Exfoliative cytology of tracheobronchial adenoid cystic carcinoma

The cytologic findings in the bronchial brushing and washing specimens of three cases of tracheobronchial adenoid cystic carcinoma are reported and compared with those reported in the literature. The cytodiagnostic features including cribriform epithelial clusters, epithelial balls, branching epithelial cylinders, cellular hyaline mucous globules, and a heretofore unemphasized diagnostic clue in exfoliative cytology--naked hyaline globules in washing smears, are illustrated and discussed.

[Post-obstructive pulmonary edema following extubation--report of two cases]

Pulmonary edema may develop in healthy patients after anesthesia. It usually results from upper airway obstruction which may be caused by laryngospasm or aspiration. Increased inspiratory effort following airway obstruction significantly produces negative intrathoracic pressure that may lead to pulmonary edema. We reported two cases of post-obstructive pulmonary edema following extubation. They were essentially healthy young males, one of whom received urethroplasty and the other received pulmonary blebectomy. Their hemodynamic and ventilatory conditions had been kept stable during surgery. Upper airway obstruction followed by pulmonary edema developed immediately after extubation, which was successfully treated without any sequelae.

Genomic structure of carp mitogen-activated protein kinase kinase 1 gene

Carp mitogen-activated protein kinase kinase 1 (cMKK1) gene was isolated from a liver genomic library. The sequence around the exon-intron boundaries and 2 kb of the promoter region were determined. Our data indicate that this gene is composed of 11 exons and 10 introns spanning about 9 kb. Multiple potential transcription initiation sites were located by primer extension analysis. Examination of 2 kb of 5'-flanking sequence revealed potential binding sites for a variety of transcription factors such as E2F, Ets-1, GATA-1, Myb, NF-IL6, Sp1, and NF-kB.

Effects of low dose gamma-ray irradiation on peripheral leukocyte counts and spleen of mice

OBJECTIVE

To study the effects of low dose gamma-ray irradiation on peripheral leukocyte counts and spleen weight of mice.

MATERIALS AND METHODS

Two hundred male mice of ICR strain were divided into four groups. Group A served as normal control. Groups B, C and D, the experimental groups were treated with 5, 50 and 100 cGy (exposure dose in air) of whole body gamma-ray irradiation respectively. The leukocyte counts and its differential counts, body weight and the spleen weight of mice were measured on days 1, 5, 12, 19, 26 and 33 after irradiation. The relative spleen weight derived from the data of body weight and spleen weight was also calculated in tested animals.

RESULTS

The leukocytes and its differential counts and relative spleen weight in mice decreased after 100 cGy gamma-ray irradiation. Fifty cGy gamma-ray irradiation could inhibit the leukocyte and its differential counts. The lowest dose, 5 cGy had no considerable damage.

CONCLUSIONS

One hundred cGy of 137Cs gamma-ray irradiation had an inhibitory effect on counts of total leukocyte, lymphocyte, neutrophil, monocyte, spleen weight and body weight, while 50 cGy gamma-ray irradiation had an evident inhibition on peripheral leukocytes and its differential counts in mice. However, 5 cGy gamma-ray irradiation had no obvious inhibition in the tested mice in the period of the investigation.

Effects of glycyrrhizae and glycyrrhizic acid on cellular immunocompetence of gamma-ray-irradiated mice

OBJECTIVE

To investigate the effects of glycyrrhizae (GL) and glycyrrhizic acid (GA) on cellular immunocompetence in the gamma-ray-irradiated mice.

MATERIALS AND METHODS

Tested mice of ICR strain were treated with GL and GA for 10 days continuously after 4 Gy gamma-irradiation. The counts of total leukocytes, lymphocytes, neutrophils and monocytes in peripheral blood of mice were measured. The blastogenic responses of splenocytes to mitogens, such as PHA, PWM, Con A and LPS were also detected. The cellular immunocompetence was measured by 3H-thymidine incorporation in each tested mouse.

RESULTS

The leukocytes and their differential counts decreased in gamma-irradiated mice. The blastogenic responses of splenocytes to mitogens were inhibited by gamma-ray irradiation. GL and GA were effective in enhancing the recovery of leukocyte count and the blastogenic responses of splenocytes to mitogens, such as PHA, PWM, Con A and LPS from the inhibition of 4 Gy gamma-irradiation.

