p53 status and prognosis in stage I-IIIa non-small cell lung cancer

To investigate the role of p53 abnormalities in predicting the survival of patients with non-small cell lung cancer (NSCLC), polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and immunohistochemical analyses were performed on 74 and 67 tumor samples, respectively, from patients with pathological stage I-IIIa NSCLC. An abnormally migrating SSCP band was observed in 21 of 74 (28%) tumor specimens. DNA sequence analysis revealed 23 intragenic mutations including 3 small deletions and 20 point mutations. Immunohistochemical analysis using the DO-7 monoclonal antibody showed abnormal expression of p53 in 27 of 67 (40%) patients. The concordance rate between immunohistochemical and PCRSSCP analyses was 73% (49/67) in this study. Univariate and multivariate analyses demonstrated that abnormal expression of p53 may be associated with prolonged survival (p=0.0997 and 0.0099, respectively). In contrast, no relationship was observed between p53 mutation and overall survival (0.6968). These results suggest that p53 status and the survival outcome changes between immunohistochemical and mutational analyses in stage I-IIIa NSCLC.     

The effects of oligomers content and surface morphology on foreign-body tumorigenesis with polyetherurethanes: two years subcutaneous implantation study in rats

Three polyurethane materials were prepared by removing and adding the leachable oligomers from and to the same polyetherurethane (PEU). The three PEU materials were dissolved in tetrahydrofuran (THF) and dimethyformamide (DMF) and the solutions were cast on a glass plate to make films of smooth and foamed surfaces, respectively. These six materials and polydimethylsioxane (silicone) were implanted into subcutaneous pocket of rats for 2 years to evaluate the long-term effects around the implant. Among the smooth surface implants, PEU materials induced a higher incidence of tissue responses, including tumor formation than silicone. However, no relationship between the oligomer content and the tissue responses was found. Changing surface morphology from a smooth to a foamed one prolonged the latent period of tumor development and decreased the total tumor incidence.     

Quantification of cerebral blood flow using 123I-IMP SPECT--a new method of estimating the input function from brain dynamic data

In order to avoid continuous arterial blood sampling, we estimated input function by the method in that the whole brain time activity curves were fitted by two-term exponential function and differentiated analytically after the injection of N-isopropyl-p-[123I]iodoamphetamine (123I-IMP). This method was applied to 4 patients with cerebral infarction and 2 patients with brain tumor. Values of regional cerebral blood flow (rCBF) were calculated from the input function calibrated by one-point arterial sampling at 5 minutes after the injection using microsphere method, and then were compared with those obtained from the table-lookup method. In this study, we used the individual input function for the table-lookup method instead of the standard input function. The overall accuracy errors between two-term exponential functions and the whole brain time-activity curves were about 1%. The values of rCBF calculated by this method were well correlated with those by the table-lookup method (r = 0.901, p < 0.001). Optimal calibration time for this method was between 3-minute and 10-minute after 123I-IMP injection and the deviation of the rCBF values obtained by this method from those obtained by the table-lookup method in which the input function was calibrated at 5 minutes remained within 10%. This method is a less invasive and convenient alternative to the conventional methods which require continuous arterial blood sampling.     

Cerebellopontine angle pilocytic astrocytoma mimicking acoustic schwannoma

We describe a case of pilocytic astrocytoma of the cerebellum mimicking an acoustic schwannoma. The tumour protruded into the porus acusticus and enlarged the internal auditory meatus, which is a quite unusual characteristic of glial tumours. Received: 2 February 1999 Accepted: 21 April 1999     

Non-invasive continuous hemodynamic measurement during operation for a child with coarctation of aorta

For non-invasive hemodynamic monitoring, DYNEMO 3000 (SOMETEC Inc) has a 10 mHz ultrasonic echo scan and a 5 mHz Doppler velocimeter connected to an echo-oesophageal probe allowing continuous measurement of the aortic diameter and of the blood flow velocity in the descending aorta. This device thus can only measure the aortic blood flow, but also calculate the stroke volume and the systemic vascular resistance. Moreover, the systolic time intervals and the length of the pre-ejection period can be measured with the oscillometric tensiometer and the electrocardiography. This paper describes a case in which this device was used for a child with coarctation of the aorta. The hemodynamic changes were measured continuously during coarctectomy. During the temporary bypass, the aortic blood flow and the stroke volume decreased, but on the other hand, the total vascular resistance increased at the same time. After the bypass, these parameters returned to the values before the bypass. We think that this device is useful as a non-invasive monitor to observe the hemodynamic changes continuously during operation for a child with congenital heart disease.     

Utility of endoscopic ultrasonography in assessing the indications for endoscopic surgery of submucosal esophageal tumors

BACKGROUND: The submucosal tumor (SMT) of the esophagus presents good indications for minimal invasive surgery, such as endoscopic or thoracoscopic resection. However, it is essential that the layer of origin be ascertained. The SMT can be detected as hypoechoic lesions in the wall of the esophagus, and the intramural location can be estimated in terms of destruction or deviation of the ultrasonic layer structure of the esophagus. METHODS: To test the efficacy of this approach, a series of patients were examined by an endoscopic ultrasonography (EUS). RESULTS: In one patient, the lesion was diagnosed as located in the muscularis mucosa, and endoscopic resection was performed. In another four patients, the lesions appeared to be in the proper muscle layer, and enucleation was carried out under thoracoscopy or open surgery. Histologically, all of the lesions were leiomyomas, and the EUS diagnosis was correct in all of the patients. CONCLUSIONS: Thus, the intramural condition of SMTs can be estimated and indications for endoscopic or thoracoscopic resection assessed by this approach.     

Surgical treatment of a case of early infantile epileptic encephalopathy with suppression-bursts associated with focal cortical dysplasia

We report a surgically treated case of early infantile epileptic encephalopathy (EIEE) with suppression-bursts associated with focal cortical dysplasia. Tonic-clonic seizures followed by a series of spasms occurred about a hundred times a day at a few days of age. Interictal electroencephalogram (EEG) revealed a suppression-burst pattern that was predominant in the left hemisphere. Magnetic resonance imaging (MRI) suggested focal cortical dysplasia in the left prefrontal area. Combination therapies with antiepileptic treatments showed only partial efficacy. The patient underwent lesionectomy at age 4 months, after which he gradually showed psychomotor development and a decrease of spasms to 0-2 series daily. In cases of EIEE with focal cortical dysplasia, surgical treatment may have beneficial effects on both psychomotor development and seizure control.