Endoscopic Diagnosis of Colorectal Villous Adenoma

Villous adenoma or adenoma with a predominant villous componentshowed a characteristic finding on macroscopic or endoscopicobservation. The fundamental elements which constitute thisfinding were reddish sulcus and whitish ramified relief similarto the villous pattern normally seen on the mucosa of the smallbowel. We called this feature "V (villous) pattern." A comparativestudy of the endoscopy and pathology of 70 polypoid lesionsof the large intestine was conducted, with the following results:The frequency of the V pattern in the endoscopic picture increasedin proportion to the population of the villous component inhistological picture of the polypoid lesions. However, evenin small polyps the V pattern could be observed when the lesionhad a villous component. Careful and close endoscopic observationmay allow the diagnosis of villous component (which means ahigh frequency of malignancy) of the colorectal polyp even withoutbiopsy. Dr. Makino's present address: Av. Ceará, 335, Belém—Pará,Brasil.     

A Case of Reversible Ventricular Tachycardia and Complete Atrioventricular Block Associated with Primary Cardiac B-Cell Lymphoma

We report a long-term survival case of primary cardiac lymphoma with reversible ventricular tachycardia (VT) and complete atrioventricular block (C-AVB). A 65-year-old man with VT was treated by oral amiodarone administration. Later, a dual-chamber pacemaker was implanted because of C-AVB. Then, he was readmitted, as he complained of fever and chest pain. Echocardiography showed an enlarged cardiac mass and thus an open-chest biopsy was performed. He was then diagnosed with primary cardiac lymphoma. The chemotherapy and radiotherapy resulted in the disappearance of the mass. Complete remission has been maintained for 8 years after the therapy, and no VT or C-AVB has been detected.     

The pharmacokinetics of fosfestrol and diethylstilbestrol in chronic hemodialysis patients with prostate cancer

BACKGROUND: Fosfestrol drip infusion therapy is an available endocrinotherapy for prostate cancer. But since there have been few reports of its use in chronic dialysis patients, the pharmacokinetics of fosfestrol in these patients remains unclear. We conducted fosfestrol drip infusion therapy as an induction therapy in chronic hemodialysis patients with prostate cancer. METHODS: Two male patients were included in this study. One was a 68-year-old man who had been in hemodialysis for 15.7 years and had stage B2 prostate cancer. The other was a 74-year-old man who had been in hemodialysis for 4.4 years and had stage C prostate cancer. A total of 250 mg of fosfestrol was dissolved in 250 mL of 5% glucose solution and administered by drip infusion. The drug was given subcutaneously during 14 consecutive days and a luteinizing hormone-releasing hormone agonist was injected on day 15. RESULTS: Serum fosfestrol levels increased rapidly after the drip infusion was started and remained at high levels during infusion, but fell quickly after the treatment ended. Diethylstilbestrol (DES) was also detected in blood after the infusion was started and its levels peaked when infusion ended. But on the next day, neither fosfestrol nor DES were detected in the blood of the patients. Moreover, neither fosfestrol nor DES was detected in the blood of the two patients before administering fosfestrol on day 15. Fosfestrol was quickly eliminated from the blood after hemodialysis was started, while DES remained in the blood during hemodialysis. The adverse reactions were mild hepatic dysfunction and gynecomastia. CONCLUSIONS: Fosfestrol drip infusion therapy appeared to be safe as an endocrinotherapy for prostate cancer in chronic hemodialysis patients.     

Neural substrates of emotionally valenced episodic memory: A PET study using film stimuli

Abstract  To reveal the pathogenetic mechanism of post-traumatic stress disorder (PTSD), we modeled the 're-experience' symptom of PTSD in healthy subjects, and investigated its neural substrates using PET activation experiments on an emotionally (fear) valenced episodic memory task and several contrast tasks. Ten right-handed healthy male volunteers underwent H₂¹⁵O-PET. Each subject was required to watch a horror film the previous day. During the PET scan, the subject was shown part of the film for 60 s immediately before the terrifying climax scene and told to recall the following scene. The subject did not watch the scene directly, but re-experienced fear induced by the trigger. The rCBF in this task compared with that in control tasks was analyzed with SPM99. The subjective emotional state of the subject in each task was evaluated using an analog scale. The main cerebral areas where rCBF significantly correlated with the task of emotionally valenced episodic memory, compared with the novel emotional task, were the left retrosplenial cortex (Brodmann's area: BA 31), the left visual association cortex (BA 19) and the right prefrontal cortex (BA 10). Although the retrosplenial cortex or the posterior cingulate gyrus has been regarded as engaged in processing either only emotion or only episodic memory, this area is considered to be involved in processing 'emotionally valenced episodic memory'.     

