Variations in the cystic duct: frequency and the relationship among insertion sides and heights on the bile duct.

Background: Evaluation of the cystic duct anatomy prior to bile duct or gallbladder surgery is important, to decrease the risk of bile duct injury. This study aimed to clarify the frequency of cystic duct variations and the relationship between them.

Methods: Data of 205 patients who underwent cholecystectomy after imaging at Sada Hospital, Japan, were analyzed.

Usefulness of several factors and clinical scoring models in preoperative diagnosis of complicated appendicitis.

Background: The preoperative distinction between uncomplicated and complicated appendicitis is important to determine the appropriate treatments, such as antibiotics, surgery, or interval appendectomy. Computed tomography (CT) plays an important role; however, combining clinical and imaging factors may make preoperative evaluation more reliable. This study evaluated and analyzed cases and the usefulness of several preoperative factors and clinical scoring models to detect complicated appendicitis.

Effect of gallbladder polyp size on the prediction and detection of gallbladder cancer.

Background: Gallbladder polyps are relatively common. Although most gallbladder polyps are benign, some are malignant. Current guidelines state that malignancy should be suspected for polyps ≥ 10 mm in diameter.

Preoperative diagnoses and identification rates of unexpected gallbladder cancer.

Background: Unexpected gallbladder cancer (UGBC) is sometimes found in the resected gallbladder of patients during or after surgery. Some reports have indicated UGBC identification rates for all gallbladder surgeries, but scarce data are available for the UGBC identification rates for specific gallbladder diseases. The present study was performed to clarify UGBC rates and the factors suspicious for UGBC categorized according to preoperative diagnoses, in patients undergoing laparoscopic cholecystectomy (LSC).

An additional suture secures against pitfalls in delta-shaped gastroduodenostomy after laparoscopic distal gastrectomy.

Laparoscopic gastrectomy is widely used as a minimally invasive surgery for gastric cancer. Laparoscopic distal gastrectomy must be followed by either a gastroduodenostomy or gastrojejunostomy to restore continuity of the alimentary tract. The intraabdominal delta-shaped gastroduodenostomy using endoscopic linear staplers, which was developed by Kanaya et al.

Multiple lysine methylation of PCAF by Set9 methyltransferase.

The molecular functions of several non-histone proteins are regulated through lysine modification by histone methyltransferases. The p300/CBP-associated factor (PCAF) is an acetyltransferase that has been implicated in many cellular processes. Here, we report that PCAF is a novel substrate of Set9 methyltransferase.

Association of Polycomb group SUZ12 with WD-repeat protein MEP50 that binds to histone H2A selectively in vitro.

SUZ12 is a Polycomb group protein that forms Polycomb repressive complexes (PRC2/3) together with EED and histone methyltransferase EZH2. Although the essential role of SUZ12 in regulating the activity of the PRC2/3 complexes has been demonstrated, additional function of this protein was suggested. Here, we show that SUZ12 interacts with WD-repeat protein MEP50 in vitro and in vivo.

Significant clinical differences in primary hyperparathyroidism between patients with and those without concomitant thyroid disease.

Purpose: We evaluated the differences in diagnosis and treatment for primary hyperparathyroidism (pHPT) in patients with and those without concomitant thyroid disease.

Methods: One hundred and ten patients with pHPT underwent parathyroid localization and thyroid examination by ultrasonography (US) and sestamibi scintigraphy (MIBI). The clinical and biochemical findings, parathyroid localization, and operations performed were compared in 49 patients without thyroid disease and 61 patients with thyroid disease.

Thyroid evaluation in patients with primary hyperparathyroidism.

We evaluated the efficacy of preoperative high-resolution ultrasonography (US) for diagnosing possible concomitant thyroid disease which affects the surgical management in patients with primary hyperparathyroidism (pHPT). One hundred and nine patients with sporadic pHPT underwent US with or without ultrasound-guided fine-needle aspiration biopsy (US-FNAB). Diagnosis of concomitant thyroid nodules by US and US-FNAB were compared with the histopathological findings.

Crank-shaped sternotomy for upper mediastinal lymph node dissection in patients with differentiated thyroid cancer.

We describe our modification of the reversed T-shaped sternotomy. The conventional technique consists of a limited upper sternotomy with transverse division of the sternum. Our modification involves shifting the transverse division lines one costal space between the right and left sides for perfect apposition of the divided upper and lower sternum.

Liver cyst with biliary communication successfully treated with laparoscopic deroofing: a case report.

A 71-year-old Japanese woman complained of right upper abdominal fullness and pain. Computed tomography revealed a huge cyst in the right lobe of the liver, measuring 16 cm in diameter. She underwent laparoscopic deroofing of the liver cyst.

Influence of renal function on clinico-pathological features of primary hyperparathyroidism.

Objective: Disturbed renal function may play an important role in the clinico-pathological presentation of primary hyperparathyroidism (pHPT). We studied the influence of renal function on the clinico-pathological characteristics of 141 patients (123 women and 18 men) with surgically proven pHPT.

Methods: The 141 patients were assigned to one of two groups based on creatinine clearance (C(cr)) level: a renal insufficiency group (n=37) in which C(cr) of patients was <70 ml/min and a normal renal function group (n=104) in which C(cr) was > or =70 ml/min.

Serous cystadenoma of the pancreas associated with pancreas divisum.

Pancreas divisum is an embryologic anomaly of the pancreas that is characterized by a lack of fusion of the dorsal and ventral pancreatic ducts. It is rarely associated with pancreatic neoplasms. We report herein a rare association of pancreas divisum and serous cystadenoma of the pancreas.

Mucinous cystadenoma of the pancreas resected 11 years after cystgastrostomy.

There have been numerous reports that mucinous cystadenoma of the pancreas can transform to mucinous cystadenocarcinoma after cystenterostomy, but few authors have reported morphological changes long after cystenterostomy for mucinous cystadenoma. A 41-year-old Japanese woman had undergone cystgastrostomy at a nearby hospital 11 years before undergoing the treatment reported here. The preoperative diagnosis at the time of cystgastrostomy was a pancreatic cyst.

Vitamin D status in Japanese patients with hyperparathyroidism: seasonal changes and effect on clinical presentation.

The disturbance of vitamin D metabolism plays an important role in determining the clinical presentation of hyperthyroidism. We studied 72 patients (65 women, 7 men) with primary hyperparathyroidism (pHPT). Clinical presentation, biochemical indices, and bone mineral density (BMD) were compared in three patient groups classified according to their serum 25-hydroxyvitamin D (25OHD) levels: 23 patients whose 25OHD level was <25 nmol/L comprised the low group, 26 whose level was 25 to 40 nmol/L made up the intermediate group, and 23 whose level was > 40 nmol/L comprised the high group.