Chronic Ischemic Colitis Associated with Marked Calcifications of the Mesenteric Vessels —Report of Two Cases—

Abstract: Phlebosclerosis of the mesenteric vein is a rare cause of ischemic colitis. The current report includes two patients with segmental ischemic colitis associated with marked calcifications of the mesenteric vessels. No evidence of systemic vasculitis, tuberculosis nor amyloidosis was observed. The patients were previously healthy and had no history of drug use of any kind. Clinical findings included abdominal pain in the right upper quadrant and diarrhea alternating with constipation, and colonic narrowing were discoverd by barium enema. An abdominal X-ray examination revealed some patchy calcifications in the right and left upper quadrants. An angiography of the superior mesenteric artery revealed sclerosis of the artery, disturbance of colonic blood flow, and calcifications of the mesenteric vessels. The patients were treated with an anticoagulant. In follow-up studies, barium enema and colonoscopy revealed a gradual progression of the disease over the last five years. Treatment with an anticoagulant may have prevented rapid advancement of the disease and thereby eliminated the need for emergency operations. These unusual venous lesions have been rarely reported, and their etiology and pathogenesis remain unknown.     

A parathyroid cyst effectively treated with a sclerosing agent

Sclerosing solution was injected into a parathyroid cyst through a needle used for aspiration biopsy cytology. One year has passed without a recurrence and a cure is expected.     

Ontogeny of the transplantation immunity of mice for rejecting ascitic allogeneic tumors

Ontogeny of the murine transplantation immunity for rejecting ascitic allogeneic tumors (chemically-induced RG lymphoma and L1210 leukemia) as a model of $\text{in vivo}$ cytotoxic T cell immunity was studied. challenge by 10⁶ to 10⁷ allogeneic tumor cells per 20 g body weight (b.w.) of the mouse was fatal to 1–3 day-old mice, whereas 7–30 day-old mice rejected the tumor. In newborn mice however some yet undetermined mechanism worked to temporally depress the initial tumor growth. Injection of low (10⁶ cells per 20 g b.w.) to moderate (10⁷) doses of semiallogeneic spleen cells into newborn mice prepared for second set rejection of the tumor carrying the same alloantigens as the spleen cells, although injection of high dose (3 × 10⁸) cells reduced the tumor rejecting immunity. This second set rejection occurred even against the allogeneic tumor inoculated as early as 3 days old, if the mice had been primed with the alloantigens at birth. It appears therefore that newborn and early suckling mice are protected from tumor invasion by cytotoxic immunity more powerfully than expected from earlier $\text{in vitro}$ works.     

Omental transposition and skin graft in patients for advanced or recurrent breast cancer

Nine patients, including 4 with primary advanced breast cancer (stage IV) and 5 with local recurrent cancer, underwent chest wall reconstruction using an omental flap and mesh skin grafting. In 2 of these patients the defect of bony chest wall was reconstructed with an acryl-resin plate and omental flap. The postoperative course in all patients was uneventful, except for a slight necrosis on the transposed mesh skin. Flail chest or dypsnea did not occur in those with a bony chest wall reconstruction. The immediate postoperative performans status in 6 of 9 patients and also quality of life improved.     

Calcium regulating activity of 26,27-dialkyl analogs of 1α,25-dihydroxyvitamin D3

Summary A series of analogs of 1,25-dihydroxyvitamin D₃[1,25(OH)₂D₃] with alkyl substitutions in 26- and 27-positions were tested for calcium (Ca) regulating activity. The potencies of dialkyl analogs in stimulating bone resorption in neonatal mouse calvaria cultures were the highest in 1,25-dihydroxy-26,27-dimethylvitamin D₃[1,25(OH)₂-(Me)₂D₃], followed by 1,25(OH)₂D₃, 1,25-dihydroxy-26,27-diethylvitamin D₃[1,25(OH)₂(Et)₂D₃], and 1,25-dihydroxy-26,27-dipropylvitamin D₃[1,25(OH)₂(Pr)₂D₃] in that order. A similar order of potential regarding formation of osteoclast-like cells in mouse bone marrow cell cultures and on bone Ca mobilization with long-term vitamin D-deficient rats was observed in the same series. The relative potencies of 1,25(OH)₂D₃, 1,25(OH)₂(Me)₂D₃, 1,25(OH)₂(Et)₂D₃, and 1,25(OH)₂(Pr)₂D₃ in competing with 1,25(OH)₂D₃ for binding to chick intestinal cytosol receptors were 1:1:0.16:0.036. A similar order of potential in case of intestinal Ca transport in situ was observed in the same series. The potencies of dialkyl analogs in competing with 25-hydroxy-vitamin D₃ for binding to rat serum vitamin D binding protein were much lower than that of 1,25(OH)₂D₃. Effect of 1,25(OH)₂(Me)₂D₃ on osteopenia in rats induced by ovariectomy and right sciatic neurotomy was higher than that of 1,25(OH)₂D₃. From these results, the lengthening by one carbon at 26- and 27-positions was shown to maintain the Ca regulatory activity of 1,25(OH)₂D₃.     

