Human platelet glycoprotein V: its role in enhancing expression of the glycoprotein Ib receptor

Platelet adhesion to an injured blood vessel wall is a critical initiating step in hemostasis mediated by a four member receptor complex (glycoprotein Ib/V/IX) interacting with plasma von Willebrand factor (vWF). The function of the GPV subunit within this complex is presently undefined. To study the role of glycoprotein (GP) V within the GPIb receptor complex, we transfected the GPV subunit gene into a hematopoietic cell line that constitutively expresses the other three subunits (human erythroleukemia [HEL] cells). Using flow cytometry, we found transfected GPV was surface expressed in HEL cells; this, in turn, led to increased surface expression of the ligand-binding GPIb alpha and GPIX subunits. Radioligand binding assays showed that GPV-transfected HEL cells bound more vWF than their non- or mock-transfected counterparts. We employed confocal microscopy of GPV-transfected HEL cells to show that GPV colocalizes with GPIb alpha on the cell surface. These findings suggest that the GPV subunit plays a role within the GPIb receptor complex by enhancing Ib alpha surface expression.

A huge immature cervical teratoma in a newborn: report of a case

A neonate with a large cervical mass was transferred to our hospital at 4 days of age. A computed tomography scan showed a contrast-enhanced solid mass with multiple cystic elements and fine calcification. Ultrasonography also revealed a predominantly solid mass with calcification, containing multiple cysts. These studies suggested a teratoma, but could not rule out a hemangioma. The tumor was removed on the 12th day of life. A pathological study revealed an immature teratoma that demonstrated fetal type cartilage and an immature neural tube. The operative complete removal of a cervical teratoma in neonates is recommended as soon as possible. The management of a pediatric cervical teratoma should also be similar to that of a sacrococcygeal teratoma. The incidence of cervical teratoma in all pediatric teratomas ranges from 2.3%-9.3% in the West, and from 1.6%-8.3% in Japan.

[Intestinal motility after massive small bowel resection]

To evaluate intestinal motility after 80% massive distal small bowel resection (MSBR), we continuously monitored interdigestive and postprandial bowel motility using bipolar electrodes and/or contractile strain gage force transducers in conscious beagle dogs before, and at 0-4 weeks and 8-13 months after the surgery. Fasting duodenal migrating myoelectric (or motor) complexes (MMCs) occurred at longer intervals in the short-term after 80% MSBR than in controls, and were simulated in long-term that in controls. MMCs arising from the duodenum were often migrated to the proximal jejunum, the jejunum above the anastomosis, and to the terminal ileum beyond the anastomosis. The velocity of duodenal MMC propagation was slowed in every intestinal segment in the short-term, and had not recovered even long after the operation. The duration of the postprandial period without duodenal MMCs was prolonged significantly in the short-term, and still remained longer in the long-term than in controls. These findings suggest that changes in gut motility after MSBR tend to compensate for the shorter intestine and maintain small bowel absorption early postoperatively, and adaptations of motility would occur over the long-term to increased intestinal absorption.

Transient expression of type I collagen in glomeruli with anti-Thy-1 antibody-induced mesangial proliferative lesions

Glomerular expression of extracellular matrices at the protein and mRNA levels was examined in rats with mesangial proliferative glomerulonephritis induced by the intravenous administration of a monoclonal anti-rat Thy-1 antibody. In close association with the mesangial proliferative lesion, type I collagen was immunostained at day 8 but not demonstrated at day 28 in the glomeruli of the kidneys. Type I collagen mRNA expression prominently increased in the nephritic glomeruli at day 4, prior to the appearance of type I collagen protein. In addition, fibronectin expression was also elevated in the diseased glomeruli at both the protein and mRNA levels. These results indicated that glomerular, probably mesangial cells, change their phenotypes during this disease, to synthesize abnormal extracellular matrices that lead to the progression of glomerular sclerosis.

Analgesic and hypnotic effects of subanaesthetic concentrations of xenon in human volunteers: comparison with nitrous oxide

The purpose of this study was to examine the effects of xenon and nitrous oxide in equipotent doses of 0.3 MAC on pain threshold and auditory response time in six healthy male volunteers. Compared with 100% oxygen inhalation, xenon and nitrous oxide significantly increased the pain threshold as measured by a radiant heat algometer. There was no significant difference in analgesic effects between xenon and nitrous oxide. Xenon significantly prolonged the response time to auditory stimuli compared with 100% oxygen, but nitrous oxide did not. The inhibitory effect of xenon on the auditory response time was significantly greater than that of nitrous oxide. The same six volunteers were studied to test if naloxone antagonized analgesia induced by xenon or nitrous oxide. The analgesic effects of xenon and nitrous oxide did not differ with or without naloxone.

