Osaka city medical journal最新文献

{"title":"Clinical outcome of amrubicin therapy according to the prior chemotherapy sensitivities of extensive small cell lung cancer.","authors":"Shigeki Mitsuoka,&nbsp;Shinzoh Kudoh,&nbsp;Tatsuo Kimura,&nbsp;Naruo Yoshimura,&nbsp;Hidenori Tanaka,&nbsp;Tomohiro Suzumura,&nbsp;Kanako Umekawa,&nbsp;Misato Nagata,&nbsp;Takako Ueda,&nbsp;Kazuto Hirata","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Amrubicin (AMR) is an active agent for relapsed small cell lung cancer (SCLC). However, the activity of AMR in refractory relapsed patients is controversial. The objective of this retrospective analysis was to evaluate the efficacy and safety of AMR as second-line chemotherapy in SCLC, especially refractory relapsed SCLC.</p><p><strong>Methods: </strong>Between July 2003 and February 2009, a total of 27 patients were treated with AMR at a dosage of 40 mg x m(-2) x day(-1) on days 1-3 every 3 weeks. Safety was assessable for all patients. Efficacy was evaluated in 26 patients (one patient was not assessable for response), in 12 patients with chemotherapy-sensitive relapse and 14 patients with chemotherapy-refractory relapse. Sensitive relapse means that a first-line response lasted more than 90 days. Refractory relapse means that either did not respond to first-line chemotherapy or responded initially but relapsed within 90 days.</p><p><strong>Results: </strong>Thirteen patients (50%, 95% CI, 31% to 69%) had partial response, including 6 (50%) of the 12 patients with chemotherapy-sensitive relapse and 7 (50%) of 14 patients with chemotherapy-refractory relapse. Median survival times of patients with chemotherapy-sensitive and -refractory relapse were 9.7 months and 8.4 months, respectively, showing significant difference (p = 0.0337). Adverse events were observed in all 27 patients. Grade 3 and 4 neutropenia was seen in 8 patients (29.6%) and 15 patients (55.5%), respectively. Grade 3 and 4 thrombocytopenia occurred in 10 patients (37.0%) and 2 patients (7.4%). Non-hematologic toxicities were generally mild, except for febrile neutropenia. Febrile neutropenia was seen in 6 patients (22.2%). No treatment-related deaths occurred.</p><p><strong>Conclusions: </strong>AMR is an active agent for the treatment of relapsed SCLC, especially chemotherapy-refractory relapse SCLC, with predictable and manageable toxicities.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"57 2","pages":"59-66"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30523492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral nevus of Ota: a rare manifestation congenital type in a boy.","authors":"Chiharu Tateishi,&nbsp;Toshiyuki Ozawa,&nbsp;Makiko Shirakawa,&nbsp;Daisuke Tsuruta,&nbsp;Masamitsu Ishii,&nbsp;Teruichi Harada","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The nevus of Ota is usually characterized by small, flat, unilateral, blue-black or gray-brown spots occurring on skin innervated by the first or second branch of the trigeminal nerve. It comprises dermal melanocytes, presumably arising due to the dermal arrest of cells migrating from the neural crest. Nevus of Ota is 3-5 times more common in women than men, and is classified into congenital type, appearing soon after birth, and acquired type, appearing during or after puberty.</p><p><strong>Methods: </strong>We report on a six-year-old Japanese boy with the bilateral nevus of Ota. He was referred to our hospital because of bilateral hyperpigmentation of the face, present since birth. Our treatment consisted of Q-switched ruby laser irradiation under general anesthesia. The Q-switched ruby laser (Model IB101; Niic Co. Ltd., Tokyo, Japan), had a wavelength of 694.3 nm, a spot size of 5 mm, a 1 Hz repetition rate, a pulse duration of 20 nsec and fluence ranged from 3.0 J/cm2 to 6.0 J/cm2.</p><p><strong>Results: </strong>Q-switched ruby laser irradiation improved his pigmentation, and will therefore be repeated several times.</p><p><strong>Conclusions: </strong>This case of congenital bilateral nevus of Ota in a young male patient was very rare. And Q-switched ruby laser irradiation was effective as same as another nevus of Ota.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"57 1","pages":"45-8"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30274504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectrum of glutamate dehydrogenase mutations in Japanese patients with congenital hyperinsulinism and hyperammonemia syndrome.","authors":"Kazuyoshi Aso,&nbsp;Yoshiyuki Okano,&nbsp;Taisuke Takeda,&nbsp;Osamu Sakamoto,&nbsp;Kyoko Ban,&nbsp;Kazumi Iida,&nbsp;Tsunekazu Yamano,&nbsp;Haruo Shintaku","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital hyperinsulinism and hyperammonemia (CHH) is caused by gain of function of glutamate dehydrogenase (GDH). The genetic abnormalities are known to be located in three specific regions on the GDH protein. We describe here three different missense mutations identified in five new Japanese patients with CHH. And to study the genotype-phenotype correlations in patients with GLUD1 mutations, we analyzed previously reported Japanese cases.