Diffuse heterotopic submucosal cystic malformation of the stomach: ultrasonographic diagnosis.

The preoperative diagnosis of diffuse heterotopic submucosal cystic malformation of the stomach is very difficult to make with upper gastrointestinal (GI) series or endoscopy. We report a case of submucosal cysts associated with an early gastric carcinoma in which ultrasonography (US) and endoscopic ultrasonography (EUS) were very useful in the preoperative diagnosis.     

Plasma thrombomodulin level in very low birthweight infants at birth

Objective: Plasma soluble thrombomodulin level reflects endothelial damage. The plasma thrombomodulin level at birth is increased in asphyxiated full-term infants. There is no report of plasma thrombomodulin level in premature infants. To determine the thrombomodulin level in premature infants and whether it might reflect endothelial damage, we examined the plasma thrombomodulin level in very low birthweight (VLBW) infants at birth. Methods: Forty-five VLBW infants, of whom 14 had perinatal asphyxia complications, were recruited. As a control, 50 full-term infants wimout complications were also studied. Plasma thrombomodulin concentration, pH, base deficit, serum creatinine and D-dimer concentration, platelet count and fibrinogen concentration were measured within 1 hour after birth. Results: There were significant differences in plasma pH, creatinine concentration, platelet count, antithrombin in activity and D-dimer concentration between VLBW infants and full-term infants. Plasma thrombomodulin concentration (39. 0 (16. 6–93. 7) vs 27. 0 (16. 6–39. 1) μg/L, p < 0. 0001) and plasma taombomodulin-to-serum creatinine ratio (0. 82 (0. 19–2. 65) vs 0. 47 (0. 24–0. 70) μg/μmol, p < 0. 0001) were significantly higher in VLBW infants than those in full-term infants. By univariate analyses for all neonates, there were significant relations between plasma thrombomodulin concentration and gestational age, birthweight, plasma pH, creatinine concentration, platelet count and antithrombin in activity. A stepwise multiple linear regression model using the above variables as dependent factors showed only birthweight contributed significantly to plasma thrombomodulin concentration (plasma thrombomodulin concentration (μg/1) = 45. 677–0. 006 (birthweight; g), r²= 0. 323, p < 0. 0001, n= 94). Plasma thrombomodulin concentration and plasma thrombomodulin-to -serum creatinine ratio in VLBW infants with asphyxia were higher than in those without asphyxia, but not significantly different (43. 2 ± 17. 7 vs 38. 3 ± 8. 5 μg/1 and 0. 92 ± 0. 60 vs 0. 83 ± 0. 37 μg/μmol). Conclusion: Plasma thrombomodulin level in VLBW infants shows a high value at birth, and we consider the main factor responsible for this elevation may be endothelial damage or low clearance rate of thrombomodulin, which may be related to early gestational age.     

Urinary dysfunction and autonomic control in amyloid neuropathy

Abstract Uro-neurological assessment was performed in four patients with small-fiber neuropathy due to amyloidosis (2 transthyretin-type/2 immunoglobulin light-chain-type). Voiding difficulties were due to detrusor weakness and impaired bladder sensation. In two patients cholinesterase inhibition treatment caused urge incontinence, indicating detrusor denervation supersensitivity. The underlying mechanisms of urinary dysfunction seem to involve postganglionic cholinergic and afferent somatic nerves.     

In vivo selection of tumorigenic subline from non-tumorigenic human gastric carcinoma cells: in relation to proliferative properties in vivo and in nude mice

