Serum Lipids in Patients With Carcinoma and Benign Diseases of the Breast

The serum levels of total triacylglycerol, cholesterol and phospholipidsin 121 patients with breast carcinoma, 61 patients with benignbreast diseases and 145 healthy females were studied especiallyin relation to their alteration by aging. At all age levels the patients with breast carcinoma had significantlyhigher concentrations of serum triacylglycerol than those withbenign breast diseases. In carcinoma patients a gradual increasein the levels of serum cholesterol was observed with age, showingthe same tendency as healthy females. Increases in serum phospholipidswere observed with age in patients with carcinoma and benigndiseases of the breast but were not statistically significantin comparison with those of healthy controls.     

Evaluation of the maximal excretion rate of indocyanin green as a prognostic indicator in patients undergoing biliary decompression for obstructive jaundice

To assess the postoperative outcome of jaundiced patients and to select the optimal timing for surgical intervention, indocyanin green (ICG) concentrations in the bile were measured after biliary decompression in patients with obstructive jaundice. The maximal excretion rate of ICG in the bile was calculated as a function of time (ICG B_max). Among 59 patients with positive ICG B_max values, morbidity was 15.2% and postoperative hospital mortality was 3.3%. However, the morbidity and mortality in nine patients with values between - 0.5 and 0 were 88.8 and 44.4%, respectively. The 13 patients with in ICG B_max below - 0.5 had a 76.9% morbidity and a 61.5% mortality. The patients with ICG B_max values below 0 showed a significantly higher morbidity and mortality than positive ICG B_max patients. In patients showing ICG B_max values below - 0.5, surgery is contraindicated despite intensive postoperative care. The ICG B_max value improved according to the increasing effect of biliary decompression. The index is useful not only as a prognostic index in the early phase of biliary decompression but also as an index of bile secretory capacity at a given time. By means of time course measurement of this index, the suitable time for operation can be determined. The ICG B_max is a useful and reliable indicator in the assessment of hepatobiliary functional reserve in jaundiced patients after biliary decompression and prior to further surgical intervention.     

Flow Cytometric Measurement of DNA Index and BrdUrd Labeling Index in Endoscopic Biopsy Specimens of Colorectal Carcinoma

We compared values of the DNA Index (DI) and bromodeoxyuridine (BrdUrd) labeling index (BULI) of biopsy specimens with those of resected specimens from 12 patients with colorectal cancer, to evaluate the cell cycle by flow cytometry (FCM). From each patient, 4 biopsy specimens were endoscopically removed. Also, small pieces of tissue, 0.5 cm in diameter, were taken from 4 different sites of the resected tumor. Both kinds of specimens were labeled in vitro with BrdUrd. Their DI and BULI values were evaluated from the DNA/BrdUrd bivariate scatter diagram by FCM. It was found that the coefficients of variation (CVs) for endoscopic biopsy specimens were siginificantly lower than those for resected specimens, 4.2 ± 1.3 (Mean ± S. D.) and 5.4 ± 1. 7, respectively. In 8 cases without intratumoral DI heterogeneity, there was a good correlation in the values of DI between the biopsy and resected specimens (r = 0.99, p < 0.01). A significant correlation was also found in the BULI values between the two types of specimens (r = 0.73, p < 0.01). These results suggested that 4 biopsy specimens were enough to estimate DI and BULI by FCM and that DI and BULI values determined by flow cytometry could be useful for decision-making about the therapeutic modality for preoperative patients.     

