The postoperative recurrence of crohn's disease: An analysis of 37 patients with crohn's disease who underwent endoscopy during initial surgery

A total 37 patients with Crohn's disease who underwent intraoperative endoscopy during resection of the affected intestine were evaluated in this study. The average age of the patients at surgery was 23.2 years. The residual lesions in the remaining intestine identified by intraoperative endoscopy were classified according to their pathologic profiles into three groups: A, B and C. In group A, comprising patients with longitudinal ulcers and/or a cobblestone appearance, 10 of 12 patients had recurrence. In 5 of these 10, the residual lesions were exacerbated and 2 required a further operation. The remaining 5 patients showed recurrence at the site of previous anastomosis and 2 of these 5 required additional surgery.In group B, comprising patients with small ulcers, aphthoid ulcers, or scars, and group C, comprising patients with no residual lesions, recurrence was observed in 13 of 16, and 3 of 9 patients, respectively. The recurrent lesions were all found proximal to, or at the site of previous anastomosis. Additional operations were performed on 3 of the group B patients. The findings of this study revealed that recurrence requiring additional surgery is more frequent at the site of anastomosis, regardless of the endoscopic appearance of the residual lesions.     

The effect of a carbon dioxide pneumoperitoneum on rabbit follicular oocytes and early embryonic development

The effect of a carbon dioxide (CO2) pneumoperitoneum and its duration on rabbit follicular oocytes was assessed by evaluating fertilization and subsequent embryonic development rates. CO2 may cross the plasma membrane and form carbonic acid, which liberates H+, thus lowering the intracellular pH. There were no significant differences in arterial pH and [HCO3-] between CO2 and air treatment groups, whereas arterial pCO2 and pO2 were significantly increased in the CO2 treatment group. We found that the duration of pneumoperitoneum, irrespective of type of gas used, was negatively correlated with success of embryonic development. These findings necessitate that more attention be given to the gas used for creation of a pneumoperitoneum during egg retrieval for in vitro fertilization and an attempt be made to minimize duration of the pneumoperitoneum.     

New surgical technique of left ventricular free wall rupture: double patch sealing method.

We experienced two cases of left ventricular free wall rupture (LVFWR) following acute myocardial infarction (AMI). Case 1, with the blowout type of LVFWR was initially closed by direct suture, followed by hemostasis using a double patch sealing method (DPS) by which the tear was doubly sealed with large and small bovine pericardium patches to which GRF glue was applied. Case 2 with the oozing type of LVFWR was treated only using DPS. Complete hemostasis was achieved in both cases, and aneurysmal dilatation or constrictive heart failure were not detected by postoperative left ventriculography. Therefore, DPS may be useful for treating LVFWR following AMI.     

Correction of cryptotia using a subcutaneous pedicled flap

Cryptotia is a relatively common deformity of the ear among orientals. Although many methods for correcting this deformity have been reported, there is no one perfect method. We have developed a method using a subcutaneous pedicle flap raised from the retroauricular region, where relative abundance of skin exists. We have treated 9 ears of 7 patients by the method reported herein. Results are satisfactory in all cases.     

Production and characterization of two monoclonal antibodies to human glutathione peroxidase.

Glutathione peroxidase (GSH-Px) is an important selenium-containing enzyme which protects cells from oxidative damage. Two hybridoma clones (GPX-121 and GPX-347), producing mouse IgG1 monoclonal antibodies specific for GSH-Px, were established. Immunoblot analysis revealed that GPX-347 was specific for human GSH-Px, while GPX-121 cross-reacted with human, rat, mouse and rabbit GSH-Px. Correlation between GSH-Px content and its enzymatic activity was investigated in erythrocytes of 76 humans and in human lung adenocarcinoma PC-9 cells by using a sandwich type ELISA. The results indicated that GSH-Px activity was expressed higher than expected from GSH-Px content especially in the range of low GSH-Px concentration. PC-9 cells selenium depleted medium did not stain but the cytoplasm of PC-9 cells grown in medium supplemented with selenium stained strongly.     

