LONG‐TERM FOLLOW UP OF PATIENTS WITH SMALL GASTROINTESTINAL STROMAL TUMORS IN THE STOMACH USING ENDOSCOPIC ULTRASONOGRAPHY‐GUIDED FINE‐NEEDLE ASPIRATION BIOPSY

Background: Gastrointestinal stromal tumors (GIST) are one of the most common mesenchymal tumors of the gastrointestinal tract. GIST are defined by positive immunohistochemical staining for KIT or CD34 and thus are generally diagnosed after surgery. Because small GIST are rarely diagnosed before surgery, the clinical course of these small tumors is not clear. The aim of the present study was to follow changes in size and configuration of small GIST that were pathologically confirmed using endoscopic ultrasonography‐guided fine‐needle aspiration biopsy (EUS‐FNAB). Methods: Between July 1997 and December 2003, 16 tumors in 16 patients (10 men and 6 women) with an immunohistochemical diagnosis of GIST were regularly followed in our hospital. The median patient age when EUS‐FNAB was performed was 62 years (range 26–82 years) and the median follow‐up period was 4.9 years (range 0.5–9.6 years). Results: Fourteen tumors showed no remarkable changes in size and shape during follow up compared with the initial diagnosis. Two tumors enlarged: one tumor approximately doubled its diameter in 8 years and the other tumor increased from 1.8 cm at diagnosis to up to 10 cm after only 2 years. Doubling time of the latter tumor was calculated as 3.1 months. Conclusions: We conclude that EUS‐FNAB might be a good modality for final diagnosis of GIST without surgery, and that GIST without rapid growth on follow up can be endoscopically followed.     

Is additional epidural sympathetic block in microvascular surgery contraindicated? A preliminary report

The use of additional epidural sympathetic block during and after microvascular surgery in the lower extremities to prevent vasospasm is generally agreed on. However, a significant fall in the perfusion rate of the transplants was seen after application of bupivacaine (Marcain) via the epidural catheter. This effect has, to our knowledge, not been described before and is probably caused by the sympathectomy effect of this type of analgesia.     

Metabolic and hormonal parameters of humans during long-term hyperbaric exposure (the recompression treatment table)]

Several metabolic and hormonal parameters were evaluated in blood of two human subjects during simulation of an extended saturation dive. Increases in creatine kinase and an upward trend in cholesterol and glucose were observed after decompression. The levels of TTH and thyroxin went up in both subjects during exposure. The significant changes in cortisol, ACTH, insulin and C-peptide were a fingerprint of stress-reaction. After eight days of recovery most of the parameters returned to baseline values. The investigation suggests that the recompression treatment table did not cause pathological changes in the biochemical and hormonal parameters of humans.     

Erosive gastropathy not associated with duodenal ulcer]

There was a study of 422 in-patient subjects of the therapeutic profile. Endoscopy enabled to discover mucous coat erosions of the antral part of the stomach associated with Helicobacter pylori and absence of ulcer in the anamnesis in 8.7% of them (more frequently in women). As many as 81% of such patients belonged to patients with the ischemic heart disease. Erosive gastropathy is accompanied by the activity of the chronic inflammation response in the duodenum mucous coat that is most evident in IHD patients.     

Culturing of human placental macrophages

Cells were isolated by successive dissociation of human placenta in dispase and collagenase solutions and separated by centrifugation in Ficoll-Verografin gradient. Cell suspension was enriched with macrophages by adhesion to plastic followed by washing with RPMI-1640. Isolated placental macrophages can be cultured for a long time. Cell culture homogeniety assessed by various methods was equal or exceeded 95%. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 125, No. 5, pp. 579–582, May, 1998