CD34 expression in endothelial cells of small hepatocellular carcinoma: Its correlation with tumour progression and angiographic findings

The angiogenic process plays an important role in tumour growth and metastasis during hepatocarcinogenesis, but it is still uncertain when the process begins during tumour formation. Forty-two small hepatocellular carcinomas (HCC) that measured either less than or equal to 2 cm in diameter were studied by comparing the histologic findings with the angiographic findings, and with immunohistochemical expression of endothelial marker QB-end/10 (QB), a new monoclonal antibody raised against CD34, in the sinusoidal wall. Twenty (91%) of 22 moderately or poorly differentiated HCC revealed a positive reaction for QB, while only eight (40%) of 20 well differentiated HCC demonstrated a positive reaction (P < 0.01). In the tumours showing a ‘nodule in nodule’ appearance, the less differentiated areas were more reactive for QB. Twenty-three (82%) of 28 QB positive tumours were hypervascular, while only three of 14 (21%) QB negative tumours were hypervascular (P < 0.01) by angiography. All six of the poorly differentiated and 13 (81%) of the 16 moderately differentiated tumours were hypervascular, while only seven (35%) of 20 well differentiated HCC were hypervascular (P < 0.01). These results indicate that as the tumour becomes less differentiated, the QB positive areas become wider and angiography demonstrates hypervascularity. We therefore speculate that the HCC sinusoids acquire the characteristics of capillary and precapillary blood vessels during de-differentiation from well to moderate, and thus the tumour begins to reveal hypervascularity on angiography. The above process may be correlated with the stepwise progression of HCC.     

The ability of QRST isointegral maps to detect myocardial infarction in the presence of simulated left bundle branch block

The clinical value of QRST isointegral maps (I-maps) for thedetection of myocardial infarction (MI) in the presence of leftbundle branch block (LBBB) was investigated. We recorded I-mapsduring sinus rhythm and right ventricular (RV) pacing, whichsimulated LBBB, in 62 patients with MI (42 patients had at leastone akinetic segment and the remaining 20 patients had onlyhypokinesis or normal contraction) and 26 patients without MI.An abnormal decrease in the QRST value of the I-map was assessedby the difference map (D-map), which indicated a ‘–2SDarea’, where the QRST integral value was less than thelower limit of the normal range (mean –2SD) calculatedfrom 608 normal individuals. The I-maps recorded during thetwo activation sequences were similar to each other in patientswith and without MI (r = 0.87 and 0.92, respectively). The ‘–2SDarea’ was located over the left anterior chest in patientswith an anterior MI and over the lower torso in patients withan inferior MI during each activation sequence. We were ableto diagnose MI during simulated LBBB with a sensitivity of 84%,a specificity of 81% and a diagnostic accuracy of 83% when weused the criterion that MI is present if the sum of QRST integralvalues below the normal range (DM) exceeds 100 mV.ms. We wereable to diagnose an akinesis with a sensitivity of 81%, a specficityof 85% and a diagnostic accuracy of 83% when we used the criterionthat akinesis is present DM exceeds 500 mV .ms during simulatedLBBB. These findings demonstrate that I-maps may be useful indetecting the presence of MI and estimating severity of asynergyin patients with LBBB.     

Analysis of bilirubin conjugates in human bile by column liquid chromatography—Changes in their composition in hepatobiliary diseases

Bilirubin in human bile was analysed by high performance liquid chromatography (HPLC), and seven peaks were identifiable. There was no difference in the proportion of bilirubin between the B bile and C bile from healthy humans obtained by the Meltzer-Lyon method. HPLC coupled with nuclear magnetic resonance spectroscopy on bilirubin after diazotization permitted differentiation between endovinyl and exovinyl conjugates of bilirubin.
In patients with Gilbert's syndrome, type II Crigler-Najjar syndrome, and haemolytic anaemia, the proportion of bilirubin diglucuronide (BDG) in the C bile decreased, and that of bilirubin monoglucuronide (BMG) increased. In patients with type II Crigler-Najjar syndrome, marked elevations in BMG and bilirubin IXα and decreases in bilirubin monoglucuronide monoglucoside diester (BGG) and bilirubin monoglucuronide monoxyloside diester (BGX) were observed. In normal subjects and patients with unconjugated hyperbilirubinaemia, the diazobased indirect-reacting bilirubin levels in blood and the proportion of BMG in bile were in good correlation. In patients with acute hepatitis, chronic hepatitis, and liver cirrhosis, there was no difference in the bilirubin composition in bile as compared to normal subjects, except for slight elevations in BGG observed in patients with chronic hepatitis and liver cirrhosis. In gallbladder bile obtained from patients with cholelithiasis, bilirubin IXα increased, suggesting some deconjugation of BDG.     

Laparoscopy in a Case of Primary Sclerosing Cholangitis with an Ultrasonographically Detected Portal Thrombus

A case of sclerosing cholangitis is presented. The patient was a 65 year-old male and visited a hospital because symptoms of a biliary tract infection suddenly appeared. These symptoms improved in the short term with antibiotic therapy. As a high level of serum CA19–9 was found and the double wall structure of the intrahepatic bile duct and a portal thrombus were observed during an abdominal ultrasonography, the patient was transferred to our clinic for further examination of his hepatobiliary system. A malignant lesion was suspected from an endoscopic retrograde cholangiography and celiac angiography, although the patient's serum CA19–9 level rapidly decreased after admission. A liver with a smooth surface, some focal wide depressions, and an increase of white markings was observed laparoscopically. An adenomyomatosis-like lesion was observed in the gallbladder. Bile duct destruction with periductar fibrosis was histologically proven. This is a case of histologically diagnosed sclerosing cholangitis but without the typical findings usually found during an endoscopic retrograde cholangiography.     