Characterization of colonic motor activity in conscious dogs

Diurnal changes in canine colonic motility were investigated by means of chronically implanted force transducers. A characteristic of the colonic motor profile in the fasted state was the occurrence of colonic motor complexes consisting of tonic contractions superimposed with phasic ones. On feeding, motor complexes were immediately induced in the whole colon and continued to occur at significantly shorter intervals than those in the fasted state, but the duration and the amplitude of the colonic motor complexes were not affected by feeding. This increased activity period lasted for 8–16 h after feeding, and 83.3% of the defecations were observed in this period. Of the defecations 33% occurred in the first 2 h after feeding (P < 0.05). More than 80% of the giant migrating contractions associated with defecation propagated from the middle to the distal colon, and the start of faeces evacuation coincided with the end of the relaxation period of the distal colon preceding the arrival of the giant migrating contractions. More than 90% of the giant migrating contractions not associated with defecation migrated from the proximal to the middle colon. More than 60% of the colonic motor complexes migrated in an aboral direction and about 18% of them in an oral direction. These results suggest that (1) defecations tend to occur immediately after feeding; (2) the regional distribution of giant migrating contractions was different between those associated and not associated with defecation.     

Usefulness of arousal for the diagnosis of sleep breathing disorder

Abstract We hypothesize that breathing disorder related arousal index (B-ArI) can differentiate sleep breathing disorder from simple snorer when apnea hypopnea index (AHI) is low. We studied 54 patients using polysomnography. Breathing disorder related arousal (B-Ar) was defined as arousal accompanied by apnea, hypopnea, desaturation or snort. Mean AHI was 44.2 ± 34.0/h, and B-ArI correlated significantly with AHI, desaturation index, percentage total sleep time with SpO₂ below 90%. Breathing disorder related arousal index was greater than AHI when AHI was below 20. In 11/54 patients, AHI was below 10, and B-ArI more than 10. Nasal continuous positive airway pressure was applied to six patients and showed reduced B-ArI. Breathing disorder related arousal index may be one of the useful indices for the diagnosis of sleep breathing disorder when AHI is less than 10.     

Regurgitation of bile acids in rat liver under bile drainage: quantitative analysis by taurine or ursodeoxycholate loading test

Abstract In rats with an interrupted enterohepatic circulation of bile acids, levels of serum taurine-conjugated bile acids were increased significantly 3 h after intravenous administration of taurine. Similarly, serum taurine- or glycine-conjugated ursodeoxycholic acid (UDCA) was increased significantly 2 h after UDCA administration. These findings suggested that the administered taurine or UDCA was taken up into hepatocytes and utilized to form conjugated bile acids, which were thereafter regurgitated into the systemic circulation from the liver. The proportion of regurgitated taurine-conjugated bile acids relative to total serum bile acids measured by taurine loading (30%) almost coincided with that of regurgitated taurine- or glycine-conjugated UDCA relative to total serum bile acids measured by UDCA loading (31.6%). Thus, the present study showed conclusively that at least 30% of serum bile acids are derived from newly conjugated bile acids that are regurgitated from the liver in rats with bile fistula.     

Inhibition of platelet adhesion to collagen by monoclonal anti-CD36 antibodies

Monoclonal anti CD36 antibodies capable of inhibiting platelet adhesion to collagen have not previously been identified. We have now prepared two groups of monoclonal antibodies. One group was prepared using, as immunogen, highly purified (99+%) CD36 prepared by a denaturing procedure. These antibodies (Mo series) reacted strongly with CD36 on protein blots but did not immunoprecipitate native CD36 from platelet lysates nor inhibit platelet adhesion to collagen. The second group of monoclonal antibodies (131 series) was prepared using CD36 purified to >95% by a non-denaturing procedure. These antibodies reacted with control platelets, but not Nak^a-negative platelets which lack CD36, as measured by flow cytometry and by immunoprecipitation. Three monoclonal antibodies of this latter group (131.4, 131.5 and 131.7) inhibited platelet adhesion to collagen in static systems under Mg²⁺-independent conditions but had little effect in the presence of Mg²⁺. 131.4 and 131.7 also inhibited adhesion to collagen using citrated whole blood in a parallel plate flow chamber at physiological shear rates (800 s^?1), whereas 131.5 was without effect. These are the first anti-CD36 monoclonal antibodies shown to be capable of inhibiting platelet adhesion to collagen and provide further evidence that CD36 plays a role in platelet–collagen interaction.     

Basaloid-squamous cell carcinoma of the oral mucosa: Report of two cases and study of the proliferative activity

Two cases of basalold-squamous cell carcinoma (BSC) of the oral mucosa are described. The first case occurred at the floor of the mouth in a 58-year-old man, and the second case occurred at the mandibular gingiva in a 79-year-old woman. The laboratory data of the first case showed a positive response to hepatitis C virus antibody. in the first case, the tumor mass measured 4 times 4 cm in size, and was i-texl at the lingual side of the median mandible beside the sublingual gland. In the second case, the tumor mass measured 25 times 15 mm In size, and was located in the alveolar mucosa of the right mandible. Histologically, both tumors showed a neoplastic epithelium arranged in a solid pattern with evidence of peripheral palisading, central necrosis, and some squamous differentiation. The pro-ilferathfe activities of the BSC were compared with conventional squamous cell carcinomas (SCC) in the oral floor and gingiva, respectively, by employing a sensitive argy-rophillc nuclear organizer region (AgNOR) staining method. The number of AgNOR per nucleus of the BSC was higher than that of any other SCC cases. The results support the opinion that BSC of the oral mucosa has a worse prognosis than conventional SCC.