Cancer of esophagus and esophagogastric junction: analysis of results of 1,025 resections after 5 to 20 years

Resection was carried out in 1,025 of 1,654 patients with cancer of the esophagus or esophagogastric junction at the Peking Medical College Hospitals in China from 1953 through 1973. All cancers of the esophagus were squamous cell carcinomas except for five adenocarcinomas. A lesion localized within the esophageal wall was found in 55% and lymph node metastasis in 41.3% of the patients undergoing resection. All cancers of the esophagogastric junction were adenocarcinomas. The tumor had invaded beyond the boundaries of the stomach in 76.7% of these patients, and positive nodes were found in 61% of the patients. The rate of resectability was 81.2% for esophageal cancer and 74% for cancer of the esophagogastric junction. Surgical mortality after resection was 4.9% (50/1,025). The 5-year survival after resection was 20.9% (214/1,025). Better results were found following complete resection: 24% (210/875) for all patients, 28.2% (162/575) for patients with cancer of the esophagus, and 16% (48/300) for patients with cancer of the esophagogastric junction. Late survival at 10, 15, and 20 years after resection of esophageal cancer was 20%, 12%, and 7.4%, respectively. The favorable prognostic factors after resection of esophageal cancer were tumor of the lower third of the esophagus, the absence of lymph node involvement, and the presence of a localized lesion. The 5-year survival for patients with cancer of the lower third of the esophagus was 32.7%. It was 64.2% for patients with a localized lesion with negative nodes in this subgroup.     

The plasminogen-activation system in ovarian tumors

We studied the plasminogen activation system in tumor tissue by measuring the antigen level of the 2 plasminogen activators, tissue-type (t-PA) and urokinase-type (U-PA) and their inhibitors, plasminogen-activator inhibitors type-1 (PAI-1) and type-2 (PAI-2) in the tissue extracts of 43 human benign and malignant ovarian tumors. U-PA levels were significantly higher in malignant than in benign tumors. In addition, U-PA antigen levels were higher in the metastatic tissue of advanced disease (FIGO stage III) than in the primary localized tumor (FIGO stage I/II). Also PAI-1 concentrations tended to be higher in malignant than in benign tumors, but this difference was not statistically significant. In contrast, t-PA levels were lower in metastatic than in non-metastatic tumors, whereas PAI-2 levels were unrelated to the stage of ovarian malignancy. These results were integrated in a plasminogen-activation-dependent malignancy index (U-PA × PAI-1/t-PA). This index distinguished the different groups of benign ovarian tumors, localized and metastatic ovarian carcinomas better than U-PA levels. It could be useful as a prognostic indicator in ovarian cancer © 1993 Wiley-Liss, Inc.     

Fictive oesophageal peristalsis evoked by activation of muscarinic acetylcholine receptors in rat nucleus tractus solitarii

The aim of the present study was to determine if muscarinic acetylcholine receptor-mediated peristaltic rhythmogenesis in the rat oesophagus is a central motor program that can be generated without peripheral sensory support. In anaesthetized male Sprague-Dawley rats, pressure-ejection of glutamate (10–20 pmol) and muscarine (5–10 pmol) in the subnucleus centralis of the nucleus tractus solitarii (NTS_C) evoked monophasic pressure waves and rhythmic oesophageal peristalsis, respectively, but did not change mean arterial blood pressure or respiration. Application of muscarine (50–100 pmol) to the NTS extraventricular surface evoked rhythmic multi-unit burst discharges in the compact formation of the nucleus ambiguus (AMB_C) that led to oesophageal peristalsis in a phase-locked manner. Evoked rhythmic AMB_C activity persisted during neuromuscular blockade with curare, although the peak frequency of individual bursts was decreased. In a brainstem slice preparation, intracellular and whole cell patch recordings from AMB_C neurones during focal stimulation of the NTS_C region with muscarine revealed rhythmic depolarizing waves that showed a pattern similar to that of rhythmic oesophageal peristalsis. The present findings support the concept that medullary circuits comprising premotor neurones of the NTS_C are intrinsically capable of generating rhythmic oesophagomotor output, but are subject to a powerful modulation by peripheral sensory feedback.     

