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The LigaSure TM vessel-sealing system (VSS) represents a new approach to intraoperative ligation. This clinical study retrospectively examined the utility of the VSS in thyroid surgery. In this study, we analyzed 56 consecutive patients who underwent thyroid surgery. Characteristics such as operative duration, the volume of intraoperative hemorrhage, and postoperative course were analyzed and compared between thyroid surgery using the VSS or conventional handtie methods. The present results indicate no significant differences in operative duration, volume of intraoperative hemorrhage, postoperative course, or duration of postoperative drainage between surgeries using the VSS or conventional methods. However, the postoperative hospital stay was found to be significantly shorter (p<0.05) with the VSS. No serious postoperative complications were encountered, and no significant differences were observed in the frequency of postoperative complications between methods. The VSS may simplify procedures for thyroid surgery, and hemostasis is effective for both thyroid vessels and thyroid parenchyma. However, further evaluation is warranted to adequately determine the relative merits of the VSS compared to conventional handtie methods.

Deficiency of glucose-6-phosphate dehydrogenase (G6PD) causes acute hemolytic anemia triggered by oxidative drugs such as primaquine. It is therefore essential in malaria-endemic areas for malaria patients to be confirmed for their G6PD activity before taking primaquine. The WST-8 method, a newly established screening method for G6PD deficiency, has been demonstrated to be suitable for field conditions, particularly for on-site malaria surveys. Here we report a laboratory evaluation by this method of the reactivity of blood-spotted filters. A time-course experiment was conducted to evaluate the reactivity of blood samples spotted onto 4 types of filter paper, Whatman 31ET Chr (ET), 3MM Chr (3MM), P81, and Advantec No. 2 (AD2). The rank of the relative reaction intensity was ET > 3MM = AD2 > P81. Blood-spotted filters stored at 4 degrees centigrade gradually decreased G6PD reactivity with the passage of storage time, whereas those stored at room temperature rapidly reduced their reactivity. Unexpectedly, saponin supplementation reduced the reactivity of blood-spotted filters. In conclusion, 1) ET is the most suitable filter for the WST-8 method ; 2) blood-spotted filters stored in cold condition can be assayed within 14 days, or those stored at room temperature should be tested within 3 days ; and 3) reaction mixtures should not contain saponin.

This study was conducted to develop a simple surrogate index comprised of routinely available laboratory tests to reflect the histological fibrosis stage. Clinical characteristics and laboratory data from 368 and 249 consecutive patients with chronic hepatitis C, a training cohort and a validation cohort, respectively, were retrospectively evaluated. Platelet (Plt) count and albumin (Alb) level contributed to the discrimination of the respective fibrosis stages. We derived the fi brosis index (FI), FI = 8.0-0.01 x Plt (10 multiply 3/microliter) - Alb (g/dl), from a multiple regression model. FI significantly correlated with the histological fibrosis stage in both the initial and validation cohort at p=0.691 and p=0.661, respectively (Spearman's rank correlation coefficient, p<0.0001). The sensitivity and positive predictive value of FI at a cutoff value < 2.10 for predicting fibrosis stage F0-1 were 66.8% and 78.8% in the initial cohort and 68.5% and 63.6% in the validation cohort, respectively. Corresponding values of FI at a cutoff value >- 3.30 for the prediction of F4 were 67.7% and 75.0% in the initial cohort and 70.8% and 81.0% in the validation cohort. The fibrosis index comprised of platelet count and albumin level reflected the histological fibrosis stage in patients with chronic hepatitis C.

Response rates and survival times were studied in 47 patients who had multiple myeloma and who were being treated with Prednisolone and sequential Melphalan and Ifosfamide (MIP therapy). The clinical response was determined by objective parameters such as the reduction of M-protein level, tumor volume and healing of bone destruction. Twenty-eight of the patients (59.6%) responded to the MIP therapy. The 50% survival time as followed from the initiation of treatment to death was 19 months. Of the prognostic factors, the age (greater than or equal to 70 years), clinical stage III of Durie and Salmon, hypercalcemia, extensive bone lesions, and the patho-morphological type IV of Brucher were associated with a decreased life-span. Therefore, MIP therapy was more effective in poor risk (high tumor mass group) than in good risk (low or intermediate tumor mass group) patients, but the survival of patients on MIP therapy was shorter in the poor risk group than in the good risk one. In addition, the group which responded rapidly (i.e. within 2-5 weeks) had longer remission and longer survival than the group which improved slowly (i.e. after 6-16 weeks).

