Sulfhydryl blocker-induced colitis in the rat: Immunological changes in thymus gland and colonic mucosa

The study was designed to examine the changes of thymus in sulfhydryl blocker-induced colitis. We used N-ethylmaleimide (NEM) as sulfhydryl blockers. Fasted male Sprague-Dawley rats were given 3% NEM in 1% methyl cellulose into the colon. N-ethylmaleimide treatment caused severe diarrhoea with bleeding for the first 7 days. At autopsy, adhesions, colon dilatation, and single or multiple erosions and ulcers were observed. Time-course studies revealed that the lesions were most extensive and severe 3 or 7 days after the administration of NEM. Histological examination of colon on the 3rd day after NEM treatment demonstrated mucosal erosion, oedema and extensive infiltration of neutrophils. The mucosal lesions extended into the submucosa and muscle on the 7th day after NEM treatment. Immunohistochemical studies showed that T cells and macrophages were markedly increased in the lamina propria of colonic mucosa. After 3 weeks, the infiltration of chronic inflammatory cells was observed and regeneration of the mucosa was noticed. The thymus gland was significantly decreased in weight and size on the 3rd day after NEM treatment, but the weight loss of thymus gland was regained in 3 weeks. Transient atrophy of thymus gland was noticed in this colitis model. The phenotypes of thymocytes were not influenced by NEM treatment. It is concluded that the thymus abnormalities in human ulcerative colitis are not induced in this animal model and that other chronic models are necessary for the elucidation of the immunological abnormalities, including thymus abnormalities.     

Human Chorionic Gonadotropin-Like Substance (hCG-LS)-Producing Urothelial Carcinoma: Immunohistological Location of hCG-LS

We experienced three cases of human chorionic gonadotropin-likesubstance (hCG-LS)-producing tumors of urothelial carcinoma(two cases of renal pelvic tumor and one case of bladder tumor),which revealed high levels of luteinizing hormone in the urine,serum and tissue. The pathological diagnosis was transitionalcell carcinoma, grade III (two cases) and undifferentiated carcinoma(one case). The present study is aimed to determine the locationof hCG-LS in tumor cells by an immunohistochemical approach.By the immuno peroxidase technique using anti-hCG-ßserum, hCG-LS was located in the cytoplasm of anaplastic giantcells and trophoblastic-like cells. In two cases the diseaseprogressed rapidly, to terminate fatally in a short time. hCG-LSproducing urothelial carcinomas generally seem to contain anaplasticgiant cells and/or trophoblastic-like cells, and are suggestiveof poor prognosis.     

Continuous Intravenous Administration of l-(2-Tetrahydrofuryl)-5-Fluorouracil [FT] by Intravenous Hyperalimentation (IVH) -- Stability of FT in IVH Solution and Tumor Levels of 5-Fluorouracil (5-FU) --

The continuous intravenous administration of l-(2-tetrahydrofuryl)-5-fluorouracil(FT) to colorectal cancer patients was studied in regard tothe stability of FT in intravenous hyperalimentation (IVH) solutionsand tumor levels of 5-fluorouracil (5-FU). FT was very compatiblewith IVH solutions, because the decomposition of FT in IVH solutionwas very low, 3%. High levels of 5-FU, which is an active metaboliteof FT, were obtained in the tumors, averaging 0.369 mcg/g. Theratios of 5-FU levels in the tumor to those in serum and normaltissues were 13.6 and 3.7. respectively. The difference in 5-FUlevels between normal tissues and the tumors was statisticallysignificant (P<0.01). Therefore, continuous intravenous administrationof FT should be widely used to treat patients with colorectalcancer, as the method of administration of antitumor agents.     

Ultrastructuctural Characterization of the Extramammary Paget Cell Plasma Membrane: A Freeze – Fracture Study

The plasma membrane ultrastructure of the extramammary Paget cells was characterized by freeze-fracture electron microscopy, which was first employed for the study of Paget cells. The Paget cell plasma membrane revealed a flat fractured plane with much fewer and smaller desmosome-particle aggregations than those of the keratinocyte. No gap junctions were detected. Many intramembranous particle-free vesicles were seen in the intercellular spaces. Particle-free blebs projecting from the plasma membranes were seen on some cell surfaces. These features greatly differed from those of keratinocytes. On the other hand, an increase of gap junctions was noticed o the keratinocytes around or in the Paget's disease lesions.     

