Stellate ganglion radiation by polarized light (SGR) and placebo radiation were applied to healthy adults to compare the effects on the autonomic nervous system and electroencephalogram (EEG) of these radiations and the following results were obtained:
(1) The pulse rate tended to decrease during and after both SGR and placebo radiation. In contrast, the systolic blood pressure tended to increase during and after both radiations. No significant difference between radiations was found in either the pulse rate or systolic blood pressure. The coefficient of variation of the pulse rate (CV-PR), which reflects conditon of the cardiovascular parasympathetic nervous function, tended to increase during and after SGR and tended to decrease during placebo radiation. The value of CV-PR was significantly higher after SGR than after placebo radiation.
(2) The surface skin temperature of the lower extremities after SGR was slightly higher than that after placebo radiation, but the temperature of the upper extremities did not show any difference between SGR and placebo radiation.
(3) The relative power of alpha-2 wave as determined by quantitative EEG tended to be greater during and after SGR than during and after placebo radiation. The value 10min after SGR was significantly higher than after placebo radiation.
These results suggested that SGR activated the cardiovascular parasympathetic nervous function and relatively suppressed the cardiovascular sympathetic nervous function. We concluded that SGR influences not only the cardiovascular autonomic nervous system and surface skin temperature of the lower extremities, but also a wide range of EEG.

The surface-coated vascular stent of shape memory alloy was made for use of occlusion of pseudo-lumen of the dissecting aneurysm of the aorta, as the usage of shape memory alloy in angioplasty, and the metal flexible delivery catheter was also made for the introduction of the stent. In the present study, antithrombogenicity of the vascular stent was much improved by surface-coating with EPTFE and segmented polyurethane. The long-term usage of the stent was confirmed by radiological, macroscopic, and electron microscopic examinations. Moreover, the metal flexible delivery catheter was demonstrated to be of much benefit for the introduction of the surface-coated vascular stent of shape memory alloy.

In order to reduce the blood transfusion volume in open heart surgery, the new blood autotransfusion technique using cardiotomy reservoir unit BCR 3538, which was configured to serve also as a receptacle for postoperative mediastrinal drainage, was introduced. To investigate the utility and the problem in this system, every clotting factor, platelets' function and the extent of the hemolysis were measured serially both in patients' arterial blood and the shed mediastinal blood. The bank blood transfusion was significantly reduced to 250ml±330ml by this system compared to the 1080ml±820ml in the cases of usual system (p<0.01). Every clotting factor recovered well in patients' arterial blood after cardiopulmonary bypass (CPB). In the reservoir blood, the clotting factor IX, XI, XII were extremely suppressed at 1h CPB, and 3h after the CPB, every clotting factor except fibrinogen (42±28mg/dl) showed the quite higher activity, such as factor VIII 400%, IX 365%, XI 72%, XII 267%. Namely, the anticoagulability of the reservoir blood was maintained due to the effect of the residual heparin at 1h after the CPB, and due to the contact defibrinogation of the shed mediastinal blood at 3h after CPB. The free hemoglobin level was extremely high on the reservoir blood at 3h after CPB. In 6 cases, the autologous blood retransfusion was abandoned by clott formation in the unit because of the contamination of the intraoperatively used fibrin glue. From this study, the autologous blood transfusion using cardiotomy reservoir BCR 3538 was useful not only for saving the transfusion of the bank blood but also the hemostasis after CPB. But to reduce the hemolysis in this system, and to establish the safety against the other clotting material such as fibrin glue were the problems which should be resolved in future. I appreciate the kind support of Alexander von Humboldt Foundation for this study.