A total of 19 cases with bone tumors, including six osteosarcomas. three giant cell tumors of bone, one malignant fibrous histiocytoma, four nonossifying fibromas, four chondromas and one chondrosarcoma, were examined as to enzyme histochemistry; the enzymes consisted of alkaline phosphatase (ALPase), acid phosphatase (ACPase), nonspecific esterase (NSE), adenosine triphosphatase (ATPase), 5'-nucleotidase (5'-Nucl) and beta-glucuronidase (beta-Gl). Osteosarcoma was strongly positive for ALPase followed by 5'-Nucl. Giant cell tumor, malignant fibrous histiocytoma and nonossifying fibroma showed enzyme histochemistry similar to each other: multinucleated giant cells and round cells in these tumors were strongly positive for ACPase, NSE, ATPase and 5'-Nucl simulating osteoclasts and histiocytes, whereas spindle cells were positive for ATPase and 5'-Nucl in their cytoplasm and weakly positive for ACPase. Chondroma and chondrosarcoma were focally positive for ACPase and NSE; the ACPase was sensitive to tartaric acid treatment. These observations showed that ALPase activity is very characteristic to osteosarcoma, and is useful for its diagnosis. From enzyme histochemistry, giant cell tumor, malignant fibrous histiocytoma and nonossifying fibroma can be regarded as a histiocyte-derived tumor of bone in contrast to osteosarcoma and cartilaginous tumors.

<P>Blood-cells: extraembryonically it is found in very early stages, but it first appears in the heart, in the 13 - 14 somite stage. Pericardial cavity: the first sign of its appearance is indicated in the 2 somite stage. It commences simultaneously in the multiple foci, and thus formed intramesodermal spaces become confluent to form a single pericardial cavity. Angioblast: it is derived from the cardiogenic plate, and first appears in an embryo with 3 somites. It is fundamentally bilateral in origin, and at very early stage are the two sides anastomosed with each other in the cranial region. Myocardium: it is formed from paired cardiogenic folds. There can not be noted any distinct demarcation on the surface of the myocardial tubes before they are fused together. The folds are first fused at the middle part in the 7 - 8 somite stage, and the fusion is completed in the 12 somite stage. Mesocardium: the ventral mesocardium first appears in the embryo having 6 - 7 somites, and ruptures at its middle part in the 8 - 9 somite stage. Its remnant is observed in still later stages, namely, we can find it in an embryo with 12 somites. The dorsal mesocardium formes between the 9 and 10 somite stages, and rupture between the 15 and 18 somite stages. Endocardium: it is formed from angioblasts. It has the endothelial character in the 5 - 6 somite stages, and the paired tubes are derived from it in the 9 somite stage. The endothelial tubes unite in the bulbar and the ventricular region. From the network of angioblasts which are spread at the cranial portion of the embryonic shield from which a pair of aortic arches are derived. In the bulbar region, the right endothelial tube markedly exceeds in caliber that of the left side. The latter atrophies and disappears, and the former makes the genuine bulbus cordis. Caudally, on the contrary, the left tube exceeds that of the right and the former is situated sinistro-ventrally to the latter. In the 13 - 14 somite stages the fusion of the paired tubes is almost completed, and the ventricle and atrium may be distinguished by the atrioventricular constriction. In closing, I wish to express my cordial thanks to Prof. Dr. J. Shikinami for his kind criticism and advice.</P>

<P>1. It is possible to isolate the immune bodies from the globulin fraction, which was obtained by the salting out with ammonium sulphate or electrodialysis, by the biologic method. The rate of isolation is almost the same as the rate of the isolation by the biologic method. 2. The isolated serum from the globulin fractions by the combination of the physical or the chemical with the biologic method, has less antigenic and nitrogen contents than the isolated serum by the biologic method alone; especialy the isolated immune substance by the combination of the physical with the biologic method has the least antigenic contents. 3. The best results are obtained in the physiologic salt solution at 65℃, for the isolation of precipitin by means of the combination of the physical with the biologic method.It is a pleasure to express my indebtedness to Prof. Ogata for the encouragement and valuable suggestions which he has given. I am also indebted to Dr. Sunouti for various assistance he has offered in the preparation of this work.</P>