Morphological and biochemical changes in a hematopoietic cell line induced by jacalin, a lectin derived from Artocarpus integrifolia

Treatment of the human erythroleukemia cell line K562 with the galactose-binding lectin, jacalin, results in rapid and profound alterations in the morphology and biochemistry of the cells. Within minutes of lectin addition, the cells adhere to the plastic tissue culture surface, and within hours, the cells spread on the surface, acquiring a monocyte-like appearance. Jacalin treatment results in elevated expression of CD61 (integrin beta 3) and CD14, a monocyte-associated cell surface antigen. These results suggest that jacalin treatment of K562 cells triggers intracellular events that result in differentiation along the monocyte lineage.

Electrogastrography prior to and following total gastrectomy, subtotal gastrectomy, and gastric tube formation

On electrogastrography (EGG) spectral analysis, an activity of 3 cycles per minute (cpm) is supposed to be specific for the stomach. After total or subtotal gastrectomy, the original site of the stomach is occupied mainly by the intestine. We attempted to determine if intestinal activity could be recorded in this region with EGG. Epigastric recordings were performed in patients prior and following gastrointestinal or control surgeries. Spectral analysis, using the maximal entropy method and ensemble means was applied to data analysis from these recordings. Preoperatively, the majority of the power peaks were found around 3, 6, and 11 cpm. The postprandial-to-fasting power ratio of all of these power peaks increased significantly postprandially (P < 0.05-0.01). Following total gastrectomy, the power peak around 3 cpm disappeared or was significantly diminished in amplitude (P < 0.05). The postoperative-to-preoperative power ratio ranged from 0.03 to 0.10 (P < 0.001-0.01). However, the power peak around 11 cpm did not significantly change prior to or following total gastrectomy, and the 11 cpm peak appeared relatively dominant. Simultaneous manometric studies in the Roux limb demonstrated a correlation between the power spectral frequency of EGG and manometry at 11 cpm. Therefore, the 11 cpm peak appeared to reflect jejunal or Roux limb electrical activity. The postoperative to preoperative power ratio for the 3 cpm also was significantly reduced following subtotal gastrectomy and gastric tube formation in patients in the postprandial state (P < 0.05-0.001).

Columbin isolated from calumbae radix affects the sleeping time of anesthetized mice

In a screening series of bioactive components in edible and medicinal plants, we found that Calumbae Radix (Colombo root, 1% powdered feed, for 5 d) and its component, columbin (20-40 mg/kg/d, for 5 d, orally), shortened the sleeping time induced by a urethane and alpha-chloralose mixture and prolonged the sleeping time induced by hexobarbital in mice.

Evaluation of long-term survivors after pancreatoduodenectomy for pancreatoduodenal carcinoma

Long-term survivors (> or = 5 years) of pancreatoduodenal carcinoma were evaluated. The absence of retropancreatic invasion seemed to be an important factor for long-term survival in carcinoma of the pancreatic head, carcinoma of the intrapancretic bile duct confined within the bile duct wall, and stage II papilla of Vater carcinoma. The mode of infiltration was INF alpha or INF beta, with a low infiltration tendency. Lymph node metastasis, when present, was confined to the pancreatic head. It is noteworthy that two of the patients with intrapancreatic bile duct cancer had perineural infiltration to the pancreatic head plexus. In patients treated by extended resection, postoperative malnutrition and diarrhea was severe, indicating the importance of long-term nutritional management.

Prognostic significance of nucleolar organizer regions in hepatocellular carcinoma

It has been suggested that the number of argyrophilic nucleolar organizer regions (AgNORs) correlates with cellular activity and the aggressiveness of malignancy. The mean number of AgNORs per nucleus may, therefore, be a prognostic factor for hepatocellular carcinoma (HCC). The purpose of this study was to evaluate the prognostic significance of the number of AgNORs in HCC. The silver-staining technique was applied to surgically resected specimens to indicate AgNORs. Eighty-nine of the specimens were of HCC, 23 were of normal liver adjacent to HCC, and 32 were of cirrhotic liver adjacent to HCC. The number of AgNORs of HCC (mean +/- SD, 3.26 +/- 1.23) was significantly higher than those of normal liver (1.37 +/- 0.13) and cirrhotic liver (1.49 +/- 0.14). The number of AgNORs was significantly correlated with serum alpha-fetoprotein level, tumor size, portal vein invasion, and Edmondson-Steiner histological grade. In patients undergoing curative resection, the survival rate of those with a high number (> 3.04) of AgNORs was significantly worse than that of those with a low number (< or = 3.04) of AgNORs. Multivariate analysis showed that the number of AgNORs was a significant prognostic indicator in patients without portal vein invasion, and portal vein invasion was the only significant variable when all patients undergoing curative resection were assessed together. The results of this study suggest that the number of AgNORs is useful as an indicator of the grade of malignancy and as a predictor of the prognosis of patients with HCC who do not have portal vein involvement.