</p><p><strong>Methods: </strong>An Epstein-Barr virus-transformed lymphoblastoid cell line was established from the 5 patients and control subjects, and was used for enzymatic and molecular analyses.</p><p><strong>Results: </strong>All patients developed seizures with loss of consciousness associated with hypoglycemia and had persistent hyperammonemia. All patients had similar basal GDH activity of lymphoblasts and insensitivity to GTP inhibition. Genetic studies identified heterozygous I444M mutation in Patient 11, S217C mutation in Patient 1, and H262Y mutation in Patients 2, 3, and 4. Patients 3 and 4 were child and father, respectively. COS cell expression study confirmed that I444M and H262Y mutations were disease-causing genes.</p><p><strong>Conclusions: </strong>We identified three mutations (I444M, H262Y, and S217C), and the former is a newly described mutation. A summary of 17 reported Japanese patients (10 boys and 7 girls) with GDH mutations showed 8 patients had mutation at the site of the GTP-binding region, 2 at the site of the antenna-like structure, and 7 at the site of the hinge region. Analysis of the reported cases showed no clear association between clinical phenotype and mutation sites. However, G446D mutation seems to be associated with serious abnormalities.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"57 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30274500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of six-minute walk distance (6MWD) with resting pulmonary function in patients with chronic obstructive pulmonary disease (COPD).","authors":"Hiroki Fujimoto,&nbsp;Kazuhisa Asai,&nbsp;Tetsuya Watanabe,&nbsp;Hiroshi Kanazawa,&nbsp;Kazuto Hirata","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The six-minute walk test (6MWT) is widely used for integrated assessment of patients with chronic obstructive pulmonary disease (COPD). However, little is known concerning which resting pulmonary function test measurements relate to six-minute walk distance (6MWD).</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive data of spirometry, lung volume analysis, and measurements of diffusing capacity of the lung for carbon monoxide (DLCO) and 6MWT from total of one-hundred and thirty patients with COPD. Univariate and multivariate analyses were performed to examine the relationships between 6MWD and variables.</p><p><strong>Results: </strong>By linear regression analysis, 6MWD was significantly associated with age, weight, BMI, FEV1.0, FEV1.0 (% predicted), IC, TLC, IC/TLC, FEF25-75, DLCO (% predicted), and DLCO/VA. Stepwise multiple regression analysis revealed that age (r2 = 0.173; p < 0.0001), IC (r2 = 0.18; p < 0.0001), and DLCONA (r2 = 0.238; p < 0.0001) significantly accounted for 6MWD.</p><p><strong>Conclusions: </strong>The present results suggest that age, IC, and DLCONA were significantly associated with 6MWD in patients with COPD.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"57 1","pages":"21-9"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30274502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of therapeutic response to donepezil by positron emission tomography.","authors":"Aiko Shimada,&nbsp;Hiroshi Hashimoto,&nbsp;Joji Kawabe,&nbsp;Shigeaki Higashiyama,&nbsp;Toshihiro Kai,&nbsp;Kouhei Kataoka,&nbsp;Ryo Tagawa,&nbsp;Youjirou Kawarada,&nbsp;Aki Nakanishi,&nbsp;Koki Inoue,&nbsp;Susumu Shiomi,&nbsp;Nobuo Kiriike","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Donepezil hydrochloride (Donepezil) is an acetylcholinesterase inhibitor (AChEI) that is used for the symptomatic treatment of Dementia of the Alzheimer's Type (DAT). Recently, the effects of AChEI in patients with DAT have been investigated using positron emission tomography (PET) or single photon emission computed tomography (SPECT). This study is to evaluate the usefulness of fluorine-18-fluorodeoxyglucose (FDG)-PET in assessing the therapeutic response of Donepezil to DAT using Regions of Interest (ROI) analysis.</p><p><strong>Methods: </strong>The participants included eleven outpatients diagnosed as having DAT according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The patients were performed FDG-PET before initiating Donepezil therapy and after 12 weeks of medication. Cognitive change was measured using the Japanese version of the Alzheimer's disease Assessment Scale cognitive subscale (ADAS-J cog) and the group was divided into Responders and Non-responders based on these results. We used FDG-PET to investigate glucose metabolism of the brain and measured FDG uptake in the ROI set in each lobe of the brain. Then the ratios of the post-treatment uptake to pre-treatment uptake were determined.</p><p><strong>Results: </strong>In the Responders, the mean ratios in the frontal, temporal, occipital, parietal, and temporoparietal lobes were 2.18, 1.62, 1.15, 1.12, and 1.09 respectively. The mean ratios of the Non-responders were 0.69, 0.88, 0.75, 0.98, and 0.68 respectively. Significant differences were found between the ratios of the Responders and Non-responders in the frontal and occipital lobes (p < 0.05).