Functional polymer affinity matrix for purifying hexahistidine-tagged recombinant protein

A functional polyacrylic acid (PAA) adsorbent has been prepared for metal chelate affinity chromatography. It has been found to chelate nickel ion Ni2+ strongly, and was evaluated for the ability to bind proteins containing neighbouring histidine residues. The principle of the technique was illustrated with Aeromonas hydrophila outer membrane protein OmpTS. DNA elements coding for adjacent histidines were fused to the Aeromonas hydrophila ompTS gene. Subsequent expression in E. coli resulted in the production of hybrid protein His6-OmpTS that could be purified by Ni2+-PAA affinity chromatography. The remarkable specificity found makes it an attractive addition to the range of adsorbents for metal chelate affinity chromatography.

Calmodulin protects cells from death under normal growth conditions and mitogenic starvation but plays a mediating role in cell death upon B-cell receptor stimulation

Calmodulin (CaM) is the main intracellular Ca2+ sensor protein responsible for mediating Ca2+ triggered processes. Chicken DT40 lymphoma B cells express CaM from the two genes, CaMI and CaMII. Here we report the phenotypes of DT40 cells with the CaMII gene knocked out. The disruption of the CaMII gene causes the intracellular CaM level to decrease by 60%. CaMII-/- cells grow more slowly and die more frequently as compared to wild type (wt) cells but do not exhibit significant differences in their cell cycle profile. Both phenotypes are more pronounced at reduced serum concentrations. Upon stimulation of the B-cell receptor (BCR), the resting Ca2+ levels remain elevated after the initial transient in CaMII-/- cells. Despite higher Ca2+ resting levels, the CaMII-/- cells are partially protected from BCR induced apoptosis indicating that CaM plays a dual role in apoptotic processes.

The distraction reduction fixation system and its application in spondylolisthesis

OBJECTIVE

An internal fixation apparatus--distraction reduction fixation system (DRFS) was designed to satisfy the clinical needs for spondylolisthesis.

METHODS

Since 1996, 53 patients were treated with DRFS. Among them, 35 had spondylolisthesis, 12 had lumbar canal stenosis accompanied with instability, 2 had vertebral tumors and 4 suffered from spinal fracture. The average age was 53.6 years old (ranged 24 approximately 72 yrs). The mean time for follow-up was 30.6 months (16 approximately 44 months).

RESULTS

The slip rate was 0.15 +/- 0.10 before operation, and decreased to 0.09 +/- 0.07 after operation. Entire slip reposition was achieved in 19 cases (54.3%). The change in height of the intervertebral space within the fixation segments was 0.7 +/- 0.17.

CONCLUSION

DRFS achieved better results for spondylolisthesis less II degree and no other adverse effects were found. Compared with other foreign and domestic techniques, it had advantages in less implants, less operation gears required and ease to utilize in operation. It was proved to be an ideal internal fixation apparatus.

[A clinical evaluation on reconstruction in extended partial laryngectomy for transglottic cancer]

OBJECTIVE

Transglottic cancer has been a definite indication for total laryngectomy in decades, compromising function of the larynx. The purpose of this study is to present a new radical surgery of extended partial laryngectomy and reconstruction to restore the essential function of larynx.

METHODS

Forty-one cases of transglottic cancer were treated by extended vertical laryngectomy (26/41), extended frontolateral laryngectomy (5/41) and subtotal laryngectomy (10/41); the defects of larynx were reconstructed by rotary door myocutaneous flap in twenty-seven cases, by sternohyoideus flap in seven cases, by osteomuscular flap in five cases and by sternocleidomastoid flap in two cases.

RESULTS

The 3 and 5 year survival rates were 85.7% (30/35) and 74.1% (20/27) respectively, those for stage III were 84.6% (22/26) and 76.2% (16/21), for stage IV were 3/4 and 1/2 respectively. All cases resumed acceptable voice, 92.7% (38/41) and enjoyed satisfactory phonation. The over-all decannulation rate was 87.8% (36/41), those with rotary door myocutaneous flap was 96.3% (26/27), with sternohyoideus flap was 5/7, with osteomuscular flap was 4/5 and with sternocleidomastoid flap was 1/2. All patients had normal swallow function.

CONCLUSION

Extended partial laryngectomy is a kind of radical operation in selected cases of transglottic cancer. The method of reconstruction with rotary door myocutaneous flap can improve curative effect and the essential functions of the larynx.

