GIANT FOLLICULAR LYMPHOMA OF THE STOMACH – REPORT OF 4 CASES –

Four cases of primary giant follicular lymphoma of the stomach are reported. All patients were males and their ages were 53, 63, 66 and 71 years, respectively. Macroscoplcally, they were divided into 2 cases of ulcerative type, 1 case of polypoid type with hypertrophied rugae and 1 case of diffuse infiltrative type. One case transformed to the diffuse type of lymphosarcoma and died 9 months after gastrectomy.
Giant follicular lymphoma could be differentiated from reactive lymphoid hyperplasia, based on the following histological features; uniformity of cellular composition, loss of lymphocytic rim, fusion of follicles, cellular atypism, and lack of phagocytosis and mixed inflammatory infiltrates.     

Inhibitory effect of nifedipine and cromolyn sodium on skin reactions and 45Ca uptake and histamine release in rat mast cells induced by various stimulating agents

The effect of nifedipine, one of the calcium channel antagonists, was examined in allergic and nonspecific reactions using rat skin and peritoneal mast cells. Rat passive cutaneous anaphylaxis response mediated by IgE antibody was inhibited by nifedipine (100 micrograms/rat) and also by cromolyn sodium (5 mg/rat). Skin reactions induced by histamine or methacholine were not inhibited, and skin reaction induced by serotonin was slightly inhibited by these drugs. The 45Ca uptake and histamine release in sensitized mast cells stimulated by ovalbumin were suppressed by nifedipine. In actively sensitized cells, nifedipine seems to be more effective on the inhibition of 45Ca uptake, but less effective on histamine release than cromolyn sodium. In mast cells, nonimmunologically stimulated by concanavalin A, compound 48/80, and calcium ionophore A23187, nifedipine exerted considerable inhibitory effects on both 45Ca and histamine release.     

Zilver PTX Post-market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan: 2-Year Results

CardioVascular and Interventional Radiology - A prospective, multicenter post-market surveillance study in Japan evaluated the 2-year safety and effectiveness of the DES in real-world patients with...     

Valvular regurgitation in patients with Kawasaki disease and in healthy children: a pulsed Doppler echocardiographic study

Valvular lesions in the acute stage of Kawasaki disease were observed using pulsed Doppler echocardiography. The subjects consisted of 65 patients with Kawasaki disease (2 months-6 2/12 years) who had been followed from the acute stage. The age-matched 113 controls were selected from 661 healthy children (2 months-14 years of age). In the acute stage of Kawasaki disease, tricuspid regurgitation (TR) was detected in 31 (48%), pulmonary regurgitation (PR) in 22 (34%) and mitral regurgitation (MR) in 17 (26%). There was no aortic regurgitation (AR). In the convalescent stage, TR was found in 26 (40%), PR in 20 (31%), and MR in 11 (17%), but no AR was detected. The incidence of each valvular regurgitation between the acute and convalescent stages in patients with Kawasaki disease did not differ significantly. Furthermore, there was no significant difference in the incidence of valvular regurgitation between patients with Kawasaki disease and the normal controls. In nine patients, however, valvular regurgitation in the acute stage had disappeared by the convalescent stage, and two patients had developed a new pansystolic murmur in the acute stage. We estimated the incidence of pathologic valvular involvement in Kawasaki disease to be 11/65 (17%). The incidence of valvular involvement in patients with coronary artery aneurysms was significantly higher than that of patients without coronary artery aneurysms (p less than 0.01). It was concluded that mild and transient valvular regurgitation, which cannot be detected by auscultation, may occur in some patients in the acute stage of Kawasaki disease. These may be caused by acute inflammation of the valve related to coronary artery lesions. In view of the Doppler echocardiographic findings in normal controls, these regurgitations should be distinguished from "physiological" ones.     

Clinical implication of main pulmonary artery Windkessel size after banding operation

Background:  The Windkessel model, proposed in 1895 by O. Frank, successfully explained systemic and abnormal pulmonary hemodynamics of congenital cardiac defects. The model is essentially a functional one and describes only hemodynamics, not anatomical or geographic structures. Because pulmonary arterial banding (PAB) adds a substantial resistance proximal to arterioles, it provides an ideal anatomical structure of the Windkessel model, namely, an elastic reservoir of much dilated main pulmonary artery (mPA) followed by a substantial artificial resistance of banding.
Methods:  The pulmonary artery (PA) Windkessel size (WS) of 10 patients, several months to years after PAB, were estimated both in peak systole (WSs) and minimum diastole (WSd), as the product of Windkessel compliance and proximal to distal pulmonary arterial pressure difference at each cardiac phase. They were compared to cineangiogram-determined corresponding volumes (Vs, Vd) of PA proximal to the band or mPA.
Result:  WSs and WSd correlated well with Vs and Vd, respectively, with the correlation coefficient of 0.91 and 0.62, indicating that the Windkessel in these patients corresponds to mPA. Among five patients whose resistance at the band comprised more than half of the whole PA resistance, the coefficients proved even better.
Conclusion:  Much bigger secondarily developed Windkessel, as placed proximal to the band on top of a substantial resistance at PAB, contributed much to alleviate the stress downstream at the periphery caused by greatly increased systolic stroke volume into mPA in these cardiac defects.     

Dscam is associated with axonal and dendritic features of neuronal cells.

