Electron Microscopic and Microspectrophotometric Observations in Scirrhous Carcinoma of the Stomach

Electron microscopic findings obtained from nine scirrhous carcinomasof the stomach were analyzed and each carcinoma was dividedinto deep, superficial, and peripheral areas. Proliferationof collagen fibrils, disappearance of the plasma membrane, andextracellular release of cell organellae of cancer cells werethe peculiar findings in the deep area of the carcinoma. Inthe superficial area, cancer cells containing many mucous granulesgrew within the tunica mucosa, preserving their plasma membranes.In the peripheral area, undamaged cancer cells were seen floatingin the edematous stroma, accompanied by a small amount of collagenfibrils. Microspectrophotometric estimation of the DNA contentof the cancer cells demonstrated an increase of cells belowthe hyperdiploid range in the deep area of the scirrhous carcinomawhen compared with the histograms of the peripheral and superficialareas. From these studies it can be concluded that the scirrhousarea of the carcinoma has little significance for tumor growth.Tumor growth can be determined from the scattered cancer cellsin the edematous stroma at the periphery of the lesion.     

The Characteristics of an Abnormal Electrogram on the Atrialized Right Ventricle in a Patient with Ebstein's Anomaly

Catheter ablation with the use of radiofrequency energy has been used as a treatment for atrioventricular reciprocating tachycardia in patients with Ebstein's anomaly. However, the success rate in these patients is generally low. We experienced a case in which the decision regarding precise accessory pathway (AP) localization was impaired by the presence of an abnormal electrogram in the atrialized right ventricle (ARV) in a patient with Ebstein's anomaly. After the AP conduction was abolished, the abnormal electrogram was observed behind the ventricular wave in the ARV during sinus rhythm. Furthermore, the interval between ventricular potential and the abnormal electrogram observed in the proximal ARV was longer than that in the distal ARV. We suggest that the abnormal electrogram might represent delayed local ventricular activation, and that the potential conduction might be impaired in the ARV.     

Comparison of Body Distribution of Poly(vinyl alcohol) with Other Water-soluble Polymers after Intravenous Administration

The body distribution of poly(vinyl alcohol) (PVA) with molecular weights (MW) from 14800 to 434000 Da was investigated after intravenous administration and compared with that of other water-soluble polymers such as poly(ethylene glycol) (PEG), gelatin, dextran, and pullulan. The half-life of PVA in the circulation was prolonged from 90 min (MW 14800 Da) to 23 h (MW 434000 Da), similar to that of PEG which had a half-life of 30 min (MW 6000) and 20 h (MW 170000). However, the half-life of PVA was much longer than that of other polymers when compared at a similar molecular weight. PVA was located in most organs but with very small accumulation. An insignificant interaction of PVA with cell components, such as macrophages and blood cells, was observed. Similar to PEG, the excretion rate of PVA at the glomeruli was rapidly reduced around 30000 Da, as the molecular weight increased. These results indicate that the half-life of intravenously injected PVA in the blood was mainly determined by the permeation characteristics of the kidney.     

Mathieu and Barcat repair with a V incision sutured meatoplasty for secondary hypospadias surgery

AIM: Today single-stage methods are more frequently selected for hypospadias repair than multistaged methods, but complications cannot always be avoided. We employed two kinds of meatal based flip-flap urethroplasty procedures for those with an unsuccessful primary hypospadias repair. PATIENTS AND METHODS: From 1997 to 2005, a meatal based flip-flap urethroplasty was performed as a secondary hypospadias surgery on 17 patients. Basically we attempted the Mathieu repair, but when the wings of the glans were not generously widened and the urethral groove was not sufficiently deep we applied the Barcat procedure. While 11 patients were repaired with the Mathieu technique, six patients underwent the Barcat repair. The V incision sutured meatoplasty was added to obtain a natural ventral slit-like meatus. RESULTS: Ten of the 11 patients who underwent the Mathieu repair had a good outcome, but one patient developed a urethrocutaneous fistula. None of the six patients repaired with the Barcat procedure encountered postoperative complications. Cosmetically, a vertical slit was constructed near the normal neomeatus with the Mathieu and V incision sutured (MAVIS) meatoplasty and the Barcat and V incision sutured (BAVIS) meatoplasty. CONCLUSIONS: The Mathieu or the Barcat meatal based flip-flap urethroplasty procedure is feasible as a salvage surgery for those with relatively short urethral defects and adequate mobile ventral skin if an exact procedure is selected. Excellent cosmetic results could be obtained by adding the technique of V incision sutured meatoplasty.