Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US

PURPOSE: To compare the performance of helical computed tomography (CT) and endoscopic ultrasonography (US) in the preoperative staging of gastric cancer. MATERIALS AND METHODS: Fifty-one consecutive patients with a primary malignant gastric tumor (stage T2-T4) were preoperatively evaluated with both helical CT and endoscopic US within 3 days. Each tumor was staged according to the TNM classification system with both modalities. All patients subsequently underwent surgery. Results of CT and endoscopic US were compared with histologic staging of tumor invasion depth and regional lymph node metastasis. For comparison of CT and endoscopic US data, the marginal homogeneity test was used, and a P value of less than.05 was determined to indicate statistical significance. RESULTS: In comparison with histologic results, CT achieved correct T staging in 39 patients (76%) and correct N staging in 35 patients (70%). The corresponding results for endoscopic US achieved correct T staging in 44 patients (86%) and correct N staging in 45 patients (90%). There was no significant difference between T staging (P =.55) and N staging (P >.99). Because of challenging detection of wall layers, correct T staging was difficult for CT and endoscopic US in the differentiation of T2 and T3 lesions. CONCLUSION: Compared with endoscopic US, helical CT focused on the stomach provides valuable results regarding T and N staging in patients with gastric cancer.     

Hypertrophic cardiomyopathy in infancy and childhood

Hypertrophic cardiomyopathy (HCM) presented in 10 children under 2 years of age (group 1) and in 5 between 3 and 8 years (group 2). The clinical, ECG, chest radiographic and echocardiographic features are reviewed and prognosis over a mean follow-up period of 3.5 years is reported. Patients in group 1 had more symptoms and 7 had evidence of heart failure at some stage; all had ECG abnormalities. Group 2 patients presented with murmurs and only 1 had heart failure. Medical management of these patients is discussed and the importance of accurate diagnosis stressed, since HCM may have a poor prognosis in childhood; 3 out of 15 patients have died.     

Adenosine cardioplegia: reducing reperfusion injury of the ischaemic myocardium?

Hyperkalaemia-induced hypopolarization of the sarcolemnal membrane during standard crystalloid cardioplegic arrest potentiates calcium influx during reperfusion and is associated with depletion of high-energy phosphate reserves. Adenosine has been shown to induce fast cardiac arrest whilst preserving membrane hyperpolarization in an isolated rat heart model. In this study we compared the efficacy of adenosine, both as an arresting agent and as an ultrastructural, haemodynamic and high-energy phosphate preserving agent, in an in situ global ischemia model in the baboon with St. Thomas' Hospital solution No. 2 (ST2; n = 8) and with Krebs-Henseleit buffer (KHB; n = 7). The addition of 10 mM adenosine to the non-cardioplegic KHB (ADO; n = 8) improved haemodynamic recovery significantly in terms of cardiac index (91.6% +/- 7.2 vs 59.9% +/- 9.9) and stroke volume index (101.6% +/- 8.9 vs 55.6 +/- 10.0) and was not statistically distinguishable from the ST2 with regard to cardiac index (91.6% +/- 7.2 vs 94.8% +/- 5.8), stroke volume index (101.6% +/- 8.9 vs 114.0% +/- 8.3) or left ventricular dP/dt (73.1% +/- 9.9 vs 87.0% +/- 12.4). Adenosine triphosphate was best preserved with ADO (103.5% +/- 21.1 vs 67.9% +/- 9.3 and 48.5% +/- 8.7) although this was not statistically significant. This suggests therefore that the mechanism of cardioprotection by adenosine occurs by means other than its role as high-energy phosphate precursor.     

Effective component from verbena officinalis L.inhibits proliferation and induces apoptosis of human choriocarcinoma JAR cells

<正> Objective:To examine the action of the effective component,4'-methylether-scutellarein,from Verbena officinalis L.(VOL)on the proliferation and apoptosis of human choriocarcinomaJAR cells.Methods:Cell proliferation was measured by MTT[3-(4,5-dimethylthiazol-2-yl)-2,5-di-phenyl tetrasodium bromide,MTT]assay and the incorporation of tritiated thymidine(~3H-TdR).Apoptosis of cell was evaluated by flow cytometry(FCM)and the characteristic apoptoticDNA ladder by agarose gel electrophoresis,and the morphological changes of apoptotic JAR cellswere observed under fluorescence microscopy and electron microscopy(EM).Expressions of ap-optosis proteins,poly(ADP-ribose)polymerase(PARP)and caspase-3,-8,and -9 were deter-mined with Western blot.Results:The effective component from VOL inhibited the proliferation of JAR cells in a dose-and time-dependent manner.The treated cell cycle was arrested in S phase and an apoptotic peakwas found in S phase using FCM analysis.A typical DNA ladder appeared in the treatment groupwhen analyzed by agarose gel electrophoresis.Using fluorescence microscopy,the percentage ofapoptotic cell was 0.9%,6%,and 14% after treatments of 10,20,and 40 mg·L~(-1) of the effec-tive component,respectively,for 48 h.Typical apoptotic changes,such as condensed chromatinand presence of apoptotic bodies,were observed under EM.Treatment with effective componentfor 48 h and 72 h also induced protein expression of PARP and caspase-3,-8,and -9 as seen byWestern blot.Conclusions:The effective component from VOL inhibits cell proliferation and induces apop-tosis in human choriocarcinoma JAR cells.     

Oxypurine cycle in human erythrocytes regulated by pH, inorganic phosphate, and oxygen.

The effect of pH, PO2, and inorganic phosphate on the uptake and metabolism of hypoxanthine by erythrocytes has been studied. Uptake of hypoxanthine and accumulation of inosine 5'-monophosphate (IMP) were markedly increased at acid pH, high external phosphate concentrations, and low PO2. Release of accumulated IMP as hypoxanthine occurred at alkaline pH values and low external phosphate concentrations. Conditions favoring IMP accumulation gave rise, in the absence of hypoxanthine, to a corresponding increase in 5'-phosphoribosyl-1-pyrophosphate. Intracellular phosphate concentrations were markedly pH dependent and a model is presented whereby hypoxanthine uptake and release are controlled by intracellular concentrations of inorganic phosphate and 2,3-bisphosphoglycerate. These allosteric effectors influence, in opposing ways, two enzymes governing IMP accumulation, namely 5'-phosphoribosyl-1-pyrophosphate synthetase and 5'-nucleotidase. These metabolic properties suggest that the erythrocyte could play a role in the removal of hypoxanthine from anoxic tissue.