Intestinal myoelectric activity and contractile motility in dogs with a reversed jejunal segment after extensive small bowel resection

To evaluate the functioning and effectiveness of a reversed jejunal segment after extensive small bowel resection, we continuously measured the postoperative bowel motility (using bipolar electrodes and/or contractile strain gage force transducers) in interdigestive and postprandial conscious dogs at 2 to 5 weeks after surgery. The fasting duodenal migrating myoelectric (or motor) complex (MMC) occurred at markedly longer intervals in dogs with a 20-cm reversed jejunal segment created after 75% to 80% extensive small bowel resection (group 3) than in dogs that received extensive resection alone (group 2) or dogs that underwent construction of a reversed jejunal segment without bowel resection (group 1). The MMC arising from the duodenum was often interrupted at the jejunum above the proximal anastomosis and did not migrate smoothly to the reversed segment or terminal ileum in group 3. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum above the proximal anastomosis in group 3. The duration of the postprandial period without duodenal MMC activity was significantly prolonged in groups 2 and 3. These results suggest that the transit time and passage of intestinal contents were delayed and that the periodical MMC was disturbed in group 3. The delay of transit time was due to prolongation of the interval between duodenal MMCs, the interruption of MMC propagation at the jejunum above the proximal anastomosis, the dominance of MMCs that followed the inherent anatomical continuity of the bowel, and discordant movements across the proximal anastomosis. Functional obstruction could be a potential problem in a 20-cm reversed jejunal segment inserted after extensive small bowel resection.

[A temporal bone study of the jugular fossa]

This study was performed to elucidate the anatomic variations of the jugular fossa (JF) on the basis of examination of 120 human temporal bones. Observations were made of temporal bones sectioned along a plane including the cochlea, the JF, and long axis of the internal auditory canal. The position of the upper margin of the JF was classified according to its relation to the tympanic cavity, the cochlea, and the internal auditory canal. The height of the upper margin of the JF was classified as follows. Low type; inferior to the level of the external auditory canal. Middle type; between the level of the external auditory canal and the cochlea. High type; superior to the level of the cochlea. The results revealed that 58 ears were of low type, 46 middle type, and 16 high type. Middle and high type comprised 62 ears, thus in 52% of ears the upper margin of the JF was situated superior to the external auditory canal. The relation between the JF and the cochlea was classified as follows. Medial type; medial to the medial margin of the cochlea. Lateral type; lateral to the medial margin of the cochlea. The results showed that 74 ears were of medial type, and 46 lateral type. Therefore, in 62% of ears the upper margin of the JF was situated medial to the medial margin of the cochlea. Forty-seven ears of medial type were of middle or high type. Ears of lateral type included none of high type. The jugular bulb diverticulum was observed in 32 ears, which consisted of 3 of low type, 13 middle type, 16 high type. When the upper margin of the JF was positioned higher, the JF was in a more medial position. However, no defect of the bony labyrinth was observed. In conclusion, it is considered that protrusion of the jugular bulb into the tympanic cavity was not caused by the abnormally high position of the JF, but by its lateral displacement. Distances from the JF to the surrounding structures were as follows; to the tympanic membrane 5.58 +/- 2.43mm (mean +/- S.D.), to the tympanic cavity 2.94 +/- 1.92mm, to the cochlea 4.93 +/- 2.20mm, and the internal auditory canal 5.82 +/- 2.38mm.

Alpha-fetoprotein production by hepatocellular carcinoma is prognostic of poor patient survival

Immunohistochemistry using the avidin-biotin-peroxidase complex method was performed to study the production of alpha-fetoprotein (AFP) in hepatocellular carcinoma (HCC) tissue specimens which were obtained surgically. The relationship between staining for AFP and serum AFP levels or pathological findings was examined. The prognosis of the patients with HCC who underwent curative hepatic resections was studied with respect to the staining for AFP in their tumors. The mean serum AFP level in patients with positive AFP staining was significantly higher than in those with negative AFP staining. No significant relationship was found between AFP positivity and tumor size, tumor encapsulation, degree of vascular invasion, or the histological differentiation grade of the tumor. The patients with AFP-positive carcinomas had a poorer prognosis than did those with AFP-negative carcinomas (5-year survival rate of AFP-positive and negative groups were 26.7% and 56.5%, respectively.

A resected case of hepatoblastoma originating in the caudate lobe

A very rare case of hepatoblastoma originating in the caudate lobe in an 18-month-old female infant is reported. Three years after surgical resection of the tumor, she is alive without signs of a recurrence.