Familial nesidioblastosis in two sisters

We herein present two female siblings with persistent hyperinsulinemic hypoglycemia in the neonatal period who were diagnosed as having familial nesidioblastosis. Despite both the administration of diazoxide and the intravenous infusion of glucose, one of the affected infants died of severe metabolic acidosis at about 1 month of age, before pancreatectomy could be performed. The other, in whom the disorder was diagnosed early, also failed to respond to conservative medical treatment and ultimately required a 99% pancreatectomy for control of hypoglycemia. A third female sibling was normal. The possibility of familial nesidioblastosis should thus be considered in the case of neonatal intractable hypoglycemia to ensure a prompt diagnosis and allow for early surgical intervention when indicated. The relevant literature on this life-threatening disorder is also reviewed.

Immunohistochemical quantitation for extracellular matrix proteins in rats with glomerulonephritis induced by monoclonal anti-Thy-1.1 antibody

Extracellular matrix proteins (type I collagen and fibronectin) in frozen histologic sections of kidney cortex from rats with glomerulonephritis induced by a single intravenous administration of anti-Thy 1.1 antibody were quantified using an immunohistochemical micromethod. Type I collagen and fibronectin contents in renal cortex of rats with experimental glomerulonephritis (4.33 +/- 0.79 and 10.41 +/- 2.01 microgram/mg of total protein, respectively) were 262% and 151%, respectively, higher than in control rats given normal mouse IgG (1.65 +/- 0.16 and 6.88 +/- 0.95 microgram/mg, respectively; p < 0.01 in each case). In the glomerulonephritic rats, the increase in the contents of extracellular matrix proteins, especially type I collagen, correlated with increasing glomeruli with expansion of mesangial areas. The increase in type I collagen content correlated well with increasing urinary protein excretion and blood urea nitrogen and serum total cholesterol levels (r = 0.851, 0.812, and 0.837, respectively; p < 0.05 in each case). The decrease in creatinine clearance correlated with increasing content of type I collagen (r = 0.781; p < 0.05). The immunohistochemical micromethod may make it possible to evaluate the histopathological diagnosis of mesangial proliferative glomerulonephritis quantitatively.

Long-term results after nonshunt operations for esophageal varices in children

The clinical results of nonshunt operations for esophageal varices in 15 children were evaluated. The varices were caused by congenital extrahepatic portal obstruction (EHPO) in 10, liver cirrhosis or fibrosis (C/F) in 3, and idiopathic portal hypertension (IPH) in 2. The operative procedures were transthoracic esophageal transection with paraesophageal devascularization (TR) for 2 EHPO patients under 5 years of age, TR combined with splenectomy and paragastric devascularization (Sugiura procedure) for 11 (8 EHPO, 3 C/F), and splenectomy with devascularization (SP) or splenectomy for the 2 IPH patients. In the EHPO patient under 5 years of age, TR is associated with a likelihood of gastric or esophageal hemorrhage resulting from hypersplenism, gastric congestion, or persistent distal esophageal varices, which can be treated with partial splenic arterial embolization (PSE), endosclerotherapy, or an additional abdominal procedure. The Sugiura procedure has provided satisfactory long-term results, without rebleeding from esophageal varices, in patients with EHPO and C/F for 1 to 20 years. But EHPO patients who undergo the Sugiura procedure before age 6 can have gastric hemorrhage, because of mucosal congestion, for more than 10 years after the procedure, and selective gastric arterial embolization (GAE) might be necessary. In some EHPO patients, especially young ones who have variceal bleeding, a significant increase in hepatopetal portal flow may not develop, but hepatofugal natural shunts may progress. Therefore we recommend direct operative procedures, ie, TR for patients < or = 6 years of age and a one- or two-stage Sugiura procedure for those over 7 years old.(ABSTRACT TRUNCATED AT 250 WORDS)

Resulting long-term intestinal motility in dogs following construction of a reversed jejunal segment after extensive small bowel resection

To evaluate the long-term function and effective motility of a reversed jejunal segment after extensive small bowel resection, the authors continuously measured postoperative bowel motility during interdigestive and postprandial periods in conscious dogs 6 to 10 months after surgery. The long-term findings were compared with previously reported short-term results measured 2 to 4 weeks after the operation. In the long-term follow-up dogs with a 20-cm reversed jejunal segment constructed after extensive (75% to 80%) small bowel resection, the fasting duodenal migrating myoelectric (or motor) complex (MMC) was often interrupted in the jejunum above the reversed segment, and did not migrate smoothly to the reversed segment or terminal ileum. The MMCs arising from the duodenum predominantly propagated to the ileum through the inherent anatomic continuity of the bowel. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum, above the proximal anastomosis. These findings are similar to those of the MMC propagation pattern noted 2 to 4 weeks after surgery. However, the postprandial duration without duodenal MMC activity was significantly shorter in the dogs with long-term follow-up than in those with short-term follow-up (both were longer than in control dogs). Marked dilatation of the jejunum and reversed jejunal segment was noted across the proximal anastomosis. These results suggest that the transit time and passage of intestinal contents can be delayed and stagnated for at least 10 months after extensive small bowel resection with a 20-cm reversed jejunal segment.(ABSTRACT TRUNCATED AT 250 WORDS)

