Objective Peritoneal lymphatic features are studied to provide necessary data for understanding transport capabilities of the endothelial and mesothelial cells. Methods Enzyme\|histochemical staining methods were employed to investigate organization of the lymphatic networks and their endothelial ultrastructures in the monkey peritoneum using light,scanning and transmission electron microscopy. Results 5' Nase positive initial lymphatics showed extensive network,obvious valve like structures and numerous blind ends.The calibre of lymphatics with extremely irregular lumen varied greatly from 40 to 120?m.Lymphatic endothelium was usually separated from mesothelium by a small quantity of loose connective tissue,or they directly contacted each other in some areas.No basal lamina occurred between the peritoneum and the lymphatics originating from milky spots in the omentum and mesovarium.Milky spots are oval or round visible bodies aggregated by macrophages and lymphocytes.Both the endothelium of lymphatic lacunae and the mesothelium that forms the peritoneal stomata,represent a strong 5' Nase activity.Abundant microfibrils attached the stomatal edge. Conclusion The distribution and structure of peritoneal initial lymphatics reveal significant regional variations,and lymphatic endothelium has a close morphological and functional relationship with the mesothelium. [

Objective: For pharmacists to select a suitable auxiliary device for eye drop administration for patients who have difficulty in applying eye drops, the pharmacists need to know the characteristics and level of difficulty of using each device.
Methods: Thus, we compared the characteristics of New Rakuraku Tengan, Rakuraku Tengan III, and an eye-drop self-help device and also conducted a survey involving 40 healthy volunteers on each device’s accessibility and suitability for people with motor disabilities.
Results: New Rakuraku Tengan received the highest score for “usage was able to easily understand” (70.0% of the respondents answered positively) and “suitability for poor-sighted people” (65.0%).  Rakuraku Tengan III received the highest score for the “effectiveness of photos and illustrations in the manual” (77.5%),but was evaluated to be difficult to use.  The eye-drop self-help device received the highest score for “suitability for people with difficulty raising their shoulders and arms” (75.0%).
Results: Thus, we observed the need for pharmacists to have thorough knowledge of the products in order to recommend suitable auxiliary devices for eye drop administration for each patient.

The number of patients with diabetes mellitus (DM) in Japan is increasing. Progression of DM leads to the development of diabetic peripheral neuropathy, which causes foot sensory disturbances. This study examined the effect of DM on plantar tactile point pressure sensitivity (TPPS) and identified the site with the highest threshold of plantar TPPS. The subjects were 42 DM patients (aged 71.7±8.2 years) and 122 local elderly residents (aged 72.6±4.8 years). TPPS of eight sites, including the right and left halluces, hallux and fifth toe metatarsal heads, and heels was measured using the Semmes-Weinstein monofilament test. The measurement was performed three times at each site. The results were adopted when all repeated measurements were valid. The Friedman test was used for comparison among the four sites within the same group. The Mann-Whitney U test was used for comparison of sites between groups. A significance level of 5% was adopted. The ages of the DM patients were not significantly different, but the patients had significantly higher TPPS threshold for halluces, and hallux and fifth toe metatarsal heads, compared to the local elderly residents. The TPPS threshold was highest in the heels in both the DM patients and local elderly residents. The threshold of plantar TPPS increases in DM. It is important to evaluate both the forefoot and the heels.

Oketsu-night sweat was first mentioned in the “Yi lin gai cuo” by Wang Qing ren and the “Xue zheng lun” by? Tang Rong chuan, but there are few explanations of its disease condition. Thus we made pathological studies in Oriental medicine based on three cases (women), where Oketsu-sho was alleviated with Keppu-chikuo-to modification, and Teitou-gan and Tokaku-joki-to (Tao he cheng qi tang) modification. Common disease conditions were Netsu-sho or heat syndrome (summer incidences, redness, flushing during night sweat), and lower Oketsu symptoms (lower abdominal distention, distention and cramping of the lower abdomen, and increased urinary frequency). The theory of these disease conditions is as follows: During sleep, Wei-energy enters the blood. Because of this, Wei-energy of the body surface becomes asthenia making it easier to break out in sweat. The Wei-energy in the blood is depressed by Oketsu, and heat of Oketsu becomes stronger during the night. This fever heats and evaporates bodily fluids, and as a result fluids are pushed outward and cause night sweat. Therefore heat syndrome appears to be a pre-condition of Oketsu-night sweat. If the lower aspect of the body is taken to mean the liver, one would hypothesize that Oketsu-night sweat is more likely to emerge because blood accumulates in the lower area because it returns to the liver at night. Thus, it is thought to be necessary to consider Oketsu as one of the causes of night sweat.

