Estrogen receptor expression in anomalous arrangement of the pancreaticobiliary duct

BACKGROUND/PURPOSE

Anomalous arrangement of the pancreaticobiliary duct (AAPBD) is a malformation of the bile and pancreatic ducts which is commonly associated with congenital biliary dilatation and predominantly occurs in girls. Estrogen receptor (ER) is reported to modulate cholangiocyte proliferation and play a role in tumorigenesis of estrogen-dependent malignancies. The present study investigated the presence of ER in the gallbladder of patients with AAPBD to elucidate whether ER expression is correlated with sexual specificity and biliary histology.

METHODS

Specimens comprised samples of 29 gallbladders from patients with AAPBD (21 girls and 8 boys; mean age at surgery, 5.3 years). Medical records were retrospectively reviewed, and sex, age, radiographic parameters, and laboratory data were collected for this study. Immunohistochemistry was performed using anti-ER and anti-MIB-1 antibodies, and MIB-1 score was calculated for evaluation of cell proliferation.

RESULTS

ER expression was observed in both the nuclei and cytoplasm of gallbladder epithelium in 12 of 29 specimens. No difference in background characteristics were noted between ER-positive and ER-negative groups. Mucosal hyperplasia was found in 17 specimens. ER-positive cases were significantly more common in AAPBD with mucosal hyperplasia than without (P <0.03). MIB-1 score did not differ significantly between ER-positive and ER-negative groups.

CONCLUSIONS

ER expression seems to be related to hyperplastic mucosa of the gallbladder in AAPBD. ER might play a role in the proliferation of gallbladder epithelium.

Intralobar pulmonary sequestration diagnosed by MR angiography

A definitive diagnosis of pulmonary sequestration necessitates evidence of a systemic arterial supply to the sequestered lung segment by aortography. We report a case of intralobar pulmonary sequestration in an 11-month-old girl in whom the diagnosis was made by contrast-enhanced magnetic resonance (MR) angiography. Contrast-enhanced MR angiography is the most reliable noninvasive method for the definitive diagnosis of pulmonary sequestration in children.

Impaired expression of myogenic regulatory molecules in the pelvic floor muscles of murine embryos with anorectal malformations

BACKGROUND/PURPOSE

Recent biological studies have elucidated the molecular mechanism of muscle development, in which various regulatory factors (myogenic regulatory factors [MRFs]) play key roles during embryogenesis. To investigate the development of anorectal malformations (ARMs), we studied MRF expressions in myogenic cells in the pelvic floor using murine embryos affected with ARM.

METHODS

Anorectal malformation embryos were obtained from the 10.5th embryonal day (E10.5) to the 7.0th postnatal day (D7.0) in a natural mutant strain (Sd/+, RSV/Le). Serial frozen sections were prepared for immunohistochemistry using specific antibodies to M-cadherin, myoD, Myogenin, myosin heavy chain, and alfa-actin molecule.

RESULTS

In normal mice, embryonal caudal somites differentiated into myogenic stem cells and migrated to the pelvic floor between E11.0 and E14.0. In the ARM mice, however, caudal somites were irregularly arranged and MRF expressions in myogenic cells were markedly decreased in the dorsocaudal region at E11.5 to E13.0, leading to hypoplastic pelvic floor muscles.

CONCLUSIONS

The maldevelopment of pelvic floor muscles in ARM is derived from a deficient supply of myogenic stem cells, with impaired MRF expression. These results suggest that myogenic stem cells, available from bone marrow contents, may be used for postnatal muscle regeneration to reinforce the pelvic floor muscle function in children with ARM.

Surgical treatment for anomalous arrangement of the pancreaticobiliary duct with nondilatation of the common bile duct

BACKGROUND/PURPOSE

For anomalous arrangement of the pancreaticobiliary duct (AAPBD) with nondilatation of the common bile duct (CBD), the optimal surgical procedure remains controversial. The authors investigated which procedure would be most effective for AAPBD with nondilatation of the CBD.

