Significance of the 14q32 translocations in childhood acute lymphoblastic leukemia

To assess the frequency and significance of 14q32 translocation abnormalities in childhood acute lymphoblastic leukemia (ALL) and the differences between the clinical and cytogenetic features of patients with the 8; 14 translocation and those of patients with other 14q32 translocations, we analyzed our experience with 124 consecutive cases with completely banded karyotype. Eight cases (6.5%) with 14q32 translocation were identified :5 with the 8; 14 translocation and 3 with other 14q32 translocations. As compared with ALL children lacking 14q32 translocations, these 8 cases had a higher serum lactic dehydrogenase (LDH) level, more L3 (FAB classification), and a poorer outcome. On the other hand, in comparison with ALL patients with other 14q32 translocations, patients with the 8:14 translocation were likely to be younger (median age 4.5 years vs 10.4 years), to have a higher serum LDH level (median 5832 IU/l vs 504 IU/l), to have more L3 (3/5 vs 0/3), to have a higher induction failure rate (4/5 vs 1/3), and to have more partial duplication of the long arm of chromosome 1 (4/5 vs 0/3). These results helped clarify the characteristic features of ALL children with 14q32 translocations and showed that ALL children with the 8 ; 14 translocation have different clinical and cytogenetic findings from those of ALL children with other 14q32 translocations.     

Clinico-pathological study of autopsy cases of nonresected gastric cancer in the young and old

To elucidate the difference between the natural history of gastric cancer in young and old patients, this study was carried out. Fifty-four cases were studied, representing the autopsy findings of gastric cancer patients who did not undergo operation. The characteristics of the gastric cancer in the young patients were as follows: had infiltrative macroscopical types, had histologically diffuse types, had deeper and wider infiltration, showed a severer invasion into the vessels, and, showed marked lymphatic disseminated, and distant metastasis. The elderly, in comparison, showed various types of gastric cancers. The extension of the cancer in the old group was significantly, less than in the young, even in the same diffuse type. The period from the onset to death was almost same in both groups. The age of the host seems one of the important factors influencing the natural history of gastric cancer.     

Interstitial fluid pressure in the facial nerve: relationship between facial nerve pressure and cerebrospinal fluid pressure

The possibility of measuring interstitial pressure in the facial nerve using a servo-nulling system was investigated. As a pilot study, interstitial fluid pressure in the extirpated medulla oblongata was measured using this system, and was found to be proportional to the pressure applied to the surrounding tissue block. Interstitial fluid pressure of the facial nerve in guinea pigs was also measurable with this system. The pressure in the facial nerve fluctuated with respiration and/or heart beat, as did CSF pressure. Respiratory fluctuations in facial nerve and CSF pressures ceased when the respirator was stopped. Facial nerve pressure appeared to be closely related to CSF pressure; the injection of saline into the CSF space resulted in an increase in facial nerve pressure. Measurement of facial nerve pressure by a servo-nulling system should be useful in evaluating the pathogenesis underlying facial palsy.     

Chronic expanding intrapericardial hematoma after coronary artery bypass surgery presenting with congestive heart failure.

We report the successful treatment of a rare case of chronic expanding intrapericardial hematoma that had slowly developed into a large mass after coronary artery bypass surgery. An 85-year-old man with a history of coronary artery bypass surgery presented with dyspnea on exertion and leg edema in 2006. Chest roentgenograph demonstrated right pleural effusion and severe pulmonary edema. An echocardiographic study demonstrated a mass located posterior to the left ventricle that severely compressed the left ventricle toward the ventricular septum. Surgical resection of the mass was planned to release the symptoms and to confirm the diagnosis of the mass. The mass was completely resected through a left thoracotomy, and the histological findings confirmed the diagnosis of a chronic expanding intrapericardial hematoma. The patient's postoperative course was uneventful, and his symptoms improved markedly. There has been no sign of recurrence 1 year after the operation.     

A case of hereditary cherubism

We report one case of hereditary cherubism involving two generations. Cherubism is a rare noneoplastic bone lesion of the jaws that causes a progressive, painless, symmetrical expansion of the maxilla and mandible. A 5-year-old boy was referred to our hospital requesting examination and treatment, with the chief complain of painless, bilateral, symmetrical swelling. In a local hospital, biopsy was performed and histological findings revealed giant cell granuloma. His mother and his uncle had been diagnosed with cherubism and were both treated surgically during childhood. Radiographs and CT images showed multilocular, well-defined, cystic spaces causing expansion of the bilateral mandibular angles and sparing only a thin layer of cortex. Radiographic findings of the mother's mandible were similar to these of the present case.     

