Could Chronic Mesenteric Originated Hypoxia Insult Produce Opposite Pathologic Features： Hypoplasia and Hyperplasia of the Intestine

Chronic ischemia produces corresponding tissue hypoplasia. However, here we report a distinctive hypertrophy of the intestine due to chronic mesenteric insufficiency, which was confirmed by angiography in two patients with opposite characteristic pathologic presentation of intestine. During surgery of the first patient, an approximately 60cm long ileum with sausage consistency and cyanosis color was identified proximal to the caecum; wall-attached thromboembolism material and the hypertrophied segment of ileum were removed. In the other patient, the intestine wall was paper thin; after aorto-mesenteric bypass the intestine wall grew thicker. Post operative recovery of both patients was uneventful. The commonly observed situation after a long-standing hypoxic insult in a setting of chronic mesenteric ischemia is that the target tissue will at least develop a slight hypoplasia. However, the cases we present here had either pronounced hyperplasia or severe hypoplasia. We thus report it, expecting to identify a special mechanism to explain this paradox.     

鼻内镜下等离子射频治疗儿童腺样体肥大60例分析

目的探讨鼻内镜下运用等离子治疗仪行腺样体射频减容的优点。方法分析60例腺样体肥大儿童接受等离子手术前、后的临床资料,并对术前术后听力、夜间打鼾、鼻塞等症状恢复情况进行观察比较。结果术后腺样体明显缩小,A/N值小于0.6,鼻咽部结构显示良好,无咽鼓管损伤等并发症发生。随访1~2年,患儿症状消失或明显减轻,治疗有效率为100%。结论鼻内镜下运用等离子射频减容手术治疗腺样体肥大是一种安全有效、简单易行的手术方法,值得推广。     

Ossification of the ligamentum flavum of the thoracic spine in adult kyphosis

Summary Ossification of the ligamentum flavum has been recognised as a definite clinical entity as is ossification of the posterior longitudinal ligament. The incidence of both is high in Japan. This study demonstrates that the incidence of ossification of the ligamentum flavum in persons who have a kyphosis of the thoracic or lumbar spine is higher than in those who do not. It is considered that localised mechanical stress affecting the ligamentum flavum is a contributing factor to the development of ossification, together with the generalised factors which may favour bone formation. However, the aetiology of this lesion is still obscure as is that of ossification of the posterior longitudinal ligament.

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Résumé L'ossification du ligament jaune représente une entité clinique définie, de même que celle du ligament longitudinal postérieur. Les deux affections sont fréquentes au Japon. Cette étude montre que l'ossification du ligament jaune s'observe plus souvent chez les sujets qui présentent une cyphose dorsale ou lombaire. On peut penser que les contraintes mécaniques localisées au ligament jaune constituent un facteur contribuant au développement de l'ossification, et s'ajoutant aux facteurs généraux susceptibles de favoriser la formation osseuse. Cependant, l'étiologie de cette affection demeure mystérieuse de même que l'ossification du ligament longitudinal postérieur.

     

Plain radiographic findings in anterior cruciate ligament injury and repair

Although magnetic resonance imaging is the most accurate imaging method of evaluating the anterior cruciate ligament, several plain radiographic signs suggestive of anterior cruciate ligament injury have been described. Plain radiographs also play an important role in evaluating anterior cruciate ligament reconstruction.     

L－缬氨酸菌种选育

以硫酸二乙酯（ＤＥＳ）诱变处理黄色短杆菌（Ｂｒｅｖｉｂａｃｔｅｒｉｕｍｆｌａｖｕｍ）ＸＱ５１２２，得到突变株Ｖ３－３６＜Ｌｅｕ￣１、α－ＡＢ￣ｒ、ＡＨＶ￣ｒ），在１０％葡萄糖培养基中可积累２．３％Ｌ－缬氨酸。以亚硝基胍（ＮＴＧ）诱变Ｖ４－１５３，得到一株突变株（Ｌｅｕ￣１、α－ＡＢ￣ｒ、ＡＨＶ￣ｒ、２－ＴＡ￣ｒ），再进行单菌落分离，得到突变株ＺＱ－２，能在培养基中积累Ｌ－缬氨酸４．２％～４．５％，最高达５．５７％．     

排尿期尿道压力分布描记诊断膀胱出口梗阻及比较

应用排尿期尿道压力分布描记（ＭＵＰＰ）方法诊断膀胱出口梗阻（ＢＯＯ），并与压力流率结果相比较，对２４例前列腺增生症患者进行排尿期尿道压力测定与压力流率测定，将ＭＵＰＰ所得后尿道压力跌落（ＵＰＧ）与压力流率测定所得尿道阻力因子（ＵＲＡ）及被动尿道阻力关系（ＰＵＲＲ）进行相关性研究与诊断试验。结果表明：ＵＰＧ与ＵＲＡ及ＰＵＲＲ呈显著性正相关，ＭＵＰＰ诊断ＢＯＯ结果与ＡＧ图、ＵＲＡ及ＰＵＲＲ具有较高的诊断符合率。与压力流率相比，ＭＵＰＰ诊断ＢＯＯ各有优点与缺点，但不失为定量诊断ＢＯＯ的一种新方法。     

Effect of prolonged inhibition of neutral endopeptidase on cardiac hypertrophy in rats with myocardial infarction

