A study of autorotating plant seeds.

A leading edge vortex exists on the upper surface of an autorotating plant seed. The vortex enhances the vertical aerodynamic force acting on the seed and decreases the rate of descent. We analyzed the flight data of rotary seeds and revealed that the lift-drag ratio affects the descent factor more strongly than the vertical force coefficient. This has also been confirmed by falling tests of model rotors, which have various aspect ratios, airfoil shapes and total masses.

Postoperative Psychiatric Complications in Living Liver Donors.

BACKGROUND: To understand the impact of psychologic variables on donor quality of life, we studied long-term data on postoperative psychiatric complications in living liver donors. This study is a focused psychological investigation of diagnoses, treatments, and long-term clinical courses of living liver donors with psychiatric complications. METHODS: Of the 142 donors who underwent live-donor liver transplantation at Nagoya University Hospital between April 2004 and July 2014, we investigated those without a history of mental illness who had developed such illness after transplantation and required psychiatric treatment. RESULTS: A total of 6 (4.2%) donors developed the following psychiatric complications after transplantation: major depressive disorder (n = 2), panic disorder (n = 2), conversion disorder (n = 1), and substance use disorder (n = 1). Concerning psychiatric treatment, all donors received antianxiety drugs, 3 took antidepressants, and supportive psychiatric therapy was concomitantly provided to all subjects. The average treatment period was 53.3 months. Regarding subject outcomes, 3 donors achieved remission, and the other 3 continued treatment. All subjects showed improvement in Global Assessment of Functioning Scale. CONCLUSION: It is important to accurately diagnose postoperative psychiatric complications and provide long-term treatment in close coordination with transplant surgeons.

Fluid-dynamic characteristics of a bristled wing.

Thrips fly at a chord-based Reynolds number of approximately 10 using bristled rather than solid wings. We tested two dynamically scaled mechanical models of a thrips forewing. In the bristled design, cylindrical rods model the bristles of the forewing; the solid design was identical to the bristled one in shape, but the spaces between the 'bristles' were filled in by membrane. We studied four different motion patterns: (i) forward motion at a constant forward velocity, (ii) forward motion at a translational acceleration, (iii) rotational motion at a constant angular velocity and (iv) rotational motion at an angular acceleration. Fluid-dynamic forces acting on the bristled model wing were a little smaller than those on the solid wing. Therefore, the bristled wing of a thrips cannot be explained in terms of increased fluid-dynamic forces.

Rathke's cleft cyst with large frontal extension: unusual shape and pathomechanism of its formation.

The patient was a 62 year old woman who presented with a visual field defect. Magnetic resonance images showed an intra-and supra-sellar low intensity mass on T1 weighted images. The preoperative diagnosis was craniopharyngioma, Rathke's cleft cyst (RCC) or arachnoid cyst. The patient underwent transsphenoidal surgery & the pathological diagnosis was RCC. We conclude that although RCC has a round, ovoid or dumb-bell shaped configuration, it may present a unusual shape in cases with preconditions, as were seen in our patient.

Growth hormone secreting adenoma with unusual extension: coexisting pituitary cyst and its clinical significance.

A 58 year old man showed acromegalic features. The serum growth hormone (GH) level was 7.3 ng/ml and SMC (somatomedin-C) 637 U/ml. Triple stimulation test showed abnormal response compatible with a GH secreting tumour. The conventional enhanced MRI revealed a less enhanced hemisphere-shaped lesion at the right corner of the sella turcica. In addition, dynamic MRI demonstrated an elongated lesion extending to the left beyond the midline. The patient underwent transsphenoidal surgery. Besides the soft and suckable tumour at the right corner, we entered into a small cavity loosely filled with the tumour, which was subsequently also removed. The operative finding corresponded to the lesion shown in dynamic MRI. Postoperative GH and SMC levels became 2.3 ng/ml and 326 U/ml respectively. Incidental pituitary cystic lesions in autopsied cases have been reported to be 6-33%. This case had a GH secreting adenoma with coexisting pituitary cyst. The coexisting pituitary cyst supposedly influenced the unusual shape and extension of the pituitary adenoma. Coexistence of such lesion should be kept in mind for microadenoma on neuroradiological evaluation and on intraoperative inspection surrounding the tumour.

Delayed postoperative CSF rhinorrhea of intrasellar arachnoid cyst.