感染患者血清可溶性细胞间粘附分子含量的变化及其对脑梗死的影响

目的：探讨感染合并脑梗死患者血清可溶性细胞间粘附分子（sICAM-1)的变化及临床意义。方法：采用双抗体（ELISA）法测定50例感染合并脑梗死患者血清中sICAM-1的含量，并与30例脑梗死患者和30例健康人对照。结果：感染合并脑梗死患者急性期血清sICAM-1的水平明显高于对照组。结论：感染合并脑梗死时sICAM-1的表达明显升高，sICAM-1水平的增高加重了脑梗死的发生发展。     

松花粉对人肺成纤维细胞增殖活性影响的实验研究

目的 :研究松花粉对人肺成纤维细胞增殖的影响 ,探讨中药松花粉可能的作用机理。方法 :松花粉作用于人肺成纤维细胞不同时间后观察细胞生长速度 ,应用台盼蓝对细胞进行染色 ,测定细胞死亡率。松花粉浓度分别为 10 0、2 0 0、40 0、80 0mg·L-1,以未经松花粉处理的细胞为对照。结果 :松花粉作用于人肺成纤维细胞能够明显促进细胞群体倍增水平 ,降低死亡细胞数目 ,且呈剂量依赖关系。结论 :松花粉可通过促进细胞生长而影响细胞增殖。     

Validation of the Taiwan Birth Registry using obstetric records.

BACKGROUND AND PURPOSE: Birth certificates are a major source of population-based data often used in maternal and child health research, but their value depends upon the level of accuracy of the data. The purpose of this study was to assess the validity of the birth registry data in Taiwan. METHODS: Obstetric records of a total of 2779 infants born at a municipal hospital in Taipei between 1995 and 1997 were abstracted and linked to the Taiwan Birth Registry (TBR). Concordance was presented by agreement percentages for various birth characteristics including gender, birth order, birth weight, and gestational age. Concordance was further assessed using Cohen's k and sensitivity/specificity for both birth weight and gestational age, with both variables categorized according to their customary definitions. RESULTS: Missing data for specific items in the TBR ranged from 0% (gender) to 1.6% (birth order). The birth registry accurately reported all 4 selected items, with the highest and lowest concordance percentage noted for gender (99.0%) and gestational age (88.3%), respectively. The level of agreement indicated by the Cohen's k statistic ranged from 0.92 to 0.96 for birth weight and gestational age when both variables were treated as categorical variables. CONCLUSIONS: The TBR showed a low rate of missing information and high levels of validity for the elements frequently used in maternal and child health research in Taiwan.     

Carvedilol protects ischemic cardiac mitochondria by preventing oxidative stress.

Ischemia negatively affects mitochondrial function by inducing the mitochondrial permeability transition (MPT). The MPT is triggered by oxidative stress, which occurs in mitochondria during ischemia as a result of diminished antioxidant defenses and increased reactive oxygen species production. It causes mitochondrial dysfunction and can ultimately lead to cell death. Therefore, drugs able to minimize mitochondrial damage induced by ischemia may prove to be clinically effective. We analyzed the effect of carvedilol, a beta-blocker with antioxidant properties, on mitochondrial dysfunction. Carvedilol decreased levels of TBARS (thiobarbituric acid reactive substances), an indicator of oxidative stress, which is consistent with its antioxidant properties. Regarding cell death by apoptosis, although ischemia did increase caspase-8-like activity, there were no changes in caspase-3-like activity, which is activated downstream of caspase-8; this may indicate that the apoptotic cascade is not activated by 60 minutes of ischemia. We conclude that carvedilol protects ischemic mitochondria by preventing oxidative mitochondrial damage, and, by so doing, it may also inhibit the formation of the MPT pore.     

An oral selective M3 cholinergic receptor antagonist in COPD.

Cholinergic antagonists have been used since the early 1900s as bronchodilators for chronic obstructive pulmonary disease (COPD). The present study investigated whether an oral muscarinic M3-selective anticholinergic agent (OrM3) would provide an improved therapeutic advantage compared with an inhaled anticholinergic agent in patients with COPD. A 6-week, multicentre, randomised, placebo- and active-controlled, parallel-group study was performed at 56 sites in the USA. In total, 412 male and female patients (aged 35-86 yrs) with a clinical history consistent with COPD were randomised to receive OrM3 0.5, 2, 3 or 4 mg orally once daily, ipratropium bromide 36 mug by inhalation four times daily or placebo. OrM3 demonstrated a significant dose-related improvement in serial forced expiratory volume in one second and a trend for dose-related improvement in patient-reported symptoms compared with placebo. However, at a dose that provided efficacy less than that of ipratropium, the incidence of dose-related, mechanism-based side-effects for OrM3 exceeded those observed for ipratropium. In patients with chronic obstructive pulmonary disease, the oral M3-selective agent did not offer a therapeutic advantage over inhaled ipratropium. These results do not support the hypothesis that high selectivity for muscarinic M3 receptors over airway neuronal M2 receptors will represent a more effective therapy than current inhaled anticholinergics in obstructive airway disease.