A retrospective analysis of clinical and pathological factors was performed on 132 surgical cases with solitary-nodule type HCC in our hospital. The overall cancer-free survival rates after 1, 3 and 5 years were 82.2%, 42.3% and 26.5%, respectively. With univariate analysis, the significant prognostic factors for survival were tumor size, cancer cell infiltration of the fibrous capsule of the tumor (fc-inf), invasion into portal vein (vp), and intrahepatic metastasis (im), while significant prognostic factors for non-recurrence were tumor size, fc-inf, vp, im, Edmondson-Steiner's classification and perioperative blood transfusion. With multivariate analysis for recurrence, significant factors were vp, clinical stage (CS), and perioperative blood transfusion. Therefore, prognostic factors for long-term survival in surgical cases of HCC are thought to be good hepatic function, absence of portal invasion, and avoidance of perioperative blood transfusion if possible.
A 62 year-old man, who was followed for an increase in ALP and anemia on an ambulant basis, was diagnosed with having an approximately 4cm tumor mass in the liver on CT. ERCP showed an irregularity of the intrahepatic bile duct, and venography showed narrowing of the inferior vena cava (IVC) and development of collateral vessels from the IVC to the azygos vein. We suspected advanced cholangiocellular carcinoma and performed a hepatectomy. The tumor was intraoperatively frozen sectioned and diagnosed as cholangiocellular carcinoma. But on postoperative microscopic examination, fibrosis and lymphocyte infiltration were seen in the tumor, and no malignant cells were detected. Histopathologically the tumor was inflammatory pseudotumor (IPT) of the liver, sclerosing type. Thus this was a case of liver IPT that showed atypical image findings, complicating stenotic IVC, and presented difficulty in diagnosis. There have been no previous reports in the Japanese literature describing a stenotic IVC caused by IPT of the liver. Therefore this case is very unique.
K99 fimbriae of enterotoxigenic Escherichia coli consist of eight different subunits. A major subunit called fimbrillin forms fimbrial structure and a minor subunit called adhesin localizes at the tip of fimbriae and recognizes host receptor ganglioside. Within this eight gene cluster, fanE and fanF have not yet been sequenced. In this study, fanE and fanF genes were sequenced by analyzing several DNA fragments produced by endonuclease or exonuclease digestion. The fanE gene encoded 227 amino acids containing 20 amino acids of signal peptide starting from GTG (valine) and showed a homology to fanA-fanB. The fanF gene encoded 271 amino acids containing 20 amino acids of signal peptide starting from ATG (methionine) and showed homologies to the fanD gene, fimbrillin gene of F41, adhesin gene of P fimbriae (papG) and adhesin gene of Type 1 fimbriae (fimH). E and F subunits had fifteen and fourteen hydrophobic domains, respectively, which periodically appeared possibly forming a hydrophobic region.
We previously investigated the role of the Lys108 residue of ribonuclease (RNase) Rh from Rhizopus niveus, and suggested that Lys108 probably acts to stabilize the pentacovalent intermediate, and that an Arg residue could replace the role of Lys108. In RNase Le2 from Lentinus edodes, a homologous enzyme of RNase Rh, Lys108 is replaced by Thr. In this paper, the enzymatic properties of a K108T mutant and its analogous enzyme, K108S, were investigated to determine the effect of Thr and its analog, Ser at the 108th position on enzyme activity. The enzymatic properties of these mutant enzymes were compared with those of other mutant enzymes at this position (K108M, K108A, K108L). The results showed that Thr and Ser could replace Lys108 but resulted in only 2-20% of the activity of the native enzyme depending on the substrates used.
Single-incision laparoscopic surgery (SILS) is widely used in many surgical procedures in various specialties. Among the access methods used in SILS, the glove technique, which is typically similar to the multi-trocar approach, is simple, convenient, and inexpensive. However, given the absence of a fulcrum supporting the endoscopic surgical forceps, the technique is less advantageous than methods using commercially available access devices because of the poor maneuverability of the forceps.By creating a fulcrum as a support to use with existing surgical forceps in the glove technique, we designed and used a novel method known as the "ring technique." This technique aimed to improve the maneuverability of endoscopic surgical forceps.Placing a fulcrum resulted in the improvement of the forceps' maneuverability, which helped to ameliorate a weakness of the glove technique. The ring technique could be a useful option as a method of access in SILS.