[Different sampling method affects the voice assessment results for the patient with vocal polyp]

OBJECTIVE

In order to definitude the influence caused by the different sampling in voice assessment.

METHOD

We comparing the results acquired by total section and subsection sampling.

RESULT

The results acquired by subsection tended to normal more than those acquired by total section.

CONCLUSION

Subsection sampling voice assessment might conceal the degree of the disease state of patients.

Histological reaction to hydroxyapatite in the middle ear of rats

OBJECTIVE

Present study was performed to evaluate the histological response of rat middle ear mucosa following implantation of Apaceram granules, a synthetic dense hydroxyapatite [Ca10(PO4)6(OH)2], prepared from commercially available synthetic auditory ossicle, and to assess the precise histological response of the rat middle ear to implantation of Apaceram granules, by microscopic examination of mucosal tissue at various time points after implantation.

METHODS

Apaceram granules were implanted in the temporal bulla of 32 rats. As control, sham surgery was performed in a group of ten rats. Bulla specimens were removed at 1, 3, 7, 14, and 30 days after surgery in the implant and control groups, and at 90, 180 and 300 days in the implant group. Specimens were decalcified, sectioned at a thickness of 6 microm, and stained with haematoxylin and eosin, and Mallory's azan for histological examination of mucosal tissue.

RESULTS

Evidence of inflammatory reaction was slightly greater in the implant group than in controls. Lymphocyte and macrophage counts were higher in the implant group 1 day after surgery, but decreased to similar levels by day 3, and continued to decrease thereafter, and few were observed in the implant group at 300 days. Neutrophils observed at 1 day after surgery were not evident in either group at 3 days. Gradual fibrosis development continued in both groups over all time points studied. Foreign body giant cells were never observed in either group. No bony reaction was observed in any specimen.

CONCLUSION

The results of this study suggest that Apaceram is biocompatible and suitable for reconstructive ear surgery.

[Screening and characteristics of mutants of E. coli resistant to acetate inhibition]

Acetate is accumulated in the aerobic high cell density culture of Escherichia coli, Which seriously inhibits cell growth and expression of recombinant proteins. To alleviate acetate inhibition, mutants of E. coli JM101 were generated by 60Co radiation and then enriched in continuous culture with acetate as the selective pressure. One of the mutants isolated, JL3, showed obvious increased tolerance toward acetate and maintained phenotypic stability on slant without acetate. In MA medium containing 10 g/L of sodium acetate, the specific growth rate and the glucose consumption rate of JL3 were higher than those of JM101.

[Impact of substrate salinity on caloric value, energy accumulation and its distribution in various organs of Bruguiera gymnorrhiza seedlings]

The study with artificial culture showed that the accumulation of dry matter and energy in Bruguiera gymnorrhiza seedlings was promoted by low substrate salinity, but inhibited by high substrate salinity, which peaked at 10 mg.g-1 substrate salinity. With the increase of substrate salinity, the dry matter and the energy tended to be allocated to the micro-roots and leaves, which are nutrient-absorbing organ and photosynthetic organ, respectively. With the increase of substrate salinity, the changes in caloric values were differed in various organs of B. gymnorrhiza seedlings, and those in leaves could reflect the changes in the salt-resistance of the seedlings.

The crystal structure of an aldehyde reductase Y50F mutant-NADP complex and its implications for substrate binding

In order to understand more fully the structural features of aldo-keto reductases (AKRs) that determine their substrate specificities it would be desirable to obtain crystal structures of an AKR with a substrate at the active site. Unfortunately the reaction mechanism does not allow a binary complex between enzyme and substrate and to date ternary complexes of enzyme, NADP(H) and substrate or product have not been achieved. Previous crystal structures, in conjunction with numerous kinetic and theoretical analyses, have led to the general acceptance of the active site tyrosine as the general acid-base catalytic residue in the enzyme. This view is supported by the generation of an enzymatically inactive site-directed mutant (tyrosine-48 to phenylalanine) in human aldose reductase [AKR1B1]. However, crystallization of this mutant was unsuccessful. We have attempted to generate a trapped cofactor/substrate complex in pig aldehyde reductase [AKR1A2] using a tyrosine 50 to phenylalanine site-directed mutant. We have been successful in the generation of the first high resolution binary AKR-Y50F:NADP(H) crystal structure, but we were unable to generate any ternary complexes. The binary complex was refined to 2.2A and shows a clear lack of density due to the missing hydroxyl group. Other residues in the active site are not significantly perturbed when compared to other available reductase structures. The mutant binds cofactor (both oxidized and reduced) more tightly but shows a complete lack of binding of the aldehyde reductase inhibitor barbitone as determined by fluorescence titrations. Attempts at substrate addition to the active site, either by cocrystallization or by soaking, were all unsuccessful using pyridine-3-aldehyde, 4-carboxybenzaldehyde, succinic semialdehyde, methylglyoxal, and other substrates. The lack of ternary complex formation, combined with the significant differences in the binding of barbitone provides some experimental proof of the proposal that the hydroxyl group on the active site tyrosine is essential for substrate binding in addition to its major role in catalysis. We propose that the initial event in catalysis is the binding of the oxygen moiety of the carbonyl-group of the substrate through hydrogen bonding to the tyrosine hydroxyl group.