</p><p><strong>Conclusions: </strong>These findings suggest that FDG-PET could be useful for the evaluation for monitoring response to Donepezil.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"57 1","pages":"11-9"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30274501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histological differentiation, histogenesis and prognosis of cutaneous angiosarcoma.","authors":"Riei Kamo,&nbsp;Masamitsu Ishii","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous angiosarcoma (CAS) is a rare, extremely malignant vascular tumor. The optimum treatment for patients with CAS has not been defined because of its exremely rarity. As prognostic factors in patients with CAS, tumor less than 5 cm in size has a better prognosis. Although tumor differentiation in other sarcoma is an important prognostic factor, tumor differentiation in CAS is not a prognostic factor. CAS is thought as a collection of hemangiosarcoma, lymphangiosarcoma, tumors which cannot be classified as of vascular and lymphatic origin, or mixed tumor of both. Histogenesis of CAS have not been clarified yet. We tried to classify histogenesis by immunohistochemistry and evaluate the prognosis among histogeneses.</p><p><strong>Methods: </strong>Using immunohistochemistry, we classified histogenesis of CAS in 20 patients who visited Osaka City University Hospital between 1998 and 2008.</p><p><strong>Results: </strong>From the results of immunohistochemical staining with CD34 and D2-40, histogenesis of CAS can be divided into vascular type (CD34 positive D2-40 negative), mixed type (CD34 positive D2-40 positive), and lymphatic type (CD34 negative D2-40 positive). Vascular type was found in 2 cases, mixed type in 5 cases, and lymphatic type in 13 cases. Survival rates were not significantly affected by histogenesis, however, survival rate of mixed type was better than those of others.</p><p><strong>Conclusions: </strong>CAS can be divided into vascular type, mixed type, and lymphatic type based on immunohistochemistry. Because of a small group, we did not suggest that histogenesis of CAS was related with prognosis. We speculate that antiangiogenic agents might be important in the treatment based on histogeneses in CAS. In the future, further accumulation of chemotherapeutic cases might upgrade histogenesis classification as an important prognostic factor in the treatment of CAS.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"57 1","pages":"31-44"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30274503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small bowel obstruction due to an intramesosigmoid hernia diagnosed by multidetector row computed tomography: a case report.","authors":"Tohru Takeshita,&nbsp;Teruhisa Ninoi,&nbsp;Hironori Shigeoka,&nbsp;Yukiyoshi Hirayama,&nbsp;Yukio Miki","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Small bowel obstruction caused by an internal hernia involving the sigmoid mesocolon is rare, and this condition is difficult to diagnose clinically. We herein report a case of small bowel obstruction due to an intramesosigmoid hernia that was diagnosed by a 64-row multidetector computed tomography and surgically treated.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"56 2","pages":"37-45"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29792991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different effects of diabetic autonomic neuropathy on regional transcutaneous oxygen tension in patients with peripheral arterial disease.","authors":"Yohei Mima,&nbsp;Shinya Fukumoto,&nbsp;Hiroki Ueno,&nbsp;Hidenori Koyama,&nbsp;Shinji Tanaka,&nbsp;Tomoaki Morioka,&nbsp;Koka Motoyama,&nbsp;Masanori Emoto,&nbsp;Tetsuo Shoji,&nbsp;Yoshiki Nishizawa,&nbsp;Masaaki Inaba","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Diabetic autonomic neuropathy (DAN) is thought to reduce skin nutritive perfusion through increase of arteriovenous shunting flow, resulting in foot ulceration. However, the correlation between skin tissue oxygenation and DAN has not been fully elucidated. Transcutaneous oxygen tension (TcPO2) is a reliable indicator of skin nutritional microcirculation. The aim of this study was to evaluate the influence of DAN on skin microcirculation by using TcPO2 measurements.</p><p><strong>Methods: </strong>The resting TcPO2 (REST-TcPO2) and post-exercise TcPO2 (Ex-TcPO2) of the calf and dorsalis pedis regions were measured simultaneously in 52 patients (104 limbs), including 41 diabetes patients. All patients underwent angiography, and the presence of arterial stenosis was evaluated.</p><p><strong>Results: </strong>TcPO2 levels were compared among the groups of patients with no neuropathy, sensory neuropathy alone, and DAN. In both the calf and dorsalis pedis regions, Ex-TcPO2 levels in diabetes patients with DAN were significantly lower than those in diabetes patients without any neuropathy. However, there was no difference in REST-TcPO2 levels among these groups. We then performed multiple regression analysis to evaluate the influence of DAN on each TcPO2 after adjustment for multiple clinical factors. DAN was a significant determinant of REST- and Ex-TcPO2 in the calf region, and it was independent of arterial stenosis and sensory neuropathy. In contrast, DAN was not an independent determinant of REST- and Ex-TcPO2 in the dorsalis pedis region.