“Para-lesional” Saline Injection Method for Assessment of Small Gastric Cancers by Endoscopic Ultrasonography

Abstract: Accurately diagnosing the depth of invasion in small early gastric cancers is essential for determining whether endoscopic resection of a lesion is indicated. It is often difficult, however, to demonstrate such small lesions by conventional endoscopic ultrasonography (EUS) which is considered to be a useful tool for assessing depth of invasion. To facilitate demonstration by EUS, we injected 2-5 ml of saline into the submucosal layer at an appropriate point 1 -2 cm from the lesion. With the collection of saline serving as a guide, the lesion was demonstrable on the same EUS image (“para-lesional” injection method). Using this method, we were able to evaluate all 12 of the small early gastric cancers we examined. Five of these lesions were endoscopically resected uneventfully after EUS examination. The accuracy of the diagnosis of vertical invasion with this method was 83% (10/12). Histologically, fibrotic changes were observed beside the lesion, but no EUS-related effects were recognized beneath the lesion. The present results suggest that the “para-lesional” injection method is useful for assessing small early gastric cancers by conventional EUS.     

An Approach to the Detection of Autonomic Neuropathy hy Use of Signal-Averaged Electrocardiography

The beat-to-beat variation of PR interval, which is thought to be a reflection of autonomic nervous system, is difficult to measure with accuracy because the variation is too subtle. However, R wave amplitude in the P wave triggered SAECG is easily attenuated in comparison to that in the R wave triggered SAECG, which might he due to PR interval fluctuation. To determine whether autonomic neuropathy could be detected by use of SAECG, two types of SAECGs triggered by P and R waves were recorded in 23 diabetics with autonomic neuropathy and 41 age matched controls. The peak voltage of filtered QRS complex was measured in the R wave and P wave triggered SAECGs. Percent attenuation of the filtered QRS voltage was calculated by dividing the difference between the voltages in the R wave and P wave triggered SAECGs by the voltage in R wave triggered SAECG. The percent attenuation of filtered QRS voltage was significantly smaller in diabetics with autonomic neuropathy than controls (4.6%± 4.9% vs 16.3%± 15.0%; P < 0.001). These results suggest that the degree of attenuation of filtered QRS voltage in the P wave triggered SAECG would be useful for the detection of autonomic neuropathy.     

Selective effector mechanisms for the expulsion of intestinal helminths

In the middle of the era of molecular biology, much less attention is paid to in vivo phenomena. However, carefully designed experimental systems in vivo still can provide valuable information as to the mechanisms underlying the establishment and maintenance of host-parasite relationships. In this review we describe the advantage of using concurrent infections with appropriately chosen combinations of different genera or different maturation stages of parasites to segregate the cellular responses of the host. By means of simple experimental approaches we have found that mucosal mast cells and goblet cells, both of which have long been considered as non-specific effectors, are in fact highly selective and specific effector cells of the host defence mechanisms capable of acting on the establishment and the expulsion of intestinal helminths.     

Detection of Carcinoplacental Alkaline Phosphatase by Polyacrylamide Gradient Gel Electrophoresis

Human serum alkaline phosphatase (E.C. 3.1.3.1.) was subclassified into several isoenzymes including carcinoplacental alkaline phosphatase isoenzyme (CPALP) by electrophoretic procedures. Since CPALP has three subtypes, such as Regan, Nagao and Variant type, their properties are somewhat different among them, and have no specific property, no simple method has yet been ascertained to detect CPALP separately.
CPALP was detected as the fastest migrating isoenzyme band to the anode, using the polyacrylamide gel electrophoresis of more than 8.0% gel concentration. Thus, a polyacrylamide gradient gel electrophoresis of 16–8% gel concentration in Tris-borate buffer system was introduced, which resulted in CPALP being found to be the fastest migrating isoenzyme band to the anode and microheterogeneities of each CPALP were also identified: CPALP (Variant) was electrophoresed rather faster to the anode, CPALP (Nagao); intermediate, and CPALP (Regan), as well as placental alkaline phosphatase isoenzyme; rather slower. In addition, each isoenzyme of CPALP and placental alkaline phosphatase further differentiated clearly into a few subbands.
Slow moving new bands appeared by Triton X-100 treatment.     

