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Biomedical subjects

J So

Publications and source records attributed to J So.

15 recordsLinked to original sources

Evaluation of a head-mounted display (HMD) in the performance of a simulated laparoscopic task.

BACKGROUND: Head-mounted display (HM) units are used in various industries, but they have been tried only recently in surgery. In this study, we evaluated whether a commercially available HMD would improve or impede a laparoscopic task-in this case, suturing. METHODS: Six participants performed a total of 120 laparoscopic suture knots in an experimental model. The Olympus FMD011 model with a two-dimensional image was used. The order of each task with or without the head display unit was random. The time to complete each knot was recorded, and the results were analyzed. RESULTS: The display unit prolonged the suturing times of the subjects by 10% (p < 0.04). CONCLUSIONS: In this experimental model, the HMD we utilized did not appear to improve laparoscopic suturing. More developments, such as improved depth perception and better resolution, may increase its usefulness for laparoscopic tasks.

Computer Simulation↗

Two-trocar laparoscopic cholecystectomy: a reproducible technique.

Laparoscopic cholecystectomy is usually performed with a four-trocar technique. From December 1998 to March 1999, 25 of 42 admitted patients underwent a two-trocar laparoscopic cholecystectomy. In our technique, after establishing umbilical carbon dioxide pneumoperitoneum, a 30 degree scope was inserted, and a second 5-mm trocar was positioned below and to the left of the xiphoid process. Then two stitches with nonabsorbable sutures were passed: one at the fundus to pull up the gallbladder, and the second through the neck of the gallbladder to expose the structure of the Calot triangle. Intraoperative cholangiography was performed with a percutaneous catheter in 15 patients. Retrograde cholecystectomy was performed and the gallbladder was extracted through the umbilical port. Scars were closed with glue, and bupivacaine was injected to reduce pain. The technique was feasible in approximately 84% (25 of 30) of patients. The mean operative time was 42 minutes, and the mean hospital stay was 1.6 days. We conclude that this method is similar to four-port laparoscopic cholecystectomy in terms of safety and operation time. This technique seems to be well reproducible and offers better results in terms of postoperative pain, hospital stay without considering better cosmetic results, and cost-effectiveness.

Adult↗

Protease-catalyzed tripeptide (RGD) synthesis.

The tripeptide Bz-Arg-Gly-Asp(-OMe)-OH was synthesized by enzymatic method. Bz-Arg-Gly-OEt was synthesized by trypsin in ethanol containing 0.1 M Tris/HCl buffer (pH 8.0), and then H-Asp(-OMe)(2) was incorporated into the Bz-Arg-Gly-OEt using chymopapain in 0.25M CHES/NaOH buffer (pH = 9.0, EDTA 10 mM). The yield of Bz-Arg-Gly-OEt and Bz-Arg-Gly-Asp(-OMe)-OH were 80% and 70% using 1M Bz-Arg-OEt and 0.5M Bz-Arg-Gly-OEt, respectively. For Bz-Arg-Gly-OEt synthesis reaction at high concentrations of the substrates, the buffer content in ethanol was a key factor to determine the optimal reaction condition. In Bz-Arg-Gly-Asp(-OMe)-OH synthesis reaction, the yield was low in organic solvent due to various side products such as Bz-Arg-OH, Bz-Arg-Gly-OH, and Bz-Arg-Gly-Asp(-OMe)-Asp(-OMe)-OH, suggesting that chymopapain has a very broad substrate specificity of the S(1) site. The Bz-Arg-Gly-Asp(-OMe)-OH synthesis rate and its yield were dramatically elevated and the side reactions were reduced using only the CHES/NaOH buffer (pH = 9.0, EDTA 10 mM) as a reaction media. The final product Bz-Arg-Gly-Asp(-OMe)-OH was identified to be formed via C-terminal hydrolysis of Bz-Arg-Gly-Asp(-OMe)(2) after the nucleophile, H-Asp(-OMe)(2), was added.

Journal Article↗

p21 expression is increased by irradiation in esophageal squamous cell carcinoma.

The p21 cyclin-dependent kinase inhibitor blocks cell cycle transition and replication in response to DNA damage. Although required for p53-mediated cell cycle arrest, p21 expression can also be initiated via p53-independent pathways. This study examines the postirradiation expression of p21 in squamous cell carcinoma (SCC) of the esophagus to determine whether this p21 production is p53-dependent or independent. We sequenced p53 exons 5-8 and the exon-intron junctions of four esophageal SCC lines, KYSEs 30, 150, 410, and 960. We exposed these same lines to increasing doses of radiation (3 to 24 Gy) and subsequently extracted their total protein. The p21 content of the protein was then determined via p21 ELISA. The same cell lines were also irradiated for determination of clonogenic survival over the course of 7 days. Cells were counted via a Coulter machine. KYSE 30 and 410 were found to have mutations in their p53 genes, while KYSEs 150 and 960 had wild-type p53 genomes. All cell lines produced basal levels of p21 (from 3.2 to 7.8 ng/ml) and all lines increased production in response to radiation (6.4 to 16.8 ng/ml at 3 Gy, P < 0.05 for all lines vs. their controls). Cells displayed dose-dependent mortality in response to radiation, with only minor differences in survival between two of the lines. All of the esophageal SCC lines studied produced basal p21 and increased p21 with irradiation. p21 production was independent of p53 status. Previous reports have failed to detect elevation of p21 expression in esophageal SCC, and this is the first report of radiation-induced p21 expression in esophageal cell lines.