METHODS

The authors encountered 60 children with AAPBD in our institution between 1979 and 2002. Six of the 60 were classified as the nondilated type (CBD diameter; less than 8 mm), whereas the other 54 were classified as the dilated type (CBD diameter; more than 9 mm). Amylase levels in serum, CBD, and gallbladder were examined. Cellular activity of the resected gallbladder was examined for the incidence of hyperplasia and Ki-67 labeling index (Ki-67 LI).

RESULTS

The amylase level in the nondilated type was elevated as in the dilated type. Epithelial hyperplasia of the gallbladder was present in 4 of the 6 with the nondilated type (67%). 10 of the 20 with the dilated type (50%), and none of the 6 controls (0%). The Ki-67 LI of the dilated type was significantly higher than that of control.

CONCLUSIONS

A free reflux of pancreatic juice into the biliary system was found regardless of dilatation, and cellular proliferative activity of the gallbladder mucosa was increased in both the nondilated and dilated type. Therefore, excision of the extrahepatic bile duct including cholecystectomy is recommended for AAPBD with nondilatation of the CBD.

Postoperative clinical evaluation following pylorus-preserving gastrectomy

BACKGROUND/AIMS

Recent pathological study demonstrated that extended lymphadenectomy is not always necessary for patients with early gastric cancer.

METHODOLOGY

Twenty-eight patients underwent pylorus-preserving gastrectomy. The clinicopathological findings of patients with pylorus-preserving gastrectomy were compared to those of 58 patients with conventional distal gastrectomy.

RESULTS

There were no significant differences in surgical duration, blood loss, blood chemistry, food intake, and body weight loss. Regarding abdominal symptoms, early dumping syndrome was significantly higher in distal gastrectomy than in pylorus-preserving gastrectomy (35.6% vs. 12.0%, p<0.05). Remnant gastritis was also significantly higher in distal gastrectomy (57.1% vs. 27.7%, p<0.05). However, food residue tended to be more frequently seen in pylorus-preserving gastrectomy (33.3% vs. 61.1%, p=0.052). Based on questionnaire results, the rate of patient satisfaction with their surgical outcome tended to be lower in pylorus-preserving gastrectomy than in distal gastrectomy (84.0% vs. 95.6%, p=0.098). The tendency was more pronounced in patients over 70 years old (77.8% vs. 100%, p=0.065).

CONCLUSIONS

Pylorus-preserving gastrectomy is superior to conventional distal gastrectomy in the prevention of dumping syndrome and reflux gastritis. However, since delayed emptying is frequently seen post pylorus-preserving gastrectomy, this procedure is not recommended for older patients under simplistic indications.

Prognostic value of lymph node staging in gastric cancer

BACKGROUND/AIMS

The latest TNM classification (5th edition) changed the definition of nodal staging from the anatomical localization to the total number of metastatic lymph nodes. This study was designed to evaluate and compare the prognostic significance of nodal staging between the two widely known staging systems, the TNM classification (TNM) and Japanese Classification for Gastric Cancer (JCGC).

METHODOLOGY

A total of 582 patients who underwent curative gastrectomy with extended lymphadenectomy for gastric cancer were reviewed retrospectively from hospital records. Based on the localization of metastatic nodes according to the JCGC and the total positive node number according to TNM, the patients were divided into subgroups and their prognoses compared.

RESULTS

Lymph node metastasis was found in 189 of the 582 patients (32.5%). Both nodal staging systems were found to be significant prognostic factors by multivariate analysis. A prognostic analysis of the patients by subdivision with the two staging systems indicated that the nodal staging system in TNM was more homogenous than that of the JCGC.

CONCLUSIONS

The nodal staging system of the TNM classification is superior to that of the Japanese Classification of Gastric Cancer, because it is simple, reproducible and homogeneous.

Esophagogastrostomy reconstruction after limited proximal gastrectomy

BACKGROUND/AIMS

Recent advances in diagnostic techniques have led to the detection of an increasing number of early gastric cancers in the upper third of the stomach. The objective of this study was to determine the most appropriate surgical treatment for these cancers.