Ultrastructural features of goat oviductal secretory cells at follicular and luteal phases of the oestrous cycle

The aim of the present study was to investigate the ultrastructure of secretory cells in the various regions of the goat oviduct during the follicular and luteal phases of the oestrous cycle. During the follicular phase in the fimbriae, the secretory cells contained small secretory granules with electron-dense matrices. In the luteal phase, the secretory granules disappeared and cytoplasmic protrusions, extending beyond the luminal border of the ciliated cells and often containing the nucleus, were predominant. During the follicular phase in ampullary secretory cells, numerous secretory granules with moderately electron-dense matrices were present in the supranuclear cytoplasm and exocytosis of secretory granules was observed. The number of secretory granules was dramatically reduced in the ampullary secretory cells at the luteal phase. Conspicuous cytoplasmic protrusions of secretory cells were observed similar to those of the fimbrial epithelium. Isthmic cells were almost free of secretory granules and lysosome-like bodies were found both at the follicular and luteal phases. In conclusion, our ultrastructural observations of goat oviduct revealed marked cyclic changes in the ultrastructural features of secretory cells and the ultrastructural features and the numbers of secretory granules were distinctive for each particular segment.     

Effects of Atrial Tachypacing on Symptoms and Blood Pressure in Severe Orthostatic Hypotension

The treatment of severe orthostatic hypotension (OH) is currently unsatisfactory and usually includes various pharmaceuticals to expand the blood volume and promote peripheral vasoconstriction. This study examined the short- and intermediate-term effects of atrial tachypacing (ATP) in patients with severe OH. We implanted dual chamber pacemakers in five patients (mean age 64 ± 7 years; four men), presenting with drug refractory, recurrent syncope, and OH due to panautonomic failure with severe chronotropic incompetence and absence of rate acceleration upon assuming the upright posture. The blood pressure (BP) was measured in the supine and passive upright postures, during sinus rhythm, and during atrial pacing at 90, 100, and 110 ppm, at 1 week and at discharge and/or 3 months after pacemaker implantation. Alleviation of symptoms and a delay in the fall in upright BP were observed in a single patient at 1 week, while at discharge and/or 3 months, all patients were markedly improved. The mean fall in systolic/diastolic BP between supine and upright position decreased from 73 ± 17/46 ± 13 mmHg before, to 56 ± 27/41 ± 30 mmHg during ATP. Although these changes did not reach statistical significance, the time required for the fall in BP lengthened significantly from 2.1 ± 0.2 minutes during sinus rhythm to 9.3 ± 1.5 minutes during ATP (P < 0.001).
Conclusions: At discharge and/or 3 months of follow-up, ATP conferred beneficial effects on orthostatic BP and alleviated symptoms in patients with severe OH. The short-term effects of ATP did not reflect its longer-term effects in four of the five patients.     

Suppression of contact sensitivity by local hyperthermia treatment due to reduced Langerhans cell population in mice

The effects of local hyperthermia treatment on contact sensitivity (CS) and on the number of Langerhans cells (LCs) were studied in mice. CS was significantly suppressed when mice were sensitized in the hyperthermia treated skin I, 2 or 4 days after treatment (43 degrees C for 45 min). This suppressive effect was not observed 7 or 14 days after the treatment. CS was also suppressed when mice were sensitized in non-treated skin I day after the treatment. The density of LCs detected as ATPase-positive cells also decreased significantly 1, 2, 4 and 7 days after the treatment. There appeared to be a positive correlation between the number of LCs and the extent of CS when mice were sensitized at hyperthermia treated skin. It was observed that this suppressive effect on CS was dose- and temperature-dependent. It could be transferred by spleen cells from the hyperthermia treated and DNFB-sensitized donors, and was antigen specific when spleen cells were transferred before sensitization of the recipient mice. This indicated it was, in part, associated with the induction of suppressor cells. These findings suggest that local hyperthermia treatment reduces the number of LCs with subsequent suppression of the induction phase of delayed-type hypersensitivity by the generation of antigen-specific suppressor cells.     

Anatomical Investigation of 39 Cases of Congenital Duplication in Calves

Abstract The anatomical features of congenital duplication in the bovine calf encountered in 39 cases over eleven years in Hokkaido were investigated macroscopically. Among the animals studied, 14 were male, 20 female and 5 of unknown gender, and the anomaly was noted in 35 Holstein-Friesians, 3 Japanese Blacks and 1 Hereford.
The duplications observed in this study were classified by four types: free asymmetrical, 4 (all 4 acardius); attached symmetrical, 25 (14 cranial duplication, 2 dipygus, 2 dicephalus dipygus, 5 thoracopagus, and 2 pygopagus); attached asymmetrical, 6 (1 parasitic dipygus, 4 notomelia, and 1 pygomelia); and miscellaneous, 4. The four acardii were holoacardii amorphi covered with skin and hair. Cranial duplication was subdivided into five types based on the number of eyes and ears. In symmetrical twins the anterior part of the body was affected in 16 out of 25 cases (64%), the posterior part in 2 out of 25 (8%) and both the anterior and posterior in 7 out of 25 (28%). All were mirror-image duplicates on the various planes, and in some the internal organs had a center of symmetry. All four notomeli calves were female. Among the miscellaneous duplications, three were of the genital organs (male 1, and female 2) and one was a spinal cord duplication.