The peak (dPower/dt), the maximum value of dPower/dt calculated by differentiation of ventricular power with respect to time, is verified from the physiological studies to be quite useful index indicating the ventricular contractility independent of the pre- and afterloads. However, the index has the disadvantage in the clinical application that it can not be measured by a non-invasive method. In the present study, peak (dPower/dt) could successfully be determined in a non-invasive manner as the product of aortic flow as measured with an ultrasonic pulsed Doppler flowmeter and brachial blood pressure as measured with cuff in the new apparatus. Involved in this study were 21 children, 52 adults with normal cardiac performance and 11 adult patients with coronary artery disease. The measurement of the index was successfully carried out in 28 of 61 adults and especially 16 of 21 children. The results of the study are summarized as follows:
1. Power waveform is similar to blood flow waveform and is little influenced by blood pressure waveform.
2, Peak (dPower/dt) can be determined as product of peak rate of change of aortic flow (peak (dF/dt) ) and mean brachial blood pressure without resorting to measurement of blood pressure waveform.
3. Peak (dPower/dt) was found significantly lower in cases having an ejection fraction less than 50% (93.5 J/sec²) than in those showing an ejection fraction of above 50% (145.3 J/sec²) (p<0.001) .
4. Peak (dPower/dt) normalized with body surface area was not significantly different from 8 years old children (80.2 J/sec²/m²) and 21-34 years old adults (88.0 J/sec²/m²) . According to this index, the cardiac contractility of 8 yearus old children seemed to reach the adult level.
From these findings it is concluded that the non-invasive method of determining a cardiologic parameter, peak (dPower/dt), as an index of cardiac contractility provides a means of salient clinical value.

Nonvariceal upper gastrointestinal (GI) bleeding is one of the most common reasons for hospitalization and a major cause of morbidity and mortality worldwide. Recently developed endoscopic devices and supporting apparatuses can achieve endoscopic hemostasis with greater safety and efficiency. With these advancements in technology and technique, gastroenterologists should have no concerns regarding the management of acute upper GI bleeding, provided that they are well prepared and trained. However, when endoscopic hemostasis fails, endoscopy should not be continued. Rather, endoscopists should refer patients to radiologists and surgeons without any delay for evaluation regarding the appropriateness of emergency interventional radiology or surgery.
Emergencies ; Endoscopy ; Equipment and Supplies ; Hemorrhage* ; Hemostasis ; Hemostasis, Endoscopic ; Hospitalization ; Humans ; Mortality ; Radiology, Interventional

During the last decade, researchers have made great progress in the development of new image processing technologies for gastrointestinal endoscopy. However, diagnosis using conventional endoscopy with white light optical imaging is essentially limited, and ultimately, we still rely on the histopathological diagnosis from biopsy specimens. Molecular imaging represents the most novel imaging methods in medicine, and the future of endoscopic diagnosis is likely to be impacted by a combination of biomarkers and technology. Endoscopic molecular imaging can be defined as the visualization of molecular characteristics with endoscopy. These innovations will allow us not only to locate a tumor or dysplastic lesion but also to visualize its molecular characteristics and the activity of specific molecules and biological processes that affect tumor behavior and/or its response to therapy. In the near future, these promising technologies will play a central role in endoluminal oncology.
Biological Processes ; Biopsy ; Diagnosis ; Endoscopy ; Endoscopy, Gastrointestinal ; Gastrointestinal Neoplasms ; Methods ; Molecular Imaging* ; Optical Imaging ; Biomarkers

Sixteen cases of malignant soft tissue sarcoma (STS; 10 canines and six felines) were treated with a novel triple therapy that combined photodynamic therapy, hyperthermia using indocyanine green with a broadband light source, and local chemotherapy after surgical tumor resection. This triple therapy was called photodynamic hyperthermal chemotherapy (PHCT). In all cases, the surgical margin was insufficient. In one feline case, PHCT was performed without surgical resection. PHCT was performed over an interval of 1 to 2 weeks and was repeated three to 21 times. No severe side effects, including severe skin burns, necrosis, or skin suture rupture, were observed in any of the animals. No disease recurrence was observed in seven out of 10 (70.0%) dogs and three out of six (50.0%) cats over the follow-up periods ranging from 238 to 1901 days. These results suggest that PHCT decreases the risk of STS recurrence. PHCT should therefore be considered an adjuvant therapy for treating companion animals with STS in veterinary medicine.
Animals ; Antineoplastic Agents/*therapeutic use ; Cat Diseases/drug therapy/surgery/*therapy ; Cats ; Combined Modality Therapy/veterinary ; Dog Diseases/drug therapy/surgery/*therapy ; Dogs ; Hyperthermia, Induced/veterinary ; Indocyanine Green/*therapeutic use ; Photochemotherapy/veterinary ; Photosensitizing Agents/*therapeutic use ; Sarcoma/drug therapy/surgery/therapy/*veterinary