CSF rhinorrhea due to a transsphenoidal approach usually follows accidental or intentional arachnoid opening. We report a patient with an intrasellar arachnoid cyst, who developed delayed onset of CSF rhinorrhea. A sixty-two-year-old man presented with bitemporal type visual field defect for the last 3 years. With the diagnosis of arachnoid cyst or Rathke's cleft cyst, based on MRI findings of intra-and supra-sellar cyst with CSF intensity, he successfully underwent transsphenoidal surgery without evidence of intra-operative CSF leakage. He developed CSF rhinorrhea one week later. This needed another operation for sellar floor repair. The pathomechanism of this delayed onset is explained as follows. Incomplete or oneway communication of subarachnoid space to cyst cavity, unrecognized during surgery, might cause delayed onset of CSF rhinorrhea. By using MRI, identification of the residual gland, which was compressed posteriorly, is useful for differentiating an arachnoid cyst from other cystic lesions. In highly suspect cases, even without evidence of intra-operative CSF leakage, peri-operative measures to prevent occurrence of postoperative CSF rhinorrhea are required.

On the aerodynamics of moult gaps in birds

During the moult, birds sequentially replace their flight feathers and thus temporarily have gaps in their wings. These gaps will vary in size and position(s) during the course of the moult. We investigated the aerodynamic effects of having moult gaps in a rectangular wing by using a vortex-lattice (panel) approach, and we modelled the effect of moult gap size at the wing moult initiation position, of gap position in the primary tract and of two simultaneous gaps (as occurs during secondary feather moulting in many birds). Both gap size and gap position had a detrimental effect on aerodynamic performance as measured by lift curve slope, effective aspect ratio and the aerodynamic efficiency of the wing. The effect was largest when the moult gap was well inside the wing, because the circulation declines close to the wing tip. In fact, when the gap was at the wing tip, the performance was slightly increased because the lift distribution then became closer to the optimal elliptical distribution. The detrimental effect of moult gaps increased with increasing aspect ratio, which could help to explain why large birds have relatively slow rates of moult associated with small gaps.

[Results of SMANCS/Lipiodol injection therapy for multiple intrahepatic recurrence of hepatocellular carcinoma].

Hepatocellular carcinoma (HCC) often recurs in the remnant liver after hepatectomy. Treatment is often ineffective in cases of multiple recurrence. We treated 18 cases of multiple recurrence with SMANCS/Lipiodol injection (SML). Four patients were treated with SML once, 11 patients were treated twice, and each patient was treated with three or four times with SML. The Effective rate of the 1st SML was 30%, but the effective rate of the 2nd SML was 60% in the plasma tumor marker levels. The effective rate between unilobular recurrence and bilateral recurrence was the same. A complete response was obtained in 2 cases, and partial response in 2 cases. The effective rate of SML was 4/18 (22.2%). These effective cases suffered a recurrence within a year. The cumulative survival rate at the end of the 24th month was 42.4%. Overall survival was significantly higher in the group with SML than in the group with TAE or TAI with the multiple recurrence. SML may be effective in early recurrence because these recurrent nodules are vascular-rich and there is much lipiodol accumulation. SMANCS/lipiodol injection therapy is expected to be an effective treatment in cases of early multiple recurrence after hepatectomy.

Hemorrhagic type moyamoya disease.

The clinical picture of hemorrhagic type Moyamoya disease was analyzed in 20 cases. Hematoma at the basal ganglia was noted in 40% of cases, intraventricular hemorrhage (IVH) in 30%, thalamic hemorrhage with ventricular rupture in 15% and subcortical hemorrhage in 5%. The location was undetermined in two cases (10%) due to bleeding in the pre-computed tomography (CT) era. The frequencies shown above were correlated well to previous reports. In magnetic resonance imaging (MRI) performed 1 year or more after IVH, the primary bleeding site was demonstrated at the lateral wall of lateral ventricle, in portion density weighted and T2 weighted images. MRI can detect the site of old bleeding points and its chronological change if the study is repeated. In a follow-up period of 6.2 years, 35% of the cases had rebleeding once or twice. The second bleeding occurred seven times and the third twice. IVH occurred five times and the most common, basal ganglia hematoma three times while thalamic hemorrhage once. As a result, the rate of good outcome was 60% after the first bleeding and 40% after rebleeding. The mortality rate was 5% after the first 25% after rebleedings. Factors related to rebleedings and their poorer outcome are sex (with women being more susceptible), massive ICH and early recurrence. Rebleeding worsened the outcome. Therefore, prevention of rebleeding is important. From a therapeutic viewpoint, although a close relation between rebleeding and untreated hypertension could not be established, blood pressure control is critical at the both acute and chronic stages. Bypass surgery for bleeding type of Moyamoya disease seems to be less promising than ischemic type, even though a definite answer may not be obtained from our small number of cases.

