Uptake of 99Tcm-MDP in lung metastasis from osteosarcoma: clinical and animal studies

Bone scintigraphy was performed in 17 patients with previously known lung metastases of osteosarcoma. 99Tcm-MDP uptake was observed in all primary bone lesions but lung metastatic lesions were positive in only six patients (35%). 99Tcm-MDP uptake by lung metastases was significantly correlated with bone and osteoid formation in the metastatic lesions and preoperative serum ALPase values. These clinical observations were confirmed by using nude mice transplanted with human lung metastatic osteosarcoma. 99Tcm-MDP scintigraphy appears to be useful for detecting lung metastases of osteosarcoma only in a selected group of patients.     

Lipid metabolism in experimental acute pancreatitis

In order to study the changes of lipid metabolism in acute pancreatitis, the following experiments were performed in monogrel dogs. Bile-induced pancreatitis (severe type) and collagenase-induced pancreatitis (mild type) were prepared, and changes of FFA, TG, IRI and IRG were determined for one week. In addition, IVFTT and PHLA were determined at 24th hour, on the 3rd day and 7th day. A rise of FFA was observed during the first 24 hours, which was considered the lypolytic stage. On the 3rd day TG reached the maximal level, while K values in IVFTT and PHLA showed the lowest levels. The above results suggest that the elimination mechanism of TG was impaired on the 3rd day. Changes of FFA, TG, IRI and IRG showed marked differences between the two groups. Therefore it is thought that lipid metabolism in acute pancreatitis is regulated by balance of endogenous pancreatic hormones.     

Tunica albuginea cyst: a case report]

A 47-year-old male visited our hospital complaining of painless swelling of the right scrotum. Ultrasonography demonstrated hydrocele and a 13 x 12 x 10 mm cystic space along the margin of the right testis. Hydrocelectomy and simple resection of the cyst were performed. Pathologic examination of the excised cyst showed a serous cyst lined with simple flattened epithelium. Ultrasonography is useful for the diagnosis of tunica albuginea cyst.     

The morphological and biochemical changes in skeletal muscle fibers by dietary protein restriction.

The effects of dietary protein restriction on skeletal muscle fibers were studied according to morphological and biochemical approaches. Protein and DNA content of quadriceps muscles from young adult rats were decreased by the low protein and protein-free diet. Morphological examination demonstrated that there was a significant decrease in the size of muscle fibers without change in their numbers due to protein restriction. The protein/DNA ratio, accepted as an index of cell size in biochemical approaches, was compared with cell size on photomicrographs. Actual fiber size appeared much smaller than that indicated by the protein/DNA ratio.     

Determination of common esterase D phenotypes by HPLC]

The analysis of blood Esterase D (ESD) phenotypes was performed by using high performance liquid chromatography (HPLC). The hemolysate was first treated with a cation exchanger to remove hemoglobin, injected into HPLC on a weak anion exchange column, and developed to become fluorescent with reaction reagent. The chromatogram of each ESD phenotype was distinct from those of the other phenotypes. ESD protein was confirmed by isoelectric focusing in the HPLC fraction that was referred for ESD typing. This HPLC method can be used to determine the common ESD phenotypes in blood.     

Electromyographic study of facial expressions during pathological laughing and crying.

We studied facial expressions during pathological laughing and crying in 6 patients using EMG investigation. Increased EMG discharges of M. frontalis and M. corrugator supercilii are characteristic of pathological laughing and crying in addition to an increase of EMG discharges of M. orbicularis oculi, M. levator labii superiors, M. zygomaticus major, M. risorius and M. mentalis which we observed during natural laughing. Its patterns of facial expressions are similar to that of crying in normals. From the fact that normals show the same expression of laughing and crying in an extreme emotional outburst, we speculate that pathological laughing and crying is maximal manifestations of facial expressions caused by a release phenomenon of the upper center.     

Respiratory symptoms and cigarette smoking in 3,197 pulmonologist-based asthmatic patients with a highly prevalent use of inhaled corticosteroid.

