MORPHOMETRY FOR MICROVESSELS IN EARLY GASTRIC CANCER BY NARROW BAND IMAGING‐EQUIPPED MAGNIFYING ENDOSCOPY

Background and Aim: Microvascular architecture is a variable characterizing early gastric cancer (EGC) against the background. The aims of the present study were to measure morphological variables of the microvessels and to compare the variables between EGC and the background. Methods: Narrow band imaging (NBI)‐equipped magnifying endoscopic pictures from 32 patients with EGC were used. The endoscopic pictures were taken under maximal magnification and processed for the microvessels in an in‐focus area after correction of image distortion. The segmented microvessels were numbered for microvessel density (counts/mm²) and vascular bed area (% ratio of vascular bed against the region of interest). The microvessels were further processed for a set of skeletonized pixels to count the characteristic points, including end‐points, crossing points, branching points and connecting points. Results: Microvessels in cancer were found to have a significantly larger connected point number (20.5 ± 6.1, P = 0.0002) than those in the background (17.4 ± 3.9). Numbers of the end‐points and branching points were found to be significantly larger in cancer than in the background (end‐points 3.6 ± 0.7 for cancer vs 3.3 ± 0.4 for background, P = 0.0005; branching points 0.8 ± 0.4 for cancer vs 0.7 ± 0.2 for background, P = 0.0014). However, microvessel density, vascular bed area and mean diameter did not significantly differ between cancer and the background. Conclusion: This finding can be considered to reflect the reported observation of an irregular vascular pattern in gastric cancer. This method may provide a means for microvessel morphometry, regardless of the organ studied.     

Pharmacological Properties of Pteleprenine,a Quinoline Alkaloid Extracted from Orixa japonica,on Guinea-pig Ileum and Canine Left Atrium

We have investigated the pharmacological properties of pteleprenine, a quinoline alkaloid, on contractile responses of the guinea-pig ileum and on inotropic responses of the canine left atrium. Although pteleprenine (0·1–1 μM) had no effect on the contraction of the ileum induced by acetylcholine at 10 μM it significantly inhibited acetylcholine-induced contraction of the ileum. Pteleprenine (0·1–10 μM) reduced nicotine induced-contraction of the ileum in a concentration-dependent manner yet had no maximum relaxant effect even at a concentration of 10 μM From Schild analysis the pA₂ of pteleprenine on the guinea-pig ileum was found to be 6-6. The contraction of the ileum induced by 10 μM 1,1-dimethyl-4-phenylpiperazinium, a specific agonist of nicotinic acetylcholine. receptors, was concentration-dependently suppressed by 10 nM-10 μM pteleprenine. In contrast, 0.1–10 μM pteleprenine did not antagonize the acetylcholine- and nicotine-induced negative inotropic contractile responses of the canine left atrium. These results show that pteleprenine has inhibitory action against nicotinic acetylcholine receptors in the guinea-pig ileum but not in the canine left atrium. Our findings also suggest that pteleprenine might be a novel lead compound as a nicotinic receptor antagonist.     

Activities of Four Enzymes in Blood Serum Determined Simultaneously in Patients with Malignancy before Radical Surgery

The activities of serum alkaline phosphatase (ALP), glutamicoxaloacetic transaminase (GOT), glutamic pyruvic transaminase(GPT) and lactate de-hydrogenase (LDH) were determined simultaneouslyin a group of healthy subjects (351) and in groups of patientswith carcinoma of the lung (379), the stomach (797), the cervix(293), the breast (865), the liver (30) and the pancreas (6)before radical operation. In general, LDH gave the highest rateof positivity of the four enzymes and the activity of this enzymeabove the upper limit of the normal range (M+2SD) was foundin 44.9, 24.1, 19.1 and 13.0% of the patients with carcinomaof the lung, the stomach, the breast and the cervix, respectively. In the patients with adenocarcinoma of the lung, the positivityof serum LDH activity before surgery was shown to increase withthe size of the radically resected tumor. In the two other carcinomas,however, the serum enzyme with the highest rate of positivitywas not LDH but GOT and ALP in pancreatic carcinoma and GOTin hepatocellular carcinoma. As for the rate of independentelevation of serum enzyme activity, LDH exhibited the highestpercentage in all the carcinomas examined, with the exceptionof pancreatic carcinoma in which ALP showed the highest rate.Combined assays of these four enzyme activities gave positivityrates of 100%, 93.3%, 56.5%, 35.9%, 25.4% and 25.3% in carcinomaof the pancreas, the liver, the lung, the stomach, the breastand the cervix, respectively, demonstrating the practical diagnosticvalue of this combined assay system.     