Rotating electrode potentiometry: lowering the detection limits of nonequilibrium polyion-sensitive membrane electrodes

A rotating electrode configuration is evaluated as a means to lower the detection limits of newly devised polyion-sensitive membrane electrodes (PSEs). Planar potentiometric polycation and polyanion PSEs are prepared by incorporating tridodecylmethylammonium chloride and calcium dinonylnaphthalenesulfonate, respectively, into plasticized PVC or polyurethane membranes and mounting disks of such films on an electrode body housed in a conventional rotating disk electrode apparatus. Rotation of the PSEs at 5000 rpm results in an enhancement in the detection limits toward heparin (polyanion) and protamine (polycation) of at least 1 order of magnitude (to 0.01 unit/mL for heparin; 0.02 microg/mL for protamine) over that observed when the EMF responses of the same electrodes are assessed using a stir-bar to achieve convective mass transport. A linear relationship between omega(-1/2), where omega is the rotating angular frequency, and C1/2, the polyion concentration corresponding to half the total maximum deltaEMF response toward the polyion species, is observed. It is further shown that the rotating polycation sensor can be used as an end-point detector to greatly enhance (relative to nonrotated indicator electrode) the analytical resolution and precision for measurement of low concentrations of heparin when such samples are titrated with protamine. The theoretical basis for lowering the detection limits by rotating PSEs is discussed based on the unique nonequilibrium response mechanism of such sensors.

Characterization of a novel trans-activation domain of BRCA1 that functions in concert with the BRCA1 C-terminal (BRCT) domain

Mutations in the breast cancer susceptibility gene, BRCA1, account for a significant proportion of hereditary breast and ovarian cancers. The BRCA1 C-terminal (BRCT) domain, which can activate transcription when fused to a heterologous DNA binding domain, is required for BRCA1 function in suppression of tumorigenesis. Here, we provide evidence for a new activation domain in BRCA1 that lies adjacent to the BRCT domain. We name the two domains AD1 and AD2, respectively. Like AD2, the newly discovered AD1 can act independently as an activation domain in both yeast and human cells. However, unlike AD2, AD1 activity in mammalian cells is cell type context-dependent. Furthermore, combination of these two domains in mammalian cells can result in a robust synergy in transcriptional activation. A highly conserved coiled-coil motif in AD1 is required for the cooperative transcription activation. Interestingly, the functional cooperativity between AD1 and AD2 is absent in certain breast and ovarian cancer cell lines, although each domain can still activate transcription. Therefore, the differential and cooperative actions of the two activation modules may contribute to the heterogeneous risk of BRCA1 mutations in different tissues.

Immunomodulation for intestinal transplantation by allograft irradiation, adjunct donor bone marrow infusion, or both

BACKGROUND

The passenger leukocytes in the intestine have a lineage profile that predisposes to graft-versus-host disease (GVHD) in some animal models and have inferior tolerogenic qualities compared with the leukocytes in the liver, other solid organs, and bone marrow. Elimination by ex vivo irradiation of mature lymphoid elements from the bowel allografts is known to eliminate the GVHD risk. We hypothesized that infusion of donor bone marrow cells (BMC) in recipients of irradiated intestine would improve tolerogenesis without increasing the risk of GVHD.

METHODS

Orthotopic small intestine transplantation was performed with the GVHD-prone Lewis (LEW)-to-Brown Norway (BN) combination and the reverse GVHD-resistant BN-to-LEW model under a short course of tacrolimus treatment (1 mg/kg/day, days 0-13, 20, 27). Grafts were irradiated ex vivo, using a 137Cs source. In selected experimental groups, donor BMC (2.5 x 10(8)) were infused on the day of small intestine transplantation.