The relation between smoking and risk of asthma has been well-examined; however little attention has been paid to the correlation between smoking and asthma symptoms. The aims of this study were to examine respiratory symptoms in asthmatics with a highly prevalent use of inhaled corticosteroid (ICS) and to assess the effects of smoking and its cessation. A cross-sectional study of pulmonologist-based 3197 asthmatics (men 45.2%, ages 20-97) was performed using a questionnaire about smoking habits, the incidence and frequency of symptoms (sputum, cough and wheezing, night symptoms, and shortness of breath), physical activity interference, and medication. Although 81.4% of the patients used ICS according to the international guideline, 14.9% had activity interference, and daily symptoms remained in 43.3%. At the time of the questionnaire, 21.6% were current and 25.1% were ex-smokers. In multiple logistic regression analysis, the factors of significance (p < 0.0001) were (1) smoking; for all four symptoms, (2) age and duration of asthma; for shortness of breath. Current smokers were at a risk of sputum (age-adjusted odds ratio 2.32 [95% confidence interval 1.73-3.11]; 2.09 [1.57-2.79]), of cough and wheezing (2.38 [1.81-3.14]; 1.78 [1.35-2.36]), of night symptoms (1.95 [1.41-2.60]; 1.47 [1.09-1.98]), and of shortness of breath (1.70 [1.26-2.28]; 1.30 [0.97-1.75]) in men and women, respectively. These ratios in ex-smokers decreased to the level similar to nonsmokers. Although 81.4% of asthmatic patients used ICS, 43.3% complained of daily respiratory symptoms, especially sputum. It is suggested that the effects of ICS on asthma symptoms may be interfered with by smoking and therefore more emphasis should be placed on cessation of smoking.     

Lower extremity reconstruction after necrotising fasciitis and necrotic skin lesions using a porcine-derived skin substitute.

Seven consecutive clinical cases of necrotising fasciitis or necrotic skin lesions (42-78 years old; average 65.0 years of age, three females and four males) due to group A Streptococcus, group B Streptococcus, methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa in the lower extremities, who demonstrated rapid systemic symptoms, were investigated for the usefulness of a bilayer artificial dermis, derived from porcine tendons, over 4 +/- 2.4 years (1-7 years). All surgical debridement was confirmed as sufficiently deep and wide for clinically infected lesions and artificial dermis was applied to all wounds. The average interval to secondary split-thickness skin grafting was about 17.5 days (17.5 +/- 2.44 days, 21 days max., 14 days min.) and the average thickness was 0.009 +/- 0.0022 in. (range: 0.006 - 0.012 in.). No clinical problems were noted during the application of the artificial dermis and the subsequent skin grafting. Since, the donated skin graft was thin, the morbidity was minimised. The use of artificial dermis after extensive surgical debridement in necrotising fasciitis was easy and effective. Local or systemic infection was negligible.     

A case of aseptic meningitis caused by relapsing polychondritis]

We report a patient of relapsing polychondritis (RP) with antecedent aseptic meningitis. A 65-year-old man has developed headache and fever. Neurological examination showed meningeal signs, and cerebrospinal fluid (CSF) examination revealed meningeal inflammation which contained 450 polymorphonuclear cells/microl, 302 mononuclear cells/microl, and 0 red cells/microl, with 79 mg protein/dl. Serologic testing for autoimmune disease as well as the culture and cytology of CSF were negative. He admitted our hospital as having aseptic meningitis and experienced antibiotic therapy. However, his pyrexia continued and he developed repeating visual and hearing impairment reacting to steroid. Three months later, he became behaviorally deaf, and bilateral auricular chondritis occurred with nonerosive seronegative inflammatory polyarthritis. The result of condral biopsy was consistent with the diagnosis of RP showing cartilage surrounded by an intense inflammatory cell response with a decreased number of chondrocytes. A clinical diagnosis was made and prednisolone 60 mg/day was begun with the result of resolution of the auricular chondritis, and slight improvement of his deafness. Aseptic meningitis is a rare complication of RP. Only one report detailed RP patient who had preceding meningitis. RP is a potentially lethal disease resulting from suffocation by airway collapse, the complications of a cardiac large vessel, and so on. For improvement of a life prognosis, an early diagnosis and treatment are indispensable. Although RP is a rare discovery, it is necessary that RP should be taken into consideration and be differentiated as a cause of relapsing aseptic meningitis.