Oral contraceptive-dependent growth of focal nodular hyperplasia

Abstract A 22 year old woman was incidentally found to have a hepatic small haemangioma-like mass, measuring 1.4 cm in diameter, by an ultrasonographic examination. The mass demonstrated no change in size or appearance for 6 months until the patient began to take oral contraceptives. Eventually, the mass increased to 2.0 cm in diameter after using oral contraceptives for 6 months. A histological examination suggested the mass to be typical focal nodular hyperplasia, and not hepatic adenoma. There was no further change in either size or appearance in the ensuing 1 year after the discontinuation of oral contraceptives.     

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.     

Immunohistochemical Cell Kinetic Study of Human Lung Cancer by Using Monoclonal Antibody to Bromodeoxyuridine

In vitro cell kinetic studies of 27 surgically removed humanlung cancers were performed by the immunohistochemical procedureusing monoclonal antibody to bromodeoxyuridine (BrdU). BrdUwas incorporated under hyperbaric oxygenation, and labeled cellswere found to be evenly distributed in the tissue blocks. Acomparison of the in vitro and in vivo labeling index (L.I.)in human tumors transplanted to nude mice showed good correlation. Surgically resected adenocarcinoma of the human lung had a significantlylower L.I. than squamous cell carcinoma, the mean values being6.0% and 17.2%, respectively. In adenocarcinoma, L.I. valuesdisclosed a trend toward a higher L.I. in poorly differentiatedcarcinoma.     

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.     

Multiple Endocrine Neoplasia Type 2b (I) Report of a Case

This is a case report of a 14-year-old girl with multiple endocrineneoplasia (MEN) type 2b. The patient had mucosal neuromas, medullarycarcinoma of the thyroid, bumpy lips, hypertrophied cornealnerves, absent flare response following intradermal histamineinjection, high arched palate, oligodontia, pes cavus and polypoidlesions in the colon. Urinary catecholamines were normal andthe patient's blood pressure did not rise abnormally after glucagonor histamine infusions. The left adrenal gland was not visualizedon examination by adrenal scintiscanning, but by computed tomographyit was enlarged. Nerve growth factor (NGF) was normal in theserum. Extensive studies failed to identify other family memberswith MEN. This patient seems to be a sporadic case.     

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.     

Usefulness of the Adenosine Triphosphate with a Sufficient Observation Period for Detecting Reconduction after Pulmonary Vein Isolation

Background: Although reconduction after pulmonary vein (PV) isolation is considered to play a key role in the recurrence of paroxysmal atrial fibrillation (AF), there have been few reports regarding the precise time course of early reconduction. Several studies have suggested that transient PV reconduction facilitated by adenosine may predict long-term AF recurrence. This study was designed to clarify the incidence and time course of early reconduction after PVI during the procedure and to confirm whether the use of ATP after a certain observation period was useful to detect early reconduction after PVI.
Methods: In 21 patients (18 males, 56 ± 11 years) with drug refractory AF, radiofrequency circumferential PV antrum ablation was performed in all 4 PVs. After the completion of isolation, electrograms in each PV were repeatedly recorded (1.98 ± 0.57 times per PV) using a circular mapping catheter for an observation period of 87 ± 29 minutes. After isolation of all 4 PVs, 30 mg of adenosine triphosphate (ATP) was administered during isoproterenol infusion.
Results: PV electrical isolation was initially achieved in all 81 PVs. During the observation period, 12 (15%) PVs in 10 (48%) of 21 patients exhibited spontaneous reconduction. Among the remaining 69 PVs, 8 (12%) additional PVs had reconduction with the use of ATP. All PV reconduction was successfully eliminated by 4.5 ± 2.2 additional radiofrequency applications.
Conclusion: A sufficient observation period and the use of ATP are useful to detect early reconduction after PV isolation.     

Immunohistochemical Analysis of a Case of Gastritis Cystica Profunda Associated with Carcinoma Development

We report a rare case of gastritis cystica profunda (GCP) accompanied by carcinoma that developed in a 51-year-old Japanese man without antecedent gastric surgery. The polypoid tumor was located in the upper body of the resected stomach. Histologically, it was characterized by herniation of surface epithelium and cystic glands in the submucosa, muscularis propria, and subserosa. Marked chronic atrophic gastritis was found throughout the stomach, and dysplastic epithelia and a few adenocarcinoma cells were found in the deeper parts of the GCP. The Ki-67, p53, and p21^WAF1/CIP1 labeling indices for the deeper part of the GCP were higher than those for the superficial parts or the surrounding mucosa, suggesting that both epithelial cell proliferation and p53-dependent p21^WAF1/CIP1 expression in DNA-damaged cells, which might be associated with gastritis, are enhanced in line with penetration of glands. The underlying mechanisms might be linked in a chain of factors leading to malignancy.