RESULTS

The unmodified LEW intestine remained intact, whether transplanted alone or with adjunct donor BMC infusion, but all of the BN recipients died of GVHD after approximately 2 months. Intestinal graft irradiation (10 Gy) effectively prevented the GVHD and prolonged survival to 92.5 days, but all of the BN recipients died with chronic rejection of the LEW grafts, which was prevented by infusion of adjunct donor BMC without causing GVHD. In the GVHD-resistant reverse strain direction (BN-->LEW), all intestinal recipients treated for 27 days with tacrolimus survived > or =150 days without regard for graft irradiation or adjunct BMC, but chronic rejection was severe in the irradiated intestine, moderate in the unaltered graft, and least in the irradiated intestine transplanted with adjunct BMC. Mild arteritis in the 150 day allografts of both strain combinations (i.e., LEW--> BN and BN-->LEW) may have been irradiation associated, but this was prevented when weekly doses of tacrolimus were continued for the duration of the experiment rather than being stopped at 27 days.

CONCLUSIONS

Recipients are protected from GVHD by irradiating intestinal allografts, but the resulting leukocyte depletion leads to chronic rejection of the transplanted bowel. The chronic rejection is prevented with adjunct donor BMC without causing GVHD. Although application of the strategy may be limited by the possibility of radiation injury, the results are consistent with the paradigm that we have proposed to explain organ-induced graft acceptance, tolerance, and chronic rejection.

[The study on hereditary polymorphism of thiopurine S-methyltransferasein Chinese Han population of Shanghai area]

OBJECTIVE

To gain an insight into the hereditary polymorphism of thiopurine methyltransferase(TPMT) activity in Chinese Han population of Shanghai.

METHODS

The present authors measured the erythrocyte TPMT activity in 320 healthy Chinese volunteers and 51 children with acute lymphoblastic leukemia(ALL) by means of radiochemical assay.

RESULTS

The TPMT activity levels ranged from 4. 32 to 32.33 U/ml pRBCs, with a mean value of (16.64+/-4.50) U/ml pRBCs, male (16.78+/-4.96) U/ml pRBCs, female (16.52+/-4.44) U/ml pRBCs. Eight point one percent of the sample had low activity. The TPMT activity levels for subjects who were <12 years, 13-18 years, 19-45 years and >45 years old were (16.52+/-4.31) U/ml pRBCs, (16. 71+/-4.24) U/ml pRBCs, (16.28+/-5.21) U/ml pRBCs and (17.11+/-3.98) U/ml pRBCs, respectively; the TPMT activity levels for healthy volunteers and patients with ALL were (16.65+/-4.72) U/ml pRBCs and (16.52+/-4.47) U/ml pRBCs, respectively.

CONCLUSION

There were no differences of TPMT activity in gender, age, and between healthy volunteers and patients with ALL.

[ATP synthesis by free yeast catalysis coupling hollow fiber ultrafiltration separation]

A novel process for the ATP production employing free yeast catalysis and coupling a hollow fiber module ultrafiltration separation was studied. The experimental results of biocatalyst half-life and operating stability for ultrafiltration showed that the enzymes released from free yeast cell could be cut-off efficiently from the product output stream by hollow fiber membrane. The intercepted percentage of ADH and HK reached more than 95% during the steady running. The efficiency of enzymes utilized was 2.0-2.5 fold as much as that of batch reaction. And the time of yeast cells used repeatedly for ATP synthesis reached 2.5-3.0 batches. Under 0.1 MPa, the ultrafiltrating speed of hollow fiber membrane could keep on a stabilizing value for 11 batches continuously. The continuous operation mode of ATP synthesis simultaneous product ultrafiltration separation could be maintained in higher conversion rate for 5.0 h when the whole system fell in a pseudo-stat where the dilution rate was equal to 0.25 h-1.

Identification and characterization of estrogen receptor variants in prostate cancer cell lines

A sensitive semi-nested reverse transcriptase-polymerase chain reaction (RT-PCR) amplification was performed to evaluate estrogen receptor-alpha (ER-alpha) mRNA expression in prostate cancer cell lines. We demonstrated the presence of wild-type ER-alpha (wt ER-alpha) and five ER-alpha variants, designated ER-alphaA, B, C, D, and E. Unlike ER-alphaA and D, ER-alphaB, C, and E were not previously reported in normal or cancerous mammalian cells. DNA sequencing analysis of these ER-alpha variants revealed the genetic changes to be either in-frame or out-of-frame deletions. The expression of each ER-alpha variant differs significantly depending on the androgen responsiveness, tumorigenic and metastatic potentials of each prostate cancer cell line. The potential functional significance of ER-alpha variants was assessed in yeast two-hybrid and ERE promoter-reporter mammalian transcription assay systems. The results of these studies indicated that none of the ER-alpha variants can form homo- or heterodimers either with wt ER-alpha or among themselves in vivo, and that these ER-alpha variants have no demonstrable transcriptional or dominant-negative activity, as assessed in vitro.

