Endoscopic decompression using a transanal drainage tube for acute obstruction of the rectum and left colon as a bridge to curative surgery

OBJECTIVE

The aim of this study was to clarify the usefulness of the management of acute left colon and rectum obstruction because of colorectal carcinoma using a transanal ileus drainage tube before curative surgery.

METHOD

Forty-six patients (24 males and 22 females, aged 24-94 years, mean = 56.2) treated between September 2005 and March 2007 for acute left colon and rectal obstruction were identified in a colorectal obstruction database, and their clinical and radiological features were reviewed. After a cleaning enema was administered, urgent colonoscopy was performed. Subsequently, endoscopic decompression using a ileus tube was attempted.

RESULTS

Endoscopic decompression using the ileus tube was technically successful in 45 of 46 patients (97.8%). Perforation occurred in one patient 3 days later and emergent operation was performed. The site of obstruction was the rectum in 15 patients, the sigmoid colon in 18, the descending colon in 13. Following adequate cleansing of the colon, patients' abdominal girth were decreased from 91 +/- 4 cm before drainage to 82 +/- 2 cm 7 days later, and one-stage surgery after 8 +/- 1 days (SD; range 7-10 days) were performed. No anastomotic leakage or postoperative stenosis occurred after operation.

CONCLUSION

Management of acute left colon and rectum obstruction because of colorectal carcinoma using the ileus tube was found to be effective and safe, considered as a bridged method before curative surgery.

Immune modulation by chondroitin sulfate and its degraded disaccharide in the development of experimental autoimmune encephalomyelitis (EAE) (50.2)

We attempted to understand the immune modulation mediated by chondroitin sulfate A (CS-A) and its disaccharide degradation product (CSPG-DS) in the development of experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis. Clinical symptoms in myelin oligodendrocyte glycoprotein peptide (MOG35-55)-induced EAE mice significantly enhanced following CS-A injection, whereas CSPG-DS injection completely inhibited EAE development. When a clinically more severe form of EAE was induced, CS-A accelerated the clinical disease, whereas CSPG-DS significantly delayed EAE. Further studies demonstrated that CS-A up-regulated STAT4 expression, and thus induced interferon-gamma production and Th1 CD4 T cell differentiation. CS-A also up-regulated STAT3 expression and increased IL-17 producing T cell populations. CSPG-DS treatment both in vivo and in vitro decreased tumor necrosis factor - alpha production from splenocytes. In vitro and in vivo assay indicated that CSPG-DS treatment significantly blocked T cell migration, whereas CS-A treatment increased lymphocyte infiltration in the brain when compared to MOG-treated control mice. Our results suggest that while CS-A exacerbates the development of EAE, CSPG-DS administration may be useful in its treatment. (Supported in part by NIH grants R01AI053703, R01ES09098, R01 AI058300, R01DA016545, R01HL058641 and P01AT003961).

Endoscopic ultrasound-guided drainage of abdominal abscesses and infected necrosis

Traditionally abdominal abscesses have been treated with either surgical or radiologically guided percutaneous drainage. Surgical drainage procedures may be associated with considerable morbidity and mortality, and serious complications may also arise from percutaneous drainage. Endoscopic ultrasound (EUS)-guided drainage of well-demarcated abdominal abscesses, with adjunctive endoscopic debridement in the presence of solid necrotic debris, has been shown to be feasible and safe. This multicenter review summarizes the current status of the EUS-guided approach, describes the available and emerging techniques, and highlights the indications, limitations, and safety issues.

Blind adaptive filtering for non-invasive extraction of the fetal electrocardiogram and its non-stationarities

The objective is to extract automatically a beat-to-beat fetal electrocardiogram (fECG) from a maternal electrocardiogram (mECG) using surface electrodes placed on the maternal abdomen and to derive fetal PR, QT, QTc, and QS durations to allow early diagnosis and monitoring treatment of certain fetal cardiac disorders. mECG and abdominal noise in abdominal maternal recordings can be orders of magnitude stronger than the fECG signal and the P and T waves that are embedded in them. A two-stage blind adaptive filtering algorithm was used for fECG extraction, the first stage using frequency-domain electrocardiogram features and the second considering time-domain features. Three channels of abdominal recordings were obtained from 12 patients at 20–40 weeks of gestation. In each case beat-to-beat unaveraged fECGs were isolated. The combined filter allowed identification of diagnostically important PR, QT, and RR durations. Comparison with synthetic data is also included.