[Experience with the Groshong port in a home TPN patient--a case report].

We experienced a home TPN patient using Groshong port. A 45-year-old woman, recurrent pancreatic head cancer, was treated with home TPN. The Groshong port was inserted via external jugular vein and stayed at home for 8 months with home TPN. Lipid emulsion was administered twice a week. After administration of lipid emulsion, 20 ml of saline was injected and catheter lock was performed with only saline. Heparin was not used for catheter lock. After 8 months' home TPN, patient died. We could not find any precipitate in the catheter and reservoir. A unique feature of Groshong port is a pressure-sensitive two-way valve at the intravascular end. The valve of this port opens outward during fluid infusion or bolus injection. During blood withdrawal, the valve opens inward and then closed after the procedure. Because the valve is designed to remain closed between -7 and 80 mmHg, it will not open spontaneously under normal central venous pressure conditions. This valve eliminates the need for heparin flusing. Catheter obstruction during prolonged TPN is a serious complication. Compound of heparin, lipid emulsion and electrolytes, especially calcium is now becoming one of the most important causes of catheter obstruction and catheter removal. We used the Groshong port to prevent catheter obstruction. After 8 months' use of this port, no precipitate was found in this port. We conclude that the Groshong port is useful for home TPN catheter because it can prevent catheter obstruction due to heparin-lipid-electrolytes compound.

Early stage gastric lymphoma: is operation essential?

To assess the efficacy of primary chemotherapy for treatment of early stage patients with gastric lymphoma, multiple agent chemotherapy was given to patients prior to surgery. Five patients with stages IE and IIE of primary gastric lymphoma (54-65 years of age; three men, two women) were treated with multiple agent chemotherapy prior to gastric resection. In all patients the diagnosis was established by endoscopic biopsy. Two patients had stage IE disease, and three had stage IIE. Histopathologically, there was one diffuse large cell lesion and four diffuse medium cell lesions. All patients received two cycles of VEPA every 4 weeks. On the 16th to 44th day after completion of chemotherapy, total gastrectomy, systematic dissection of regional lymph nodes with resection of the caudal pancreas, and splenectomy were performed. Swelling of the regional lymph nodes was noted in four cases. In all five cases, histologic findings revealed no residual cells of malignant lymphoma in the resected specimen. None of the patients had no evidence of recurrence at 12 to 40 months after surgery. Primary chemotherapy alone thus resulted in the disappearance of malignant cells in stage IE/IIE gastric lymphoma. Our results suggest that surgery may not be an essential procedure for treatment of early stage gastric lymphoma.

Right atrial to left atrial shunt through foramen ovale during pneumoperitoneum for laparoscopic cholecystectomy.

A 62-year old female patient in whom paradoxical right atrial to left atrial shunt flow through the foramen ovale was detected by transesophageal echocardiography during pneumoperitoneum for laparoscopic cholecystectomy was reported. This patient had a history of mitral valve replacement with residual tricuspid valve regurgitation. It was considered that the onset of paradoxical interatrial shunting through the foramen ovale might be caused not only by mechanical ventilation with positive end-expiratory pressure but also by pneumoperitoneum, especially in patients with heart disease, even if the intra-abdominal pressure was maintained at 12 mmHg.

Laparoscopic deroofing for symptomatic liver cysts: report of a case.

We present herein the case of a 73-year-old woman with symptomatic liver cysts and cholelithiasis for whom successful deroofing of the liver cysts and cholecystectomy were performed via laparoscopy. Histopathological diagnosis of the resected cyst wall and direct observation of the inner surface of the remaining cyst wall confirmed that they were benign biliary cysts. The laparoscopic deroofing of liver cysts is therefore not only an effective means of treatment, but it also facilitates the establishment of an exact differential diagnosis.

Eradication of metastatic tumour cells from lymph nodes by local administration of anti-CD3 antibody.

The possibility of in vivo removal of metastatic tumour cells from lymph nodes by local intradermal administration of an anti-CD3 monoclonal antibody (mAb) was examined. Murine tumour cells in the lymph nodes were completely eradicated by intradermal injections of the mAb. This treatment was effective for removal of Lewis lung cancer cells from lymph nodes, but not for removal of subcutaneous tumours of this cell line. This treatment induced in vivo cytotoxicity in the regional lymph nodes against the syngeneic tumour cells. The following in vitro studies suggested that the cytotoxicity was probably mediated mainly by CD4+ T cells, with slight participation of CD8+ T cells. Normal lymph node and spleen cells showed cytotoxicity after in vitro incubation with the mAb for 2 days. Cell sorting with a fluorescein-activated cell sorter showed that CD4+ T cells developed during the incubation to lyse syngeneic tumor cells directly by themselves, macrophages not being involved in this tumour cell lysis. The lytic activity was detected in the cellular fractions, but not in the culture supernatants of these T cells. Furthermore, it was completely blocked by specific antiserum for tumour necrosis factor-alpha (TNF alpha). An immunoprecipitation study revealed that these T cells expressed TNF alpha molecules of 26 kDa, but not of 17 kDa, suggesting that tumour cell lysis was caused by membrane-integrated integrated TNF alpha molecules. These results strongly suggest that local administration of anti-CD3 antibody is a very effective and appropriate procedure for eradication of metastatic tumour cells from regional lymph nodes.