[Effects of an extract of Ginkgo biloba on the blood flow of brains and back legs of dogs]

After injecting the injection of an extract of Ginkgo biloba, the cerebral blood flow of dogs wrer increased (P < 0.05-0.001). So were the back legs. And the cerebrovascular resistance was decreased (P < 0.05-0.001).

Scaffold precoating with human autologous extracellular matrix for improved cell attachment in cardiovascular tissue engineering

Cell attachment to a scaffold is a precondition for the development of bioengineered valves and vascular substitutes. This attachment is generally facilitated by the use of precoating factors, but some can cause toxic or immunologic side effects. Autologous extracellular matrix (ECM) is used as a precoating factor in our study. Ascending aortic tissue was cultured to obtain human myofibroblasts. Autologous ECM was extracted from the same aortic tissue. Poly(glycolic acid) (PGA) scaffolds were precoated with autologous ECM, human serum, or poly-L-lysine; the control group was pretreated with phosphate buffered saline (PBS). Myofibroblasts were seeded onto each scaffold, and the cell attachment was assayed and compared. Compared with the control group, precoating with human serum, poly-L-lysine, and ECM increased number of attached cells by 24%, 53%, and 48%, respectively. Differences between precoating groups were significant (p < 0.01), except for ECM versus poly-L-lysine. Scanning electron microscopy also demonstrated the high degree of cell attachment to the PGA fibers on scaffolds precoated with ECM and poly-L-lysine. Precoating polymeric scaffold with autologous human extracellular matrix is a very effective method of improving cell attachment in cardiovascular tissue engineering without the potential risk of immunologic reactions.

Constituents of red yeast rice, a traditional Chinese food and medicine

Detailed analyses were undertaken of the natural constituents of red yeast rice, a traditional Chinese medicine and food known for centuries to improve blood circulation. Preparation of red yeast rice following ancient methods by fermenting the fungal strain Monascus purpureus Went on moist and sterile rice indicated the presence of a group of metabolites belonging to the monacolin family of polyketides, together with fatty acids, and trace elements. The presence of these compounds may explain in part the cholesterol-lowering ability associated with this traditional Chinese food.

Donor and recipient leukocytes in organ allografts of recipients with variable donor-specific tolerance: with particular reference to chronic rejection

We have attributed organ engraftment to clonal exhaustion-deletion of host-versus-graft and graft-versus-host reactions that are reciprocally induced and governed by migratory donor and recipient leukocytes. The so-called donor passenger leukocytes that migrate from the allograft into the recipients have been thoroughly studied (chimerism), but not the donor leukocytes that remain in, or return to, the transplanted organ. Therefore, using flow cytometry we determined the percentage and lineages of donor leukocytes in cell suspensions prepared from Lewis (LEW) cardiac allografts to 100 days posttransplantation. The LEW hearts were transplanted to naïve untreated Brown Norway (BN) recipients (group 2), to naïve BN recipients treated with a 28-day or continuous course of tacrolimus (TAC) (groups 3 and 4), and to drug-free BN recipients pretolerized by earlier bone marrow cell (BMC) or orthotopic LEW liver transplantation (groups 5 and 6). The findings in the heart cell suspensions were correlated with the results from parallel histopathologic-immunocytochemical studies and other studies of the grafts and of host tissues. Although the LEW heart allografts were rejected in 9.6 days by the unmodified recipients of group 2, all beat for 100 days in the recipients of groups 3 through 6. Nevertheless, all of the long-surviving cardiac allografts (but not the isografts in group 1) were the targets of an immune reaction at 5 days, reflected by dramatic increases in the ratio of leukocytes to nonleukocyte nucleated cells from normal values of 1:5-1:6 to 1:1-5:1 and by manifold other evidence of a major inflammatory event. The acute changes returned to baseline by 100 days in the chronic rejection (CR) free hearts of groups 4 and 6, but not in the CR-afflicted hearts of short-course TAC group 3 or the less-severely damaged hearts of the BMC-prime group 5. The freedom from CR in groups 4 and 6 was associated with a large donor contribution to the intracardiac leukocyte population at 5 days (28.6% and 22% in the respective groups) and at 100 days (30.5% in group 4 and 8.4% in group 6) compared with 2% and 1.2% at 100 days in the CR-blighted allografts of the partially tolerant animals of groups 3 and 5. Whether large or small, the donor leukocyte fraction always included a subset of class II leukocytes that had histopathologic features of dendritic cells. These class II(+) cells were of mixed myeloid (CD11b/c(+)) and lymphoid lineages; their migration was markedly inhibited by TAC and accelerated by donor-specific priming and TAC discontinuance. Although a large donor leukocyte population and a normal leukocyte/nonleukocyte cell ratio were associated with freedom from CR, these findings and the lineage profile of the intracardiac leukocytes were not associated with tolerance in the animals of groups 3 and 4 under active TAC treatment. The findings in this study, singly and in their entirety, are compatible with our previously proposed leukocyte migration-localization paradigm of organ allograft acceptance and tolerance.