Dscam, a novel cell-adhesion molecule belonging to the Ig-superfamily mediates homophilic intercellular adhesion and is expressed abundantly in the nervous system during development. To gain better understanding on the role of Dscam in neuronal differentiation, we raised an antibody and characterized its protein product. Anti-Dscam antibody detected an approximately 200-kDa protein band in human and mouse brain lysates. Immunohistochemical studies showed that during embryonic development of mice, mouse Dscam is expressed throughout the neuronal tissues and also in nonneuronal tissues such as lung, liver, and limb buds. In adult brain Dscam expression is predominant in the cerebellum, hippocampus, and olfactory bulb. Immunofluorescence double labeling of hippocampal and cerebellar primary cultures revealed that Dscam is associated with axonal and dendritic processes. In view of its cellular localization and spatiotemporal expression pattern, we suggest that Dscam is involved in cell-cell interactions during axonal-dendritic development, and maintenance of functional neuronal networks.     

Rapid and diverse changes of gene expression in the kidneys of protein-overload proteinuria mice detected by microarray analysis.

BACKGROUND: Microarray is a method that allows the analysis of a large number of genes at the same time. We applied this method to show the difference of gene expression in the kidney caused by proteinuria. METHODS: An experimental mouse model of protein overload was prepared by bovine serum albumin injection. The mRNAs of kidneys isolated after 0, 1, 2, 3 and 4 weeks loading were analysed by Northern blotting. We analysed about 18000 genes by microarray. The expression patterns of the microarray were displayed on control, 1 and 3 weeks of protein overload using the clustering procedure. A clone showing the greatest changes of up-regulation in the kidney was cloned and analysed by in situ hybridization and immunohistochemistry. RESULTS: Over 1600 kinds of gene expression were confirmed in control kidneys. Proteinuria caused systematic changes of gene expression demonstrated by the cluster analysis. The up-regulation of osteopontin mRNA was shown and confirmed by Northern blot analysis. One of the clones showing the largest changes, AA275245, was isolated and characterized. It revealed that AA275245 was an unreported 3' non-coding region of vinculin mRNA which was associated with cytoskeleton proteins (e.g. alpha-actinin, talin, F-actin). Immunohistochemistry and in situ hybridization showed that this clone was identified in glomeruli as a mesangial pattern. The detected signal intensity using both methods, however, was virtually identical in control and disease kidney models. All data including images and analysed signal intensities are accessible on the web site. CONCLUSION: The microarray analysis revealed that the renal gene expression pattern was changed dynamically in mice with experimentally induced proteinuria within a few weeks.     

Interval between the First Cancer and the Genetic Diagnosis in Lynch Syndrome Probands

Objective Little is known about the time from developing a first cancer to confirming the presence of a mismatch repair (MMR) gene mutation for Lynch syndrome (LS) probands. Methods This was a retrospective single center study. LS probands, who have an MMR gene mutation that was confirmed first in a pedigree and thereafter developed at least one cancer, were included in this study. Results There were 21 LS probands who had developed at least one cancer; 6 with MLH1 mutations, 9 with MSH2 mutations, 4 with MSH6 mutations, and 2 with EPCAM deletions. The median ages at the first cancer and the genetic diagnosis were 47 (34-71) and 62 (38-84) years old, respectively. The mean interval between the first cancer and the genetic diagnosis was 11.0 (0-25) years, and 20 years or longer interval was required for the 5 probands. Six (28.6%) probands were older than 70 years, and 3 (14.3%) were in their 80s when they were diagnosed to have LS. The genetic diagnosis was confirmed at the first, second, third, and fourth cancer or later in 5, 5, 6, and 5 probands, respectively. Of the 16 cancers examined, 2 (12.5%) were microsatellite stable (MSS), both of whom had germline MSH6 mutations. All 17 LS probands who developed colorectal cancer met the revised Bethesda guidelines at the genetic diagnosis, but only 7 of 11 (63.6%) met them at the first cancer. Twelve out of 21 (57.1%) met the revised Amsterdam criteria. Conclusion It took 11 years for the LS probands from the first cancer to the diagnostic confirmation by genetic tests. A quarter of the probands were in their 70s or 80s at genetic diagnosis.     

Catheter closure of moderate to large sized patent ductus arteriosus using the simultaneous double or triple coil technique

BACKGROUND: Although the clinical experience with transcatheter closure of the patent ductus arteriosus using the coils has grown rapidly, one important complication of this procedure using the conventional Gianturco coil was the migration of coils into peripheral vessels. This is especially for patients with a relatively larger size ductus and the risk for such complications could be increased. In this situation, the detachable coil may have some technical benefits to perform coil occlusion and reduce the incidence of complications. METHODS: We describe the clinical efficacy of a simultaneous double or triple coil occlusion technique using the Cook detachable coil or bioptome delivered 0.052 inch Gianturco coil to close the ductus arteriosus. This was performed in patients whose ductus diameter was greater than 3.0 mm. RESULTS: From February 1995 to December 2000, 118 patients with patent ductus arteriosus were treated by coil occlusion using Cook detachable coils, of whom 58 patients whose minimum diameter of ductus > or = 3.0 mm were reviewed. All patients had successful placement of coils. According to the evaluation by color flow mapping, a trivial shunt was observed in 17 patients (29%) within 24 h after the procedure. In 11 out of 17 patients, a residual shunt was not detected 1 month after the procedure. At 6 months after the procedure, the residual shunt was detected only in three patients. CONCLUSIONS: Although this study did not calculate the statistical significance between detachable and non-detachable coils in term of occlusion rate, our institutional experience suggests that the simultaneous double or triple coil technique using the detachable or 0.052 inch Gianturco coils can reduce the prevalence of coil migration or complications.