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N Kano

Publications and source records attributed to N Kano.

32 records · Page 2Linked to original sources

Preliminary experience using an ultrasonic aspirator for laparoscopic cholecystectomy.

An ultrasonic aspirator (Olympus) specially designed for laparoscopic surgery, which also includes cautery and suction-irrigation systems, was evaluated in 40 patients undergoing laparoscopic cholecystectomy. The generating power of each system is controlled by hand or foot switches, and most operating procedures could easily be performed through a 10 mm trocar inserted through the abdominal wall. The ultrasonic aspirator successfully fragmented and aspirated soft tissue, allowing a precise differentiation between the cystic duct and artery, small vessels, lymphatics and fibrous tissue. Removal of the gallbladder could be performed successfully using the cautery and ultrasonic aspirator, whereby parts of cauterization or division could easily be identified. Identification of the cystic duct and artery, course of the cystic duct and Hartmann's pouch in the same field of vision was possible which is important for avoiding major complications such as injury of the common bile duct. No complications were seen during or after surgery in any of the patients.

Cholecystectomy, Laparoscopic↗

[MR imaging of adrenal masses smaller than 5 cm. Characterization with T2 relaxation time at 1.5 T].

The T2 relaxation times of 28 adrenal masses smaller than 5 cm obtained using a 1.5 Tesla MR imaging system were analysed to evaluate the ability of this parameter to characterize the tissue masses. The adrenal masses included 13 nonhyperfunctioning adenomas, five hyperfunctioning adenomas, five metastatic tumors, two pheochromocytomas, one nodular hyperplasia, one ganglioneuroma, and one cyst. The mean T2 value of nonhyperfunctioning adenomas was almost the same as that of hyperfunctioning adenomas. A significant difference was found in T2 (p less than 0.01) between nonhyperfunctioning adenoma (50 msec +/- 7 msec; mean +/- S.D.) and metastatic tumor (63 msec +/- 11 msec), whereas there was no significant difference in mass size between them. The two pheochromocytomas and the ganglioneuroma, which were derived from adrenal medulla, had relatively long T2 of over 70 msec. The T2 values of nodular hyperplasia and adrenal cyst were 58 msec and 123 msec, respectively. Although the T2 values of metastatic tumors tended to be longer than those of nonhyperfunctioning adenomas, differentiation between them with a T2 of 60 msec was not necessarily possible, especially in smaller masses. The T2 values of two metastatic tumors of less than 2 cm indicated 50 msec levels. There seemed to be a correlation between mass size and T2 in metastatic tumors. In adenomas, however, no significant correlation was demonstrated. We conclude that the characterization of small adrenal masses by T2 at 1.5 Tesla is unsatisfactory in differentiating metastatic tumors from nonhyperfunctioning adenomas.

Adrenal Gland Diseases↗

[Detection of common bile duct stones by hepatobiliary scintigraphy].

Hepatobiliary scintigraphy and direct X-ray cholangiography were compared in 29 patients with common bile duct (CBD) stones confirmed at surgery. The scintigraphic findings included no visualization of the biliary system (NV), pooling of bile in the biliary system (PB), prolonged transit time over 60 min (PTT), filling defect in the CBD image (FD), and reflux of bile toward the intrahepatic ducts after gallbladder stimulation (RB). The positive rates of NV, PB, PTT, FD, and RB in patients with CBD stones were 7%, 31%, 17%, 48%, and 14%, respectively. One or more of these five findings was found in 83%. Although the NV was a useful finding suggesting complete obstruction of the CBD, it shared little in the diagnosis of CBD stone. The positive rate of the PB was relatively high and it would be a useful finding as an indication of the presence of passage disturbance of the CBD. The PB was usually accompanied by the FD. The PTT had some usefulness in the detection of incomplete obstruction of the CBD in patients with a visualized gallbladder. In patients with no visualization of the gallbladder, however, the transit time tended to be shorter than that of gallbladder visualized patients. Therefore, the judgment of PTT in patients with no visualized gallbladder needed another criteria. The FD was the most frequent among the five findings and the sites of FD correlated well with CBD stones on direct X-ray cholangiography. The FD would be a reliable finding indicating CBD stone or CBD stenosis. Although the RB was a finding limited in patients with a visualized gallbladder, it seemed to be a helpful findings for the detection of CBD stone in patients with a mildly dilated CBD.

