A case of malignant haemangioendothelioma treated with recombinant interleukin-2

A case of malignant haemangioendothelioma of the scalp in an 82-year-old female treated with intralesional, intra-arterial and intravenous recombinant interleukin-2 (rIL-2) is reported. The scalp lesions disappeared after injection of 35 350 000 Japan reference units of rIL-2 and excision of the residual tumour. Immunohistochemical characterization of the cells infiltrating the lesion after rIL-2 administration revealed 30–40% CD4⁺ and CD8⁺ T lymphocytes, 20–30% macrophages and 5–10% natural killer cells. These findings are similar to those in other human cancers. Almost all of the cells in the intersticies of the lesion after rIL-2 injection expressed leucocyte function-associated antigen-1, and some of the tumour cells and the infiltrating cells around them expressed intercellular adhesion molecule-1. HLA-DR-positive cells markedly increased in number after rIL-2 administration. This report suggests that rIL-2 administration is the most effective therapy for malignant haemangioendothelioma.     

Current Density Distribution by Ring and Diagonally Arranged Half‐Ring Electrodes in Bipolar and Overlapping Biphasic Impulse Stimulation

Background: We have studied the acute and long‐term efficacy of overlapping biphasic impulse (OLBI) stimulation for atrial pacing with VDD pacemakers and demonstrated the feasibility of DDD pacing in OLBI with diagonally arranged half‐ring (Half‐Ring) electrodes. We made two three‐dimensional computational analysis models to verify our clinical studies. Methods and Results: Model I was composed of a heart, a pacemaker, and a human body. Model II was a cube with dimensions of 20 by 20 by 20 mm quarried from Model I for the detailed study of current density distributions. Laplace's equation was solved using the finite element method and the current density J was calculated. For Model I, the distal and proximal voltages were ?10 V, 0 V in bipolar and ?5 V, +5 V in OLBI, using Ring electrodes. In Model II, the actual measurements of electrode impedances obtained from the clinical study (1,180 Ω for Ring and 630 Ω for Half‐Ring) were added to the analysis conditions. Model I showed that OLBI produced more concentrated current density distributions than those by bipolar. According to Model II, at the atrial myocardium position current density produced by Half‐Ring was larger than that by Ring electrodes, 70 μA/mm² versus 30 μA/mm² in OLBI configuration. It also indicated that even if electrode impedances were equal between Half‐Ring and Ring electrodes, the maximum current density produced by Half‐Ring would be greater than that by Ring electrodes. Conclusions: It was considered that OLBI configuration with Half‐Ring electrodes provides more effective current density distributions. (PACE 2010; 33:1063–1073)     

双层法氧合冷保存心跳停搏大鼠肝细胞移植研究

目的 观察双层法(TLM)氧合冷保存较UW保存能否改善心跳停搏供体(NHBD)肝细胞存活率和功能.方法 SD大鼠为供体,建立NHBD模型,NAPs大鼠为受体.根据热缺血时间(WIT)15 m/n和30 m/n分成2组;按TLM、UW分别保存3、12 h和未保存再各分5个亚组(n=5).检测NHBD肝细胞存活率和ATP水平,观察肝细胞移植(HTx)后肝细胞形态和功能.结果 TLM3、12 h组肝细胞存活率分别显著高于UW 3、12 h组[(69.7±4.1)%和(69.1±2.0)%比(55.1±2.3)%和(53.3±2.0)%;P<0.01];TLM 3、12 h组AlP水平分别显著高于UW 3、12 h组(3.25±0.79和3.06±0.67比2.25±0.53和1.63±0.40;P<0.05或P<0.01).HTx后几乎所有时间点TLM组血清白蛋白(ALB)水平都显著高于UW组(P<0.05或P<0.01).在HTx 14d后,形态学显示TLM组肝细胞保持强活力,糖原和ALB染色呈强阳性.结论 TLM氧合冷保存可显著改善和逆转NHBD肝细胞存活率和功能,减少NHBD肝细胞缺血性损伤.     

长乐地区居民血清胃蛋白酶原和幽门螺杆菌抗体水平分析

[目的]分析长乐地区居民血清胃蛋白酶原（PG）含量和幽门螺杆菌（Hp）感染率,了解基本人群分布特征,探索相关影响因素。[方法]用ELISA法检测224名居民血清PGⅠ、PGⅡ含量,并计算PGⅠ/Ⅱ比值;用ELISA法检测血清Hp IgG抗体水平。[结果]长乐地区居民血清PGⅠ、PGⅡ及PGⅠ/Ⅱ中位值分别为110.8μg/L、13.9μg/L、7.9,在不同性别、不同年龄组中3者类似。Hp感染率为49.6%,感染者血清PGⅡ值（中位数为15.8μg/L）高于非感染者（11.6μg/L,P〈0.01）,但PGⅠ/Ⅱ比值（7.3）较后者低（8.5,P=0.023）。[结论]长乐地区居民血清PG水平呈明显偏态分布,与Hp感染密切相关,是否受性别、年龄影响有待进一步研究。     

