Development of multifocal duodenal erosions after anti-Helicobacter pylori triple therapy.

BACKGROUND AND PURPOSE: Anti-Helicobacter pylori triple therapy is effective for healing duodenal ulcer (DU) diseases and reducing disease recurrence. However, multifocal duodenal erosions or shallow ulcers may develop after triple therapy. The purpose of this study was to investigate the incidence and outcome of duodenal erosions that developed after triple therapy. METHODS: A total of 106 Taiwanese with active DU and with H. pylori infection were enrolled in this study. All patients received anti-H. pylori triple therapy (i.e., 2 weeks of antimicrobial agents combined with treatment for 4 to 6 weeks with acid suppression agents). Follow-up endoscopy was performed immediately after stopping treatment. The incidence of multifocal erosions or shallow ulcers over the bulb and/or second portion of the duodenum was studied. Additional acid suppression agent was given for 4 weeks whenever duodenal erosions or shallow ulcers were found. RESULTS: Out of 106 patients, 11 (10.4%) were found to have multifocal duodenal erosions and/or shallow ulcers on the duodenal bulb and/or second portion of the duodenum at the end of treatment. Ten of the 11 patients with newly developed erosions had healed DU in the S1 or S2 stage, and all 11 had successful H. pylori eradication. The duodenal erosions and/or shallow ulcers of these 11 patients were healed after an additional 4 weeks of histamine-2-receptor antagonist therapy. CONCLUSIONS: Multifocal duodenal erosions and/or shallow ulcers were noted in around 10% of Taiwanese DU patients who received anti-H. pylori triple therapy. An additional 4 weeks therapy with acid suppression agents healed these lesions.     

Suppressive effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the high-affinity antibody response in C57BL/6 mice.

In the humoral immune response to an invasion of foreign antigens, B cells differentiate into low-affinity antibody-forming cells (AFCs) that mainly secrete IgM or, through germinal center (GC) formation, into high-affinity AFCs that secrete IgG-class antibodies with a higher affinity for the antigen. Previous studies have established the suppressive effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on low-affinity antibody responses to antigens. However, whether and how TCDD affects the high-affinity antibody response to antigens has not yet been clarified. In this paper we investigate the effects of TCDD on GC formation, high-affinity AFC generation, and high-affinity antibody production in the primary humoral immune response. C57BL/6 mice were orally administered 0 or 20 microg/kg of TCDD and subsequently immunized with alum-precipitated ovalbumin (OVA) on day 0. Then the GC formation in the spleen and OVA-specific antibodies in the plasma, was evaluated until day 14 postimmunization. TCDD exposure reduced the production of OVA-specific IgG1 on days 10 and 14. GC formation in the spleen was also suppressed by TCDD exposure, and the suppression persisted from day 7 until day 14. In TCDD-administered mice, on day 7, cellular proliferation in the GCs was significantly suppressed, although apoptosis was not markedly affected. In order to measure high-affinity antibody and high-affinity AFCs, the mice were administered TCDD followed by immunization with alum-precipitated (4-hydroxy-3-nitrophenyl) acetyl linked to chicken gamma-globulin (NP-CG). The frequency of high-affinity NP-specific AFCs that bind to low-haptenated antigen was clearly shown to be reduced in the spleen on days 10 and 14. Furthermore, the high-affinity anti-NP IgG1 levels on days 10 and 14 postimmunization were significantly reduced by TCDD exposure. Taken together, the results of this paper demonstrate that TCDD exposure inhibits the generation of high-affinity AFCs and high-affinity antibody production during the primary humoral immune response and suggest that these alterations were caused by the suppression of antigen-responding B-cell proliferation induced by TCDD during GC formation.     

Possible dominant-negative mutation of the SHIP gene in acute myeloid leukemia.

The SH2 domain-containing inositol 5'-phosphatase (SHIP) is crucial in hematopoietic development. To evaluate the possible tumor suppressor role of the SHIP gene in myeloid leukemogenesis, we examined primary leukemia cells from 30 acute myeloid leukemia (AML) patients, together with eight myeloid leukemia cell lines. A somatic mutation at codon 684, replacing Val with Glu, was detected in one patient, lying within the signature motif 2, which is the phosphatase active site. The results of an in vitro inositol 5'-phosphatase assay revealed that the mutation reduced catalytic activity of SHIP. Leukemia cells with the mutation showed enhanced Akt phosphorylation following IL-3 stimulation. K562 cells transfected with the mutated SHIP-V684E cDNA showed a growth advantage even at lower serum concentrations and resistance to apoptosis induced by serum deprivation and exposure to etoposide. These results suggest a possible role of the mutated SHIP gene in the development of acute leukemia and chemotherapy resistance through the deregulation of the phosphatidylinositol-3,4,5-triphosphate (PI(3,4,5)P3)/Akt signaling pathway. This is the first report of a mutation in the SHIP gene in any given human cancer, and indicates the need for more attention to be paid to this gene with respect to cancer pathogenesis.     

跨声门癌50例观察

为确立一种原发喉室的跨声门癌，选择肿瘤主体以喉室为中心经全喉切除手术的标本５０例，火棉胶包埋，连续切片观察。结果发现①跨声门癌的肿瘤原发部位在喉室，５０例中有Ｔ２３例。②肿瘤以深层浸润为主占９０％（４５／５０），易侵及声门旁间隙（８２％，４１／５０）和甲状软骨（６４％，３２／５０），临床分期与病理分期不符达４８％（２４／５０）。结论：原发喉室的跨声门癌是声门上型癌的一种特殊类型。     

HPLC测定佛手增乳膏中阿魏酸的含量

佛手增乳膏经乙醚，2％碳酸钠液萃取后，用HPLC测定阿魏酸的含量。方法简便，快速，准确。     

喉近全切除喉功能重建术

目的 为了减少喉全切除率并重建喉功能。方法 自１９９１￣１９９６年作喉近全切除喉功能重建术１９例。男８例，女１１例。年龄最大７４岁，最小４０岁，平均５７．６岁。临床分期Ⅱ期２例，Ⅲ期９例，Ⅳ期８例。手术特点是：切除舌骨，保留环状软骨及一侧杓状软骨，将五状软骨前缘与舌根切缘吻合，增强了舌根对新喉口的遮盖作用，减轻了误咽．结果 全部病例术后发音功能良好，多数病例误咽不重。５例拔除套管经喉呼吸。１４例新     

膀胱粘膜下层无细胞基质的研制

目的 探讨膀胱粘膜下层无细胞基质的制作与评价。方法 自膀胱解剖出膀胱粘膜下层，置于PBS、0．5％SDS、双蒸水中反复洗涤去除细胞，必要时加用胰蛋白酶消化。获得的细胞外基质采用HE、免疫组化、扫描电镜评价去细胞效果，细胞植入无细胞基质观察细胞能否粘附于该材料。结果 HE、免疫组化、扫描电镜均未见制备的材料中存在细胞及细胞碎片，体外细胞植入试验见细胞可粘附于材料并增殖。结论 采用本制备方法可以得到膀胱粘膜下层无细胞基质，有望为临床提供尿道下裂生物替代材料。     

DIAGNOSIS AND TREATMENT OF MEDIASTINAL ENTEROGENOUS CYSTS IN CHILDREN

MEDIASTINAL enterogenous cysts are congen-ital anomalies rarely seen in the pediatric agegroups.Most children are first admitted tohospital due to respiratory symptoms.Neonates and littleinfants often have the symptom of respiratory distress,while a few a…