Expression of interleukin-8 correlates with vascularity in human gastric carcinomas.

Interleukin (IL)-8 is a multifunctional cytokine that can stimulate the division of endothelial cells. We examined the expression of IL-8 mRNA using Northern blot analysis and in situ mRNA hybridization (ISH) and protein production using enzyme-linked immunosorbent assay and immunohistochemistry in 8 human gastric carcinoma cell lines and 39 gastric carcinomas and corresponding normal mucosa (34 surgical specimens and 5 biopsy specimens). Of the 8 human gastric carcinoma cell lines, 6 expressed 1.8-kb IL-8 mRNA and secreted various levels of IL-8 protein. The expression of IL-8 by TMK-1 cells was induced by exposure to IL-1 alpha, epidermal growth factor, and transforming growth factor-alpha, shown previously to be autocrine growth stimulators for human gastric carcinoma cells. In tumor tissues, most of the tumors (28 of 34 surgical specimens and 4 of 5 biopsy specimens) expressed IL-8 at higher levels than the corresponding normal mucosa. ISH and immunohistochemical analyses revealed that IL-8 mRNA and protein were localized in the cytoplasm of tumor cells. The number of blood vessels in the gastric carcinomas was determined by using antibodies against CD34. The level of IL-8 mRNA in the neoplasms strongly correlated with vascularization (Spearman correlation, r = 0.812; P = 0.001). The data suggest that IL-8 produced by tumor cells may regulate neovascularization and, hence, the growth and spread of human gastric carcinoma.     

Danaparoid reduces transplant‐related mortality in stem cell transplantation for children

In SCT, death from transplant‐related complications is the major obstacle hindering improvement of transplant outcomes, and proper supportive care is essential to reduce TRM. The transplant outcomes of 210 pediatric patients with malignant and non‐malignant disorders who consecutively underwent SCT in our institution from 2000 to 2013 were analyzed. The transplant years were divided into three periods: A (2000‐2004), B (2005‐2008), and C (2009‐2013), and an improvement in 5‐year OS and a decrease in 5‐year TRM were observed over these time periods; that is, OS was 61.5%, 60.3%, and 79.5% (P = .062), and TRM was 19.9%, 7.9%, and 0.0% (P < .001) in periods A, B, and C, respectively. On multivariate analysis, the prognostic factor for TRM for all patients was administration of danaparoid (HR = 0.109, 95% CI = 0.033‐0.363, P < .001), and for patients with hematological malignancies in allogeneic SCT, the prognostic factors were danaparoid (HR = 0.046, 95% CI = 0.006‐0.326, P = .002) and advanced disease at SCT (HR = 4.802, 95% CI = 1.734‐13.30, P = .003). A reduction in TRM after SCT was observed over the time periods, and supportive care with danaparoid was found to be significantly effective in reducing TRM in SCT for children.     

AN ULTRASTRUCTURAL STUDY ON PRECANCEROUS AND CANCEROUS LESIONS OF THE GLANDULAR STOMACH IN RATS INDUCED BY N-METHYL-N'-NITRO- N-NITROSOGUANIDINE

Electron microscopic study was made on precancerous and cancerous lesions in glandular stomach of rats induced by MNNG. Three types of lesions, were found; regenerative glandular hyperplasia, adenomatous hyperplasia and adenocarcinoma. These were compared with the fine structure of similar lesions produced by X-irradiation in the glandular stomach of mice. The precancerous lesion in the present study demonstrated formation of adenomatous hyperplasia by epithelial cells which included mucoid cells characterized by sparce surface microvilli, a few erratic terminal webs, small number of mucous granules, many small mitochondria, and a bizarre nucleus. The development of these mucoid cells seems to be related with the growth of gastric carcinoma. The ultrastructure of adenocarcinomas revealed many structural variations or abnormalities of cellular differentiation. They were classified into 1) surface and pit mucous cell type, 2) pyloric gland cell type, 3) goblet cell type, 4) paneth cell type, 5) intestinal epithelial cell type, 6) endocrine cell type, 7) oncocyte type, 8) filament-rich cell type, and 9) anaplastic cell type involving intracellular microcyst cells. Filament-rich cells were found in poorly differentiated adenocarcinoma or scirrhous carcinoma and may be derived from metaplasia of tumor cell.     