Cyclic adenosine monophosphate promotes the proliferation of chicken granulosa cells in culture.

The aim of this study was to determine if cAMP regulates the proliferation of chicken granulosa cells and if there is a difference in the effects of cAMP on the granulosa cell proliferation between the largest follicle (F1) and the smaller follicles. Granulosa cells collected from F1 and the third largest follicle (F3) were cultured in medium M199 containing 1% calf serum with or without dibutyryl cAMP (dbcAMP). Proliferation of granulosa cells of F1 was promoted by dbcAMP in a dose-dependent manner. The most effective concentration of dbcAMP to promote the granulosa cell proliferation was 2 mM. In the culture without dbcAMP, the number of the granulosa cells was not changed significantly for 6 days, whereas, in the presence of 2 mM dbcAMP, the number of the granulosa cells was markedly increased during 2 to 6 days. The proliferation of the granulosa cells of F3 was stimulated by dbcAMP in the same manner as that of F1. Morphologically, the granulosa cells of F1 and F3 cultured for 2 days had a sheet-like appearance in control culture, whereas they were contracted, leaving finger-like cytoplasmic processes attached to the adjacent cells and substratum in the presence of 2 mM dbcAMP. After 6 days culture, approximately 90% of the cells of F1 stained positive for 3 beta-hydroxysteroid dehydrogenase activity in 2 mM dbcAMP-containing culture, whereas only about 20% of the cells were positive in control culture. These results suggest that cAMP promotes the proliferation of the granulosa cells during the follicular growth and this response of granulosa cells to cAMP is similar for F1 and F3.     

Investigation of association of mycobacteria with inflammatory bowel disease by nucleic acid hybridization.

We used DNA-DNA hybridization to characterize a mycobacterial isolate, strain Linda, that was obtained from a patient with Crohn's disease and that has been reported to cause ileitis in experimental animals. We also investigated the association of this mycobacterium with Crohn's disease. Our results identified Mycobacterium strain Linda as a strain of Mycobacterium paratuberculosis, the etiologic agent of Johne's disease, a disease of ruminants that has some superficial resemblance to Crohn's disease. Sequences that hybridized with strain Linda DNA probes were detected in DNA extracted from human intestinal tissues from patients with Crohn's disease, ulcerative colitis, and noninflammatory bowel disease. These hybridizing DNA sequences were more prevalent in the muscle layers than in the intestinal mucosa, making it unlikely that they represented DNA from bacterial contaminants in the intestinal lumen. Measurement of the melting temperatures of the DNA-DNA hybrids formed between strain Linda probes and tissue DNAs indicated that the related sequences detected were of mycobacterial origin but were not identical to each other or to strain Linda DNA. These results do not support the proposed specific relationship between Mycobacterium strain Linda and Crohn's disease. The possible etiologic role of mycobacteria in Crohn's disease is discussed.     

Contraction of urinary bladder by central norepinephrine originating in the locus coeruleus

Studies were performed to elucidate the role of the locus coeruleus, which is rich in norepinephrine-containing cell bodies, in vesical function using alpha-chloralose anesthetized cats. Stimulation of the locus coeruleus caused contraction of the urinary bladder, which was not affected by transection of the bilateral hypogastric nerves, but blocked by intravenous administration of hexamethonium, a ganglion blocking agent. In animals with transected hypogastric nerves, the locus coeruleus-induced contraction was inhibited by intrathecal administration of phentolamine (alpha-blocker) and prazosin (alpha 1-blocker), but not affected by intrathecal sotalol (beta-blocker) or yohimbine (alpha 2-blocker). In animals treated with reserpine, the locus coeruleus-induced contraction was enhanced by intravenous application of L-dopa, a precursor of norepinephrine. These results suggest that norepinephrine derived from the locus coeruleus activated preganglionic neurons in the sacral intermediolateral nuclei via alpha 1-receptors, thereby producing urinary bladder contraction.