A case of intestinal intussusception caused by multiple lipoma diagnosed preoperatively]

A 45-year-old man presented with intermittent abdominal pain for a month. Intestinal intussusception was diagnosed by the findings of abdominal ultrasonography and computed tomography. Intussusception was reduced by barium enema. Based on magnetic resonance imaging, we diagnosed intestinal intussusception due to multiple lipoma. At laparotomy, after successful reduction of the intussusception with Hutchinson's maneuver, an ileoceal resection was performed. Intussusception in adults is relatively rare and may be difficult to diagnose preoperatively. In the diagnosis of this disease, abdominal echo, CT, and MRI are useful.     

Hepatic “intravenous fat pigment” in infants and children receiving lipid emulsion

In 23 patients who received fat emulsion (Intralipid) intravenously and had subsequent necropsy, the deposition of pigment in the liver was evaluated quantitatively. Pigment was found in hepatic cells (HC) in 14 of 23 patients as well as reticuloendothelial cells (REC) in 22 of 23 patients. There was more pigment deposition in HC in younger children. HC pigment deposition occurred most frequently in patients with acute inflammatory processes within the abdomen. Patients infused with emulsion at rates less than 0.5 g/kg body wt/hr had less pigment deposition than patients infused at faster rates. Neonates infused at rates less than 0.2 g/kg body wt/hr for 24 hr had less HC pigment than neonates infused at higher rates. The quantity of REC pigment bore no apparent relationship to age, clinical diagnosis, rate or total dose of fat emulsion, but was increased in groups infused more than 14 days.     

The Proliferation of Plasma Cells from Mouse Bone Marrow in Vitro III. Primary and Secondary Immune Responses Associated with Thymic RNA

In vitro primary and secondary immune responses involving the proliferation of IgG-forming plasma cells from cultures of normal or antigen-primed mouse bone marrow cells have been investigated in order to clarify the relationships between the bone marrow cells and thymic RNA derived from each animal. By an administration of soluble and insoluble antigens with thymic RNA to bone marrow cultures, 54 ± 13% of IgG-forming plasma cells were found to produce specific immunoglobulin following stimulation with antigen. Thymus independent antigen polyvinylpyrrolidone (PVP) induced the proliferation of anti-PVP specific antibody forming cells in the abcence of thymic RNA, although more of these cells were generated when PVP-primed thymic RNA was administered with PVP to normal bone marrow cultures. Other antigens such as keyhole limpet hemocyanin (KLH), flagellar antigen of Salmonella, apofferitin and SRBC were investigated using the same bone marrow culture system. These antigens induced various numbers of antibody forming cells from the cultures. Antigen-primed thymic RNA derived from mice inoculated with antigen caused secondary immune response-patterns of plasma cell proliferation from normal bone marrow cultures. Bone marrow cells, however, derived from antigen primed animals proliferated with patterns of primary immune response when cultured with normal thymic RNA and the same antigen. On the basis of these observations, it is concluded that anamnestic immune memory is mainly associated with thymic RNA and not with immunoblasts in bone marrow.     

Quantitative determination in urine of hippuric acid and m- or p-methylhippuric acid, metabolites of toluene and m- or p-xylene

Ogata, M., Tomokuni, K., and Takatsuka, Y. (1969).Brit. J. industr. Med.,26, 330-334. Quantitative determination in urine of hippuric acid and m- or p-methylhippuric acid, metabolites of toluene and m- or p-xylene. Improved and more specific methods for the quantitative determination of hippuric and m- and p-methylhippuric acids in urine are described. The acids were extracted from urine with ether/ethanol, which was dried with silica gel, or with ethyl acetate. After removing the solvent by evaporation coloured azlactones were formed by reaction with p-dimethylaminobenzaldehyde in acetic anhydride (DAB, only usable after ether/ethanol extraction) or benzenesulphonyl chloride in pyridine, and the absorbances were measured. The sensitivities were about 4 μg./ml. of urine using DAB, and 20 μg./ml. of urine using benzenesulphonyl chloride reagent. Separation of hippuric and methylhippuric acids was achieved by paper and thin-layer chromatography before estimation. A spot test is also described.     

Pupillary abnormalities in schizophrenic patients during long-term administration of psychotropic drugs: Dissociation between light and near vision reactions

Pupillographic studies were made of the reactions to light and near vision in 12 schizophrenic patients under long-term administration of psychotropic drugs. The results showed a significant reduction in the light reaction, while the near vision reaction was preserved. The pupillographic study revealed not only reduction in amplitude of the light reaction but also changes in dynamic aspects of the reaction, i.e., prolonged latency time, shortened constriction time, and half redilatation time after the light stimulus.The mechanisms underlying the dissociation between light reaction and near vision reaction induced by long-term administration of psychotropic drugs are obscure, but both the peripheral and central actions of these drugs may be involved.     

A case of multiple liver metastases from breast cancer in which we confirmed disappearance of cancer cells after hepatic resection following hepatic arterial infusion chemotherapy

A 46-year-old woman underwent right mastectomy for stage IIA breast cancer in 1993. Six years and 8 months after this operation, she was diagnosed as having multiple liver metastasis form the breast cancer. An intra-arterial catheter was inserted percutaneously into the hepatic artery and she was given hepatic arterial infusion chemotherapy and general chemoendocrine therapy. The metastatic liver tumors were gradually reduced in size and tumor markers returned to the normal range. However, tumor size was unchanged after February 2001. After obtaining her informed consent from the patient, we performed hepatic resection in December 2001. Histopathologically, three scars were observed and no tumor cell was found. She has been free from recurrence to date. This case suggests that chemoendocrine therapy including hepatic arterial infusion chemotherapy is effective for breast cancer patients with liver metastasis.     

The effects of exercise intensity on thermoregulatory responses to exercise in women

We investigated the influence of altering exercise intensity (150, 300, and 450 kpm/min) on the resetting of the core temperature threshold for the onset of the sweating rate (M(sw)) and the alteration of sweating sensitivity during the menstrual cycle in women. Five women underwent cycling exercise for 30 min in both the luteal and follicular phases under controlled neutral environmental conditions (T: 25 degrees C, RH: 55%). A significantly higher rectal temperature (T(re)) was seen in the luteal phase at all exercise intensities, and the same time course of the T(re) response with a constant difference of approximately 0.2 degrees C was shown between the follicular phase and the luteal phase. The T(re) threshold for M(sw) was also apparently shifted rightward a constant value of 0.2 degrees C from the follicular phase to the luteal phase, independent of the alteration of exercise intensity. The slope of the M(sw)-T(re) relationship in the follicular phase did not differ from that in the luteal phase. These results indicate that (1) a rightward shift in the T(re) threshold from the follicular phase to the luteal phase can be observed independent of any alteration of the exercise intensity; and (2) the sensitivity of M(sw) is also not physiologically influenced by exercise intensity. Thus, alterative thermoregulation during the menstrual cycle was fundamentally unaffected by the change of exercise intensity.