Intracellular alkalosis stimulates potassium secretion in rabbit CCD

Background. Clinically, it is well known that alkalosis induces hypokdemia, but the precise mechanisms of these interactions between acid-base disturbances and potassium homeostasis are not known with certainty. The role of intracellular alkalosis in the regulation of transepithelial potassium transport was examined in rabbit cortical collecting ducts (CCD). Methods. Intracellular alkalosis was induced by 25 mM N-2 hydroxyethylpiperazine-N′-2-ethanesulfonic acid (HEPES) buffer in which bicarbonate and CO₂ were eliminated. Intracellular pH (pHi) was measured by the load of 2′,7′-bis(2-carboxyethyl)-5(6)-carboxyfluorescein (BCECF) dye in principal cells. Isolated CCD was perfused in vitro, and electrophysiological studies and electrolyte transport studies were performed with or without HEPES buffer. Results. Basal pHi in the Krebs-Ringer-Bicarbonate solution was 7.11 ± 0.06. Alkalization by HEPES buffer solution (pH 7.4) resulted in pHi 7.54 ± 0.16. Intracellular alkalization induced by HEPES solution significantly hyperpolarized transepithelial voltage, while net potassium flux increased from −17.3 ± 3.6 to −21.0 ± 3.4 pmol·min⁻¹·mm⁻¹. However, lumen-to-bath isotope sodium flux did not change. The basolateral membrane voltage of the principal cells increased from −74.6 ± 3.0 to −79.6 ± 2.9 mV and transepithelial resistance decreased significantly from 113.1 ± 2.7 to 100.9 ± 20.1 Ω·cm². The calculated fractional resistance of the apical membrane decreased, indicating that intracellular alkalosis increases apical potassium conductance. In the presence of either basolateral ouabain, luminal amiloride, or luminal barium, the HEPES-induced hyperpolarization was preserved. Conclusion. The present study demonstrates that intracellular pH is an important determinant of apical potassium conductance in CCD. Additionally, it should be noted that in the experiments using HEPES buffer solution, intracellular pH in certain epithelial cells was alkalinized by the elimination of bicarbonate and CO₂. Received: April 30, 1998 / Accepted: December 7, 1998     

A simple method for estimation of gastric mucus and effects of antiulcerogenic agents on the decrease in mucus during water-immersion stress in rats

In the present study Corne's technique that has been commonly used to quantify the gastric mucus in situ using the dye, Alcian blue, has been improved. Furthermore, the effects of antiulcerogenic agents on the decrease in gastric mucus gel during water-immersion stress were also studied. In order to increase the extraction of dye-recovery, we used 30% dioctyl sodium sulfosuccinate (docusate sodium, DSS) instead of 0.5 mol/l MgCl2 used in Corne's technique. The control values of the dye-recovery extracted with DSS were about 5 times higher than those with MgCl2. Indomethacin (20 mg/kg s.c.) failed to influence dye-recovery with DSS and MgCl2, while reserpine (5 mg/kg i.p.) significantly decreased the dye-recovery in both extractions. Water-immersion stress for 2 h decreased the dye-recovery with DSS but the dye-recovery with MgCl2 decreased only 15 min after water-immersion. These results suggest that extraction with DSS reflects the mucus gel secretion, and that dye-recovery with DSS is more sensitive to alteration of mucus gel than that with MgCl2. Bombesin (10 micrograms/kg), secretin (100 U/kg) and mild irritants increased the dye-recovery with DSS. Cimetidine remarkably reduced the mucus secretion and failed to improve the decrease in mucus during water-immersion stress. Pirenzepine and atropine dose-dependently prevented the decrease in the dye-recovery during water-immersion stress.     

Platelet 3H-clonidine and 3H-imipramine binding and plasma cortisol level in depression

Platelet 3H-clonidine (alpha 2-adrenergic agonist) binding and 3H-imipramine binding were measured and the Dexamethasone Suppression Test performed in 17 normal controls and 14 unmedicated depressed patients in order to clarify the relationship among these three biological markers. Increases in the Bmax and the Kd for 3H-clonidine binding and decreases in the Bmax for 3H-imipramine binding of the platelets from depressed patients were observed when compared with controls. There was a significant positive correlation among 3H-clonidine Bmax, the basal (predexamethasone) plasma cortisol levels, and the severity of depression, as indicated by the Hamilton Depression Rating Scale. On the other hand, no significant correlation was observed in 3H-imipramine binding between the Bmax and the severity of depression or between the Bmax and the basal plasma cortisol levels. There was no statistically significant correlation between the Bmax of 3H-clonidine binding and that of 3H-imipramine binding in depression, but there was a trend toward correlation in normal controls.     

A case of spontaneous cervical vertebral artery dissection resulting in Wallenberg's syndrome--diagnostic value of the cervical axial MRI

Findings of the cervical axial MRI are discussed in a case of spontaneous cervical vertebral artery dissection resulting in Wallenberg's syndrome. A 42-year-old male was hospitalized because of sudden onset of severe occipital pain. Cerebral angiography performed on the day of admission revealed severe tapering stenosis of the right vertebral artery at the C-5 level of the vertebra. Angiography repeated 50 days later showed partial resolution of the narrowing. T-1 weighted axial MRI of the neck demonstrated significantly narrowing flow void of the right vertebral artery when compared with the contralateral side. A crescent-like high intensity area was also seen surrounding the lumen. These findings were consistent with hematoma within the dissected wall of the vertebral artery. MRI is considered useful in identifying such vascular lesions as cerebral artery dissection.