Primary tuberculosis of the nasopharynx with erythema induratum of Bazin

A 44-year-old Japanese woman with primary tuberculosis of the nasopharynx associated with erythema induratum of Bazin (EI) is reported. The patient presented with erythematous nodules of the lower legs diagnosed as EI. Since EI is a tuberculosis-related skin disease, the presence of latent tuberculous lesions was investigated, and a tuberculous lesion was found in the nasopharynx. Primary tuberculosis of the nasopharynx is very rare. Furthermore, our review of the literature revealed no case in which nasopharyngeal tuberculosis acted as the latent focus of EI.

A solid and cystic tumor of the pancreas in a 10-year-old girl: report of a case and review of the literature

We report herein the unusual case of a 10-year-old girl in whom a neoplasm developed in the head of the pancreas. Complete extirpation of the tumor was performed, which was histologically classified as a "solid and cystic tumor of the pancreas." Postoperative DNA analysis revealed a diploid pattern. The patient remains well with no sign of tumor recurrence 2 years after her operation. Thus, complete tumor extirpation without pancreatectomy is recommended for pediatric patients when there is no direct invasion to the adjacent organs or distant tumor metastasis.

Postoperative adjuvant hepatic arterial infusion of Lipiodol containing anticancer drugs in patients with hepatocellular carcinoma

Vascular invasion and intrahepatic metastasis by hepatocellular carcinoma are important factors predisposing to tumor recurrence. Recurrences of this malignancy occur frequently in residual liver, and its prevention is one of the most important factors in obtaining better surgical survival. Fifty patients who underwent hepatectomy for invasive hepatocellular carcinoma with vascular invasion and/or intrahepatic metastases were studied to evaluate the effect of adjuvant bolus hepatic arterial infusion of iodized poppyseed oil (Lipiodol) containing anticancer drugs in preventing recurrence and in prolonging survival. Patients were assigned to two treatment groups. Twenty-three of the fifty patients received adjuvant bolus infusion of Lipiodol containing doxorubicin and mitomycin C, whereas 27 patients received no therapy. The disease-free survival rate for the patients who received adjuvant therapy was significantly better (p < 0.05) than that for those who did not when measured at 172, 516, 688 and 860 days after hepatectomy, and the disease-free survival curve for patients with adjuvant therapy was significantly (p = 0.0237) better than that without adjuvant therapy. The cumulative survival rates and curves were not significantly different between the two groups. While adjuvant hepatic arterial infusion of Lipiodol containing anticancer drugs was effective in improving disease-free survival, the effect was not satisfactory. Further trials of adjuvant chemotherapy are required to improve the surgical survival of hepatocellular carcinoma patients.

Induction of oesophageal and forestomach carcinomas in rats by reflux of duodenal contents

A study was designed to determine whether oesophageal carcinomas can be induced through reflux of duodenal contents. Male Wistar rats weighing 230-250 g were divided into three groups according to the surgical procedure performed: (1) the duodenal contents were directed into the forestomach through a stoma (duodeno-forestomach reflux); (2) the duodenal contents were regurgitated into the forestomach through the glandular stomach (duodeno-glandular-forestomach reflux); and (3) a sham operation was performed as a control. Animals were fed standard CRF-1 solid food and tap water that was not exposed to carcinogens and were sacrificed 50 weeks post-operatively. While no neoplasia was observed in any of the 32 control rats, 4/11 (36%) with duodeno-forestomach reflux and 3/18 (17%) animals with duodeno-glandular-forestomach reflux developed carcinomas in the lower oesophagus and forestomach. The incidence in each group was significantly higher than in the controls (P < 0.01 and P < 0.05 respectively). Six of the seven lesions consisted of squamous cell carcinomas, and one was a mucinous adenocarcinoma. Oesophageal columnar epithelial metaplasia was observed in two (18%) of the animals with duodeno-forestomach reflux. Carcinomas were always surrounded by chronic inflammatory changes, including regenerative thickening, basal cell hyperplasia and dysplasia. Additional well-differentiated adenocarcinomas were observed in the prepyloric antrum of 6/18 (33%) animals with duodeno-glandular-forestomach reflux. These findings indicate that chronic reflux of duodenal contents may cause oesophageal carcinoma.