Local Recurrence after Sphincter-Saving Procedures for Carcinoma of the Rectum--An Analysis of 141 Cases--

During the past 18 years, 141 patients with rectal carcinomaunderwent curative sphincter-saving procedures. Local recurrencesoccurred in 17 patients, a recurrence rate of 12%. No significantcorrelation between the recurrence rate and the site of tumoror nodal involvement was found. Laparotomies were performedin 14 of the 17 patients with local recurrence. Thirteen patientsunderwent abdominoperineal excision. In five of them, the recurrentgrowths were completely resected, and they were thought to havedeveloped at the previously established suture line, while inthe remaining eight cases the operation was considered palliative.As the result of pathological study of these resected specimens,it is possible to draw the following conclusions:

1. The length of the distal margin of the normal bowel should bemore than 4 cm in locally advanced cases.
2. In patients whosesecond operation was not curative the recurrencesdid not developin the rectal stump or in the levator muscle,but in the pelvicwall.
3. Local recurrence after sphincter-saving procedures couldbeeffectively avoided by adequate clearance of the pararectalsoft tissues which could contain viable cancer cells, includingthe lymphatics and vessels as well as the lymph nodes.
4. Aftera sphincter-saving operation, the patient must be examinedundera strict follow-up regimen, because curative resectionof localrecurrent tumors by abdominoperineal excision willbe made possibleby earlier detection of the recurrence.

     

Muscle sympathetic nerve activity during central,mixed and obstructive apnea: Are there any differences?

Abstract  We recorded muscle sympathetic nerve activity (MSNA) from the peroneal nerve during sleep in three OSAS patients who showed three kinds of apnea. During central apneas and central component of mixed apnea, bursts of MSNA appeared in high probability with almost each heart beat. During obstructive apneas and the obstructive component of mixed apneas, bursts of MSNA appeared in a cluster after the end of each inspiratory effort. Burst rate of MSNA during apnea were higher in central apneas and the central component of mixed apnea than in obstructive apneas and the obstructive component of mixed apneas. These findings indicate that activity in the sympathetic nervous system is enhanced not only in obstructive apnea but also in central and mixed apnea.     

Prevalence of sleep-related respiratory disorders in 101 schizophrenic inpatients

Abstract We studied the prevalence of sleep-related respiratory disorders (SRRD) in 101 schizophrenic inpatients (64 men and 37 women) and in 48 healthy volunteers (control group:22 men and 26 women) using ambulatory pulse-oximetric devices. Those with a desaturation index (DI) 5 were classified as having SRRD. The prevalence of SRRD in the schizophrenic patients (men 21.9%, women 13.5%) was not higher than that in the control group (men 30.7%, women 13.6%). Gender difference in the prevalence of SRRD was not observed in schizophrenic group. This was probably because the schizophrenic women took an increased amount of sleeping pills. Neuroleptics were shown to be least effected on SRRD.     

A Case of Metachronous Multiple Carcinomas of the Gastrointestinal Tract and Sebaceous Gland

A case of multiple carcinomas, three in the stomach, six inthe colon and rectum and one in the nasal vestibule, is reported.The first carcinoma developed in the stomach when the patientwas 36 and was treated by partial distal gastrectomy in a ruralhospital. Subsequently, he received laparotomies six times in28 years, in which six independently developing carcinomas inthe stomach and colorectum were removed. Five adenomas of therectum were removed also by endoscopic polypectomy. A sebaceousgland carcinoma of the nasal vestibule was excised later. Hedied at age 64 of general carcinosis. At autopsy, two more primarycarcinomas were found, one in the stomach remnant and the otherin the descending colon. An adenoma in the right lobe of thethyroid was also found. Metastatic lesions were disseminatedto the lung, liver, lymph nodes, bone and several other organs.