Combined cuff and suture technique for orthotopic whole intestinal transplantation in rats

For the purpose of immunological study on small intestinal transplantation (SIT), rat SIT models using direct suture technique widely have been used, which requires at least several months of training for microsurgery. Alternatively, a simple cuff technique for SIT has been mainly used by us, which reduces warm-ischemic time and the training period, but the entire intestinal grafts usually obtain a limited blood supply. This report describes a modification of a combined cuff and suture technique for rat SIT to aid beginning microsurgical transplantation researchers. The advantages are 1) use of only arterial suturing, making it easier for beginners, with the cuff technique applied to the more difficult vein anastomosis; 2) achievement of better arterial inflow and graft survival than when the arterial cuff technique is used; and 3) doing only partial clamping of the aorta, which improves animal survival and success of the procedure. A very high successful rate in orthotopic whole SIT was achieved even by beginners.     

Osteomalacia and vitamin D deficiency in hemodialyzed patients

Aluminum accumulation in plasma and tissues is a well-described complication among patients undergoing hemodialysis. Although the ratio of aluminum-induced osteomalacia has been decreasing year by year, there are still considerably many problems in such patients. Sources of aluminum now include food, drugs, and cooking tools. Besides, iron and strontium accumulations also induce osteomalacia. Early and accurate diagnosis of such metal toxicities is important because effective therapy is available.     

Effects of combined therapy with interleukin 2 and interleukin 12 gene-transfected tumor vaccine for head and neck carcinoma

BACKGROUND: The biological effects of cytokines are coming to be understood. The therapeutic effects of interleukin (IL) 2, IL-12, and interferon gamma (IFN-gamma) in cancer treatment have been reported, but there are problems when these cytokines are systemically used as therapeutic agents. OBJECTIVE: To examine the efficacy of IL-2 and IL-12 gene-transfected tumor cell vaccines for head and neck squamous cell carcinoma (SCC). METHODS: Homozygous mice with the autosomal recessive nude gene (BALB/c nu/nu mice) were inoculated subcutaneously in the right flank with cells from a human oral floor SCC cell line (KB cells). The mice were then injected with IL-2 and IL-12 gene-transfected KB cells (KB/IL-2 and KB/IL-12 cells, respectively) irradiated with 2000 rad (20 Gy). RESULTS: No mice died soon after the injection of the gene immunotherapy. The treatment with either KB/human IL-2 (hIL-2) or KB/murine IL-12 (mIL-12) was not very effective. However, the treatment with both KB/hIL-2 and KB/mIL-12 cells significantly and safely inhibited the growth of established tumors (P =.04). There was no significant difference in antitumor effect between once-weekly and twice weekly injections of both KB/hIL-2 and KB/mIL-12 cells. CONCLUSION: Double gene immunotherapy is safe and effective treatment for SCC in mice.     

Comparison of body size and composition between young adult Japanese-Americans and Japanese nationals in the 1980s

BACKGROUND: Data on body composition of American-born Japanese (Japanese-Americans) are scarce. Studies on differences of body composition between Japanese-Americans and Japanese nationals at various stages of life as well as at various times of measurements are useful for understanding the impact of lifestyle changes on body composition in the two societies. AIM: To see the differences in body size and composition between young adult Japanese-Americans and Japanese nationals. SUBJECTS AND METHODS: Body size and composition of 50 Japanese-Americans consisting of 28 males and 22 females ranging in age from 18 to 23 years were compared with Japanese nationals matched for age and height. Body composition was measured using the underwater weighing method. The study was conducted in the 1980s in the USA and Japan. RESULTS: The average percentage body fat of males was 13.7% for both Japanese-Americans and Japanese nationals, and that of females was approximately 24% for both groups, even though Japanese-American males and females had significantly greater body weight, fat-free mass, and body mass index than Japanese nationals. CONCLUSION: Although young adult Japanese-Americans showed larger body size than Japanese nationals, their percentage fat did not differ at this stage of life in the 1980s.     

