Malignant Paraganglioma of the Stomach

Abstract: We report a case of malignant paraganglioma of the stomach. A gastric endoscopic examination on a 67-year-old female, performed for follow-up purposes, revealed an irregularly elevated lesion with a central ulcer on the lesser curvature of the lower body. The lesion showed characteristics of both an epithelial tumor and a submucosal tumor by endoscopy and radiography. The biopsy specimen suggested that the lesion was a malignant poorly differentiated tumor. On abdominal ultrasonography and computed tomography, several space occupying lesions were found in both lobes of the liver. Therefore, this case was diagnosed as having an advanced gastric cancer with liver metastases and underwent distal gastrectomy. Postoperatively, a final diagnosis of gastric paraganglioma was made by histological and immunohistochemical findings (positive for Grimelius, neuron specific enolase and other stains). These findings also revealed lymph node metastases. To date, only seven cases of gastric paraganglioma have been reported. Furthermore, two cases of malignant gastric paraganglioma have also been described in the literature. This is the first case of malignant gastric paraganglioma evaluated in detail by endoscopic and radiographic examinations.     

Marked retention of indocyanine green and sulfobromophthalein with chronic persistent hepatitis

A hepatitis B virus (HBV) carrier with marked retention of indocyanine green (ICG) and sulfobromophthalein (BSP) was admitted to our hospital for assessment of liver function. On admission, he was asymptomatic and blood chemistry tests showed normal values for transaminases and bilirubin. Serum hepatitis B surface antigen (HBsAg) and antibody to hepatitis B e antigen (anti-HBe) were positive. A history of drug abuse or alcoholism was denied. Dye excretion tests revealed marked retention of ICG (R₁₅= 70%) and BSP (R₄₅= 23%). Histopathological examination of a liver biopsy specimen obtained during laparoscopic observation showed chronic persistent hepatitis (CPH). Familial research of the patient failed to prove the existence of dye excretory defect in his siblings. Usual cases of CPH due to continuous HBV infection do not show such severe disturbance of organic anion transport. This pattern of the dye excretory defect with CPH has not been reported. Although the relationship between this dye excretory defect and HBV infection is unclear, the existence of the constitutional dye excretory defect due to abnormal organic anion transport in the liver might be considered.     

Effects of treadmill training on the arteriolar and venular portions of capillary in soleus muscle of young and middle-aged rats

The effects of a 6-week programme of endurance training on soleus muscle capillarity were examined, in terms particularly of the proportions of arteriolar and venular capillaries and their capillary domain area, in young (3-week-old) and middle-aged (54-week-old) Wistar rats. Exercise protocols for the young training group were: 10–22.5 m min^?1, 60 min day^?1 for 6 days a week, with a gradient of 7 degrees during the final 2 weeks; for the middle-aged training group, the protocols were: 10–20 m min^?1, 50 min day^?1 for 6 days a week. In both young and middle-aged training groups, the density of arteriolar capillaries was significantly increased (P<0.05), but that of venular and intermediate capillaries was decreased slightly. The proportion of arteriolar capillaries therefore was significantly (P<0.05) increased, from 63.9 to 73.1%, in young rats and from 33.0 to 48.4%, in middle-aged rats after training. The increase in the proportion of arteriolar capillaries is an advantageous adaptation to exercise-induced increases in oxygen demand. In both young and middle-aged rats, capillary domain area and Krogh's tissue cylinder radii in all capillary portions decreased after training. These results suggest that adaptive changes in oxygen transport system, identified as an increase in the arteriolar capillary and a reduction in diffusion distance for oxygen, were observed in middle-aged as well as in young rats. However, capillary angiogenesis induced by exercise appeared to be greater in young than in middle-aged rats.     