Polypoid type of laryngeal sarcoidosis – case report and review of the literature

A 45-year-old mentally retarded woman was discovered to produce a stridor upon inhalation. Fiberoptic laryngoscopic study revealed a smooth-surfaced, wide, and pedunculated tumor on the right arytenoid and the right aryepiglottic fold. Histopathological study revealed that the tumor was characterized by granulomatous inflammation. The condition was diagnosed as laryngeal sarcoidosis. The tumor was resected surgically. Surgical resection of the tumor and injection of corticosteroid should be performed for polypoid-type laryngeal sarcoidosis. The case is discussed in detail, along with a review of the literature pertaining to sarcoidosis of the larynx. Received: 13 December 1999 / Accepted: 6 April 2000     

The safety and efficacy of magnetic targeting using autologous mesenchymal stem cells for cartilage repair

Purpose

A new cell delivery system using magnetic force, termed magnetic targeting, was developed for the accumulation of locally injected cells in a lesion. The aim of this study was to assess the safety and efficacy of mesenchymal stem cell (MSC) magnetic targeting in patients with a focal articular cartilage defect in the knee.

Methods

MSC magnetic targeting for five patients was approved by the Ministry of Health Labour and Welfare of Japan. Autologous bone marrow MSCs were cultured and subsequently magnetized with ferucarbotran. The 1.0-T compact magnet was attached to a suitable position around the knee joint to allow the magnetic force to be as perpendicular to the surface of the lesion as possible. Then 1?×?10⁷ MSCs were injected into the knee joint. The magnet was maintained in the same position for 10 min after the MSC injection. The primary endpoint was the occurrence of any adverse events. The secondary endpoints were efficacy assessed by magnetic resonance imaging (MRI) T2 mapping and clinical outcomes using the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation and the Knee Injury and Osteoarthritis Outcome Score (KOOS).

Results

No serious adverse events were observed during the treatment or in the follow-up period. Swelling of the treated knee joint was observed from the day after surgery in three of the five patients. The swelling resolved within 2 weeks in two patients. MRI showed that the cartilage defect areas were almost completely filled with cartilage-like tissue. MOCART scores were significantly higher 48 weeks postoperatively than preoperatively (74.8?±?10.8 vs 27.0?±?16.8, p?=?0.042). Arthroscopy in three patients showed complete coverage of their cartilage defects. Clinical outcome scores were significantly better 48 weeks postoperatively than preoperatively for the IKDC Subjective Knee Evaluation (74.8?±?17.7 vs 46.9?±?17.7, p?=?0.014) and knee-related quality-of-life (QOL) in the KOOS (53.8?±?26.4 vs 22.5?±?30.8, p?=?0.012).

Conclusion

Magnetic targeting of MSCs was safely performed and showed complete coverage of the defects with cartilage-like tissues and significant improvement in clinical outcomes 48 weeks after treatment. The magnetic targeting of MSCs is useful as a minimally invasive treatment for cartilage repair.

Level of evidence

IV.

     

A Clinical Study of Upper Gastrointestinal Endoscopy in Japanese Children

A total of 370 children who underwent upper gastrointestinal endoscopy (534 procedures) were retrospectively studied. All procedures were performed successfully. Side effects were demonstrated in only one case (0.2%), which was complicated by perioral cyanosis during the procedure. As to preendoscopic medication, it was thought that topical pharyngeal anesthesia alone may well be used for school-age children over 7 years of age, general anesthesia with endotracheal intubation for neonates, and intravenous sedation for infants and younger children. Of 370 patients studied, 70.8% had endoscopic diagnoses. The most common diagnosis was gastritis (136 cases), followed by peptic ulcer (75), duodenitis (29), and esophagitis (20). Several conclusions for indications were drawn from the present study. Pediatric upper gastrointestinal endoscopy is a safe and useful method for diagnostic and therapeutic approach, if adequate preendoscopic medication is chosen.