Evaluation of the management of blunt renal trauma and indication for surgery

OBJECTIVES: Appropriate management of renal trauma is still controversial. Many of the patients have minor injuries and conservative treatment can achieve excellent outcomes without any complications. For major injuries of deep lacerations or ruptures, we have been performing early surgical treatment to salvage the kidney in the selected cases after the precise evaluation of the injury. To obtain the optimal management options, we evaluated the clinical results of our procedures. PATIENTS AND METHODS: We conducted a retrospective study, which included 106 cases of blunt renal trauma with evident etiology over the past 22 years and 9 months. The severity of the injury was evaluated mainly by CT scanning. The indication of renal exploration included persistent renal bleeding, large hematoma around the kidney, dislocated fragments, nonviable tissue, massive urinary extravasation and vascular injury. With the patients who required an operation, we first controlled the bleeding by clamping the hilar vessels. Then, the final decision whether to repair or remove the kidney was made based on the direct inspection of the injured kidney after the complete removal of the hematoma. The severity of renal trauma was classified by the classifications found in The Organ Injury Committee of the American Association for the Surgery of Trauma. RESULTS: Sixty-three patients were managed conservatively without any interventions, while 22 surgical repairs and 21 nephrectomies were performed. Of the 63 patients, 35 patients (81.4%) were operated on within 2 days after the injury. Judging from systolic blood pressure, red cell count, blood loss during surgery and transfusion requirements, surgically treated patients were more severely injured than conservatively treated patients. And nephrectomized patients than surgically repaired patients. All the surgically repaired cases were confirmed to have preserved renal functions postoperatively. In all of the 50 patients with Grade I injuries, conservative treatment was successful. Eight out of the 19 Grade II and III cases, who were indicated for kidney exploration because of multiple lacerations or considerable bleeding, were also successfully repaired. Localized hematoma with no urine leakage, even when it was large, settled spontaneously without complication. For the 37 Grade IV and V injuries, including 4 cases with hilar injuries, we implemented conservative procedures on 2 patients, surgical repair on 14 patients and nephrectomy on 21 patients. In the conservatively treated cases, one deep laceration with relatively large, but localized, hematoma, and minimal urine extravasation healed spontaneously. Atrophy of the segment and hypertension developed in the other ruptured kidney with dislocated fragments, large hematoma and urine leakage. This kidney, which also required later surgical exploration, did have good parenchymal blood flow. Hilar injury cases were all resulted in nephrectomy. CONCLUSION: In most of our cases the indication for surgical exploration or nephrectomy based on our criteria seemed to be properly decided. Several cases, though, might have received overtreatment. Recent advances in evaluations and strategies of renal trauma have decreased the need for surgical exploration. This may have overreached the indication for conservative management. Severely injured kidneys may be managed conservatively because in most cases bleeding settles after the full formation of large hematoma within the Gerota's fascia. In such cases, though, no one can predict whether the injury will heal spontaneously or not, and, moreover, whether a complication will develop or not. We think that the optimal management of the patient requires an accurate evaluation of the injured kidney. Therefore the indication for surgical exploration should be made based on the degree of the injury.     

Cardiac lymphangioma: case report and review of the literature

Cardiac lymphangioma is uncommon and constitutes one of the rare forms of cardiac diseases. A 6-year-old girl had an abnormal electrocardiogram in a screening test on admission to an elementary school. Echocardiogram, computed tomogram, and magnetic resonance imaging showed a mediastinal multicystic mass that was adjacent to the left ventricle of the heart. The tumor was found to be originated in myocardium by left thoracotomy and pericadiotomy. A partial resection of tumor and a pericardial window were done. This case, to the authors' knowledge, represents the sixth reported case of cardiac lymphangioma. J Pediatr Surg 37:E32.