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Novel and safer endoscopic cholecystectomy using only a flexible endoscope via single port

World Journal of Gastroenterology 2016年第13期22卷 3558-3563页

作者： Hirohito Mori Nobuya Kobayashi Hideki Kobara Noriko Nishiyama Shintaro Fujihara Taiga Chiyo Maki Ayaki takashi nagase Tsutomu Masaki Department of Gastroenterology and Neurology Kagawa University Department of Gastroenterological Surgery Ehime Rosai Hospital

AIM: To apply the laparoscopic and endoscopic cooperative surgery concept, we investigated whether endoscopic cholecystectomy could be performed more safely and rapidly via only 1 port or ***: Two dogs(11 and 13-mo-old female Beagle) were used in this study. Only 1 blunt port was created, and a flexible endoscope with a tip attachment was inserted between the fundus of gallbladder and liver. After local injection of saline to the gallbladder bed, resection of the gallbladder bed from the liver was performed. After complete resection of the gallbladder bed, the gallbladder was pulled up to resect its neck using the Ring-shaped thread technique. The neck of the gallbladder was cut using scissor forceps. Resected gallbladder was retrieved using endoscopic net forceps via a port. RESULTS: The operation times from general anesthetizing with sevoflurane to finishing the closure of the blunt port site were about 50 min and 60 min respectively. The resection times of gallbladder bed were about 15 min and 13 min respectively without liver injury and bleeding at all. Feed were given just after next day of operation, and they had a good appetite. Two dogs are in good health now and no complications for 1 mo after endoscopic cholecystectomy using only a flexible endoscope via one ***: We are sure of great feasibility of endoscopic cholecystectomy via single port for human.

关键词： Laparoscopic and endoscopic cooperative surgery Endoscopic cholecystectomy Single port Safer and complete resection Feasibility

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Steroid Sulfatase Inhibitor Reduces Proliferation of Ishikawa Endometrial Cancer Cells in Co-Culture Systems

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Open Journal of Endocrine and Metabolic Diseases 2016年第9期6卷 193-204页

作者： Mitsuo Nishimoto Masafumi Toyoshima Naomi Shiga Hiroki Utsunomiya Fumihiko Suzuki Satoru nagase Hidekazu Nishigori takashi Suzuki Hironobu Sasano Kiyoshi Ito Nobuo Yaegashi Department of Obstetrics and Gynecology Tohoku University School of Medicine Sendai Japan Department of Obstetrics and Gynecology Iwate Prefectural Iwai Hospital Iwate Japan Department of Obstetrics and Gynecology Yamagata University School of Medicine Yamagata Japan Department of Pathology Tohoku University School of Medicine Sendai Japan Department of Disaster Obstetrics and Gynecology International Research Institute of Disaster Science Tohoku University Sendai Japan

Objectives: Estrogens significantly contribute toward the growth and development of endometrial cancers. Two principal pathways have been implicated in the final steps of estrogen synthesis: the steroid sulfatase (STS) and aromatase pathways. In this study, we aimed to evaluate the possible effects of tumor-stromal interactions on local estrogen biosynthesis in endometrial cancer. We also assessed the biological effects of inhibitors of steroid sulfatase and aromatase in the co-culture system compared with usual monocultures. Methods/Materials: We isolated stromal cells from endometrial cancer patients to examine local biosynthesis of estrogens and tumor-stromal interactions. Next we examined the effects of steroid sulfatase inhibitor and aromatase inhibitor in monoculture of endometrial cancer cell line (Ishikawa) and in a co-culture system involving an Ishikawa cells and stromal cells. Results: Estrogen receptor and steroid sulfatase mRNA levels in cancer cells were significantly higher in the co-cultures compared with the monocultures of endometrial cancer cells. Estradiol and androstenediol concentrations were also significantly higher in the co-cultured cells. Proliferation of the cancer cells was significantly increased through the steroid sulfatase pathway, which metabolizes androgens, estrone sulfate, and estradiol sulfate as its substrates. However, its proliferation was significantly decreased by the treatment of steroid sulfatase or aromatase inhibitors. The significant growth inhibition by the steroid sulfatase and aromatase inhibitors were also observed in the co-culture system. Conclusions: We evaluated the effects of STS inhibitor and aromatase inhibitors on the proliferation of estrogen-dependent endometrial cancer cells. Considering that intratumoral estrogen metabolism plays an important role, our co-culture systems provide an environment similar to that of the tumor in living patients in terms of metabolism and synthesis of intratumoral estrogens.

关键词： Aromatase Inhibitors Co-Culture System Endometrial Cancer Estrogen Estrogen Sulfatase Inhibitor

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