The influence of spacers on forces exerted on the abutment teeth of complete mandibular overdentures

The avoidance of lateral forces on overdenture retainers is essential to prevent pathological change in the supporting tissues of the root abutment. In this study, the influence of spacer thickness on the vertical and lateral forces exerted on overdenture abutments was examined clinically. Two subjects with an edentulous maxilla, two canines and a left first premolar remaining in the mandible were selected for the experiment. The anchor type attachment was embedded in the left canine portion of the denture base. The transducer used for the previous study (Ogata et al., 1990), was embedded in this left canine portion. The transducer could detect the magnitude and direction of lateral forces exerted on an abutment tooth parallel to the Camper's plane. The other transducer was embedded in the left first mandibular premolar area, and could detect vertical forces exerted on the abutment tooth perpendicular to the Camper's plane. Furthermore, the transducer could change the space between a denture base and an abutment tooth to 1.5 mm, 0.6 mm or 0.3 mm. Therefore measurements could be made in the same way as if three experimental dentures had been used with a different thickness spacer. Recordings of forces were taken during food chewing, using each spacer on the day of denture insertion and twice at intervals of 1-2 weeks thereafter. The results demonstrated that as spacer thickness decreased, the magnitude of the lateral forces decreased, while the magnitude of the vertical forces increased. These findings suggest that a large part of the lateral component of forces exerted on an abutment tooth could be converted into a vertical component by using a thinner spacer.     

Familial occurrence of congenital bile duct cysts

Congenital bile duct cysts are now a well-documented anomaly of the biliary tree, and have become more common in Japan. Familial occurrence of congenital bile duct cysts, however, is extremely rare, with only six reported cases in the literature. We report a familial pattern of congenital bile duct cysts in a mother and her daughter. A 33-year-old female was admitted for evaluation of right upper quadrant abdominal pain and fever 6 days after an uneventful delivery of her second child. A com- puted tomography (CT) and ultrasound scan (US) revealed an obstructed biliary tract. Percutaneous transhepatic biliary drainage was then performed, and a cholangiogram revealed a Scholtz type B choledochocele without an anomalous connection of the pancreaticobiliary ducts. Endoscopic US demonstrated that the choledochocele was associated with a stone in the cyst. A pylorus-preserving pancreatoduodenal resection was performed, and a histological study revealed that the choledochocele was lined by biliary mucosa without evidence of malignancy. The newborn infant had an abdominal tumour. An US and CT revealed a congenital bile duct cyst. An operation was performed and the intraoperative cholangiogram showed an Alonso-Lej type I congenital bile duct cyst with an anomalous connection of the pancreaticobiliary ducts. Whether congenital bile duct cysts are hereditary remains to be elucidated.     

Endoscope-assisted minilaparotomic radical retropubic prostatectomy

OBJECTIVE: To assess the clinical efficacy of endoscope-assisted minilaparotomic radical retropubic prostatectomy (EAM-RRP) compared with conventional radical retropubic prostatectomy (cRRP). METHODS: From September 2001 to December 2003, 30 patients with localized prostate cancer were treated by EAM-RRP. The surgical manipulation was performed through the wound with thoracoscopic assistance, using standard surgical instruments. In all cases, 800 mL of blood was collected from the patient for autotransfusion. For both EAM-RRP and cRRP, the internal iliac and obturator lymph nodes were dissected before the prostate removal. Clinical indicators such as operation time, blood loss, and duration of postoperative urine incontinence were analysed in the two groups. RESULTS: The postoperative period before ambulation and the duration of postoperative urine incontinence were significantly shorter after EAM-RRP than after cRRP, while no significant difference was found in operation time, blood loss, and duration of urethral catheterization. None of the cases required allotransfusion. CONCLUSION: EAM-RRP, which had a shorter postoperative period before ambulation and continence, is considered a safe and useful technique for radical prostatectomy.     

Anticardiolipin Antibodies in Patients With Pregnancy Loss Induce Factor Xa Production in the Presence of (β2-Glycoprotein I

PROBLEM : Anticardiolipin antibodies (aCL) are commonly associated with recurrent pregnancy loss, though the mechanism is uncertain. Some investigators have indicated that aCL may be directed at a complex made up of cardiolipin and a blood anticoagulant, β2-glycoprotein I (β2GPI). We therefore investigated the effects of β2GPI-dependent aCL IgG enriched fractions, isolated from sera of patients with pregnancy losses, on blood coagulation. METHOD : β2GPI-dependent aCL were prepared from sera of three women with second trimester pregnancy losses, by cardiolipin affinity column chromography, following by anti-β2GPI affinity column chromatography. The effects of β2GPI and β2GPI-dependent aCL on the activation of factor X in vitro were examined. RESULTS : β2GPI inhibited the activation of factor X and β2GPI-dependent aCL blocked this inhibitory effect in a dose dependent manner. CONCLUSION : These results imply the possibility of β2GPI-dependent aCL induce hypercoagulation or thrombus by blocking the inhibitory effect of β2GPI on activation of factor X, which may result in pregnancy loss.