Adult↗

[Effects of articulating paper on mandibular paths in lateral and protrusive excursions].

Mandibular movements in 7 normal dentulous subjects during lateral and protrusive excursions were studied to investigate the effects of the clinical use of articulating paper on mandibular paths. Mandibular movements with or without the intraoral articulating paper (thickness: 35 microns) were detected as the lower incisal point displacement and were recorded three-dimensionally with the Selspot system. The date displayed on the X-Y chart recorder on the selected plane were analyzed quantitatively. 1. The paths of the mandible differed between the outward (from the intercuspal position) and the return (backward to the intercuspal position) movements. In lateral excursions the return path tended to be antero-inferior to the outward path, whereas in protrusive excursions the former tended to be dextro-inferior to the latter. 2. In lateral excursions the return path tended to be less stable than the outward path. In protrusive excursions no significant difference was found between the two paths. 3. In lateral excursions, 21-34% of the movements performed using the articulating paper deviated from the normal paths made without using the paper, and in the case of protrusive excursions, deviation was found in 21-50%. At or near the intercuspal position, the return path showed a greater deviation than the outward path. Near the edge-to-edge position, however, the relationship between these two path was reversed. 4. It is suggested that, when the articulating paper is used, the directions of the movement should be taken into account and sufficient care should be paid in occlusal adjustment because the range of functional movement may be overestimated.

Dental Occlusion↗

[Metabolic study on acute arterial occlusion of the extremities].

Some experimental and clinical studies were done from the metabolic viewpoint to elucidate the characteristics of myonephropathic-metabolic syndrome. In experimental dogs with their femoral arteries ligated and two third of femoral muscles divided, aldolase and myoglobin showed remarkable increase without significant changes in electrolytes. Slight increase of GPT and GOT was observed. Amino acids showed elevation in urea, taurin, leucin, isoleucin, valine, threonine, 3-methylhistidine, phenylalanine, histidine, lysine, methionine, tyrosine and anserin and decrease in glutamine, alanine, glycine, proline, carnosine, citrullin and arginine. In patients with acute arterial occlusion, potassium, GOT, LDH, CPK, lactate and pyruvate increased moderately and myoglobin showed remarkable increase and aldolase slight increase. Amino acids showed remarkable increase in 3-methylhistidine and beta-amino-isobutyric acid and moderate increase in phenylalanine and arginine. These results revealed that measurement of free amino acid concentration, especially that of methylhistidine as well as myoglobin, pyruvate, lactate and some other enzymes might be of great help to predict the prognosis of patients with acute arterial occlusion of the extremities.

Acute Disease↗

Changes in polymorphic gene frequencies in strains of chickens selected for resistance to Marek's disease.

Resistance to Marek's disease (MD) was selected over five generations in three strains and their four substrains. 2. MD mortality decreased consistently on natural exposure, but in birds artificially inoculated the mortality increased again in later generations. 3. Changes of gene frequencies at five polymorphic loci--blood group A, B and D, plasma esterase and alkaline phosphatase loci--were examined. 4. The frequencies of blood group A6 and B8 alleles showed a consistent trend of increase and the B11 allele gradually decreased in most strains. The Akp allele of alkaline phosphatase increased significantly in two of seven strains. 5. Comparisons of homozygotes and heterozygotes revealed a significant difference only at the A locus.

ABO Blood-Group System↗

Extraluminal air bubble on computed tomography.

We present two cases of gastrointestinal perforation associated with a tiny extraluminal air bubble on computed tomography (CT). The air bubble was located at the round ligament of the liver in a patient of perforated duodenal ulcer and at the intraperitoneal space adjacent to the perforated site of the anterior gastric wall in the other patient. A small amount of fluid was also seen at the round ligament in the second patient. The region of the round ligament of the liver should be carefully scrutinized for the presence of extraluminal air or fluid in patients with acute abdominal symptomatology.

Adult↗