New variants of Ps salivary polymorphic proteins

Electrophoretic analysis of the Ps protein demonstrated the existence of phenotypes additional to those described by Azen & Denniston (1980). A hypothesis that the polymorphism of the Ps protein is determined by five expressed and one unexpressed alleles was supported by family studies. The gene frequencies in a Japanese population were Ps ^1F= 0.0016, Ps ¹= 0.2983, Ps ^2F= 0.0288, Ps ^2S= 0.0079, Ps ³= 0.0111, Ps ⁰= 0.6523.     

Studies on the Male Reproductive Toxicity of Freon 22

Studies on the Male Reproductive Toxicity of Freon 22. Lee,I.P. and Suzuki, K. (1981). Fundam. Appl. Toxicol. 1:266–270Freons have been used extensively as refrigerants and as propellantsin household products, and yet their possible effects on malereproduction have received little attention. In the presentstudy, adult male Sprague-Dawley rats (nine weeks of age) wereexposed to 50 000 ppm Freon 22, five hrs per day for eight weeks.The control group received filtered air at an identical flowrate. At the end of the eight week exposure period, body andorgan weights, hematology, blood chemistry, plasma gonadotropins,and fertility parameters were not significantly different fromcontrols, with the exception of serum cholesterol levels, whichwere slightly higher, and glucose and triglyceride levels whichwere lower. The weight of coagulating glands was also lowerthan those of controls, but did not interfere with fertilityfunction.     

Bilateral testicular tumors: A report of nine cases with long-term follow-up

BACKGROUND: The incidence and clinical features of bilateral germ cell testicular tumor (GCTT) in the Japanese population are not fully characterized. We examined the incidence, clinical features, management and outcome, sexual status, hormonal environment, implication of androgen replacement, and human leukocyte antigen (HLA) typing of bilateral GCTT. METHODS: We treated nine consecutive patients with bilateral GCTT from 1980 through to 1999, and reviewed their hospital and clinic charts. Testosterone, luteinizing hormone, follicle stimulating hormone, dehydroepiandrosterone, and dehydroepiandrosterone-sulfate were measured in bilateral orchiectomized patients. Human leukocyte antigen typing was assessed with peripheral lymphocyte. RESULTS: The incidence of bilateral GCTT against the total number of patients with GCTT was 9/274 (3.3%). The median age of the first tumor was 29 (range 21-75) years. Three cases were synchronous and the remaining six cases were metachronous. In the case of metachronous tumor, the median interval between first and contralateral tumor was 8 (range 2-25) years. Standard treatment was defined as surveillance policy in stage I, chemotherapy for higher stages of non-seminoma, and radiotherapy for stage II seminoma. Human leukocyte antigen typing was examined for seven cases. Five cases were positive for HLA-A24. The incidence of HLA-A24 in bilateral GCTT was identical to that of the Japanese population. The relapsing incidence of stage I disease with surveillance policy was almost identical to unilateral GCTT. A 74-year-old patient with stage II seminoma died of the disease at 1.3 years. The other eight patients remained well without any evidence of recurrence at a median follow-up period of 78 (range 12-204) months. Four patients with bilateral orchiectomy did not require androgen replacement without easy fatigability. Sexual status was conserved using androgen replacement. CONCLUSIONS: Long-term follow-up, as long as 25 years, is recommended for contralateral relapse. Some patients with bilateral orchiectomy do not require androgen replacement. The significance of HLA-A24 for bilateral testicular tumor is equivocal in the Japanese population.     

Immunoreactive Transforming Growth Factor β-1, Its Receptor,bcl-2 Protein,and p53 Protein in Colorectal Adenomas

