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Aim: As techniques in laparoscopic cholecystectomy (LC) have improved, the role of routine prophylactic abdominal drainage may be limited. A retrospective review was carried out of patients undergoing elective LC to evaluate the benefit of routine drainage in simple uncomplicated procedures. Methods: This study of 295 patients with cholecystolithiasis or gallbladder polyp included 145 patients who underwent LC with drainage and 150 patients who underwent LC without drainage between 2003 and 2007. Allocation to drain or not to drain was non-randomized and based on surgeon preference according to intraoperative findings. Patient characteristics, operative results, and postoperative outcomes were compared between the two groups with univariate analysis. Results: Time to first flatus and length of postoperative hospital stay in the LC without drainage group were shorter than in the LC with drainage group. There was no significant difference between the two groups with respect to postoperative complication rate. No complications were noted due to the lack of drain placement. Conclusion: The use of drain after simple elective uncomplicated LC could safely be limited to appropriate patients as judged by the operating surgeon.

Cerebrospinal fluid (CSF) induced neurite retraction of differentiated PC12 cells; the action was observed in 15 min (a rapid response) and the activity further increased until 6 h (a long-acting response) during exposure of CSF to the cells. The CSF action was sensitive to monoglyceride lipase and diminished by homologous desensitization with lysophosphatidic acid (LPA) and by pretreatment with an LPA receptor antagonist Ki16425. Although fresh CSF contains LPA to some extent, the LPA content in the medium was increased during culture of PC12 cells with CSF. The rapid response was mimicked by exogenous LPA, and a long-acting response was duplicated by a recombinant autotaxin, lysophospholipase D (lyso-PLD). Although the lyso-PLD substrate lysophosphatidylcholine (LPC) was not detected in CSF, lyso-PLD activity and an approximately 120-kDa autotaxin protein were detected in CSF. On the other hand, LPC but not lyso-PLD activity was detected in the conditioned medium of a PC12 cell culture without CSF. Among neural cells examined, leptomeningeal cells expressed the highest lyso-PLD activity and autotaxin protein. These results suggest that leptomeningeal cells may work as one of the sources for autotaxin, which may play a critical role in LPA production and thereby regulate axonal and neurite morphological change.

Background and Aim: Research on gastric lesions developing in response to stress is essential to elucidating the pathogenesis of these lesions as well as the interplay with other factors, including Helicobacter pylori infection and non-steroidal anti-inflammatory drug use. Genes expressed individually or in sets, such as heat shock proteins, growth factors, proto-oncogenes and cyclooxygenases, have been investigated in the stomach. However, gene expression in the stomach after stress exposure have not yet been comprehensively examined. We investigated the gastric gene expression profile in response to stress. Methods: A high-density oligonucleotide array, representing approximately 850 genes, was used to determine gene expression changes in the stomachs of water immersion-restraint stress (WIRS) rats. Results: Fifty-eight genes including expressed sequence tag (EST) genes were upregulated more than twofold in the 30 min-WIRS rat stomach as compared with the control. Concomitantly, five genes were downregulated. Numbers of up- or downregulated genes decreased rapidly at 1 and 2 h of WIRS. Altered gene expression of heat shock proteins, cell cycle regulators, proto-oncogenes and metabolic enzymes were recognized. Several of these genes, including p38 mitogen-activated protein kinase, did not reportedly show gastric expression changes in response to stress. Conclusion: These results suggest that, in addition to the previously identified stress-induced genes, expression of a number of other genes in the stomach is also involved in stress response.

Background: Accurate staging of lymph node metastasis by sentinel node biopsy is easily achieved in conventional open gastric surgery. Staging is not easily achieved in laparoscopic surgery, however, because of the technical difficulty in identifying sentinel nodes. We developed a laparoscopic method that involves lead shielding for detection of sentinel nodes in gastric cancer and examined the efficacy of this method. Methods: Laparoscopic sentinel node biopsy was performed in 18 patients with early gastric cancer. A combined dye- and radio-guided method was used in the first 10 patients; our radio-guided lead shield method was used in the subsequent eight cases. Laparoscopy-assisted distal gastrectomy was performed in all patients, and dissected nodes were examined by routine hematoxylin and eosin staining. The detection rate was compared between the two groups. Results: The detection rate for sentinel nodes was higher with the radio-guided lead shield method (88%) than with the combined dye- and radio-guided method (40%). Regional lymph node metastasis was recognized in one of 18 patients, and the sentinel node was positive in this case. Conclusions: Use of a lead shield is beneficial for accurate laparoscopic detection of sentinel lymph nodes.

