Absence of anal reflex in patients with central nervous system diseases

The anal reflex was examined electromyographically in 336 patients with central nervous system disease. The absence of anal reflex was found in a total of 78 patients. The incidence of the absence of anal reflex was 31 over 132 (23.7%) in the patients with pyramidal signs in lower extremities, 7 over 41 (17.0%) in patients with extrapyramidal signs in lower extremities, 12 over 50 (24.0%) in patients with both signs and 28 over 113 (24.8%) in patients without both signs. Further incidence of the absence of anal reflex was 6 over 26 (23.1%) in patients with unilateral pyramidal signs, 24 over 106 (22.6%) in patients with bilateral pyramidal signs, 3 over 13 (23.1%) in patients with unilateral extrapyramidal signs and 4 over 28 (14.3%) in patients with bilateral extrapyramidal signs. There was no statistical difference among the above groups, therefore the absence of anal reflex appeared to have no specific relationship to pyramidal or extrapyramidal signs. On the other hand, the incidence of the absence of anal reflex was 33 over 81 (40.7%) in patients with and 45 over 255 (17.6%) in patients without disturbance of light touch and/or pinprick in sacral area. The incidence of the former is statistically higher than that of the latter. Therefore we may conclude that the central afferent arch of the anal reflex has a strong relationship to superficial sensory tract, but the central efferent arch has almost no connection with pyramidal or extrapyramidal tracts.     

Possible Biological Growth Factors in Breast Milk and Postnatal Development of the Gastrointestinal Tract

To investigate as to whether or not biological growth factors known to be present in natural milks could influence postnatal development of Bstrointestinal (GI) tract, tests were made to determine the enteric mucasal, protein and DNA contents, alkaline phosphatase and disaccharidase activities in mongrel puppies at birth and after four days of both mother-reared and artificial reared. Microvilli of the jejunal segment were also investigated histologically by electron microscopy. Similar increases in body weight over the first four days of life were obtained and mucosal protein and DNA contents in the small intestine were greater in the mother-reared animals than in the newborn animals but neither mucosal protein content nor DNA content of the artificially reared animals was different from that of the newborn animals. Alkaline phosphatase activity was greater in both the mother-reared and artificially reared animals than that of the newborn animals. The disaccharidase activities were not different among the three groups. The jejunal microvilli of the mother-reared animals were more elaborately grown in the structure than those of the artificially reared or newborn animals. Therefore, this study demonstrated that the mother rearing over the fmt four days of life resulted in acceleration of the enteric mucosal growth, and the result indicates that breast feeding plays an important role in the development of the GI tract during the neonatal period.     

Bidirectional cavopulmonary shunt using the azygos vein

A case is described in which a two-year-old boy, diagnosed with common atrioventricular canal, pulmonary atresia, major aortopulmonary collateral artery, asplenia, and situs inversus, underwent palliative operations for the following: unifocalization of the right major aortopulmonary collateral artery, right ventricle-to-pulmonary artery shunt, and pulmonary artery plasty. Upon completion of the bidirectional cavopulmonary shunt operation, we addressed the stenotic lesions of the superior vena cava and left pulmonary artery, and a markedly expanded azygos vein. During this operation, the superior vena cava was divided and we performed cavopulmonary shunting with the azygos vein.     

Triple cancers in the urogenital area of a patient with aplastic anemia.

Three epithelial neoplastic lesions, perineal Bowenoid papulosis, uterine cervical carcinoma, and bladder transitional cell carcinoma, which occurred in a mildly immunosuppressed patient who had aplastic anemia were studied for human papillomavirus (HPV) infection. In the Bowenoid papulosis, HPV type 16 DNA was identified by polymerase chain reaction (PCR) and by in situ hybridization (ISH). In contrast, in the uterine cervical carcinoma, HPV 16 was not detected, although possibly another unidentified type of HPV in the lesion was suggested by the ISH findings. In the bladder transitional cell carcinoma, neither papillomavirus genus-specific (PGS) antigen nor HPV DNA was found.     

Purification and characterization of pili of a Vibrio cholerae non-O1 strain.

Pili of the Vibrio cholerae non-O1 strain V10 were purified and characterized. The V10 pili were physicochemically and immunologically different from those of the previously reported V. cholerae non-O1 strain S7, although the pili of the two strains had homologous N-terminal amino acid sequences. V10 plus antigen was detected only in V. cholerae non-O1 strains.     

Inferior phrenic arteries: angiographic anatomy,variations, and catheterization techniques for transcatheter arterial chemoembolization

The inferior phrenic artery (IPA) is the most common extrahepatic collateral vessel to hepatocellular carcinoma (HCC); however, there are many anatomical variations in its origin and branches. In addition, the IPA is frequently reconstructed through several pathways, mainly through the retroperitoneal network, because of the occlusion of its orifice due to atherosclerosis or previous catheter manipulation. Infrequently, selective catheterization into the IPA is impossible even using a microcatheter, particularly in the IPA that originates from the proximal or distal portion of the celiac trunk or from the aorta with an acute angle. In this article, we describe anatomical variations of the IPA and catheterization techniques, such as a catheter with a large side hole and a catheter with a cleft, to facilitate catheterization into the IPA that is difficult using a conventional coaxial technique. Radiologists should have sufficient knowledge of such variations and catheterization techniques to perform transcatheter arterial chemoembolization for HCCs through the IPA effectively and safely.