Sensorineural hearing loss associated with otitis media with effusion

The clinical records of 1,372 cases of otitis media with effusion (OME) treated during the past 10 years were reviewed in search of associations with sensorineural hearing loss (SNHL). In 14 cases (1.0%), the development of SNHL was considered to be etiologically related to OME. These 14 cases were classified into two groups. In group A, which consisted of 5 cases, the clinical feature was acute onset of SNHL and gradual improvement. In group B of 9 cases, SNHL progressed gradually or insidiously and did not improve. Different pathophysiology may be assumed to underlie these two groups. The results of this study demonstrate that we have to pay attention to a possible development of SNHL during the course of OME.

[Prognosis of acute low-tone sensorineural hearing loss]

We studied 50 patients with acute low-tone sensorineural hearing loss (ALHL) who were examined at the Department of Otolaryngology, University of Tokyo, and followed up for 18 months or more. We investigated the prognosis of hearing loss within 3 months after onset, rate of recurrence during long-term follow-up, interval between the first and the second episodes of hearing loss or between onset and the time when the diagnosis of Meniere's disease was made, and factors affecting prognosis. The results were as follows. 1. Within the initial 3 months of follow-up, hearing loss continued to fluctuate in 5 patients. In the remaining 45, hearing returned to normal in 34, improved without returning to normal in 6, showed no marked change in 4, and became worse in one. 2. In long-term follow-up, the recurrence of hearing loss without vertigo occurred in 16 patients, and 5 others were eventually diagnosed as having Meniere's disease. The average interval between the first and second episodes of hearing loss was 9.2 months, and the diagnosis of Meniere's disease was made an average of 27 months after onset. 3. Recurrence was not significantly related to the initial prognosis of hearing loss. 4. Within the initial 3 months of follow-up, the prognosis of hearing loss was significantly better in patients whose hearing loss at 1 kHz was within 20 dB, and tended to be better in females and in patients attending within one week of onset. Long-term follow-up showed that the rate of recurrence was significantly lower in patients aged 40 years or more, and tended to be lower in patients who visited the hospital within one week of onset or whose hearing loss at 1 kHz was within 20 dB. 5. There were no significant differences between patients with single and recurrent attacks with respect to sex, subjective symptoms, and results of the glycerol test and electrocochleography. ALHL tends to recur without any relationship to the initial prognosis of hearing loss. Since it is still difficult to predict whether or not hearing loss will recur, long-term follow-up is necessary even in patients with good initial prognosis.

An experience of cell sorting using samples isolated from paraffin-embedded tissue of neuroblastoma

Flow cytometric DNA content analyses were performed on samples from 72 patients with neuroblastoma. Nuclear suspensions obtained from paraffin-embedded samples were prepared using the method described by Schutte et al. Determination of DNA ploidy was possible in 62 out of 72 patients. DNA diploidy was detected in 23 (37.1%) and DNA aneuploidy was found in 39 (62.9%) of these 62 patients. Cell sorting was performed on two peak areas of the DNA histogram of samples with aneuploidy. The sorted cells of the first peak area were composed of small round cells and were considered to be normal lymphocytes. The sorted cells of the second peak area were composed of relatively large cells with obvious nucleoli and were considered to be neuroblastoma cells. Thus, two cell components could be distinguished by cell sorting. It is concluded that cell sorting may be of benefit in giving detailed information about DNA histograms, even in samples obtained from paraffin-embedded tissue.

Anterior sagittal anorectoplasty for rectovestibular and anovestibular fistula

Rectovestibular (or anovestibular) fistula is the most common form of anorectal anomaly in female infants. In the surgical repair of these malformations, anal transplantation has been in widespread conventional use. Based on the idea of posterior sagittal anorectoplasty, we devised a new approach, anterior sagittal anorectoplasty, in which, in the lithotomy position, the anterior portion of sphincter muscles are cut through a median perineal skin incision and then the rectum is pulled through the center of these muscles to make its opening at the normal position. The operation has been performed in 12 patients with satisfactory results.

A new nonoperative method of percutaneous transgastric fistulo-drainage for an intractable external pancreatic fistula--a case report

The external pancreatic fistula is a well-known complication of pancreatectomy and is conventionally classified as either a partial fistula or a total fistula. A partial fistula usually closes spontaneously and operative intervention is rarely needed, whereas, a total fistula on the other hand, very often does not close and may therefore require surgical intervention. We report herein, a case of an intractable total pancreatic fistula following pancreatoduodenectomy which was successfully repaired by a new non-operative method of percutaneous transgastric fistulo-drainage (PTFD). This technique, performed under the control of a two-way X-ray television system, is safe and considered useful for the treatment of an intractable total pancreatic fistula. In the future, this may be the method of choice for the management of such refractory total pancreatic fistulae.