Clinical and Electrophysiological Characteristics of Atrial Standstill

NAKAZATO, Y., et al .: Clinical and Electrophysiological Characteristics of Atrial Standstill . To clarify the clinical and electrophysiological characteristics of atrial standstill (AS) we studied 11 patients (7 males and 4 females), whose average age was 62 years and who were followed over a period of 4–179 months. Underlying heart disease was present in nine patients and two cases were idiopathic. Major clinical symptoms in the 11 cases included Adams-Stokes attacks, and dyspnea on exertion. In the standard 12-lead ECGs obtained on admission, the P wave was absent in six cases. Atrial flutter (AF) was noted in 3, atrial fibrillation (Af) in 1, and multifocal atrial tachycardia in 1. In some cases, the ECG initially showed AF or Af, and was transformed after several years into ectopic atrial tachycardia or an ectopic atrial rhythm with a markedly decreased amplitude of the P wave. Finally, the P wave disappeared over a prolonged period. When intracardiac mapping was performed, the atrial electrograms tended to diminish at the site of high, mid-lateral right atrium (RA). Electrograms were remained present in the vicinity of the tricuspid valve (TV) annulus. A repeated mapping and pacing study conducted in two patients revealed that the "silent" area spread toward the lower site of RA. During the average follow-up period of 64 months, four patients died. The interval until death in one patient with myocarditis was 6 months, and in another with dilated cardiomyopathy (DCM) it was 8 months. It appears that the atrial muscular lesion starts in the high lateral RA and progresses toward the lower RA, then to the vicinity of the TV annulus. A diffuse and progressive disturbance may occur not only in the atrial muscle, but also in the atrioventricular conduction system in patients with AS who had progressive myocarditis or DCM.     

A Study on the Growth and Development of the Cranial Base in the Japanese Unilateral Cleft Lip and Palate: Comparison with the Japanese Skeletal Class I Occlusion

Abstract The purpose of this study is to investigate the growth and the developmental dimension and the feature of cranial base transition in unilateral cleft lip and palate (UCLP). With regared to this proposition, we have already submitted a paper in which we compared our study with skeletal reversed occlusion on a scholary journal. The authors will present this proposition in comparison with skeletal class I. The subject group consisted of 15 males and 12 females with UCLP. The control group consisted of 11 males and 14 females with skeletal class I. Standared lateral cephalometric radiographs taken at first medical examination and three years later were used. The three linear dimensions (S-N, S-Ba, N-Ba) and craniobasal angle (N-S-Ba) were measured. The results were as follows: 1) Females showed no significant difference in S-N, S-Ba and N-Ba but males had smaller S-Ba and N-Ba in the UCLP as compared with the control at the first examination and 3 years later. 2) There were no significant difference in the three distance items, S-N, S-Ba, N-Ba, for females but significantly larger changes in N-Ba appeared in the UCLP as compared with the controls for males. 3) The cranial base angle (N-S-Ba) showed no significant difference between the UCLP and controls for both male and female subjects at any observation time. From the above evidences, it is estimated that the cranial base size and angle in the UCLP as compared with those of controls show no consistent trend owing to possible involvement of differential growth pattern between the anterior cranial base and posterior cranial base. The growth of cranial base itself per se seems to be influenced mutually at minimal level by the maxillofacial growth. This suggests growth patterns of cranial base and maxillofacial region are independent from each other.     

Testicular metastasis from squamous cell carcinoma of the lung

We present a case of squamous cell carcinoma of the testis that metastasized from lung cancer. The patient, who had received left pneumonectomy 2 years earlier for squamous cell carcinoma (SCC) of the lung, developed pulmonary metastasis, which was treated with chemotherapy. Although the recurrence regressed after treatment, the testicular tumor progressed gradually. Left radical orchiectomy was performed. Pathological examination revealed metastatic SCC. Testicular metastasis from lung cancer is a very rare disease.     

Common clonal origin of lymphocytes and plasma cells in splenic lymphoma with villous lymphocytes