From conventional relative gene expression analyses (Northern blotting, in situ hybridization, and RT-PCR), it has been reported that the expression of control genes, such as glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and β-actin, used as references may be affected by ischemia. Therefore, we extended searching and evaluation at the mRNA level of transcripts whose expression levels were not changed by cerebral ischemia, using a high-density oligonucleotide array and statistical analysis in a rat global cerebral ischemia and reperfusion model. We added a hyperthermic factor and localization factor to ischemia and identified transcripts with a stable expression level under conditions even more disadvantageous than ischemia only. Screening of more than 8,000 transcripts with the Rat Genome U34A array yielded 28 transcripts, which we listed and classified according to their expression level. Widely used control genes, GAPDH and β-actin, were not included, although cyclophilin A was included. In addition, we conducted a functional classification based on gene ontology. Under the functional classification of the 28 transcripts, many genes tended to be associated with metabolism. In conclusion, use of several transcripts is recommended, such as those we identified, as references in the analysis of gene expression in pathological models of ischemia. © 2004 Wiley-Liss, Inc.

We report herein a case of primary early ileal adenocarcinoma diagnosed definitively by colonoscopy before surgery and treated by laparoscopy-assisted ileocecal resection. A 66-year-old man visited our hospital because of fecal occult blood. Colonoscopy revealed a relatively clearly demarcated, flat elevation in the terminal ileum; it was slightly red, surrounding a hemorrhagic spot, and had a small depression at its center. The lesion was diagnosed on biopsy as a well-differentiated adenocarcinoma. Laparoscopy-assisted ileocecal resection was performed. Macroscopically, the resected specimen appeared as a partially elevated, partially depressed, reddish lesion on Kerckring's fold. It was 1.5 × 1.0 cm and located 3.5 cm from the ileocecal valve. Microscopically, the tumor was diagnosed as a type IIa + IIc well-differentiated adenocarcinoma; it was confined to the mucosa, and lymph node metastasis was not found. The patient's postoperative course was uneventful, and he is now alive, well and showing no evidence of recurrence 1 year after surgery. Early detection of ileal cancer depends on careful colonoscopic observation of the terminal ileum, where small bowel cancer usually locates, even during routine examination. To our knowledge, this is the first report of laparoscopic surgery for preoperatively diagnosed early ileal carcinoma.

A genome-wide scan for a locus responsible for exploratory eye movement (EEM), which is quantitative and can be disturbed in association with schizophrenia, was performed. A 10-cM resolution genome-wide linkage analysis of the EEM disturbance with 358 highly polymorphic microsatellite markers in 38 nuclear families with 122 members (38 probands, 47 sibs, and 37 parents) including 58 sib-pairs yielded the suggestive linkage to the GCT10C10 marker on chromosome 22q11.2 (LOD = 2.48). Dense mapping with additional markers around the GCT10C10 marker yielded evidence for significant linkage between EEM disturbance and markers D22S429 and D22S310 on chromosome 22q12.1 (LOD score of 4.63) with suggestive evidence for the chromosome region 22q11.2–q12.1. Our findings suggest that a relatively small number of loci may control the schizophrenia-related quantitative EEM trait. We believe that identifying gene(s) on chromosome 22q associated with the EEM phenotype may forward our understanding of the etiology of schizophrenia. © 2003 Wiley-Liss, Inc.