Gastric diverticulum preoperatively diagnosed as one of two left adrenal adenomas

A 47-year-old man was diagnosed with primary aldosteronism due to two left adrenal adenomas, suggested on computed tomography (CT) to be located at the upper and lower adrenal portion. However, adosterol scintigraphy revealed negligible uptake at the upper portion of the left adrenal. Laparoscopic left adrenalectomy was performed, but macroscopic examination of the specimen revealed only one adrenal tumor. Continued surgical exploration detected another mass between the spleen and the stomach, which was demonstrated to be continuous with the stomach and was eventually diagnosed as a gastric diverticulum. Postoperatively, aldosteronism resolved and repeat CT revealed staining of the adrenal pseudotumor when oral contrast was administered. Since organs located near the adrenals can simulate adrenal tumors, caution must be exercised in interpreting suprarenal masses on CT. To our knowledge, this is the first reported case of concurrent pseudotumor and true tumor of the ipsilateral adrenal.     

Pressor effect of L-threo-3,4-dihydroxyphenylserine in rats

The pressor effect of L-threo-3,4-dihydroxyphenylserine (L-threo-DOPS) in rats and its decarboxylation in vivo have been examined. On i.v. administration, it produces a slow-onset and long-lasting pressor response, but no significant change in heart rate or e.c.g. The pressor effect was markedly reduced by inhibition of peripheral decarboxylase and by blockade of α-adrenoceptors. The slow-onset and long-acting pressor effect was also evident when the drug was given orally, while intracerebroventricular administration produced a long-lasting decrease in blood pressure. Noradrenaline (NA) concentrations in the plasma were significantly increased by both i.v. and oral administration of L-threo-DOPS. Elevation of plasma NA concentration by L-threo-DOPS given i.v. was suppressed by inhibition of decarboxylase. The plasma concentration of the drug was highest immediately after its i.v. administration. Its pressor effect was enhanced in rats made hypotensive by chemical sympathectomy with 6-hydroxydopamine (6-OHDA), compared with control rats, nevertheless, L-threo-DOPS produced the same increase in plasma NA concentrations in sympathectomized rats as in the controls. These results indicate that L-threo-DOPS is gradually converted to NA by L-aromatic amino acid decarboxylase in vivo. These findings suggest that L-threo-DOPS may be clinically useful as an oral pressor agent for the treatment of certain disorders related to hypotension.     

Study profile: protocol outline and study perspectives of the cohort by the National Institute of Occupational Safety and Health,Japan (JNIOSH cohort)

How work burden affects physical and mental health has already been studied extensively; however, many issues have remained unexamined. In 2017, we commenced a prospective cohort study of workers at companies in Japan, with a follow-up period of 5–10 years, in order to investigate the current situation of overwork-related health outcomes. From 2017 to 2020, a target population of 150,000 workers across 8 companies was identified. Of these, almost 40,000 workers agreed to participate in the baseline survey. Data on working hours, medical check-up measurements, occupational stress levels, and lifestyle habits were collected. The average age of the participants at baseline was 39.2 ± 11.7 years; 73.1% were men, and 87.7% were regular employees. The most common working hours by self-reported was 41–50 hours per week during normal season, and it increased to more than 50 hours during busy season. Furthermore, more than half of the participants reportedly experienced a form of sleep problem, and the percentage of those who experienced nonrestorative sleep was particularly high.