CONCLUSIONS

Four Gy gamma-ray irradiation can decrease leukocytes and their differential counts, and the blastogenic responses of splenocytes of mice. GL and GA can help the recovery of the cellular immunocompetence in the gamma-irradiated mice.

Effects of gypenosides on cellular immunity of gamma-ray-irradiated mice

OBJECTIVE

To investigate the effects of gypenosides (Gs) on cellular immunocompetence in the gamma-ray-irradiated mice.

MATERIALS AND METHODS

Tested mice of ICR strain were treated continuously with Gs for 10 days before or after 4 Gy gamma-irradiation. Body weight and splenic weight of mice were measured. The blastogenic response of splenocytes to mitogens, such as PHA, Con A and LPS were also detected. The cellular immunocompetence was measured by 3H-thymidine incorporation in each tested mouse.

RESULTS

Body weight as well as splenic weight decreased in gamma-ray-irradiated mice. The blastogenic responses of splenocytes to mitogens were inhibited after gamma-ray irradiation. To treat with Gs was effective to enhance the recovery of body weight, splenic weight and immunocompetence in gamma-ray-irradiated mice from radiation damage.

CONCLUSIONS

Four Gy gamma-ray irradiation could decrease splenic weight and cellular immunocompetence of mice. Gs could help the recovery of the splenic weight and cellular immunocompetence in gamma-ray-irradiated mice.

Detection and Electrical Properties of Cd1-xZnxTe Detectors at Elevated Temperatures

We have studied the behavior of Cd1-xZnxTe detectors in the temperature range 24-70°C. The detector count rate stability and leakage currents are presented as a function of voltage, time, and temperature. Detector polarization due to bulk and surface effects leading to a decreased leakage current was observed. At 70°C, the position of the 32 keV photopeak of 133Ba was stable with time. The peak position varies within only 3 keV, and the peak quality factor varied between 0.31 and 0.41, for a 24 h period of operation at a 60 V bias. The net count to total count ratio was also stable, with values varying between 0.56 and 0.59. The net count to total count ratio decreased from 0.78 at 25°C to 0.71 at 60°C. The conclusion is that Cd1-xZnxTe is a promising material for gamma ray detection at temperatures above room temperature.

Protective effects of Gynostemma pentaphyllum in gamma-irradiated mice

Radiation protective effects of Gynostemma Pentaphyllum (Gp) were investigated in gamma-irradiated mice. Animals were sacrificed on days 5, 15, 25 and 35 after gamma-irradiation. GOT, GPT, serum IgG and leukocyte counts were measured. Proliferation of splenocytes stimulated by mitogens, such as PHA, Con A, and LPS were detected and compared. The results showed that all parameters measured in this study were decreased and proliferation of splenocytes stimulated by mitogens were repressed in gamma-irradiated mice. Gp helped to recover the decreased leukocyte counts, GOT, GPT and IgG in serum and the proliferation of splenocytes stimulated by PHA, LPS and Con A in the gamma-ray irradiated mice.

Prevalence of goiters in children residing in Tung-Lo Township, Taiwan

This study investigated school children in the Tung-Lo Township in central Taiwan to determine the prevalence of goiters compared to other areas of Taiwan and to elucidate the possible etiology. All children attending elementary schools in Tung-Lo were examined for thyroid enlargement by neck palpation, as recommended by the World Health Organization. Thyroid antibodies and thyroid hormones were determined in children with goiters, and in normal age- and sex-matched controls. Additionally, analysis of drinking water for humic substances was done by fluorospectrophotometry. In total, 1,823 school children were examined (965 boys and 858 girls). Of these, 174 (9.5%) were found to have a goiter of grade I or above. The prevalence was higher than our recent surveys in other areas of Taiwan (2.6%-8.8%). Goiter prevalence in school children residing in hill regions (12.9%), mainly dependent on underground water for drinking, was higher than that of school children residing in plain regions (8.2%), who depend on tap water for drinking. The quality of drinking water bore a close relationship to the prevalence of goiter. From the ratio of T3/T4 in this study, and a study of urinary iodine excretion done by others, it is concluded that goiters in Tung-Lo are not related to iodine deficiency. There was no statistically significant correlation between the relative fluorescence intensity of humic substances and the prevalence of goiter. The results of this study suggest that the higher prevalence of goiter in children living in Tung-Lo, an oil-bearing area, may be related to the quality of drinking water.