Influence of learning effect on blue-on-yellow perimetry

PURPOSE

Some studies have found that a significant blue-on-yellow perimetry (B/YP) learning effect exists in patients with ocular hypertension (OHT) or open-angle glaucoma who were experienced in standard automated perimetry. However, very little is known about the B/YP learning effect in normal subjects and patients without previous white-on-white perimetry (W/WP) experience. Meanwhile, it is unclear whether the B/YP learning effect is influenced by age and refraction.

METHODS

Twenty healthy subjects, 26 OHT and 14 primary open angle glaucoma (POAG) patients, underwent three full-threshold B/YP tests at intervals of 7 to 21 days. Of the 60 subjects, 38 had no previous W/WP experiences, 22 had previous W/WP experiences for at least two times. The parameters investigated to detect a learning effect were the perimetric indices and the test duration (TD).

RESULTS

Learning effects were demonstrated for mean deviation (MD), pattern standard deviation (PSD), short-term fluctuation (SF), and TD. Significant differences were found between the MD, PSD, SF, and TD of the first test and those of the second and third tests (p<0.05). However, no difference was found between those parameters of the second and third tests. No statistically significant differences were noted in terms of MD1st-2nd, MD1st-3rd, PSD1st-2nd, PSD1st-3rd, TD1st-2nd, and TD1st-3rd between the group with W/WP experience and the group without previous W/WP experience (p>0.05). No statistically significant differences were noted in terms of those parameters among the normal subjects and the patients with OHT or POAG (p>0.05). No significant difference was found in the B/YP learning effect among various age groups (p>0.05) and among various refraction groups (p>0.05).

CONCLUSIONS

A significant learning effect was observed between the first and the second or third tests and the perimetric indices appeared improved at full-threshold B/YP. The previous W/WP experience and the subject age and refraction did not influence the B/YP learning effect. This above all should be taken into account when considering the clinical use of this test to avoid erroneous diagnostic conclusions.

Three-dimensional direct writing of B35 neuronal cells

We have demonstrated two-dimensional and three-dimensional transfer of B35 neuronal cells onto and within polymerized Matrigel substrates, using matrix-assisted pulsed laser evaporation-direct write (MDW). The B35 cells were transferred from a quartz ribbon to depths of up to 75 microm by systematically varying the fluence emitted from the ArF (lambda = 193 nm) laser source. MDW-transferred cells were examined using terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling (TUNEL), 4',6-diamidino-2-phenylindole (DAPI), and alpha-tubulin staining. Confocal microscopy has shown that the transferred B35 cells extended their axons outward in three dimensions within the polymerized Matrigel substrate. The B35 cells made axonal connections and formed a three-dimensional neural network within 72 h after MDW transfer. In addition, TUNEL staining demonstrated that only 3% of the B35 cells underwent apoptosis after being transferred using the MDW process. MDW and other emergent direct write processes may provide unique approaches for creating layered, heterogeneous, three-dimensional cell-seeded scaffolds for use in peripheral nerve repair.

Effects of yogurt and bifidobacteria supplementation on the colonic microbiota in lactose-intolerant subjects

AIMS

Colonic metabolism of lactose may play a role in lactose intolerance. We investigated whether a 2-week supplementation of Bifidobacterium longum (in capsules) and a yogurt enriched with Bifidobacterium animalis could modify the composition and metabolic activities of the colonic microbiota in 11 Chinese lactose-intolerant subjects.

METHODS AND RESULTS

The numbers of total cells, total bacteria and the Eubacterium rectale/Clostridium coccoides group in faeces as measured with fluorescent in situ hybridization and the faecal beta-galactosidase activity increased significantly during supplementation. The number of Bifidobacterium showed a tendency to increase during and after supplementation. With PCR-denaturing gradient gel electrophoresis, in subjects in which B. animalis and B. longum were not detected before supplementation, both strains were present in faeces during supplementation, but disappeared after supplementation. The degree of lactose digestion in the small intestine and the oro-caecal transit time were not different before and after supplementation, whereas symptom scores after lactose challenge decreased after supplementation.

CONCLUSIONS

The results suggest that supplementation modifies the amount and metabolic activities of the colonic microbiota and alleviates symptoms in lactose-intolerant subjects. The changes in the colonic microbiota might be among the factors modified by the supplementation which lead to the alleviation of lactose intolerance.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provides evidence for the possibility of managing lactose intolerance with dietary lactose (yogurt) and probiotics via modulating the colonic microbiota.