In two-thirds of patients with splenic lymphoma with villous lymphocytes (SLVL) a small amount of M-protein can be detected in association with the presence of plasma cells in the peripheral blood (PB) and/or bone marrow (BM). However, it is not known whether lymphoma cells and plasma cells originate from the same clone. In this report we describe a case of SLVL which was characterized by the presence of marked monoclonal gammopathy (IgG-κ 90 g/l) and increased plasma cells in the BM. In an attempt to elucidate the origin of lymphoma cells and plasma cells, we performed morphological, cytogenetic and molecular studies on PB mononuclear cells (PBMNC) without plasma cells and BMMNC containing 10% plasma cells from this patient.
Immunofluorescence showed that lymphoma cells and plasma cells were positive for cytoplasmic γ heavy and κ light chains. Well-developed endoplasmic reticulum was observed in the cytoplasmic organelles of PBMNC using an electron microscope. The mean IgG concentration in the 3 d supernatant cultures of PBMNC was 374±24μg/l. More than 50% PBMNC differentiated into plasmacytoid cells in 6 d of liquid culture with IL-3 and IL-6. Analysis by two-colour FISH revealed that karyotypic abnormalities of monosomy X and trisomy 17 existed simultaneously in both lymphoma cells and plasma cells. JH gene rearranged bands from PBMNC and BMMNC by Southern blot hybridization were identical, whereas DNAs from PBMNC failed to hybridize with the Cμ probe.
These observations strongly suggest that lymphoma cells and plasma cells originate from the same clone, and that plasma cells, as well as lymphoma cells, which have undergone class switch recombination, could produce IgG type M-protein in this case.     

Effects of inhalation anesthetics on myocardial and hepatic energy metabolism in normotensive and spontaneously hypertensive rats subjected to hemorrhage

Forty spontaneously hypertensive rats (SHRs) and forty normotensive Wistar–ST rats (NRs) were used to assess the influence of anesthetics on myocardial and hepatic energy metabolism after hemorrhage. They were divided into five pairs of groups: a control group (pentobarbital 6 mg– 100 g BW^-1p), and four others which received 1.2% halothane, 2.2% enflurane, 1.4% isoflurane, and 3.3% sevoflurane, respectively. Following a 10 min stabilization period, blood (2 ml. 100 g BW^-1') was gradually withdrawn over a 5 min period from a femoral artery. Thirty min after the induction of hemorrhage, the heart and liver were removed and myocardial and hepatic metabolites (ATP, lactate, pyruvate and glycogen) were measured by enzymatic methods. There were no significant differences in myocardial metabolites among either the anesthetic groups or between SHRs and NRs. However, hepatic ATP levels in all SHR groups were significantly lower than those in NR groups. Moreover, ATP levels in the inhalation anesthetic groups of SHRs were significantly higher than that in the control group of SHRs. All inhalation anesthetics, especially isoflurane, may reduce metabolic deterioration of the liver during hemorrhage when compared to barbiturate anesthesia.     

A Case of Cronkhite-Canada Syndrome with Spontaneous Kemission

Abstract: A 64-year old woman visited our hospital with a chief complaint of diarrhea of nearly one year's duration. One month before seeking medical treatment at our hospital, she noticed dysgeusia, hyperpigmentation of the skin, and nail shrinkage and loss without hypoalbuminemia. Endoscopic examination demonstrated numerous sessile and semipedunculated polyps in the stomach and colon. Histological examination of biopsy specimens showed epithelial hyperplasia with cystic dilation, interstitial edema and infiltration of inflammatory cells. Based on these characteristic clinical and pathological features, a diagnosis of Cronkhite-Canada syndrome was made. As her symptoms gradually improved, she was placed under observation without specific treatment. The initial magnifying colonoscopy revealed enlargement of epithelial glands and cryptal dilation in both the protruding lesions and the intervening mucosa. On follow-up magnifying colonoscopic examination, small islets of abnormal glandular tissue persisted for 1.5 years but did eventually disappear. Magnifying colonoscopy may be useful for observation of the healing process in patients with Cronkhite-Canada syndrome.     

Age-related changes of serum progastrin-releasing peptide levels during childhood

Gastrin-releasing peptide (GRP) has attracted much attention in recent years because it has become recognized as a significant tisue-specific growth factor. To investigate the physiological significance of this peptide in growing children, the time course of serum ProGRP(31–98) level, a precursor hormone of GRP, in children was assessed. A total of 118 serum samples including cord blood was examined with informed consent by using a specific enzyme-linked immunosorbent assay (ELISA) system to measure serum ProGRP(31–98). The serum ProGRP(31–98) level was highest in cord blood and neonatal samples, rapidly declined by 1 year of age and then gradually declined to the adult level by 5 years of age. This time-dependent change of serum ProGRP(31–98) level suggests the importance of GRP as a physiological growth factor in fetal and neonatal tissues.