METHODOLOGY

The clinicopathologic characteristics of 35 patients with early gastric cancer in the upper third of the stomach who underwent three different types of gastrectomies were reviewed retrospectively from hospital records between January 1992 and August 1999.

RESULTS

Patients undergoing limited proximal gastrectomy with esophagogastrostomy reconstruction had shorter operation times and less blood loss than those for patients undergoing total gastrectomy or proximal gastrectomy with jejunal interposition. No lymph node metastasis was identified in any of these patients. Heartburn due to reflux esophagitis was seen in a few patients of each group, but they were successfully treated by antacids. The extreme reduction in food intake volume was more frequently experienced in patients with total gastrectomy than those with both proximal gastrectomies. When mortality due to other disease was excluded, all patients survived without recurrence.

CONCLUSIONS

A limited proximal gastrectomy with esophagogastrostomy reconstruction decreased surgical risk and realized preservation of maximal function.

Antenatal diagnosis of biliary atresia (noncorrectable cyst type): a case report

At 32 weeks of gestation a cystic mass was identified in the hepatic hilum of a fetus by maternal sonography. Laparotomy was performed at 39 days of life after a diagnosis of correctable type of biliary atresia (Type I). A cystically dilated extrahepatic duct, in which the proximal and distal sides of the common bile duct were occluded (Type III with cyst, noncorrectable type), was identified by operative cholangiography. A standard Kasai operation was performed, and 1 year after operation the patient was doing well and was jaundice-free. From this experience in routine maternal sonography, a cystic mass in the hepatic hilum may also suggest Type III biliary atresia with a cyst.

Morphological changes of platelets following platelet aggregation induced by collagen in Japanese Black cattle with delta-storage pool deficiency

Electron microscopic observation was performed on platelets activated by collagen stimulation in Japanese Black cattle with delta-storage pool deficiency (delta-SPD) to identify their morphological and functional abnormalities compared from normal bovine platelets. Platelets of normal Japanese Black cattle changed their shapes to spherical and were in the phase of release reactions 5 min after the collagen (90.9 microg/ml) stimulation, and most of platelets were aggregated. On the other hand, in GSPD cattle, most of a granules were still dispersed in activated platelets, although the spherical shape change of the platelets was observed. These results suggested that there are abnormalities in the release reactions in platelets of delta-SPD cattle.

Changes of platelet cytoskeletal proteins following platelet aggregation induced by collagen and platelet membrane glycoprotein in Japanese black cattle with delta-storage pool deficiency

Five Japanese Black cattle showing the tendency of persistent hemorrhage were diagnosed as delta-storage pool deficiency because of lack of dense bodies in platelets. There was no significant difference in the platelet count, fibrinogen concentration, prothrombin time and activated partial thromboplastin time between the cases and normal control cattle. However, the maximum platelet aggregation rate and the values of myosin in the cytoskeletons during platelet aggregation induced by collagen were significantly lower in the cases compared with those in normal control cattle. The quantities of platelet membrane glycoprotein were in the range of 94-160 kDa and were not different between the cases and control cattle. However, a decrease of thrombospondin in alpha-granules in platelet cytoplasm were suspected in two of the 5 cases.

Relationship between intraoperative cholangiographic patterns and outcomes in biliary atresia

