the culture medium resulted in loss of viability of MC/9 cells. The addition of SCF in the absence of IL-3 maintained MC/9 cell survival but no cell proliferation was detected. The combined addition of IL-3 and SCF to the culture medium resulted in a more marked MC/9 cell proliferation than the addition of IL-3 alone. FK506 and CsA inhibited the SCF-dependent, but not the IL-3 dependent, stimulatory effects on MC/9 cell proliferation/survival. Apoptotic changes were analyzed using fluorescent staining with acridine orange and DNA electrophoresis. FK506 and CsA inhibited the SCF-dependent rescue effect from apoptosis. Flow cytometry showed that FK506 and CsA did not affect IL-3 receptor expression. However, immunoblot and reverse transcriptase-polymerase chain reaction (RT-PCR) analyses indicated that c-kit protein and c-kit mRNA transcripts were increased following the FK506 and CsA treatments in the presence of IL-3. In addition, MC/9 cells pretreated with FK506 or CsA showed an increased adhesiveness to NIH/3T3 cells that express membrane-bound SCF. Neither FK506 nor CsA affected c-kit tyrosine phosphorylation or MAP kinase nuclear translocation of MC/9 cells following SCF stimulation. These results indicate that FK506 and CsA, while inducing c-kit of MC/9 cells, selectively inhibit the SCF-dependent stimulatory effects on MC/9 cell proliferation/survival by a mechanism independent of, or at point(s) distal to, the c-kit-MAP kinase pathway.

Peroneal artery aneurysm treated by transcatheter coil embolization and temporary balloon occlusion in Behçet's disease.

Peroneal artery aneurysms in Behçet's disease have not been described to date. We present such a patient who was treated successfully using transcatheter embolization.

Glucocorticoids inhibit proliferation and adhesion of the IL-3-dependent mast cell line, MC/9, to NIH/3T3 fibroblasts, with an accompanying decrease in IL-3 receptor expression.

We investigated the effects of glucocorticoids on IL-3-dependent proliferation and c-kit expression of cells of the mouse mast cell line, MC/9. Glucocorticoids (dexamethasone, prednisolone, and hydrocortisone) inhibited IL-3-dependent MC/9 cell proliferation, whereas sex steroids (progesterone, beta-estradiol, and testosterone) had no effect. Flow cytometric analysis revealed that glucocorticoids reduced the expression of the IL-3 receptor on MC/9 cells. Immunoblot and Northern blot analyses indicated that glucocorticoids also reduced the expression of both c-kit protein and c-kit mRNA transcript. Furthermore, the adhesion of MC/9 cells to stem cell factor-expressing NIH/3T3 cells was reduced following glucocorticoid treatment. Our results indicate that glucocorticoids inhibit IL-3-dependent MC/9 mast cell proliferation, with an accompanying decrease in IL-3 receptor expression. Glucocorticoids also reduced c-kit expression on MC/9 cells resulting in a decreased adhesion to NIH/3T3 fibroblasts.