Summary Myocardial infarction was induced in rats by ligation of the left coronary artery. Treatment with TM1, a prodrug of SQ 28,603, an inhibitor of neutral endopeptidase (NEP, EC 3.4.24.11), was started 18–20 hours after ligation and was continued for 4 weeks (100 mg/kg, orally, twice daily). Morphological and biochemical parameters were assessed at the end of therapy. The treatment resulted in a significant reduction of heart hypertrophy, which was restricted to the parts of myocardium hemodynamically upstream of the infarcted left ventricle. The weights of the right ventricle and atria were reduced by 15–20%, whereas the treatment had no effect on the left ventricle and septum weights. Treatment led to an almost complete inhibition of plasma NEP activity and to a slight decrease (-14%, p<0.05) in plasma ACE activity. Plasma ANF level increased 3.8-fold after ligation, and treatment resulted in a slight (+29%) and nonsignificant additional increase in the ANF level. The amount of hydroxyproline in the right ventricle was enhanced by +207% in control ligated rats and by +140% (NS) in treated rats. These data indicate that prolonged NEP inhibition exerts a favorable effect in heart failure by reducing the development of right ventricular and atrial hypertrophy. These effects may result from an improvement in hemodynamic conditions, leading to a reduction in cardiac preload.     

良性前列腺增生组织中一氧化氮合酶活性的变化

为探讨一氧化氮（ＮＯ）与良性前列腺增生（ＢＰＨ）发病的关系，应用双波长分光光度法测定１５例正常前列腺及２５例ＢＰＨ组织中一氧化氮合酶（ＮＯＳ）活性，并比较不同年龄组的正常前列腺及ＢＰＨ组织中ＮＯＳ活性水平。结果：ＢＰＨ组织中ＮＯＳ活性（９６．７７±２８．０２ｐｍｏｌ．ｍｇ－１．ｍｉｎ－１）明显低于正常前列腺者（２９０．９９±１３０．６８ｐｍｏｌ．ｍｇ－１．ｍｉｎ－１），Ｐ＜０．００１。不同年龄组的正常前列腺组织中ＮＯＳ活性水平与年龄无相关关系。而在５０岁、６０岁和≥７０岁三个年龄组之间的ＢＰＨ组织中ＮＯＳ活性水平有显著性差异，Ｐ＜０．０１，ＢＰＨ组织中ＮＯＳ活性水平随年龄增大呈下降趋势。结果提示前列腺组织中ＮＯＳ活性水平与ＢＰＨ有相关关系，ＮＯＳ活性降低可能是ＢＰＨ的年龄依赖性发病原因之一。     

Asymptomatic nerve hypertrophy in lepromatous leprosy: a clinical,electrophysiological and morphological study

Summary In order to learn more about early nerve lesions observed in leprosy, we performed a clinical, electrophysiological and morphological study in seven patients with untreated lepromatous leprosy, palpably enlarged radial cutaneous nerve and preserved sensation in the corresponding territory. The conduction velocity of the cutaneous radial nerve, which was decreased in all patients, did not significantly differ from that of a group of patients with lepromatous leprosy, hypertrophy of the radial cutaneous nerve and sensory loss. In contrast, the sensory action potential was significantly lower in patients with sensory loss, which demonstrates that axon loss is more important than demyelination in producing sensory loss. In all patients nerve enlargement was due to thickening of the epineurium and of the perineurium subsequent to inflammatory infiltrates and proliferation of fibroblasts and perineurial cells. In several fascicles, the inflammatory infiltrates and the infected cells infiltrated endoneurial connective tissue septa and blood vessels.Mycobacteria leprae were abundant in peri neurial cells, fibroblasts, macrophages, Schwarm cells and endothelial cells, and lymphocytic vasculitis present in all cases. The average density of myelinated fibres was 2600 SD 880 fibres/mm² (control: 7700 fibres/mm²), with marked differences between individual fascicles, versus 420 fibres/mm² in patients with nerve hypertrophy and sensory loss (range 0–2080 fibres/mm²). Single fibre preparations showed that segmental demyelination pre dominated in two patients, axonal degeneration in one, while inflammatory infiltrates and proliferation of connective tissue adhering to individual fibres were prominent in the others. Both infection of Schwann cells and secretory products released by mononuclear cells involved in the inflammatory process are likely to play a role in the lesions of nerve fibres observed in early stages of lepromatous leprosy.Presented in part at the Second Meeting of the European Neurological Society, Brighton (UK), June 1990     

The regional distribution of adenosine-regulating enzymes in the left and right ventricle walls of control and hypertrophic heart

Summary The transmural distribution of the adenosine-generating enzyme 5-nucleotidase (5N) and of the adenosine-degrading enzymes adenosine deaminase (ADA), AMP deaminase (AMP-D) and adenosine kinase (Ado-K) were determined across the walls of left and right ventricles of control and hypertrophic rat hearts.The enzyme distribution across the left ventricle wall (but not across the right wall) of normal hearts was not uniform: 5N activity shows its highest levels in the subepicardial and in the subendocardial regions, whereas all the other enzyme activities show their lowest levels. A similar pattern of transmural distribution was also detected in other mammalian species (ox and pig).In the experimental cardiac hypertrophy, caused by two different types of chronic cardiac overload, the levels and the profiles of transmural distribution of 5N and ADA enzyme activities may significantly change across the rat left ventricle wall.