Assessment of stage IIB lung cancer from the pathological factors

In our experience, the prognosis of patients with pathological T3N0M0 lung cancer is generally poor, the 5-year survival rate being almost the same as that of patients with stage IIIA disease. Thus, we assessed patients with stage IIB disease by examining the pathological factors, lymphatic invasion, vessel invasion, histological type, differentiation, tumor size, and node dissection. Lymphatic invasion was found to be positive in 20 of 21 cases, patients with T3N0M0 lung cancer, and all of those with positive vessel invasion had a significantly poor prognosis. This indicates that positive lymphatic and vessel invasion could be a prognostic factor predicting a poor outcome. Patients with T3N0M0 lung cancer that are found to have this poor prognostic factor may not be diagnosed as having stage IIB disease.     

Mutational analysis of the BMP-1 gene in patients with gastroschisis

BACKGROUND: Gastroschisis is a rare abdominal wall defect. Although the pathogenesis of gastroschisis is unknown, there is some evidence of the genetic etiology of gastroschisis. Recently, a functionally null deletion of the mouse bone morphogenic protein-1 (BMP-1) gene resulted in a phenotype that resembled a human neonate with gastroschisis. BMP-1 thus became the first potential candidate gene for gastroschisis. METHODS: To explore this possibility the authors collected blood samples from 11 patients who had gastroschisis. Mutational analysis of exons 2 to 15 of the human BMP-1 gene was performed using genomic polymerase chain reaction, single-strand conformation polymorphism analysis and direct sequencing methods. RESULTS: No mutation of the human BMP-1 gene was observed in any of these patients. CONCLUSION: Although heterogeneous etiologies might be proposed for gastroschisis, our results provide further evidence of a nongenetic etiology for gastroschisis. J Pediatr Surg 36:885-887.     

Thermal capsulorrhaphy treatment of shoulder instability: basic science

Thermal capsulorrhaphy is a new treatment modality for shoulder instability, where the joint capsular tissue is heated and reduced in length by laser or radiofrequency energy to regain joint stability. Experimental studies have shown that (1) joint capsular tissue can be modified significantly (shortened) by thermal energy at the temperature range of 70 degrees to 80 degrees C; (2) thermal energy causes immediate deleterious effects such as loss of the mechanical properties, collagen denaturation, and cell necrosis; (3) thermally treated tissue is repaired actively by a residual population of fibroblasts and vascular cells, with concomitant improvement of mechanical properties; (4) the shrunken tissue stretches with time if the tissue is subjected to physiologic loading immediately after surgery; and (5) leaving viable tissue between treated regions significantly improves the healing process. Therefore, the application of thermal energy to achieve joint stability relies on an initial effect (shrinkage), and to a great extent the tissue's healing response to regain the tissue's mechanical properties. Particularly, induction of active repair and joint capsular thickening with tissue remodeling regulated by functional demand seem to be essential factors for a successful outcome. Thermal treatment causes an initial deleterious effect on the tissue's properties, and overtreatment can lead to severe immediate and permanent tissue damage. In addition, scientific data of newly developed devices are limited, and the information from manufacturers often is unreliable and misleading. Carefully controlled long-term clinical and scientific studies should be done to additionally clarify the advantages and disadvantages of this technique.     

Sensory disturbance of the thigh after renal transplantation

PURPOSE: Although sensory disturbance of the anterior and/or lateral thigh often develops after renal transplantation, this complication is overlooked because of the minor degree of disability. We evaluated the rate of sensory disturbance of the thigh after renal transplantation. MATERIALS AND METHODS: We examined neurological deficits of the thigh on the operated side in 61 patients who underwent renal transplantation, including 48 using the internal and 13 using the external iliac artery. RESULTS: We noted sensory disturbance in 23 of the 61 cases, including 20 of the 48 in which the internal iliac artery was used. One patient had complete femoral nerve palsy involving motor weakness. Sensory disturbance was in the anterior thigh in 15 patients, in the lateral thigh in 3, and on the anterior and lateral thigh in 2. Postoperatively there was sensory disturbance of the thigh in 3 of the 13 patients in whom the external iliac artery was used. Sensory disturbance persists in all 3 cases at the time of this report, including in the anterior thigh in 1, and in the anterior and lateral thigh in 2. CONCLUSIONS: The rate of sensory disturbance of the thigh after renal transplantation is high. Therefore, we should inform patients of the possibility of sensory disturbance before renal transplantation surgery is performed.     

Cerebrospinal fluid concentrations of alpha-melanocyte-stimulating hormone in bacterial and aseptic meningitis

-Melanocyte-stimulating hormone (-MSH) has potent anti-inflammatory effects in several experimental models of inflammation. It inhibits both the actions and production of proinflammatory cytokines and neutrophil migration. We investigated whether -MSH in cerebrospinal fluid (CSF) increases during the acute stage in patients with bacterial and aseptic meningitis by measuring -MSH in CSF via radioimmunoassay. The -MSH concentrations in CSF from the children with bacterial meningitis who survived (n = 8), those with aseptic meningitis (n = 16), and the control subjects (n = 23) were all below the detection limit. However, CSF -MSH was elevated in four of the five children with bacterial meningitis who had neurological sequelae. We speculate that elevated -MSH levels in CSF during acute bacterial meningitis reflect negative feedback in response to severe inflammation associated with neurological sequelae induced by proinflammatory cytokines. Conclusion: CSF -MSH is elevated in children with severe bacterial meningitis who had neurological sequelae.     

Deletion mapping of 14q32 in human neuroblastoma defines an 1,100-kb region of common allelic loss

BACKGROUND: We analyzed loss of heterozygosity (LOH) in 54 primary neuroblastomas (NBs) using 12 microsatellite markers on 14q32, and found that 31% (17/54) NBs showed LOH. PROCEDURE: The smallest region of overlap (SRO) was identified between D14S62 and D14S987. RESULTS: There was no statistical correlation between LOH and any clinicopathologic features, including age, stage, amplification of MYCN, and ploidy. A sequence-ready bacterial artificial chromosome (BAC) contig was constructed, and the minimum tiling path of six BACs covered the SRO; the physical length of this region was no larger than 1,000 kb. CONCLUSIONS: Our findings support the existence of a putative tumor-related gene on 14q32 for the tumorigenesis of NB.     

Isolation of a Novel Gene Showing Reduced Expression in Metastatic Colorectal Carcinoma Cell Lines and Carcinomas

To investigate genes involved in mctastatic stages of cancer, we analyzed expression of mRN As in three cell lines derived from murine colon adenocarcinoma 26 by means of a differential display method. Each of these lines exhibits distinct metastatic characteristics. Among many bands representing different expression patterns in the display, we confirmed by northern analysis that a gene corresponding to one amplified fragment, termed grm2 (gene related to metastasis 2), was expressed more abundantly in NL4, the derivative with the lowest metastatic potential, than in cell lines NL17, an experimentally metastatic derivative, and in NL22, a spontaneously metastatic derivative. Using thegrm.2 fragment as a probe, we isolated murine cDNA clones and subsequently human cDNA clones corresponding to the GRM2 gene. The human and mouse homologues both encode proteins of 600 amino-acid residues, which show weak homologies to proteins belonging to the myosin family. When we examined the expression levels of this novel gene in human colon cancers and in corresponding metastatic foci, we found that in more than half of these tissues, expression was significantly reduced in association with malignant potential. Our resultsimply that in humans the GRM2 gene product may regulate the metastatic phenotype of some colorectal cancers.