Aggressive resection for advanced pancreatic carcinoma.

An aggressive pancreatectomy was performed on a 53 year old Japanese man with advanced cancer of the pancreas. The tumor originated from the body of the pancreas and invaded the stomach, duodenum, left kidney, transverse colon and common hepatic artery. An unexpected cancer was also found in the head of the pancreas during the operation. Therefore, total pancreatectomy, total gastrectomy, left adrenonephrectomy, resection of the left transverse colon and dissection of the regional lymph nodes were performed. Resection of the common hepatic artery was also performed, followed by an end-to-end anastomosis between the common hepatic artery and celiac trunk. The postoperative course was uneventful and the patient was doing well until nine months after the operation when multiple metastatic lesions were noted in the liver. He died 391 days after the operation from hepatic failure.

Recurrent valvular pneumoperitoneum caused by a minute gastric ulcer--a case report.

A rare case of valvular pneumoperitoneum is reported. A 49-year-old Japanese man underwent an emergency laparotomy under a tentative diagnosis of perforating panperitonitis on the 19th post-open heart surgery day. A large volume of free intraperitoneal gas was revealed, but no identification of gastrointestinal perforation. On the 17th postlaparotomy day, pneumoperitoneum recurred. On the 41st postlaparotomy day, a tiny gastric perforation was detected with an oral contrast medium. The patient died of liver failure due to serum hepatitis. The autopsy revealed a minute gastric ulcer scar 2 mm in diameter in the mucosa of the fornix, which was thought to have caused the valvular pneumoperitoneum. A literature review was made of 8 reports on 11 cases. In two cases of valvular pneumoperitoneum, the perforating site could not be found even during laparotomy. It is suggested that either gastrointestinal series or endoscopy must be carefully repeated in order to identify the perforating site.

Increased selectivity in the detection of glycoproteins on nitrocellulose membranes by washing with sodium hydroxide solution.

We increased selectivity in the detection of glycoproteins on nitrocellulose membranes by introducing a washing step using sodium hydroxide solution. Glycoproteins on the nitrocellulose membrane were first oxidized by sodium periodate; biotin hydrazide was then coupled to the aldehyde groups generated in the sugar moiety of the glycoproteins. The membrane was washed twice using sodium hydroxide solution, and avidin-horseradish peroxidase was then coupled to the remaining biotin. This system allows the detection of nanograms of glycoproteins on nitrocellulose membranes, and its specificity allows the clear distinction of glycoproteins from the nonglycosylated protein of bovine serum albumin.

Mucin-specific bark lectin from elderberry Sambucus sieboldiana and its applications to the affinity chromatography of mucin.

Three bark lectins were isolated from elderberry Sambucus sieboldiana using fetuin-Sepharose 4B and mucin-Sepharose 4B, and were studied comparatively for their binding to glycoprotein and to clarify various physicochemical features. For each, a unique pattern on isoelectric focusing was noted and their affinity toward various glycoproteins differed, indicating the structures of their carbohydrate binding sites possibly differ. One bark lectin showed specific binding toward porcine mucin. The purity of mucin from a crude porcine stomach mucin or an extract of porcine submaxillary glands could be improved by affinity chromatography on immobilized lectin having binding specificity toward mucin.

Pancreatoduodenectomy for periampullary cancer associated with celiac occlusion: a case report.

A 62-year-old man with atherosclerotic occlusion of the celiac axis underwent pancreatoduodenectomy because of cancer of the common bile duct. Preoperative angiography showed that the arterial blood supply to the celiac viscera was sustained through the gastroduodenal artery via the pancreaticoduodenal arcades from the superior mesenteric artery. Therefore reconstruction of the celiac circulation was attempted before division of the gastroduodenal artery. An autograft of the saphenous vein was placed between the infrarenal aorta and the common hepatic artery. The postoperative course was uneventful. Patency of the graft was demonstrated angiographically on the 50th postoperative day.