Abstract: Immunoreactive transforming growth factor-β1 (TGF-β1), its receptor (TGFR), bcl-2 protein, and p53 protein were stained in 47 samples of normal colonic mucosa and 33 samples of colorectal adenoma, with the aim of exploring an alternate, novel pathway of colorectal tumorigenesis. There was no difference in the percentage of cells positive for TGF-β1 immunoreactivity between normal mucosae and adenomas. TGFR immunoreactivity was detected in a significantly higher percentage of normal mucosae than of adenomas (p ±0.05). Bcl-2 protein and p53 protein immunoreactivities were detected in a significantly higher percentage of adenomas than of normal mucosae (p ±0.01). Expression of these immunoreactive proteins did not correlate with any of the clinicopathological features of adenomas, except for a significant negative correlation between TGFR expression and large tumor size (p±0.05) and a positive correlation between p53 protein expression and the grade of dysplasia (p±0.05). These findings indicate that (1) TGF-β1 plays little role in the tumorigenesis of colorectal adenomas, (2) TGFR is lost in most adenomas during tumorigenesis, (3) bcl-2 protein plays an important role in transformation of normal mucosa into adenoma, and (4) p53 protein is involved in the very early phase of malignant transformation from adenoma to carcinoma.     

Increased release of myeloperoxidase in vitro from neutrophils of patients with myeloperoxidase-specific anti-neutrophil cytoplasmic antibody (MPO-ANCA) related glomerulonephritis

Summary: In order to elucidate the role of neutrophils in the pathogenesis of MPO-specific anti-neutrophil cytoplasmic antibody (MPO-ANCA) related glomerulonephritis (GN), MPO release, beta-glucuronidase (BGL) release, superoxide anion (O₂⁻) production from the neutrophils of patients with MPO-ANCA related GN were measured. the effect of plasma on MPO release from neutrophils was also studied in patients with MPO-ANCA related GN. Neutrophils and plasma were obtained from patients with MPO-ANCA related GN, GN unrelated to MPO-ANCA and healthy controls. MPO release from the neutrophils of patients with MPO-ANCA related GN was higher than that of controls significantly. This was also higher than that in patients with GN unrelated to MPG-ANCA, but this was not statistically significant. Superoxide anion production from neutrophils of patients with MPO-ANCA related GN was significantly higher than that in patients with GN unrelated MPO-ANCA, However, BGL release was not significantly different among three groups. Furthermore, MPO release and O₂⁻ production increased in parallel with clinical activity of MPO-ANCA related GN. Neutrophils of patients with MPO-ANCA related GN showed to be significantly more sensitive to FMLP on MPO release than those in the other two groups. However, plasma from MPO-ANCA related GN increased the sensitivity to FMLP on MPO release, but not BGL release, in neutrophils obtained from healthy controls, whereas it suppressed MPO release from neutrophils with MPO-ANCA related GN. This suggests that in patients with MPO-ANCA related GN MPO can be highly released from activated neutrophils and that the plasma of patients with MPO-ANCA contains factor(s) which modulate reactivity of neutrophils.     

Carbamazepine-induced thrombocytopenia and carbamazepine-10,11-epoxide: A case report

Abstract The case of a patient who developed thrombocytopenia during treatment with carbamazepine (CBZ) is described. The platelet count recovered soon after discontinuation of CBZ. Lymphocyte stimulation test with carbamazepine-10,11-epoxide (CBZ-10,11-EPOX), a major metabolite of CBZ, was positive, although with CBZ it was negative. These findings suggest that CBZ-10,11-EPOX was possibly causative in the pathogenesis of CBZ-induced thrombocytopenia in this case.     

Bronchial responsiveness to methacholine during airway cooling in normal subjects

In order to investigate the effects of airway cooling on bronchial responsiveness in normal subjects, we measured bronchial responsiveness to inhaled methacholine with and without the inhalation of cold air. Two out of seven subjects showed an increase in baseline respiratory resistance (Rrs) during cooling of the airway but the other five subjects showed little change in their baseline Rrs. All subjects increased bronchial responsiveness to methacholine. Additionally, the threshold dose of methacholine decreased to one-third of the control dose with cooling of the airway. We speculate that airway cooling increased bronchial responsiveness to methacholine in normal subjects presumably due to increased vagal tone, increased alpha-adrenergic activity and/or a release of chemical mediators.