Changes of white blood cells, immunosuppressive acidic protein, and interleukin-2 receptor after open heart surgery

There are a lot of immunological changes after major surgery, especially in open heart surgery when blood flows through a cardiopulmonary bypass system. We monitored leukocyte count, lymphocyte subpopulation count, soluble IL- 2 receptor (sIL-2r) and serum IL-2 levels, and an immunosuppressive acidic protein (IAP) level before and on the 1st, 7th, and 14th day after open heart surgery. It was noted that there were significant increases of total leukocyte and granulocyte counts for more than two weeks. But total lymphocyte, T-lymphocyte, b-lymphocyte, natural killer cell, suppressor T-cell, and helper T-cell all showed significant decreases in absolute numbers for more than one week as compared to the preoperative values. Serum IAP level was elevated for more than two weeks after operation. Serum IL-2 decreased but serum sIL-2R increased in the postoperative period. It is concluded that there is a period of immunosuppression after open heart surgery which lasts for at least one week and perhaps more than two weeks.

Cytodiagnostic pitfalls in pulmonary coccidioidomycosis

Two cases of pulmonary coccidioidomycosis which were initially misdiagnosed as carcinoma in cytologic examinations of material obtained by bronchoscopy or fine-needle aspiration are reported. The cytodiagnostic pitfalls of misinterpreting reactive bronchial epithelial cells as carcinoma cells and of failing to recognize fungal organisms are discussed.

Therapeutic effects of photosensitizers in combination with laser and ACNU on an in vivo or in vitro model of cerebral glioma

This study investigated the independent and combined effects of photodynamic therapy (PDT), laser photodynamic hyperthermia (LPDH) and 1-(4-amino-2-methyl-5-pyrimidinyl) methyl-3-(2-chloroethyl) -3-nitrosourea hydrochloride (ACNU) in a rat 9L induced gliosarcoma model. The mortality rate (MR60), mean survival time (MST60), and increasing life span (ILS60) within 60 days were determined to evaluate the therapeutic effect in vivo. The MR60 and MST60 of the gliosarcoma tumor control were 100% and 16.2 days. The ILS60s of PDT and ACNU were 72.84% and 49.81%, respectively, but MR60 of both were 86.72%. All combined treatments produced significantly prolonged survival (P < 0.01). The combined effects of LPDH and ACNU, MR60, MST60, and ILS60 were 60%, 43 days, and 165.4%, respectively. The ILS60 of PDT + ACNU (96.48%) and PDT + LPDH (98.58%) also indicated a synergistic or additive effect. The survival fraction and synthetic rate of DNA, RNA, and protein of glioma 9L tumor cells in vitro after single treatment of PDT or combined with antitumor drugs and laser showed that the cytotoxicity of PDT to 9L tumor cell was obvious by using Rh123, HPD, and Pf-II as photosensitizers. Combined treatments of PDT, antitumor drugs, and laser suppressed the synthesis of DNA, RNA, and protein more significantly than single treatment with PDT.

The role of obstetrical medical technology in preventing low birth weight

Technology plays an important role in the practice of medicine, and it is essential that controlled clinical trials be conducted before new technologies are widely disseminated. In this article, information from the medical literature is summarized and critiqued for several common obstetric technologies which are aimed at reducing the incidence or sequelae of low birth weight and preterm birth. These technologies include home uterine activity monitoring, tocolytic drugs to suppress uterine contractions, corticosteriods to accelerate fetal lung maturity, bed rest to prevent preterm delivery, delivery methods, multifetal pregnancy reduction, and cervical cerclage. A major challenge to the practice of medicine is to find effective ways to modify physician behavior to encourage the use of proven, effective technologies, and discourage the use of unproven, ineffective technologies. Despite widespread use, most obstetrical technologies appear to have had little impact on reducing the incidence of low birth weight or preterm births, as rates of low birth weight and preterm birth have not decreased appreciably in the past 25 years. Uncovering the basic mechanisms responsible for the onset of preterm labor will undoubtedly facilitate the discovery of new technologies to prevent low birth weight and preterm births.