Intraoperative cholangiography revealed biliary tracts in 11 of 25 (44%) patients with biliary atresia. The outcome of these 11 patients was analyzed based on the cholangiographic patterns. In these 11 patients, 4 cases were the 1-cyst type, 3 showed a "cloudy shadow" pattern in the intrahepatic biliary tract, and 4 were subtype "a" pattern (distally patent common bile duct). Four patients showing the I-cyst type underwent hepaticojejunostomy with Rouxen-Y anastomosis, and all of the 4 became jaundice-free a few weeks after surgery. Three patients with the "cloudy shadow" pattern gained good bile drainage after hepatic portoenterostomy with Suruga II modification, all were complicated by ascending cholangitis. Three of the 4 subtype "a" pattern underwent hepatic portoenterostomy with Suruga II modification. Two became jaundice-free, while jaundice persisted in one. The subtype "a" patient who underwent hepatic porto-cholecystostomy showed poor bile drainage, and died of hepatic failure 17 months after surgery despite further surgery. From these results, we conclude that 1) hepatico-jejunostomy with Roux-en-Y anastomosis is indicated for I-cyst biliary atresia. 2) Prevention of ascending cholangitis is important in patients with the "cloudy shadow" pattern. 3) Hepatic porto-jejunostomy is indicated for the subtype "a" pattern rather than hepatic porto-cholecystostomy.

Effects of fighting after grouping on plasma cortisol concentration and lymphocyte blastogenesis of peripheral blood mononuclear cells induced by mitogens in piglets

One litter (Group A) of three unacquainted groups of littermates (4 piglets/litter), 64.0 +/- 0.8 days old, was moved to the pen of another litter (Group B) and they were housed together for 19 days after grouping (phase 1). The pigs in Group B violently attacked all the pigs in Group A for 9 hr after grouping. The remaining group was not grouped and used as controls. The plasma cortisol concentrations 1 hr after grouping were significantly higher than those 1 hr before and 24 hr after grouping, and the suppression of lymphocyte blastogenesis of peripheral blood mononuclear cells (PBMC) induced by mitogens was observed on 3, 8 and 19 days after grouping. After phase 1 ended, the pigs in Group A were returned to their own pen for 7 days, and then they were regrouped with the pigs in Group B and reared together for a further 14 days. Neither agonistic behavior nor change of plasma cortisol after regrouping was seen. Though the lymphocyte blastogenesis of PBMC induced by the mitogens on day 0 after regrouping was significantly lower in the pigs of Groups A and B compared to those in control pigs, a significant difference in lymphocyte blastogenesis among three groups was not seen on 7 and 14 days after regrouping. These findings indicate that fighting after grouping unacquainted litters increases plasma cortisol, and suppresses lymphocyte blastogenesis for 26 days after grouping.

Ongoing osteolysis in patients with lymphangioma

Severe osteolysis is a rare complication of lymphangioma. It can progress despite treatment and may be fatal. Four patients presented with massive osteolysis and serious related complications. Of these, two responded well to OK-432 therapy with arrest of the osteolysis. Complete recovery from life-threatening pleural effusion has been noted in one. Of the two nonresponders, one died of progressive osteolysis of the cervical and occipital bones, the other, despite therapy, still shows progressive osteolysis of the left leg from the femur to the phalanges. A boneless leg may be the outcome.

Renal clearance of endogenous creatinine, urea, sodium, and potassium in normal cats and cats with chronic renal failure

The renal clearance test was carried out in 6 normal male cats and 12 male cats with chronic renal failure. The average concentrations of creatinine (Cr), urea, sodium (Na), and potassium (K) in the serum of the cats with chronic renal failure were 5.09, 136.7 (mg/100 ml), 143.9 and 3.71 (mEq/l) respectively, and the specific gravity of urine was 1.009. The renal clearances of Cr, urea, Na, and K (ml/min/kg of body weight) were 2.639 +/- 0.217, 1.034 +/- 0.110, 0.024 +/- 0.007 and 0.266 +/- 0.028, respectively in normal cats, and were 0.789 +/- 0.407, 0.358 +/- 0.211, 0.095 +/- 0.084 and 0.872 +/- 0.204 in cats with chronic renal failure. Clearance of Cr and urea was significantly lower in cats with chronic renal failure than in normal cats, while the values of Na and K were significantly higher in cats with chronic renal failure. The glomerular filtration of Cr and urea and the urinary excretion of these 4 substances were significantly higher in cats with chronic renal failure. The tubular reabsorption rates of Na and K were significantly lower in cats with chronic renal failure compared to those in normal cats, but there was no significant difference in urea and creatinine.