Electronystagmographic recordings of guinea pig animal models in experimental otology

The vestibular function test in the guinea pig consists of spontaneous nystagmus recording, positional test and caloric test. If clip electrodes are used, recording of nystagmus in the guinea pig is successful. It takes less than 30 min to complete the whole test, and the animal tolerates the procedure without any complication.

Stimulation of neutrophil adherence to vascular endothelial cells by histamine and thrombin and its inhibition by PAF antagonists and dexamethasone

1. In order to clarify the roles of platelet-activating factor (PAF) in histamine- and thrombin-induced neutrophil adhesion to vascular endothelial cells, the effects of several PAF antagonists were examined. The effects of the glucocorticoid dexamethasone were also examined in order to gain further insight into the anti-inflammatory actions of glucocorticoids. 2. In culture, histamine and thrombin stimulated the adherence of rat peritoneal neutrophils to human endothelial cells from the umbilical vein. They did not stimulate neutrophil adherence in the absence of endothelial cells, suggesting that the target cells for the histamine- and thrombin-induced adherence of neutrophils were endothelial cells, not neutrophils. 3. Several PAF antagonists, such as CV-3988, L-652,731 and Y-24,180 inhibited the histamine- and thrombin-induced neutrophil adherence in a concentration-dependent manner. Indomethacin failed to inhibit it. 4. Dexamethasone, a steroidal anti-inflammatory drug, did not inhibit the histamine- and thrombin-induced adherence of neutrophils to endothelial cells when the drug was present only during the 20 min incubation period for the adherence assay. When the endothelial cells were preincubated for 3 h with dexamethasone, the adherence of neutrophils to endothelial cells induced by histamine or thrombin was not inhibited. 5. When the neutrophils were preincubated for 3 h with dexamethasone, the histamine- and thrombin-induced adherence of neutrophils to endothelial cells was inhibited. 6. Our studies indicate that: (a) adherence of neutrophils to endothelial cells induced by histamine and thrombin is mediated by PAF production since PAF antagonists inhibited the adherence of neutrophils; and (b) neutrophils, not endothelial cells, are the target cells through which dexamethasone acts to inhibit adherence.

Vestibular pathology in a new-mutant mouse

The histological characteristics of the vestibule in a strain of new-mutant mice were studied under light microscopy. These new-mutant mice, manifesting drawing back, circling, head-tossing and hyperactive behavior arose as a spontaneous mutation in the C3H/He stock. For our study, 36 of these mice ranging in age from 10 days to 18 months were used. At 10 to 15 days after birth, the vestibular gross anatomy was well-developed and all three cristae and two maculae were morphologically normal. Age-dependent degeneration of the saccular maculae was found to begin at 21 days, and almost all hair cells were missing at 90 days. Further, morphological changes in the utricular maculae appeared at one year, and a severe loss of hair cells was observed at 18 months. In contrast, the cristae ampullaris remained well preserved until the age of 18 months. The phenotype of the abnormal gene in these mutant mice correlates to the morphological abnormalities seen in the vestibule.

Morphological changes of cochlea in a strain of new-mutant mice

The hearing ability and histological characteristics of the cochlea of a strain of new-mutant mice were analyzed. This new mutant arose as a spontaneous mutation in the C3H/He stock. The genetic mode is autosomal recessive and the animals show abnormal behavior such as circling, head-tossing and hyperactivity. The audiological findings exhibited no recordable auditory brain stem response (ABR) in any homozygotes at ages ranging from 11 days to 117 days. For morphological examination, we used 36 homozygote with ages ranging from 10 days to 18 months. The primary morphological abnormalities were observed in the organ of Corti. The stereocilia of the outer hair cells showed disarray throughout the whole cochlea, although outer hair cell cytoplasm became fully developed, including the nerve terminals. Age-dependent degeneration of the outer hair cells subsequently occurred from the basal to the apical part of the cochlea. The earliest change demonstrated in the outer hair cells was cuticular degeneration. Although the abnormalities of the inner hair cells occurred late, a complete loss of inner and outer hair cells was demonstrated. The stria vascularis was well preserved at a later age as were spiral ganglion cells. These histological findings confirm that this mouse is classified as a neuroepithelial-type mutant. As this animal was expected to have a single gene abnormality, molecular genetic studies on this animal can provide important information on the nature of histological changes of the hair cell from a mode of gene action.