Five-year survival analysis of liver metastasis of colorectal cancer after hepatic resection

14571

Background: To evaluate the relation between hepatic resecion and survival rate of liver metastasis of colorectal cancer ( LMCC). Methods: Use retrograde case analysis method, 133 cases of LMCC received hepatic resection from 1/1/2000 to 31/12/2005 were included,with attention to the relation between hepatic resection and survival rate. Results: There were 133 cases underwent curative hepatic resection in all 470 LMCC cases, of which 30 cases (30/196,15.3%) in synchronous liver metastasis (SLM) group and 103 cases (103/274,37.6%) in metachronous liver metastasis (MLM) group, P<0.01. Mortality rate related to operation was 3.3%(1/30) in SLM and 1.9%(2/103) in MLM(P<0.05). Until 31/6/2006, all 133 cases were followed-up, 1,3,5 years survival rate and median survival time of SLM (81.0%, 40.3%, 16.5%, 22 months) is similar to that of MLM (88.2%, 49.1%, 31.7%, 25 months, P > 0.05), but the recurrence rate is higher(36.7% vs 20.4%,P=0.03). Compared to 49 cases whose liver metastases focus can be resected but chosen non- operative therapy, 1, 3, 5 years survival rate of 133 resected cases is higher (55.6%, 11.0%, 0 vs 86.2%, 39.2%, 29.4%, P=0.0034). In SLM, 22 cases received I stage resection of the primary colorectal tumor and liver metastasis and 8 cases received liver metastasis resection after the primary surgery (II stage operation). 1, 2, 3 years survival are 90.0% vs 87.5%(P > 0.05),61.4% vs 55.3%(P > 0.05)and 35.4% vs 30.0%(P > 0.05) and the median survival time is 28 months vs 26months(P > 0.05).COX multivariate analysis was used to analyze the prognositic factors. Incision margin =1cm(β=-0.8351,P=0.0363)and reoperation after recurrence(β=- 0.9428,P=0.0411)were protective survival factors, and postoperation recurrence (β=0.6471,P=0.0226) was survival risk factor. Conclusions: Curative hepatic resection is the first choice of liver metastasis of colorectal cancer and can improve survival.

No significant financial relationships to disclose.

Overexpression of a transcription factor LYL1 induces T- and B-cell lymphoma in mice

LYL1, a member of the class II basic helix-loop-helix transcription factors, is aberrantly expressed in a fraction of human T-cell acute lymphoblastic leukemia. Here, we generated transgenic mice ubiquitously overexpressing LYL1 using a construct expressing full-length cDNA driven by a human elongation factor 1alpha promoter. Four independent lines exhibiting high LYL1 expression were established. Of these transgenic mice, 96% displayed loss of hair with a short kinked tail. Furthermore, 30% of them developed malignant lymphoma, with an average latent period of 352 days. In these mice, histological examination revealed tumor cell infiltration in multiple organs and immunohistochemical analysis showed that the infiltrated tumor cells were either CD3 or CD45R/B220-positive; fluorescence-activated cell sorter analysis indicated that each tumor consisted either of mainly CD4, CD8 double-positive T cells or mature B cells; the clonality of LYL1-induced lymphoma was confirmed by T-cell receptor rearrangement and immunoglobulin heavy-chain gene rearrangement analyses. Mammalian two-hybrid analysis and luciferase assay suggested that excess LYL1 blocked the dimerization of E2A and thus inhibited the regulatory activity of E2A on the CD4 promoter. Reverse transcription-polymerase chain reaction results showed that the expression of certain E2A/HEB target genes was downregulated. Taken together, our results provide direct evidence that aberrant expression of LYL1 plays a role in lymphomagenesis.

Influence of growth medium on cometabolic degradation of polycyclic aromatic hydrocarbons by Sphingomonas sp. strain PheB4

The influence of growth medium on cometabolic degradation of polycyclic aromatic hydrocarbons (PAHs) was investigated when Sphingomonas sp. strain PheB4 isolated from surface mangrove sediments was grown in either phenanthrene-containing mineral salts medium (PMSM) or nutrient broth (NB). The NB-grown culture exhibited a more rapid cometabolic degradation of single and mixed non-growth substrate PAHs compared to the PMSM-grown culture. The concentrations of PAH metabolites were also lower in NB-grown culture than in PMSM-grown culture, suggesting that NB-grown culture removed metabolites at a faster rate, particularly, for metabolites produced from cometabolic degradation of a binary mixture of PAHs. Cometabolic pathways of single PAH (anthracene, fluorene, or fluoranthene) in NB-grown culture showed similarity to that in PMSM-grown culture. However, cometabolic pathways of mixed PAHs were more diverse in NB-grown culture than that in PMSM-grown culture. These results indicated that nutrient rich medium was effective in enhancing cometabolic degradation of mixed PAHs concomitant with a rapid removal of metabolites, which could be useful for the bioremediation of mixed PAHs contaminated sites using Sphingomonas sp. strain PheB4.