The patient was an 81-year-old man who was admitted to the Arita Gastrointestinal Hospital for anemia. Upper gastrointestinal series and endoscopic examinations revealed transpyloric prolapse of a pedunculated polypoid gastric carcinoma with an abnormal mucosal fold from the posterior wall of the lesser curvature of the gastric antrum. Biopsy and histological examination led to a diagnosis of papillary adenocarcinoma. The incarcerated tumor could not be restored endoscopically into the stomach, the lesion head was ulcerated, and the serum carbohydrate antigen (CA) 19-9 was elevated to 379.7 U/mL. Surgery was indicated. Intraoperatively, the tumor was found in the duodenal bulb; it was easily manipulated into the stomach, and distal gastrectomy was performed. The tumor, 5.0 × 4.2 × 2.5 cm, was diagnosed histologically as papillary adenocarcinoma of the stomach infiltrating into the submucosal layer. The carcinoma cells stained positively for CA19-9 antibody. The postoperative course was uneventful, the anemia improved, and the serum CA19-9 level decreased to within normal range. The patient remains alive 15 months after the surgery. This may be the first report of a patient with Type 0 I early gastric cancer characterized by both CA19-9 production and transpyloric prolapse.

The extracellular concentrations of amino acids in the hippocampal CA1 field and striatum of conscious freely moving rats were monitored simultaneously by in vivo brain microdialysis using HPLC with electrochemical detection. Under basal conditions, aspartate, glutamate, glutamine, glycine, taurine, and alanine were detected, but gamma-aminobutyric acid was undetectable in both regions. Intraperitoneal injection of N-methyl-D-aspartic acid (NMDA; 10 mg/kg) caused a significant increase (three- to fivefold) in the taurine concentration in the dialysate obtained from both the hippocampal CA1 and striatum, whereas other amino acids (aspartate, glutamate, and alanine) did not show significant changes. Local application of NMDA (300 microM) to both regions via the dialysis probes also caused a similar increase (three- to fivefold) in both regions. Under infusion of hypertonic Ringer's solution containing 150 mM sucrose, the effect of NMDA on the level of taurine in both the regional dialysates was not affected. The effect of NMDA was totally reduced by intraperitoneal administration of MK-801 (0.3-1.0 mg/kg), a noncompetitive antagonist of NMDA receptors. Continuous infusion of DL-2-amino-5-phosphonovaleric acid (1.0 mM), a competitive antagonist of NMDA receptors, via the dialysis probes completely inhibited the effect of NMDA. These findings suggest that systemic administration of NMDA is effective as well as local administration into the brain and that NMDA receptors might be involved in the regulation of the extracellular taurine level in the brain without dependence on cell swelling.

An infection occurred in all African green monkeys and cynomolgus monkeys experimentally inoculated with SIVAGM [TYO-1], as demonstrated by the appearance of an antibody to SIVAGM [TYO-1] and the isolation of the virus. No monkey exhibited overt clinical disorders throughout the experimental period of 42 weeks. Thus, SIVAGM was not pathogenic to its original host or to macaques. This system is proposed as a model for HIV infection manifesting no overt disease.

Introduction: In the surgical field, “suture removal on 7 days after surgery” and “daily disinfection and coverage with gauze” have been customs. The timing of suture removal and the postoperative wound treatment were devised, and their effect on wound healing was compared with the conventional method. Method: The abdominal incision was divided into two parts, one half of the suture was removed on 3 days after surgery, the other half of the suture was removed on 7 days after surgery, and the conditions of the wound were compared between 7 and 14 days after surgery. In addition, the skin was disinfected only immediately before incision, and the closed dressing was given on the wound. Results: There were no differences in the degree of skin approximation, the degree of redness, subcutaneous swelling, pain and postoperative scar between both days. However, the suture removal on 3 days gave no scar of suture, which was better cosmetically. The frequency of treatments also decreased, which led to cost reduction. Discussion: Since the wound is covered with epithelial cells in 48 hours, the suture removal on 3 days and the closed dressing are desirable in the abdominal incision to which no especially strong stress is added from the viewpoint of wound healing. In addition, this method is better than the conventional method from the aspect of cosmetics and cost reduction. We will investigate this method further in the future.

Electrogenesis of embryonic chick skeletal muscle cells differentiated in monolayer cultures was investigated. Muscle fibers in vitro generate spike potentials similar to those of fibers in vivo. However, other responses, plateaux resembling those in heart muscle, are also elicited. These results suggest that a functional differentiation exists in cultured muscle fibers.