</p><p><strong>Conclusions: </strong>We, for the first time, showed that DAN has significant effects on skin microcirculation of the calf region but not of the dorsalis pedis region.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"56 2","pages":"27-36"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29792990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytosine-arabinoside stimulates the capability of human marrow stromal cells to support normal hematopoiesis.","authors":"HongZhang Li,&nbsp;Ki-Ryang Koh,&nbsp;Takuya Toramoto,&nbsp;Hirohisa Nakamae,&nbsp;Takahisa Yamane,&nbsp;Kensuke Ohta,&nbsp;Masayuki Hino","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Acute leukemia (AL) is characterized by overgrowth of neoplastic hematopoietic precursor cells in the bone marrow. After successful chemotherapy in patients with AL, the growth of leukemic cell is thought to be replaced by the recovery of normal hematopoietic cells as a consequence of the activity of anti-cancer agents in eradicating all hematopoietic cells, whether or not they are leukemic cells. However, little is known about the effects of anti-cancer agents on marrow stromal cells, which play a crucial role in supporting hematopoietic cell development. In the present study, we investigated the direct activity of cytosine arabinoside (Ara-C), a key drug for treatment of AL, on human non-leukemic marrow stromal cells by analyzing the effect of Ara-C on gene expression.</p><p><strong>Methods: </strong>Stromal cells were established from 11 patients with no neoplastic hematopoietic precursor cells in the bone marrow. The cells were treated with Ara-C for one week, co-cultured with allogeneic CD34-positive cells, and subjected to colony assay to evaluate their supportive function. A genome-wide DNA microarray analysis was performed to determine Ara-C-induced changes in gene expression in the stromal cells.</p><p><strong>Results: </strong>Treatment of the stromal cells with Ara-C resulted in a dose-dependent increase in their supportive function. These effects were more evident in the late phase than in the early phase of co-culture with CD34-positive cells, suggesting that Ara-C-treated stromal cells preferably support very immature cells, rather than committed progenitor cells. Furthermore, gene expression profiling with DNA microarrays revealed prominent up-regulation of growth-differentiation factor 15 (GDF15), a divergent member of the transforming growth factor beta superfamily, with concomitant down-regulation of colony-stimulating factor 1 receptor (CSF-1R), both of which are predominantly expressed on macrophages.</p><p><strong>Conclusions: </strong>Our present study demonstrated that Ara-C directly enhanced the ability of stromal cells to support the development of immature hematopoietic cells, possibly by modulating the function of macrophages in the bone marrow microenvironment. This novel action of Ara-C in the marrow microenvironment may contribute to the better understanding and management of chemotherapy for AL.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"56 2","pages":"11-20"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29794725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Umbilical center insertion method for initial trocar placement in pediatric laparoscopic surgery.","authors":"Tatsuo Nakaoka,&nbsp;Sadashige Uemura,&nbsp;Tatsuyuki Yoshida,&nbsp;Terutaka Tanimoto,&nbsp;Chizuka Shiokawa,&nbsp;Ken Harumoto","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>For laparoscopic surgery in pediatric patients, the initial trocar insertion is usually made employing open laparotomy to avoid injury to the viscera. It is safe but somewhat time-consuming for establishing a pneumoperitoneum, and requires additional sutures for anchoring or preventing air leakage. We devised a new initial trocar insertion technique employing an umbilical center incision to shorten the surgical duration and improve the esthetic appearance.</p><p><strong>Patients and methods: </strong>Four hundred and thirty-one pediatric patients were indicated for this umbilical center insertion method (UCM) at 2 pediatric surgical departments. Patients suspected of having umbilical lesions (except for umbilical hernia) or extensive bowel adhesions were excluded.</p><p><strong>Results: </strong>There was no complication associated with UCM. In almost all patients, a pneumoperitoneum was established within 1 minute. The wound was completely within the umbilical ring, and very satisfactory esthetically.</p><p><strong>Discussion: </strong>We consider UCM to be a safe and easy procedure, and acceptable method of initial trocar insertion for pediatric laparoscopic surgery.</p>","PeriodicalId":19613,"journal":{"name":"Osaka city medical journal","volume":"56 2","pages":"21-6"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29794726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}