Pedunculated Submucosal Ectopic Mucosa of the Stomach Treated by Endoscopic Polypectomy: Report of Two Cases

We report here two cases of submucosal ectopic gastric mucosa which grew with pedunculation. A lesion 23 mm in size was located in the posterior wall of the upper gastric body in a 61-year-old female. A 58-year-old female had a lesion 12 mm in size in the anterior wall of the upper gastric body. Both were elevated lesions expressed as Yamada's type IV and were endoscopically diagnosed as submucosal tumors. For the purpose of total biopsy, endoscopic polypectomy was performed in both cases. Histological examination of the polypectomized specimens showed gastric mucosa in the submucosal layer. These two cases were unique in that ectopic gastric mucosa was pedunculated and diagnosed after endoscopic polypectomy, not by postoperative pathological examination.     

Prostaglandins and cyclic AMP in epidermis

Prostaglandins E1 and E2 stimulate cyclic AMP accumulation in pig epidermis and in human epidermis from patients with psoriasis. Prostaglandins A1,A2 and F2alpha are relatively ineffective. The fact that this stimulation is not inhibited by a beta-blocker (propranolol) and that the stimulation by prostaglandin E2 and adrenaline is additive indicates that each drug acts independently on the epidermal adenyl cyclase system. In other words, prostaglandins E1 and E2 act on a site other than the beta-receptor of adenyl cyclase in epidermis. The stimulation by prostaglandins E1 and E2 is not additive; hence they probably act on the same site. Concentrations of prostaglandin E above 3X10(-7) M are effective in causing stimulation. This concentration may be within the physilogical range and the contribution of endogenous prostaglandin levels in the control of intracellular cyclic AMP levels cannot be disregarded.     

Cerulein-induced Pancreatic Polypeptide Secretion

Intramuscular administration of cerulein caused an abrupt rise in plasma pancreatic polypeptide (PP) in normal subjects. Pretreatment by atropine tended to lower the basal plasma PP level and significantly blunted the cerulein-induced PP secretion. It appears, therefore, that PP secretion induced by cerulein is under vagal control. In addition, in normal subjects, a gallbladder series first revealed a well-filled gallbladder of normal size and shape, which then contracted most strongly after a cerulein injection at a time corresponding exactly with the peak plasma PP levels produced by the cerulein. Since exogenous PP is known to cause a relaxation of the gallbladder, it is possible that endogenous PP plays an important role in gallbladder motility.     

3’-当归酰氧基-4’-乙酰氧基-3’,4’-双氢邪蒿内酯对麻醉犬心脏血流动力学的影响(英文)

本文研究了3’-当归酰氧基-4’-乙酰氧基-3’,4’-双氢邪蒿内酯(Pd-Ia)和地尔硫(艹卓)(Dil)对麻醉犬心脏血流动力学的影响。Pd-Ia剂量依赖性增加冠流量,减少主动脉压(MAP), dp/dt_(max),率压积(RPP)及全身血管阻力,并加快HR。Dil与Pd-Ia作用相似,但明显减慢HR。Pd-Ia对MAP及RPP的作用约为Dil的1/10。结果再次表明:Pd-Ia是一Ca~(2 )通道阻滞剂。     

壬基酚对P450arom和MIS基因表达的影响

[目的]研究壬基酚(p-nonylphenol,NP)对细胞色素P450芳香化酶基因(P450arom)和苗勒氏管抑制物基因(MIS)表达的影响,探索其对鱼类雌激素样作用的分子机制。[方法]日本比目鱼在性分化过程中能随环境因子改变而发育为不同性别,在幼鱼孵化后第30天到第100天性分化敏感期于27℃水温下,给予幼鱼投食NP 100μg/g饲料。分别对各组比目鱼生殖腺做病理组织切片,判断其性别和雌雄比例,并通过原位杂交方法结合RT-PCR分析第100天青年期鱼生殖腺中P450arom和MISmRNA的表达,观察NP对比目鱼性分化标志基因的作用。[结果]NP对27℃水温饲养下的比目鱼幼鱼有一定程度的雌性化诱导作用,成年雌性的百分比为30%,高于27℃水温对照组(0%);比目鱼幼鱼出生后第100天时对其生殖腺进行原位杂交分析显示,P450arom的mRNA在各组的雌鱼卵巢中有明显表达,但在雄鱼精巢中未见表达;而MIS的mRNA在各组的雌鱼卵巢中不表达,却在雄鱼精巢中能见到很明显的表达。RT-PCR分析也显示,P450芳香化酶的mRNA仅仅在雌鱼卵巢中表达,而MIS也仅仅在雄鱼精巢中表达,证实了原位杂交实验的结果。[结论]在日本比目鱼体内,NP染毒可以诱导P450芳香化酶mRNA表达并抑制MIS的mRNA的表达,从而对生殖腺性分化期的幼鱼发挥雌激素样干扰作用。