The rectal tonsil is a rare polypoid lesion exclusively found in the rectum and is considered a reactive proliferation of the lymphoid tissue. Although this lesion is benign, we recommend that it should be differentiated from carcinoid or polypoid type of mucosa-associated lymphoid tissue lymphomas, based on gross findings. In this case report, we describe a case of rectal lesions with a unique appearance in a 41-year-old man. Colonoscopy revealed two 5-mm-sized nodules located opposite from each other on the left and right sides of the lower rectum. Endoscopic mucosal resection was conducted. Histopathologically, both lesions were mainly located in the submucosa and consisted of prominent lymphoid follicles with germinal centers of various sizes. No immunoreactivity of Bcl-2 was seen in the germinal centers. Immunohistochemical staining for kappa and lambda light chains revealed a polyclonal pattern. Therefore, these lesions were diagnosed as rectal tonsils.
Adult ; Carcinoid Tumor* ; Colonoscopy ; Germinal Center ; Humans ; Lymphoid Tissue ; Lymphoma, B-Cell, Marginal Zone* ; Palatine Tonsil* ; Rectum ; Twins*

Background/Aims: Visualization of palisade vessels (PVs) in Barrett’s esophagus is crucial for proper assessment. This study aimed to determine whether red dichromatic imaging (RDI) improves PV visibility compared with white-light imaging (WLI) and narrow-band imaging (NBI). Methods: Five expert and trainee endoscopists evaluated the PV visibility in Barrett’s esophagus using WLI, NBI, and RDI on 66 images from 22 patients. Visibility was rated on a 4-point scale: 4, excellent; 3, good; 2, fair; and 1, poor. The color difference between the most recognizable PV spots and surrounding areas with undetectable blood vessels was also analyzed. Results: Mean visibility scores were 2.6±0.7, 2.3±0.6, and 3.4±0.4 for WLI, NBI, and RDI, respectively. The RDI scores were significantly higher than the WLI (p<0.001) and NBI (p<0.001) scores. These differences were recognized by trainees and expert endoscopists. Color differences in PVs were 7.74±4.96 (WLI), 10.43±5.09 (NBI), and 15.1±6.54 (RDI). The difference in RDI was significantly higher than that in WLI (p<0.001) and NBI (p=0.006). Conclusions RDI significantly improved PV visibility compared to WLI and NBI based on objective and subjective measures.

Background/Aims: Visualization of palisade vessels (PVs) in Barrett’s esophagus is crucial for proper assessment. This study aimed to determine whether red dichromatic imaging (RDI) improves PV visibility compared with white-light imaging (WLI) and narrow-band imaging (NBI). Methods: Five expert and trainee endoscopists evaluated the PV visibility in Barrett’s esophagus using WLI, NBI, and RDI on 66 images from 22 patients. Visibility was rated on a 4-point scale: 4, excellent; 3, good; 2, fair; and 1, poor. The color difference between the most recognizable PV spots and surrounding areas with undetectable blood vessels was also analyzed. Results: Mean visibility scores were 2.6±0.7, 2.3±0.6, and 3.4±0.4 for WLI, NBI, and RDI, respectively. The RDI scores were significantly higher than the WLI (p<0.001) and NBI (p<0.001) scores. These differences were recognized by trainees and expert endoscopists. Color differences in PVs were 7.74±4.96 (WLI), 10.43±5.09 (NBI), and 15.1±6.54 (RDI). The difference in RDI was significantly higher than that in WLI (p<0.001) and NBI (p=0.006). Conclusions RDI significantly improved PV visibility compared to WLI and NBI based on objective and subjective measures.