[5'-deoxy-5-fluorouridine (5'-DFUR), mitomycin C (MMC), etoposide and medroxy progesterone acetate (MPA) in a previously treated patient with advanced breast cancer]

An advanced breast cancer patient refractory to CAF (Cyclophosphamide, Adriamycin, 5-fluorouracil), 5-FU-Methotrexate sequential therapy and Tamoxifen was treated with the combination 5' DFUR, MMC, Etoposide and MPA. Complete response was obtained both against liver and lymph node metastases from 7 months after the initial treatment. A mild bone marrow suppression and appetite loss were observed as the side effect. It is suggested that the combination therapy may be useful for previously treated patients with advanced breast cancer.

WS-7528, a new isoflavanone with estrogen activity isolated from Streptomyces sp. No. 7528. Taxonomy, fermentation, isolation, physico-chemical properties and biological activities

WS-7528, produced by Streptomyces sp. No. 7528, was extracted from cultured broth, purified by solvent extraction followed by chromatography on silica gel and then isolated as pale yellow powder (C16H14O5, mp 95-98 degrees C). WS-7528 inhibited estrogen binding to its receptor protein in rat uterine cytosol. The IC50 value of WS-7528 for partially purified rat uterine cytosol receptor was 5.7 x 10(-8) M. This compound was found to induce the growth of the estrogen dependent cell line MCF-7. WS-7528 was tested orally and subcutaneously in immature rats to confirm its effect on the growth of the uterus. WS-7528 has also weak anti-inflammatory activity on the carrageenin paw edema of the rat model.

Nitrogen sparing by 2-ketoisocaproate in parenterally fed rats

In rats receiving total parenteral nutrition with or without sodium 2-ketoisocaproate (KIC; 2.48 g.kg-1.day-1), L-[1-13C]leucine and [1-14C]KIC were constantly infused for 6 h. CO2 production, 14CO2 production, 13CO2 enrichment, urinary urea nitrogen (N) plus ammonia N and total urinary N were measured. Whole body protein synthesis (S) was calculated in non-KIC-infused rats and also in unfed rats infused with [1-14C]leucine from fractional oxidation of labeled leucine (1-F), where F is fractional utilization for protein synthesis, and urea N plus ammonia N excretion (C) as S = C x F/(1-F). Addition of KIC caused a significant reduction in N excretion and a significant improvement in N balance. Fractional oxidation of labeled KIC increased, whereas fractional utilization of labeled KIC for protein synthesis decreased, but the extent of incorporation of infused KIC into newly synthesized protein (as leucine) amounted to at least 40% of the total rate of leucine incorporation into newly synthesized whole body protein. We conclude that addition of KIC spares N in parenterally fed rats and becomes a major source of leucine for protein synthesis.

Direct injection analysis of ketoprofen enantiomers in plasma using column-switching high-performance liquid chromatography system

A high-performance liquid chromatography system was developed for the stereoselective determination of ketoprofen enantiomers in human plasma following direct sample injection. The system comprised of a pretreatment column and a chiral separation column connected in a series via a switching valve. When a 200 microliter portion of human plasma containing a therapeutic level of ketoprofen was directly applied to the system, ketoprofen was adsorbed in the pretreatment column, while plasma proteins were excluded. After the elution of proteins from the pretreatment column, the valve was switched and ketoprofen was desorbed and transferred to the chiral separation column where the enantiomers were separated and determined by ultraviolet-absorption. The mobile phase conditions for the pretreatment and chiral separation were optimized, which enabled rapid and complete recovery followed by satisfactory separation of the enantiomers. The calibration line for each enantiomer showed good linearity in the range of 0.25-5 micrograms/ml with a detection limit of 0.02 micrograms/ml (signal to noise ratio (S/N) greater than 3), which was sufficient for practical demands. The precision test indicated that the coefficient of variation for five repeated determinations of (-) ketoprofen was 5.4% at 0.1 microgram/ml and 1.4% at 1 microgram/ml.

[Doppler ultrasonic assessment with hemodynamics of gynecologic tumor]

Color and pulsed Doppler ultrasound examinations were done on 11 normal volunteers (NU) and 286 patients that consisted of cervical carcinoma (CC), leiomyoma and/or adenomyosis (M), endometrial carcinoma (EC), trophoblastic disease (TD), benign ovarian tumor (BO), Krukenberg tumor (KT) and ovarian carcinoma (OC). The vascularity was based on the resistance index (RI) and maximum blood flow velocity (Vmax). In uterine disease, there was significant difference (p less than 0.01) among each group, except but one correspondence between NU and CC with RI, and there was significant difference (p less than 0.001) between NU and M, CC and M with Vmax. In ovarian disease, there was significant difference among each group with RI, and there was no significant difference among each group with Vmax. Therefore, Doppler ultrasound is a useful diagnostic tool for assessing gynecologic tumor vascularity.