Relation between daily urinary creatinine and body weight in castrated male Landrace pigs

For clarifying the relation between the amount of daily urinary creatinine (Cr) and the body weight (BW), fifty-eight healthy castrated male Landrace pigs ranging from 28.6 kg to 93.5 kg in body weight (BW) were examined. There was a significant positive correlation between the BW (X = kg) and Cr (Y = mg/day), and a linear regression formula of Y = 40.7X-224.9 (R2 = 0.985, P < 0.001) was obtained. The coefficient of variation of the daily urinary Cr was small (5.1 +/- 2.4%). On the other hand, in the relation between the BW and quantity of urine in 24 hr, and in the relation between the daily urinary creatinine and daily urinary volume, no significant correlation was recognized (P > 0.2), respectively.

Results of a modified Duhamel Operation for Hirschsprung's disease using the GIA stapler

Thirty-six patients with Hirschsprung's disease underwent surgery using modified Duhamel operation with the GIA (gastrointestinal autosuture) stapler over a 12-year period at our institution. We now present our experience from the perspective of postoperative complications and anorectal function. Postoperative complications included minimal anal bleeding due to the GIA stapler in 2 patients, and mild enterocolitis in 6 patients. Severe complications such as anastomotic leakage or stricture were not observed in our series. Overall, postoperative anorectal function was good in patients without Down's syndrome or cerebral palsy. Follow-up of our patients showed that a good quality of life was achieved during childhood. We conclude, therefore, that the modified Duhamel operation, with the use of the GIA stapler, is a safe and easy procedure for correction of Hirschsprung's disease.

Management and design of the maintenance of SAM mouse strains: an animal model for accelerated senescence and age-associated disorders

The Senescence-Accelerated Mouse (SAM) was established by inbreeding and pedigree selection based on the life span, degree of senescence, as well as the incidence and degree of several age-associated disorders. At first, SAM strains were developed under conventional conditions, but now some strains are also maintained under specific pathogen-free conditions. There are many methods used to maintain such strains of mice; our methods will be introduced as one example of how to develop and maintain strains of mice used in aging research.

OK-432 therapy for lymphangioma in children: why and how does it work?

Intralesional injection of OK-432 (lyophilized incubation mixture of group A Streptococcus pyogenes of human origin) is safe and effective therapy for lymphangioma. The authors evaluated the mechanism of this therapy in 6 patients who had cystic lymphangioma. The intracystic fluid of the cystic lymphangioma was aspirated before and after (on days 1 and 4) the OK-432 therapy. Changes in cell populations and cytokine productions in each aspirated fluid were analyzed. White blood cells in the intracystic fluid increased markedly in number. Before OK-432 therapy, 96% of the intracystic white blood cells were lymphocytes, and the remaining were neutrophils and macrophages. On day 1, the percentages of neutrophils and macrophages increased to 72% and 21%, respectively. On day 4, the percentage of lymphocytes increased to 72%. Flow cytometry analysis using monoclonal antibodies showed that the number of natural killer cells (CD56+) and T cells (CD3+) had increased. The activity of cytotoxic tumor necrosis factor (TNF) and interleukin-6 increased immediately after OK-432 injection and remained high in titer until day 4. These findings suggest that the white blood cells induced and activated by OK-432, and the cytokines (including TNF) produced by these cells increased the endothelial permeability, and thus the accelerated lymph drainage and increased lymph flow let to shrinkage of the cystic spaces.

An association of multiple intestinal atresia and biliary atresia: a case report

This is the first report of a 2-day-old girl having an association of biliary atresia and multiple intestinal atresia. She developed intractable vomiting in the first hours of life. An upper gastrointestinal series and barium enema showed jejunal atresia and rectal atresia. A laparotomy was performed on the fourth day of life. The operative findings were multiple sites of atresia of the intestine, 10 atretic sites in the small bowel, and 3 in the colon. The gall bladder was normal in size and position. After the operation, the patient's stool remained acholic and her jaundice did not resolve. On the 58th day of life, another laparotomy was performed with the presumptive diagnosis of biliary atresia. The operative finding was biliary atresia, type 3; the Kasai operation with external jejunostomy was performed. The patient suffered from postoperative cholangitis and enterocolitis because of her short bowel and subsequently died at 9 months of age. This is the first case of biliary atresia associated with multiple intestinal atresia reported in the literature.