X-ray bright-field imaging analyzes crystalline quality and defects of SiC wafers

A new variety of the recently developed technique `X-ray bright-field imaging' is presented. In its basic version, this approach simultaneously yields diffraction-based information on lattice distortions and radiographic information on structural inhomogeneities, and is based on the detection of reversed diffraction contrast in transmission images. The new version extends the scope of the technique to the quantitative analysis of crystalline quality parameters such as the lattice plane curvature and mosaic distribution in SiC wafers, and makes it possible to correlate such parameters directly with defect (distortions/inhomogeneities) structures.

Gingival crevicular fluid interleukin-1?, prostaglandin E2and periodontal status in a community population

AIM

Interleukin-1 beta (IL-1beta) and prostaglandin E(2) (PGE(2)) are key inflammatory mediators involved in periodontal disease. The purposes of this molecular cross-sectional epidemiological study were to investigate relationships in a community sample between mean concentrations of IL-1beta and PGE(2) in gingival crevicular fluid (GCF) and (1) clinical periodontal signs and (2) risk factors of host inflammatory response and/or periodontal disease.

MATERIAL AND METHODS

The sample comprised 6277 community-dwelling adults aged 52-74 years enrolled in the Atherosclerosis Risk in Communities (ARIC) study. IL-1beta and PGE(2) concentrations were measured using enzyme-linked immunosorbent assay. Person-level summary variables were computed for maximum pocket depth (MaxPD), maximum clinical attachment level (MaxCAL) and presence/absence of bleeding on probing (BOP). Mean GCF IL-1beta and PGE(2) concentrations were dependent variables in multiple linear regression models with periodontal measures and covariates as explanatory variables.

RESULTS

Both GCF IL-1beta and PGE(2) were positively related to MaxPD and BOP in multiple regression models (p<0.01). Increased levels of IL-1beta and PGE(2) were associated with body mass index >or=30 kg/m(2).

CONCLUSION

Higher levels of GCF IL-1beta and PGE(2) were significantly associated with clinical signs of periodontal disease and independently related to patient-based anthropomorphic measures, behaviours and exposures in community-dwelling adults.

Study of metabolites from the degradation of polycyclic aromatic hydrocarbons (PAHs) by bacterial consortium enriched from mangrove sediments

The PAH metabolites produced during degradation of fluorene, phenanthrene and pyrene by a bacterial consortium enriched from mangrove sediments were analyzed using the on-fiber silylation solid-phase microextraction (SPME) combining with gas chromatography-mass spectrometry (GC-MS) method. Seventeen metabolites at trace levels were identified in different PAH degradation cultures based on the full scan mass spectra. In fluorene degradation cultures, 1-, 2-, 3- and 9-hydroxyfluorene, fluorenone, and phthalic acid were detected. In phenanthrene and pyrene degradation cultures, various common metabolites such as phenanthrene and pyrene dihydrodiols, mono-hydroxy phenanthrene, dihydroxy pyrene, lactone and 4-hydroxyphenanthrene, methyl ester, and phthalic acid were found. The detection of various common and novel metabolites demonstrates that SPME combining with GC-MS is a quick and convenient method for identification as well as monitoring the real time changes of metabolite concentrations throughout the degradation processes. The knowledge of PAH metabolic pathways and kinetics within indigenous bacterial consortium enriched from mangrove sediments contributes to enhance the bioremediation efficiency of PAH in real environment.

Primary precutting versus conventional over-the-wire sphincterotomy for bile duct access: a prospective randomized study

BACKGROUND AND STUDY AIMS

Precut is a well-known technique that is used if repeated attempts at common bile duct (CBD) cannulation fail. Opinions on the complication rate of precut are conflicting, however. The aim of the present study was to compare the efficacy and complication rate of precut used as a primary method of CBD access with the efficacy and safety of the conventional technique.