BACKGROUND: Epidural anesthesia is widely used to provide pain relief, whether for surgical anesthesia, postoperative analgesia, treatment of chronic pain, or to facilitate painless childbirth. In many cases, however, the epidural catheter is inserted blindly and the indwelling catheter position is almost always uncertain. METHODS: In this study, the loss-of-resistance technique was used and an imaging agent was injected through the indwelling epidural anesthesia catheter to confirm the position of its tip and examine the migration rate. Study subjects were patients scheduled to undergo surgery using general anesthesia combined with epidural anesthesia. Placement of the epidural catheter was confirmed postoperatively by injection of an imaging agent and X-ray imaging. RESULTS: The indwelling epidural catheter was placed between upper thoracic vertebrae (n = 83; incorrect placement, n = 5), lower thoracic vertebrae (n = 123; incorrect placement, n = 5), and lower thoracic vertebra-lumbar vertebra (n = 46; incorrect placement, n = 7). In this study, a relatively high frequency of incorrectly placed epidural catheters using the loss-of-resistance technique was observed, and it was found that incorrect catheter placement resulted in inadequate analgesia during surgery. CONCLUSIONS: Although the loss-of-resistance technique is easy and convenient as a method for epidural catheter placement, it frequently results in inadequate placement of epidural catheters. Care should be taken when performing this procedure.
Analgesia ; Anesthesia ; Anesthesia, Epidural ; Anesthesia, General ; Catheters ; Catheters, Indwelling ; Chronic Pain ; Humans ; Parturition ; Spine ; Thoracic Vertebrae ; Triiodobenzoic Acids

Barrett's adenocarcinoma may occur in multiple sites, and recurrence and metachronous lesions are the major problems with endoscopic resection. Therefore, early detection of such lesions is ideal to achieve complete resection and obtain improved survival rates with minimally invasive treatment. Laser imaging systems allow multiple modalities of endoscopic imaging by using white light laser, flexible spectral imaging color enhancement (FICE), blue laser imaging (BLI), and linked color imaging even at a distant view. However, the usefulness of these modalities has not been sufficiently reported regarding Barrett's adenocarcinoma. Here, we report on a patient with three synchronous lesions followed by one metachronous lesion in a long segment with changes of Barrett's esophagus, all diagnosed with this new laser endoscopic imaging system and enhanced by using FICE and/or BLI with high contrast compared with the surrounding mucosa. Laser endoscopic imaging may facilitate the detection of malignancies in patients with early Barrett's adenocarcinoma.
Adenocarcinoma* ; Barrett Esophagus* ; Humans ; Mucous Membrane ; Recurrence ; Survival Rate

AIMTo determine the biochemical effect of di-(2-ethylhexyl) phthalate (DEHP) on testes, liver, kidneys and pancreas on day 10 in the process of degeneration of the seminiferous epithelium.

METHODSDiets containing 2% DEHP were given to male Crlj:CD1(ICR) mice for 10 days. The dose of DEHP was 0.90 +/- 0.52 mg/mouse/day. Their testes, livers, kidneys and pancreata were examined for detection of mono-(2-ethylhexyl) phthalate (MEHP), nitrogen oxides (NOx) produced by peroxidation of nitric oxide (NO) with free radicals, and lipid peroxidation induced by the chain reaction of free radicals.

RESULTSHistological observation and serum analysis showed the presence of severe spermatogenic disturbance, Leydig cell dysfunction, liver dysfunction and dehydration. Unexpectedly, the concentration of MEHP in the testes was extremely low compared with that in the liver. However, the concentration of the NOx in the testes was as high as the hepatic concentration. Furthermore, free radical-induced lipid peroxidation was histochemically detected in the testes but not in the liver.

CONCLUSIONThe results indicate that DEHP-induced aspermatogenesis is caused by the high sensitivity of the testicular tissues to MEHP rather than the specific accumulation or uptake of circulating MEHP into the testes.

Animals ; Body Weight ; drug effects ; Copper ; metabolism ; Diethylhexyl Phthalate ; analogs & derivatives ; metabolism ; pharmacology ; Iron ; metabolism ; Kidney ; drug effects ; metabolism ; Lipid Peroxidation ; drug effects ; Liver ; drug effects ; metabolism ; Male ; Mice ; Mice, Inbred ICR ; Nitrogen Oxides ; metabolism ; Pancreas ; drug effects ; metabolism ; Spermatogenesis ; drug effects ; Testis ; drug effects ; metabolism ; Testosterone ; blood ; Zinc ; metabolism

Conventional endoscopy often misses early gastric cancers with minimal red discoloration because they cannot be distinguished from inflamed mucosa. We treated a patient with a small early gastric cancer that was difficult to diagnose using conventional endoscopy. Conventional endoscopy using a small-caliber endoscope showed only subtle red discoloration of the gastric mucosa. However, blue laser imaging showed a clearly discolored area measuring 10 mm in diameter around the red lesion, which was distinct from the surrounding inflamed mucosa. Irregular vessels on the tumor surface (suspicious for early gastric cancer) were observed even with small-caliber endoscopy. Biopsy revealed a well-moderately differentiated tubular adenocarcinoma, and endoscopic submucosal dissection was performed. Histopathological examination of the specimen confirmed well-moderately differentiated adenocarcinoma localized to the mucosa with slight depression compared to the surrounding mucosa, consistent with the endoscopic findings. This small early gastric cancer became clearly visible with blue laser imaging using small-caliber endoscopy.
Adenocarcinoma ; Biopsy ; Depression ; Endoscopes ; Endoscopy ; Gastric Mucosa ; Humans ; Mucous Membrane ; Stomach Neoplasms

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