Impaired proliferative activity of mesenchymal cells affects the migratory pathway for neural crest cells in the developing gut of mutant murine embryos

The developmental expression of neural and cell proliferation-related antigens in guts from mutant murine embryos (Is, lethal spotted) as a model for Hirschsprung's disease was studied. The expression was examined immunohistochemically using antibodies specific for neural cell adhesion molecule (NCAM), the L1 molecule, and proliferative cell-related nuclear antigen (PCNA). Cells immunoreactive for neural components proceeded from the esophagus to the anorectum showing a one-way migratory wave between embryonal day 10 (E10) and E14 in control specimens (Is/+, +/+). The patterns of NCAM and L1 immunoreactivity in Is/Is mutant specimens was the same as in controls on E10. However, from E10.5 to E13.5, the immunoreactivity in the mutants decreased and remained in the more oral side as compared with controls. No migration of immunoreactivity was found after E14.0. Therefore, the terminal portion of the colon remained aganglionic in Is/Is mutant embryos. PCNA immunoreactivity of mesenchymal cells preceded the migratory wave of the neural specific immunoreactivity, but the PCNA-positive cells were meager and poorly organized in the mutant embryos. Deficient PCNA staining patterns were found in mesenchymal tissue rather than in the migrating cells themselves. This impaired PCNA expression may reflect a deficient microenvironment for migration such that neural crest cells cannot colonize properly.

Increased numbers of argyrophilic nucleolar organizer regions between primary and metastatic sites predict tumor progression in stage IV and IV-S neuroblastoma

BACKGROUND

A silver colloid technique to determine nucleolar organizer region (AgNOR) number was used to study the proliferative activity of Stage IV-S neuroblastoma in which a spontaneous tumor regression is often observed.

METHODS

Primary regional lymph nodes and hepatic lesions from five children with Stage IV-S and five with Stage IV neuroblastoma were examined.

RESULTS

Average AgNOR counts per tumor cell nucleus from all five children with Stage IV neuroblastoma were lowest in the primary lesions, intermediate in the metastatic regional lymph nodes, and highest in the distant metastases. However, in four Stage IV-S patients whose metastases later disappeared and showed no sign of recurrence, the average AgNOR number was similar in primary tumors and metastatic lesions. In the other patient with progressive metastases initially diagnosed as Stage IV-S, the data showed the same pattern as in Stage IV neuroblastoma.

CONCLUSIONS

The unique AgNOR staining pattern may reflect the proliferative activity of Stage IV-S neuroblastoma. This method may provide further information to differentiate a subtype of metastatic neuroblastoma showing spontaneous tumor regression and/or favorable prognosis.

OK-432 therapy in 64 patients with lymphangioma

Intralesional injection of OK-432 was employed to treat 64 lymphangiomas between 1986 and 1992. This was used as primary therapy for 46 lesions (group A), as treatment following incomplete surgical removal in 14 (group B), and as therapy after failure of bleomycin in 4 (group C). In group A (n = 46), total shrinkage of the lesion, without serious complications, was noted in 23; there was marked shrinkage in 8, slight shrinkage in 12, and no response in 3. Of the cystic lesions (n = 24), significant shrinkage occurred in 22; of the cavernous lesions (n = 22), only 9 improved after treatment. In groups B (n = 14) and C (n = 4) there was significant clinical improvement occurred in 5 and 2, respectively. No recurrence was noted during follow-up (6 to 87 months). The only side effects were fever lasting 2 to 4 days and a local inflammatory reaction of 3 to 7 days' duration. The local inflammation did not cause any damage to the overlying skin and did not lead to scar formation. These data suggest that intralesional injection of OK-432 is effective treatment for lymphangiomas and should be considered as the primary method of treatment.