Carcinoma, Squamous Cell↗

Encoding of human basic and glycosylated proline-rich proteins by the PRB gene complex and proteolytic processing of their precursor proteins.

Proline-rich proteins (PRPs) constitute a family of about 20 members in human saliva that are encoded by six genes. Assignment of genomic DNA coding regions is complicated because of the occurrence of many alleles and the great similarity of amino acid sequences of PRPs. To overcome these problems, the nucleotide sequences of the genes encoding basic and glycosylated PRPs from one person were determined and then aligned with her previously determined protein sequences. This, together with additional protein data, has also resolved various discrepancies between corresponding protein and DNA sequences. For the first time in one person it is now possible to account for all the regions in the PRB genes encoding basic and glycosylated PRPs, and the primary structures of all secreted basic and glycosylated PRPs have been determined. Each gene encodes a precursor protein that subsequently undergoes proteolytic cleavage, thereby giving rise to the secreted proteins. The results have allowed identification of all the proteolytic cleavage sites in the precursor proteins, which all conform to a consensus cleavage site for furin. To evaluate if furin is responsible for the precursor protein cleavages, a recombinant precursor protein was synthesized by in vitro transcription translation of a PRB1 allele. The protein was shown to be correctly cleaved by furin, giving rise to the expected secreted proteins.

Alleles↗

Needlescopic retrograde cholecystectomy.

Needlescopic surgery is a refinement of laparoscopic surgery wherein instruments smaller than 3 mm are used. The advantage is the minute wounds that heal imperceptibly. Initial reports of needlescopic cholecystectomy were confined to uninflamed gallbladders where the antegrade technique was invariably used. This case demonstrates a needlescopic cholecystectomy by the retrograde approach for an inflamed gallbladder.

Aged↗

Towards quality control in cancer chemotherapy.

A survey of all hospital pharmacies in the former North Western Regional Health Authority has revealed that hospital personnel continue to prepare cytotoxic drugs in suboptimal conditions, despite the widespread introduction of pharmacy cytotoxic reconstitution services. Other concerns include the lack of formal training for medical staff in the administration of these agents and the frequent absence of written procedures for dealing with extravasation and chemotherapy errors.

Antineoplastic Agents↗

Randomized trial of periportal peritoneal bupivacaine for pain relief after laparoscopic cholecystectomy.

The aim of this study was to determine whether injection of a long-acting local anaesthetic, in relation to the port sites at the level of the parietal peritoneum, would reduce postoperative pain following laparoscopic cholecystectomy. Patients were entered into a randomized, prospective, double-blind study comparing the effects of a standard technique, in which bupivacaine (total of 20 ml, 0.5 per cent) was injected into the subcutaneous periportal tissue around the four port sites, and a technique in which bupivacaine (total of 20 ml, 0.25 per cent) was injected into the subcutaneous periportal tissue as above with the addition of periportal parietal peritoneal injection of bupivacaine (total of 20 ml, 0.25 per cent). Two scores for pain, with the patient at rest, and on movement, were assessed 6 and 18 h after surgery using a visual analogue pain scale. Median pain score was significantly higher in patients who received standard technique (n = 40) than in those given peritoneal injection (n = 40) at both 6 (rest = 3.0 versus 1.0, movement = 5.0 versus 2.9) and 18 h (rest = 1.9 versus 0, movement = 3.2 versus 1.2). Both opiate and oral analgesic requirements were reduced in patients administered peritoneal injection, although this was not statistically significant. The addition of periportal injection of bupivacaine at the level of the parietal peritoneum, performed under direct vision, reduces pain after laparoscopic cholecystectomy.

Adult↗

Immediate hypersensitivity to cockroach. Isolation and purification of the major antigens.

Crude cockroach extract elicited positive skin tests in 50% of patients with positive and in 4% with negative environmental history for cockroach exposure, suggesting a possible role of cockroach in perennial atopic disease. Three major allergens in crude American and German cockroach extracts have been identified using sequential purification steps on Sephadex G-75, diethylaminoethyl (DEAE) cellulose, and agarose gel electrophoresis. Cr-I elicits positive skin tests in 70% of patients sensitive to the crude extracts. It has a molecular weight of approximately 25,500 daltons, is highly acidic, and resists boiling for four hours. Boiling in 4 N acetic acid completely abolishes its allergenicity. The purified allergen elicits positive skin tests at a concentration of 3 mug/ml and is capable of inducing greater than 50% histamine release from sensitive leukocytes at 0.05 ng/ml. A second antigen, Cr-II, elicits positive skin tests also in approximately 70% of cockroach-sensitive individuals, has a molecular weight of approximately 63,000 to 65,000 daltons, and has similar heat stability and acid hydrolysis characteristics to Cr-I. A third, less well-characterized antigen, Cr-III, has a molecular weight less than 10,000 daltons and elicits positive skin tests in 30% of individuals sensitive to the crude extract.

Acetates↗