Human gastric carcinoma cells from one of three long-term cultured cell lines (HPE-GAC-T) were injected into peritoneal cavities of BALB/c mice. The surviving celss in vivo were collected 3 days later. Following brief cultivation in vitro, those cells were reinjected into mice by the same route. This procedure was repeated 3 times. The cultured cancer cells recovered from the mice on the 3rd passage, at a 92.5% recovery rate, showed xenotransplantability in BALB/C nu/nu mice by subcutaneous injection. This subline (GAC-T.M-2) can be maintained in vitro but not in vivo while maintaining heterotransplantability. Three original cancer cell lines did not show tumorigenicity in nude mice. Animal passages by the same protocol failed to select tumorigenic sublines from the other cell lines (HPE-GAC-2 and -3). Factors affecting tumorigenic capacity of cancer cells in nude mice were studied in vivo and in vitro by comparing the properties of GAC-T.M-2 and parental cancer cells (GAC-T.O). Treatment of the hosts by injection of anti-asialoGM1 antibody or cyclophosphamide, adult thymectomy of BALB/c mice, and 400 rads whole body irradiation did not enhance the growth of either GAC-T.M-2 or -T.O cells. There was no detectable difference between in vitro growth properties of the original and variant cells at a rather high cell density. However, at a low cell density GAC-T.M-2 cells showed a higher cell growth rate and increased [3H] thymidine incorporation and possessed higher colony forming activity in the liquid medium than their parental cells. High dense expression of epidermal growth factor (EGF) receptors was evident equally in both GAC-T cells, however, GAC-T.M-2 cells were more sensitive to down-regulation by EGF in culture. Tumor cells of HPE-GAC-2 and -3 lines expressed minimum amount of EGF receptors on their cell surfaces and were refractory to additional EGF in culture. The results indicate that growth factors and their receptors are responsible for tumorigenicity in nude mice.     

Tunica albuginea cyst: a case report]

A 47-year-old male visited our hospital complaining of painless swelling of the right scrotum. Ultrasonography demonstrated hydrocele and a 13 x 12 x 10 mm cystic space along the margin of the right testis. Hydrocelectomy and simple resection of the cyst were performed. Pathologic examination of the excised cyst showed a serous cyst lined with simple flattened epithelium. Ultrasonography is useful for the diagnosis of tunica albuginea cyst.     

Thoracoscopic surgery for lung cancer.

Thoracoscopic surgery has raised awareness in minimizing invasiveness in respiratory surgery. In the case of lung cancer, technical difficulties associated with standard curative surgery may not allow the use of a total thoracoscopic procedure. Although thoracoscopic lung cancer surgery is minimally invasive and safe, it demands a high level of skill and care. Surgery is often performed using a small incision and direct vision, with the thoracoscope serving as a light source. However, thoracoscopic surgery is expected to progress further in the near future. In addition, a new surgical system that comprehends both open and video-assisted thoracic surgery (VATS) may gain popularity.     

Antiproliferative effects of NKH477, a forskolin derivative, on cytokine profile in rat lung allografts.

OBJECTIVE: NKH477 was recently identified as a water-soluble forskolin derivative and was reported to prolong survival of murine cardiac allografts. However, the mechanism of the efficacy is not clear in vivo. The aim of this study was to investigate the immunosuppressive effects of NKH477 on acute lung allograft rejection in the rat model and its mechanism of action in vivo. METHODS: Left lungs were transplanted orthotopically from Brown-Norway donors to Lewis recipients. Recipient rats were untreated or treated daily with different doses of NKH477. Grafts were excised on Day 3 or Day 5 to determine histopathological rejection and expressions of interleukin (IL)-2, IL-4, IL-10, and interferon (IFN)-gamma by enzyme-linked immunosorbent assay. The cytokine expression at Day 3 or Day 5 was also evaluated in recipient spleens by immunohistochemistry. Furthermore, mesenteric lymph node cells from recipients at Day 5 were cultured alone or stimulated with donor antigens for 72 hours to determine cell proliferation by means of thymidine incorporation. RESULTS: NKH477 significantly extended allograft survival time in a dose-dependent manner and reduced histopathological rejection. Treatment with NKH477 inhibited IFN-gamma and IL-10 expression, whereas expression of these cytokines were markedly upregulated in the untreated allografts. Expression of IL-2 and IL-10 also increased in the spleen of untreated allorecipients. NKH477 suppressed expression of both cytokines in the spleen. In addition, lymphocyte proliferation was inhibited in NKH477-treated recipients as compared with untreated recipients. CONCLUSION: These results suggest that NKH477 exerts an antiproliferative effect on lymphocytes in vivo with an altered cytokine profile in rat recipients of lung allografts.