The role of the spleen in regulating the plasma levels of factor VIII-- von Willebrand's factor after DDAVP

Organ transplantation and perfusion studied indicate that the spleen plays an important role in the regulation of plasma levels of factor VIII-von Willebrand's factor (FVIII-vWF). To better understand the mechanisms that regulate the FVIII-vWF increases after infusion of 1- deamino-8-D-arginine vasopressin (DDAVP), we have measured factor VIII coagulant activity (FVIII:C) and antigen (FVIII:CAg) and von Willebrand's factor antigen (vWF:Ag) and ristocetin cofactor (vWF:RCof) in 9 asplenic subjects with normal baseline concentrations, in 7 asplenic subjects with high concentrations, and in 14 normal controls with intact spleens. In "normal" aasplenics, all the FVIII-vWF-related measurements increased significantly over baseline values, indicating that responsiveness to DDAVP is not abolished by splenectomy. The maximal vWF:Ag and vWF:RCof responses were no different from those of normal controls, suggesting that DDAVP releases vWF from storage sites other than the spleen. The FVIII:C response was significantly lower than in normal controls, but FVIII:CAg did not differ, making FVIII:CAg higher than FVIII:CAg in "normal" asplenics. These findings suggest that the spleen, rather than being a storage site for FVIII, is the organ in which a partially inactive form of FVIII acquires full coagulant activity. In "high" asplenics, all the FVIII-vWF-related measurements increased less than in "normal" splenics, indicating that long-term elevations of plasma concentrations of FVIII-vWF are accompanied by decreased release from those storage pool(s) mobilized by DDAVP.     

Current principles and approaches to the treatment for patients with locally advanced rectal cancer

The short-term treatment results of 91 patients with locally advanced rectal cancer are presented. All patients received surgical treatment and neoadjuvant chemotherapy. The chemoradiotherapy effect was evaluated by comparison of pre- and post-therapeutic MRI data. MRI data was also compared with post-operation tumor morphology data. In 23% of resected tumor samples complete tumor regression was evident, in 47.2% of cases partial regression was revealed. Lymph node metastases were found in 21.9% of cases. The discrepancy in MRI and morphology data can be explained by the limited ability of MRI in differentiation between viable tumor, fibronecrotic tissue and inflammatory reaction after chemoradiotherapy.     

A test of the adaptive specialization hypothesis: population differences in caching,memory, and the hippocampus in black-capped chickadees (Poecile atricapilla)

To test the hypothesis that accurate cache recovery is more critical for birds that live in harsh conditions where the food supply is limited and unpredictable, the authors compared food caching, memory, and the hippocampus of black-capped chickadees (Poecile atricapilla) from Alaska and Colorado. Under identical laboratory conditions, Alaska chickadees (a) cached significantly more food; (b) were more efficient at cache recovery: (c) performed more accurately on one-trial associative learning tasks in which birds had to rely on spatial memory, but did not differ when tested on a nonspatial version of this task; and (d) had significantly larger hippocampal volumes containing more neurons compared with Colorado chickadees. The results support the hypothesis that these population differences may reflect adaptations to a harsh environment.     

Expression of peanut agglutinin-binding mucin-type glycoprotein in human esophageal squamous cell carcinoma as a marker

Background  

The TF (Thomson – Friedenreich) blood group antigen behaves as an onco-foetal carcinoma-associated antigen, showing increased expression in malignancies and its detection and quantification can be used in serologic diagnosis mainly in adenocarcinomas. This study was undertaken to analyze the sera and tissue level detectable mucin-type glycoprotein (TF-antigen) by Peanut agglutinin (PNA) and its diagnostic index in serum as well tissues of human esophageal squamous cell carcinoma as marker.     

Endovascular treatment of scalp arteriovenous fistulas associated with a large varix

Ten patients with scalp arteriovenous fistulas associated with a large varix (cirsoid aneurysms) were treated with a combination of interventional neuroradiologic procedures. These procedures included transarterial embolization, transarterial embolization followed by surgical excision, and two new methods of treatment of cirsoid aneurysms: transvenous embolization and direct puncture of the fistula for embolization. The embolic materials included liquid adhesive agents, particulate agents, detachable balloons, and wire coils. The embolization was performed to lodge the embolic agents in the fistula or proximal draining vein, not just the feeding vessels. Surgery was performed in two cases to remove a small residual nidus of fistula that could not be completely treated with intravascular embolization. With the use of these forms of treatment, cures were obtained in seven patients, and clinical and angiographic improvement was achieved in three patients. No major morbidity, blood loss, or mortality occurred during the treatment of these patients. The follow-up period ranged from 1 month to 8 years.     

Effectiveness of combined resection and exenteration of the pelvic organs as part of the comprehensive treatment of extensive malignancies of the rectum and female genitals

The results of the surgical treatment of 865 patients with extended malignancies of the rectum and female genitals are presented. Combined resection and exenteration of organs of the small pelvis (both radical and palliative to ensure cytoreduction of tumor) were carried out in 695 cases (palliative surgery for symptoms--170). The number of resections and sphincter-saving operations has increased while the lethality rates have dropped in recent years. Three-year survival after combined radical surgery for rectal cancer was 59.1%; five-year survival--49% (palliation with removal of distant metastases--26.0 and 14.8%; without removal--24.2 and 0%, respectively; palliative surgery for symptoms--2.3 and 0%, respectively). In cases of palliative surgery for cytoreduction of tumor of the female genitals, 3- and 5-year survival after removal of all distant foci was 66.2 and 54.1%; partial cytoreduction--42.2 and 28.8%, and surgery for symptoms--13.8 and 13.8%, respectively. Cytoreduction improved both the chances and efficacy of adjuvant radio- and chemotherapy. It is suggested that surgery be included as a component of complex treatment of malignancies; combined cytoreduction is fully justified even if its effect is merely palliative.