Expression of urokinase-type plasminogen activator receptor and plasminogen activator inhibitor-1 in gastric cancer

In gastric cancer, the urokinase-type plasminogen activator (uPA) system plays important roles in invasion and metastasis, processes which entail proteolysis and adhesion. Both the urokinasetype plasminogen activator receptor (uPAR) and the plasminogen activator inhibitor-1 (PAI-1) are thought to be important factors in this system. To clarify the relationship between these two factors and gastric cancer invasiveness, we evaluated the expression of uPAR and PAI-1 in 91 cases of gastric cancer by immunohistochemistry and in situ hybridization. Urokinase-type plasminogen activator receptor-mRNA, PAI-1-mRNA, uPAR and PAI-1 protein were diffusely distributed in the cytoplasm of the cancer cells and concentrated at invasive foci. Urokinase-type plasminogen activator receptor protein expression correlated with lymphatic, venous invasion (P<.01) and lymph node metastasis (P<0.05); uPAR-mRNA expression correlated with lymphatic, venous invasion and lymph node metastasis (P<0.05). Plasminogen activator inhibitor-1 protein expression correlated with lymphatic, venous invasion, lymph node metastasis and depth of invasion (P<0.01); PAI-1-mRNA expression was linked to lymphatic, venous invasion (P<0.01), lymph node metastasis and depth of invasion (P<0.05). This suggests that the proteolytic activity of uPAR and the cellular motility of PAI-1 in gastric cancer cells may determine penetration of lymphatic and blood vessels, whereby lymph node metastasis may be promoted and that the promotion of cellular motility by PAI-1 may influence the depth of cancer invasion.     

Advanced Neuroblastoma and Disseminated Intravascular Coagulation: Report of Six Cases

We have experienced 30 patients with neuroblastoma since 1975.Disseminated intravascular coagulation (DIC) developed in sixof these patients. They were all in stage IV, namely disseminatedneuroblastoma. These six cases with DIC proved that some advancedneuroblastomas have the potential to cause coagulopathy in theprocess of the disease. The plasma concentration of heparin was measured in some patientswho were treated with heparin. The data revealed that the conventionallyused intravenous heparin dose is not appropriate in the caseof DIC. Effective treatment requires monitoring of the plasmaconcentration of heparin.     

Serum regulated upon activation, normal T cell expressed and presumably secreted concentrations and eosinophils in respiratory syncytial virus infection

BACKGROUND: The aim of this study was to characterize respiratory syncytial virus (RSV) infection. To do this, the authors evaluated eosinophil counts and chemokines including regulated upon activation, normal T cell expressed and presumably secreted (RANTES) in children with RSV, adenoviral, and influenza virus infections. METHODS: The authors enrolled 80 patients who had been diagnosed with acute viral respiratory infection caused by RSV, adenoviral, or influenza viruses. In total, 35 patients (Group A) had RSV infection, 18 (Group B) had adenoviral infection, and 27 (Group C) had influenza virus infection. The authors evaluated clinical manifestations, white blood cell and eosinophil counts, and serum chemokines including RANTES concentrations in the acute and recovery phases in each group. RESULTS: In recovery phase, eosinophil counts were higher in Group A than Groups B and C. In Group A, eosinophil counts were higher in recovery phase than in the acute phase. In Group A, serum RANTES concentration was significantly higher in the recovery phase than in the acute phase (132+/-76 pg/mL vs 52+/-25 pg/mL, P<0.05). CONCLUSION: The findings suggest that high values of RANTES in children with RSV infection may be associated with the presence of eosinophils and be an important mediator of inflammatory response.     

Atrioesophageal Fistula Complicating Cryoballoon Pulmonary Vein Isolation for Paroxysmal Atrial Fibrillation

Although atrioesophageal fistula (AEF) formation is a well known, albeit rare, catastrophic complication of atrial fibrillation radiofrequency ablation procedures, there are less data regarding this complication using the cryoballoon technique. We report on 3 cases of AEF as a complication of cryoballoon pulmonary vein isolation at 3 different institutions with 2 different generations of cryoballoons.     

Increased Propensity of Women to Develop Torsades de Pointes During Complete Heart Block

TdP and Complete Heart Block. Introduction : To determine whether an increased female gender susceptibility to torsades de pointes (TdP) may exist in a clinical model of bradycardia- induced long QT syndrome, we investigated reported cases of TdP associated with acquired complete heart block.
Methods and Results : Seventy-two cases reported in the medical literature dating from 1941 through 1993 were identified, all describing TdP or "transient ventricular tachycardia/fibrillation" (to include those cases reported prior to the use of TdP terminology) in the setting of acquired complete heart block unassociated with QT prolonging drugs. Expected female prevalence in complete heart block was estimated at 52%, based on projections derived from 206,016 hospital discharges in the National Inpatient Profile (Commission on Professional and Hospital Activities, Ann Arbor, MI), over the years 1985 through 1992. During complete heart block, mean heart rate was 37 beats/min in both sexes (combined n = 43), and absolute QT interval ranged from 0.52 to 0.88 seconds, with a mean of 0.68 seconds (n = 25). Female prevalence among patients with TdP during complete heart block was greater than expected: 72% for all studied cases (P < 0.001); 70% (P < 0.04) and 74% (P < 0.02) among those reported prior to (n = 35) and during or alter (n = 37) 1980, respectively; 73% (P < 0.03) among those with documented normokalemia (n = 26); and 68% (P = 0.2) among those with a prolonged QT interval and known polymorphic VT (i.e., unequivocal TdP; n = 25).
Conclusion : Despite inherent limitations of this retrospective study, the data are consistent in suggesting a greater than expected female prevalence among patients with TdP related to complete heart block. This finding lends support to a broadening concept of increased susceptibility of women to the development of TdP in various settings of QT prolongation.