PATIENTS AND METHODS

During the 19-month study period, consecutive patients who were scheduled for first-time endoscopic sphincterotomy (ES) for a variety of biliary disorders were randomized into two groups: patients in group A underwent conventional wire-guided biliary cannulation followed by ES (with precut being performed only when this failed); in patients in group B precut was used as a primary technique to gain biliary access, followed by wire-guided ES. We used a specially designed, modified Erlangen type of sphincterotome for precutting.

RESULTS

A total of 291 patients (100 men, 191 women; mean +/- SD age 65 +/- 17.5 years) were recruited: 146 patients were assigned to group A (conventional approach) and 145 to group B (primary precut approach). The indications for ES were comparable in the two groups. In group A, wire-guided cannulation of the CBD failed in 42 patients. Secondary precut was successful in 41 of these patients, leading to an overall success rate of 99.3 %. In group B, the ES success rate using primary precut was 100 % at the first attempt. The mean time to successful deep CBD cannulation was 8.3 +/- 2.1 minutes in group A and 6.9 +/- 1.8 minutes in group B ( P < 0.001). The incidence of mild to moderate pancreatitis was similar in the two groups (2.9 % in group A vs. 2.1 % in group B, P > 0.05). Mild bleeding occurred in only one patient (from group A) and this was controlled by epinephrine injection. None of the study patients developed severe pancreatitis or perforation.

CONCLUSIONS

In experienced hands, an approach using primary precut appears to be at least as successful and safe as a conventional approach using guide-wire-based CBD cannulation followed by ES, and might also be a quicker method.

Metabolite production in degradation of pyrene alone or in a mixture with another polycyclic aromatic hydrocarbon by Mycobacterium sp

Degradation of pyrene (PYR) alone and in the presence of phenanthrene or fluoranthene by Mycobacterium sp. strain A1-PYR isolated from mangrove sediments was investigated. When PYR was the only polycyclic aromatic hydrocarbon compound and the sole carbon source, only 33% of the added PYR was slowly degraded during 7 d of incubation. Seven metabolites were obtained, including four-ring metabolites (monohydroxypyrene and three different dihydroxypyrenes) and three-ring metabolites (dihydroxyphenanthrene, 4-phenanthrene-carboxylic acid, and 4-phenanthrol), of which more four-ring metabolites accumulated compared with three-ring metabolites. To our knowledge, this is the first report in which PYR was initially attacked by Mycobacterium sp. to form three different dihydroxypyrenes. Pyrene degradation was significantly stimulated when mixed with phenanthrene or fluoranthene. In the presence of fluoranthene, PYR was rapidly degraded (up to 57%), and significant amounts of dihydroxypyrene were formed within 3 d of incubation, followed by a period of minimal PYR degradation from 3 to 7 d with disappearance of four-ring metabolites and accumulation of three-ring metabolites. In contrast, PYR was removed completely, and little evidence of metabolites was detected in the presence of phenanthrene. These results showed that PYR was degraded to a larger extent when mixed with another polycyclic aromatic hydrocarbon concomitant with a higher turnover of PYR metabolites. The induction of complex enzyme systems and increase in biomass possibly affected the transformation of PYR metabolites in the mixture with phenanthrene or fluoranthene.

Endoscopic mucosal resection of early esophageal squamous cell cancer using the Duette mucosectomy kit

BACKGROUND AND STUDY AIM

Endoscopic mucosal resection (EMR) is a less invasive alternative treatment strategy to surgery for intramucosal esophageal squamous cell carcinoma (SCC). This study described our initial experience with the newly introduced Duette Multiband Mucosectomy Kit (Cook Ireland Ltd, Limerick, Ireland) for the treatment of extensive early esophageal SCC.

PATIENTS AND METHODS

Five patients with extensive early esophageal SCC, covering at least half of the circumference of the esophageal wall and measuring a mean of 2.8 cm longitudinally, underwent EMR after EUS staging.

RESULTS

EMR was successfully completed in one session in five patients. Post-EMR stricture occurred in four patients but was successfully treated with bougienage. One patient did not return for follow-up after bougienage and died from ischemic heart disease 3 months later. For the remaining four patients, there was no recurrence over a mean follow up of 14.7 months.

CONCLUSION

This new device obviates the need for repeated insertion of the endoscope during the process of ligation and resection and thus facilitates EMR of extensive SCC.