Changes of serum amylase, its isozyme fractions and amylase-creatinine clearance ratio in dogs with experimentally induced acute pancreatitis

To investigate the diagnostic application of amylase to canine pancreatic diseases, serum amylase activities, its isozyme fractions and amylase-creatinine clearance ratio (ACCR) were analyzed in normal intact dogs and dogs experimentally induced acute pancreatitis. There was no statistic difference between normal male and female dogs. Amylase specific activities in pancreatic tissue extracts were more than 2,300 times higher than that in serum, and were also higher than those in other tissues; parotid and mandibular salivary glands, lung, heart, liver, spleen, duodenum, jejunum, ileum and kidney. Following the chloroform injection into the pancreatic tissue, WBC increased from 6 to 240 hr and serum glucose significantly increased at 72 and 96 hr, and no urine glucose was detected. BUN as well as serum and urine creatinine showed normal levels. ACCR increased until 96 hr without statistic significance. Serum amylase activities increased significantly after 3 hr and its isozyme was separated into 4 fractions (Amy1-Amy4) in contrast to 3 fractions (Amy2-Amy4) in intact dogs. Since this extra Amy1 seen from 1 hr increasing after 6 hr similarly to other 3 fractions, the evaluation of serum amylase and its isozyme fractions was indicated to be useful for the diagnosis of acute pancreatitis in dogs.

An immunohistochemical study of neurofilament and microtubule-associated Tau protein in the enteric innervation in Hirschsprung's disease

The distribution and localization of neurofilament (NF) and microtubule-associated tau protein (Tau) in the colon from Hirschsprung's disease were examined by immunohistochemistry. Specimens of the normoganglionic, oligoganglionic, and aganglionic segments of colons from nine patients with Hirschsprung's disease were used in this study. Normal colon specimens obtained at the time of colostomy closure from two patients with anorectal malformations were also examined as controls. In normoganglionic segments, anti-NF-H and anti-NF-M immunoreactivity appeared within the nerve fibers of both the myenteric and submucosal plexuses. These findings were also observed in the oligoganglionic segments. In the aganglionic segment, hypertrophic nerve fascicules and the nerve fibers in circular muscle were positively stained with anti-NF-H and anti-NF-M antibodies. Anti-Tau staining appeared in the ganglion cell bodies of both myenteric and submucosal plexuses and in nerve fibers distributed among the circular muscles of the normal control colons, and the normoganglionic and oligoganglionic Hirschsprung's specimens. Nerve fibers in the circular muscle layer of aganglionic segments were also stained with anti-Tau serum, although the hypertrophic nerve fascicules in the intermuscular and submucosal layers did not stain. The so-called nerve fascicules distributed in the subserosal layer also did not stain with anti-Tau. These results suggest that Tau may be used as a specific marker to identify ganglion cells and intrinsic nerve fibers in colons affected by Hirschsprung's disease.

Serum total amylase activity and its isoenzyme fractions in newborn pigs with relation to growth and iron dextran-treatment

Serum amylase activity was analyzed chromogenically (blue starch method) and its isoenzyme was separated by cellulose acetate membrane electrophoresis in newborn pigs comparing with those in adult pigs. Serum amylase activity in newborn pigs was about one half of adults' and increased with age. Serum amylase isoenzymes were separated into 4 fractions from the cathode. The isoenzymes were also classified in 5 types on the basis of the combination of these 4 fractions. Incidences of the fractions and the types were not significantly different between adults and newborns. After the iron dextran treatment, serum amylase activity as well as levels of erythrocytes, hemoglobin and packed cell volume increased. The rates of increase in hemoglobin and packed cell volume were more significant in the double treatment group than in the single treatment group, while serum amylase activity increased similarly in these 2 groups. The increase in serum amylase activity seemed to indicate that the development of amylase-producing organs was reinforced by the iron compound treatment. It is thought that serum amylase activity may be an indicator of healthy growth in newborn pigs.