Effect of berberine alone or in combination with argon ion laser treatment on 9L rat glioma cell line

The cell-killing effect and its possible mechanism of berberine used alone or in combination with argon ion laser treatment on 9L rat glioma cells were studied. The survival fraction of 9L cells after single treatment of berberine has been investigated using both colony formation and microtitration (MTT) method, the half lethal dose of berberine (LD50) has been estimated to be 60 micrograms/ml. After the addition of low energy laser treatment, the LD50 of berberine markedly decreased to 10 micrograms/ml. The inhibitory effect of berberine on biosynthesis for DNA, RNA, and protein of 9L cells was enhanced by argon ion laser. Moreover, when morphologic change was examined, the 9L cells showed lysis, encystation, and degeneration after berberine treatment; the laser treatment enhanced the cell-killing effect. The study proves the cell-killing effect of berberine combined with laser treatment on 9L rat glioma cell line, hence introducing the possibility of berberine as a photosensitive agent.

Alveolar bone grafting in unilateral complete cleft lip and palate patients

Autogenous bone graft of an alveolar cleft area has the following advantages: (1) assistance in the closure of buccoalveolar oronasal fistula; (2) provision of bony support for unerupted teeth and teeth adjacent to the cleft; (3) formation of a continuous alveolar ridge to facilitate orthodontic correction of malocclusion; (4) supporting the nostril floor and alar base to improve nasal aesthetics. It has been well accepted in most craniofacial centers as routine procedure in cleft lip and palate rehabilitation. A new surgical technique for alveolar bone grafting has been introduced to the Chang Gung Craniofacial Center since July 1991. It provided a good exposure of the alveolar cleft, primary closure of the fistula and adequate volume of bone graft. A review of 27 consecutive alveolar bone grafting procedures performed in unilateral cleft lip and palate patients from July 1991 to June 1992 was presented. Patients have been followed up for at least 6 months. The alveolar bone graft was evaluated clinically and radiologically at one week, six months and one year after the surgery. The preliminary results indicated that the new surgical technique produced less chance of recurrent fistula, good postoperative gingival height, and improvement of nasal aesthetics. Based on the results of this new study we strongly advocate the use of this new surgical technique.

Experience with Furlow palatoplasty

In order to achieve a better speech result while eliminating the possible adverse effect to midfacial growth, a Furlow palatoplasty has been used for primary palatal repair as well as correction of velopharyngeal insufficiency in 54 patients since 1985. There were four oronasal fistulae in the 35 patients who received the procedure for primary palatal repair. These four patients were earlier cases in the series. There was no fistula in the patients operated on after July 1989. Among the 28 patients who had postoperative speech assessment, only two patients had velopharyngeal insufficiency (VPI). These unfavorable results were due to an inappropriate patient selection. For the 19 patients who received a Furlow palatoplasty for the correction of VPI, the results were also encouraging. The unfavorable results were also caused by incorrect patients selection. With increasing experience, the results of this technique should continue to improve.

Congenital macrostomia--transverse facial cleft

Congenital macrostomia or transverse facial cleft is a rare congenital craniofacial anomaly. It is usually associated with deformities of other structures developed from the first and second branchial arches and is thought to be part of the manifestations of hemifacial microsomia, the second most common congenital craniofacial anomaly. There were several methods to repair this deformity. All the methods emphasize the importance of restoration of the integrity of cheek and lip muscles. The role of vermilion flap and the size and direction of skin Z-plasty remained controversial. A retrospective review on the 16 congenital macrostomia patients repaired in this hospital by 4 different surgeons with 5 different methods was made. The symmetry of lip, commissural shape and scar quality were evaluated among different methods. It was felt that accurate positioning of the oral commissure and reconstruction of a functional oral musculature were quite important to a good result. The skin Z-plasty could lengthen the deficient transverse distance of the cheek tissue and prevent later scar contracture. But a Z-plasty needed careful design and good postoperative care to minimize visible scar. A vermilion flap across the commissure could also prevent the lateral migration of the commissure from a linear scar contracture. The flap also needed careful design to give a better commissural shape.

Osteomas of the gallbladder

A 39-year-old woman had multiple osteomas of the gallbladder. She presented with right upper quadrant abdominal pain associated with leukocytosis. An ultrasound showed three small intraluminal gallbladder lesions with no apparent mobility. The lesions proved to be three small polypoid osteomas in the resected gallbladder. A review of the literature showed no previous report of this type of gallbladder neoplasm.