Cadmium contamination in orchard soils and fruit trees and its potential health risk in Guangzhou, China

This study examines cadmium (Cd) contamination in orchard soils and fruit trees in Guangzhou, China, and assesses its potential health risk. Soils and tissues samples of three species of fruit trees were collected from three orchards. The average soil Cd concentration was 1.27, 1.84 and 0.68 mg/kg in orchards I, II, and III, respectively. The carambola (Averrhoa carambola) accumulated exceptionally high concentrations of Cd (7.57, 10.84, 9.01 and 2.15 mg/kg dw in root, twig, leaf and fruit, respectively), being 6.0-24 times and 4.0-10 times the corresponding tissue Cd in the longan (Dimocarpus longan) and wampee (Clausena lansium), respectively. Furthermore, all Cd concentrations (0.04-0.25 mg Cd/kg fw) of the fruits exceeded the tolerance limit of cadmium in foods of PR China (0.03 mg/kg fw). Our results indicate that the carambola tree has high Cd accumulation capacity and might be a Cd accumulator; and its fruit, among the three species of fruits studied, also poses the highest potential health risk to local residents.

Identification of Vibrio harveyi using PCR amplification of the toxR gene

AIMS

The aim of this study was to develop an effective method for the identification of Vibrio harveyi based on using the toxR gene as a taxonomic marker.

METHODS AND RESULTS

Primers for the toxR gene were designed for specificity to V. harveyi, and incorporated in a polymerase chain reaction (PCR). The results of the PCR, which took <5 h from DNA extraction to amplification, revealed positive amplification of the toxR gene fragment in 20 V. harveyi isolates including type strains, whereas DNA from 23 other Vibrionaceae type strains and 13 Vibrio parahaemolyticus strains were negative. The detection limit of the PCR was 4.0 x 10(3) cells ml(-1). In addition, the technique enabled the recognition of V. harveyi from diseased fish.

CONCLUSIONS

The PCR was specific and sensitive, enabling the identification of V. harveyi within 5 h.

SIGNIFICANCE AND IMPACT OF THE STUDY

The PCR allowed the rapid and sensitive detection of V. harveyi.

Separation of heart rate variability components of the autonomic nervous system by utilizing principal dynamic modes

This work introduces a modified Principal Dynamic Modes (PDM) methodology using eigenvalue/eigenvector analysis to separate individual components of the sympathetic and parasympathetic nervous contributions to heart rate variability. We have modified the PDM technique to be used with even a single output signal of heart rate variability data, whereas the original PDMs required both input and output data. This method specifically accounts for the inherent nonlinear dynamics of heart rate control, which the current method of power spectrum density (PSD) is unable to do. Propranolol and atropine were administered to normal human volunteers intravenously to inhibit the sympathetic and parasympathetic activities, respectively. With separate applications of the respective drugs, we found a significant decrease in the amplitude of the waveforms that correspond to each nervous activity. Furthermore, we observed near complete elimination of these dynamics when both drugs were given to the subjects. Comparison of our method to the conventional low/high frequency ratio of PSD shows that PDM methodology provides much more accurate assessment of the autonomic nervous balance by separation of individual components of the autonomic nervous activities. The PDM methodology is expected to have an added benefit that diagnosis and prognostication of a patient's health can be determined simply via a non-invasive electrocardiogram.

Stress fields of a spheroidal inhomogeneity with an interphase in an infinite medium under remote loadings

This paper presents the elastostatic solution of the problem of an arbitrarily oriented spheroidal inhomogeneity with an interphase embedded in an infinite medium. The latter is under a remote axisymmetric loading. The complete solution of this problem requires three fundamental solutions, which are obtained by the Papkovich–Neuber displacement potentials and the expansion formulae for spheroidal harmonics. New displacement potentials are given when the remote loading is a longitudinal shear. The influence of the orientation and aspect ratio of the inhomogeneity, and of the remote stress ratio on the stress concentrations at the interfaces and the von Mises equivalent stress in the inhomogeneity, are studied. It is found that the interphase between the inhomogeneity and the surrounding medium significantly alters the stress distribution in, and around, the inhomogeneity. In addition to the general solution for an inhomogeneity with an interphase, the stress field exterior to a spheroidal inhomogeneity without an interphase (the Eshelby problem) is presented in a simple form. It is pointed out that the solution of a spheroidal inhomogeneity with an interphase in an infinite medium subjected to an arbitrary uniform eigenstrain, or a combination of a uniform eigenstrain and an arbitrary remote mechanical loading, can be obtained using the procedure developed in this paper.