Correlation Between Vascular Endothelial Growth Factor C Expression and Lymph Node Metastasis in T1 Carcinoma of the Colon and Rectum

Purpose. Vascular endothelial growth factor C (VEGF-C) is known to be associated with the development of the lymphatic vessel system. Recently, VEGF-C is thought to be correlated with lymph node metastasis in some malignant tumors. In this study, we investigated the correlation between VEGF-C expression and lymph node metastasis in early carcinoma of the colon and rectum. Methods. Two hundred and twenty-one endoscopically biopsied specimens from patients with T1 colorectal carcinoma prior to operation were investigated by an immunohistochemical study. Results. VEGF-C expression was more frequently observed in the tumors with nodal metastasis than in those without metastasis. Moreover, a multivariate analysis indicated that VEGF-C expression is an independent predictor of lymph node metastasis. Conclusion. VEGF-C staining using endoscopically biopsied specimens prior to operation could be of use in the prediction of lymph node metastasis and in preoperative selection of treatment in patients with T1 colorectal carcinoma.     

Middle meningeal artery trauma

We present the case of a patient who had the symptoms of a subarachnoid hemorrhage but was subsequently found to have an unusual combination of a separate traumatic pseudoaneurysm and a traumatic arteriovenous fistula of the middle meningeal artery. A review of the literature revealed a difference in the clinical course of patients with traumatic pseudoaneurysms compared to that of patients with arteriovenous fistulas. Patients who were found to have traumatic pseudoaneurysms of the middle meningeal artery frequently manifested signs of delayed hemorrhage. This mechanism may account for the prolonged lucid intervals exhibited in some patients subsequently found to have epidural hematomas.     

Endoscopic appearance of the colon and small intestine of a patient with hemorrhagic enteric graft-vs.-host disease

Endoscopic appearance of the gastrointestinal tract of a patient with severe hemorrhagic enteric graft-vs.-host disease (GVHD) is presented. A 29-year-old man with chronic myelogenous leukemia suffered from severe enteric GVHD after allogeneic bone marrow transplantation. Endoscopy showed hemorrhagic ulceration of the upper jejunum, terminal ileum, and colon at the onset of melena. Sections of biopsies were compatible with acute GVHD. Repeat endoscopy showed gradual healing of the lesions after steroid pulse and antilymphocyte globulin therapy, but the patient died of cytomegalovirus pneumonitis 14 months later. Autopsy revealed submucosal fibrosis of the small intestine and colon.     

Improvements in smoothness of chewing cycles in adults with mandibular prognathism after surgery: a longitudinal study

Although adults with mandibular prognathism are known to show impaired smoothness of masticatory jaw movements, it remains uncertain whether/how the surgical‐orthodontic treatment is effective to improve masticatory jaw movements. The aims of this study were (i) to verify whether the surgical‐orthodontic treatment of patients with mandibular prognathism improve smoothness of the chewing jaw movements post‐operatively and, if so, (ii) to examine whether the improved parameters show similar quantities as those of the control subjects. The chewing jaw movements for 13 patients with mandibular prognathism were recorded at pre‐ and post‐treatment stages. The patient group was divided into two groups: Class III_closed showed full occlusal contact at the habitual intercuspal position, whereas Class III_open showed inability of occlusal contact between the upper and lower anterior teeth. The control group (CG) consisted of 52 subjects having acceptably good occlusion. The normalised jerk cost (NJC), movement duration and peak velocity in jaw closing were compared. For both Class III_open and Class III_closed groups, statistical comparisons revealed that the NJC and movement duration were decreased after the treatment, whereas the peak velocity was increased (all P < 0·01). For the Class III_open, these quantities at the post‐treatment stage did not show any significant differences compared with those for the CG. It is concluded that the smoothness of chewing jaw movements for patient with mandibular prognathism were improved after treatment, and for the patients with anterior open bite at pre‐treatment, the post‐operatively achieved smoothness of jaw‐closing movements did not differ from those of the CG.     

Vascular endothelial growth factor in the early stage of skin incision wounds in cyclophosphamide-induced leukocytopenic rats

