Percutaneous transesophageal gastro-tubing (PTEG) is considered a safe and effective treatment technique for drainage or feeding in patients with malignant bowel obstruction. We report six cases with malignant bowel obstruction due to recurrent gastric cancer whose bowel symptoms were satisfactory improved with PTEG. Ileus tubes were inserted in three of the six patients for decompression of the alimentary tract, a feeding tube was inserted in one patient for enteral feeding, and double elementary diet tubes (W-ED tube) were inserted in other two for decompression and enteral feeding. The median indwelling duration was 52days (rang; 24-460days). Home enteral nutrition was possible for the three patients with feeding tube and W-ED tube. Regarding decompression of alimentary tract, PTEG relieved the symptoms of all patients. One patient suffered from dermatitis around the inserted part of ileus tube because of the leakage of gastro-intestinal juice, and the ileus tube was removed. In two cases, the inserted tubes were exchanged because of the tube obstruction. PTEG made possible to use various types of tube depending on the state of the disease. From our experience, it is suggested that PTEG technique is an effective and useful procedure of choice for long-term drainage or feeding in patients with malignant bowel obstruction. Palliat Care Res 2008; 3(2): 335-342

STUDY DESIGN: Retrospective case series. PURPOSE: To elucidate the impact of postoperative occiput-C2 (O-C2) angle change on subaxial cervical alignment. OVERVIEW OF LITERATURE: In the case of occipito-upper cervical fixation surgery, it is recommended that the O-C2 angle should be set larger than the preoperative value postoperatively. METHODS: The present study included 17 patients who underwent occipito-upper cervical spine (above C4) posterior fixation surgery for atlantoaxial subluxation of various etiologies. Plain lateral cervical radiographs in a neutral position at standing were obtained and the O-C2 angle and subaxial lordosis angle (the angle between the endplates of the lowest instrumented vertebra (LIV) and C7 vertebrae) were measured preoperatively and postoperatively soon after surgery and ambulation and at the final follow-up visit. RESULTS: There was a significant negative correlation between the average postoperative alteration of O-C2 angle (DO-C2) and the average postoperative alteration of subaxial lordosis angle (Dsubaxial lordosis angle) (r=-0.47, p=0.03). CONCLUSIONS: There was a negative correlation between DO-C2 and Dsubaxial lordosis angles. This suggests that decrease of mid-to lower-cervical lordosis acts as a compensatory mechanism for lordotic correction between the occiput and C2. In occipito-cervical fusion surgery, care must be taken to avoid excessive O-C2 angle correction because it might induce mid-to-lower cervical compensatory decrease of lordosis.
Animals ; Follow-Up Studies ; Humans ; Lordosis* ; Occipital Bone ; Retrospective Studies ; Spinal Curvatures ; Spinal Fusion ; Spine ; Walking

The ability of human deciduous tooth dental pulp cells (HDDPCs) to differentiate into odontoblasts that generate mineralized tissue holds immense potential for therapeutic use in the field of tooth regenerative medicine. Realization of this potential depends on efficient and optimized protocols for the genetic manipulation of HDDPCs. In this study, we demonstrate the use of a PiggyBac (PB)-based gene transfer system as a method for introducing nonviral transposon DNA into HDDPCs and HDDPC-derived inducible pluripotent stem cells. The transfection efficiency of the PB-based system was significantly greater than previously reported for electroporation-based transfection of plasmid DNA. Using the neomycin resistance gene as a selection marker, HDDPCs were stably transfected at a rate nearly 40-fold higher than that achieved using conventional methods. Using this system, it was also possible to introduce two constructs simultaneously into a single cell. The resulting stable transfectants, expressing tdTomato and enhanced green fluorescent protein, exhibited both red and green fluorescence. The established cell line did not lose the acquired phenotype over three months of culture. Based on our results, we concluded that PB is superior to currently available methods for introducing plasmid DNA into HDDPCs. There may be significant challenges in the direct clinical application of this method for human dental tissue engineering due to safety risks and ethical concerns. However, the high level of transfection achieved with PB may have significant advantages in basic scientific research for dental tissue engineering applications, such as functional studies of genes and proteins. Furthermore, it is a useful tool for the isolation of genetically engineered HDDPC-derived stem cells for studies in tooth regenerative medicine.
Cells, Cultured ; DNA Transposable Elements ; Dental Pulp ; cytology ; Humans ; Induced Pluripotent Stem Cells ; cytology ; Nerve Tissue Proteins ; genetics ; Tooth, Deciduous ; cytology ; Transfection