Wound healing evaluation is important in forensic pathology. We have already shown that vascular endothelial growth factor (VEGF) is produced in the rat skin incision wounds. In this study, we used cyclophosphamide hydrate (CPM) to induce leukocytopenia in rats, and measured VEGF in the skin incision wound area to assess the involvement of leukocytes in the early production of VEGF. Male Sprague–Dawley (SD) rats were intraperitoneally administered CPM 75 mg/kg body weight on day 0 and 5, and dorsal skin incision wounds were made on day 5. One and 3 days after the skin incision, leukocytes counts were determined and skin specimens from the wounds were collected for measurements of total proteins, VEGF proteins, and semi-quantification of VEGF mRNA. VEGF immunohistochemistry and in situ hybridization for VEGF mRNA were also performed. VEGF proteins were smaller in the amount statistically significantly in the 1- and 3-day-old wounds of CPM-induced leukocytopenic rats, whereas VEGF mRNA was increased compared with saline-treated control rats. Immunohistochemically, VEGF was positive in leukocytes and mesenchymal cells including fibroblasts and endothelial cells in the 3-day-old wound of saline-administered control rats, while a few fibroblasts and endothelial cells were positively stained in CPM-administered rats. In situ hybridization showed the localization of VEGF mRNA in mesenchymal cells including fibroblasts and endothelial cells in the 1-day-old wound of CPM-administered rats, whereas saline-administered control rats also showed VEGF mRNA positivity in leukocytes. Our study indicates that leukocytes may be the major source of VEGF in the early stage of the rat skin incision wound.     

Two-dimensional and Doppler echocardiographic assessment of variably shaped ductus arteriosus by the parasternal approach

Summary Parasternal two-dimensional and Doppler echocardiography were compared with angiographic, surgical, and postmortem data in 213 patients with various forms of congenital heart disease for its accuracy in determining patency and anatomy of the ductus arteriosus (DA). The age range of the examined patients was from 1 day to 4 years (mean, 7.4 months). Echocardiography was always performed before any invasive procedure. An adequate window for imaging the DA was obtained by parasternal, two-dimensional echocardiography in 209 patients (98%). A persistent ductus arteriosus (PDA) was detected by invasive methods in 79 of 209 patients (38%), and by two-dimensional and Doppler echocardiography in 76 (sensitivity, 96%; specificity, 100%). The echocardiographic and angiographic findings agreed closely as to the duct's morphology. Our technique permits an accurate visualization of the duct in neonates, infants, and small children with various forms of congenital heart disease.     

Ontogenic Expression of Somatostatin-Messenger RNA in the Intestinal Tract of Neonatal Rats

Ontogenic expression of somatostatin (SRIF)—messenger RNA (mRNA) in the gastrointestinal tract was examined in neonatal rats aged from 1 day preterm to 60 days postpartum in comparison with that in the hypothalamus. SRIF-mRNA in the hypothalamus was already expressed in prenatal rats and its developmental change was relatively small. In contrast, a unique pattern of SRIF-mRNA expression was seen in the different intestinal regions, gastric antrum, duodenum, jejunum and colon. In the duodenum, SRIF-mRNA level was low at birth, markedly increased during the postnatal 3 days and declined to the previous level by day 21. Jejunal SRIF-mRNA was found in neonates but progressively decreased in a similar way to duodenum. On the contrary, gastric SRIF-mRNA level, which was low during early development, rose rapidly to a peak on day 21 and gradually declined to an adult level. In the colon age-related change was not conspicuous, remaining at a low level. These results indicate that (1) expression of SRIF gene in the intestinal tract is regulated by local factor(s) as well as developmental stage, and (2) shift of SRIF-mRNA pattern occurs during weaning from the duodenum-dominant infantile pattern to the gastric-dominant adult pattern.     

Differential responses of scirrhous and well-differentiated gastric cancer cells to orthotopic fibroblasts.

Scirrhous gastric cancer cells proliferate rapidly with fibrosis, when the cancer cells invade into the submucosa of the stomach. To investigate the mechanisms responsible for the rapid proliferation, the growth interaction between gastric cancer cells and fibroblasts was examined. Human gastric cancer cell lines established from scirrhous carcinoma or well-differentiated adenocarcinoma were used. Human fibroblast cell lines were obtained from various organs. The growth interaction between gastric cancer cells and fibroblasts was examined by calculating the number of cancer cells or by measuring [3H]thymidine incorporation of cancer cells. Gastric fibroblasts specifically stimulated the growth of scirrhous gastric cancer cells, but not that of well-differentiated adenocarcinoma cells. The growth factor(s) produced from gastric fibroblasts were then partially purified and characterised. The growth-promoting factor(s) had apparent molecular weights of 10000 dalton and was sensitive both to heat and proteinase treatment. No inhibition for the factor(s) was achieved with defined anti-growth factor antibodies. In this study, differential responses of scirrhous and well-differentiated gastric cancer cells to orthotopic fibroblasts were shown. Rapid proliferation of scirrhous gastric carcinoma should be partly controlled by orthotopic fibroblasts. The growth factor(s) from gastric fibroblasts, which was distinct from various defined growth factors such as epidermal growth factor (EGF), basic fibroblast growth factor (b-FGF), transforming growth factor-alpha (TGF-alpha), keratinocyte growth factor (KGF), vascular endothelial growth factor (VEGF), insulin-like growth factor I (IGF-I), hepatocyte growth factor (HGF), platelet-derived growth factor (PDGF) and transforming growth factor beta 1 (TGF-beta 1) may play an important role in the progression of scirrhous gastric cancer cells.