Pain as a mutual experience for patients, nurses and families: a perspective from Shanghai, China

The author of this article visited China for the purpose of helping the faculty of the School of Nursing learn research skills by participating in research--a kind of learn by doing. Both investigators had conducted quantitative studies in the US--one with children and one with adults--that were adapted for use in China. Seeking to also include a qualitative study, the investigators explored several possible research areas. Because pain is a universal phenomena, it was chosen as the subject for the study using the qualitative methodology reported in the first part of this article.

Identification of a novel FAS/ER-alpha fusion transcript expressed in human cancer cells

A semi-nested reverse transcriptase-polymerase chain reaction (RT-PCR) was applied to evaluate the presence of estrogen receptor-alpha (ER-alpha) in human prostate cancer cells. Unexpectedly, a novel fatty acid synthase (FAS)/ER-alpha fusion transcript was identified, in which the N-terminus of FAS was fused in-frame with the C-terminus of ER-alpha. The existence of the FAS/ER-alpha transcript was further confirmed by RT-PCR analysis using various sets of amplification primers and different reverse-transcribed primers in the presence of dimethyl sulfoxide to eliminate the secondary structure of RNA. The predicted FAS/ER-alpha protein would contain largely domain I of FAS and the entire ligand binding domain of ER-alpha. The FAS/ER-alpha was expressed in a variety of human cancer cell lines including prostate, breast, cervical and bladder cancer cell lines. Our data suggest that the presence of FAS/ER-alpha may complicate the FAS and the ER-alpha signalling pathway.

[A clinicopathological study of hepatic focal nodular hyperplasia]

OBJECTIVE

To study the clinicopathological features of focal nodular hyperplasia (FNH).

METHODS

The clinicopathological characteristics of 25 cases of FNH were studied retrospectively. 20 cases followed for 6 to 47 months. All were evaluated by use of paraffin-embedded sections, special and immunohistochemical staining (EnVision method) and electron microscope.

RESULTS

17 female and 8 male FNH patients aged 14 to 58 (median 38) years of age, all alpha-fetoprotein negative, asymptomatic and normal biochemical liver tests in most cases. The macroscopic hallmark is a central stellate fibrotic scar, composed of fibrous connective tissue and tortuous blood vessels, the fibrous tissue radiated peripherally, dividing the mass into multiple, variably sized nodules, simulating the pattern of cirrhosis. Microscopically, multinodular proliferation of benign-appearing hepatocytes separated by bile-duct-containing fibrous septae that radiate from the central scar. Internodular bile duct proliferation is abundant and merge imperceptibly with the hepatocyte elements near the fibrous septa. Immunohistochemically, the keratin expessed by hepatocytes and by the proliferated bile ducts were similar. Electron microscopic examination found that the ultrastructure of tumor cells were similar to normal hepatocytes. 20 cases were followed for 6-47 months, all survived with no recurrence.

CONCLUSION

FNH is a benign hepatocytic lesion, i.e. a reactive proliferation of hepatic cells to local blood vessel anomalies.

[Effects on the adjacent segment after spinal fusion and instrumentation]

This paper reviewed the literatures about the pathology at the segments adjacent to the fusion segments. The hypertrophic degenerative arthritis of the facet joints and spinal stenosis were the most common pathologic conditions. The pathology usually occurred at the upper segment in the patients of spinal fusion; and the lower segment would also show degeneration in those of instrumentation. The reason lied mainly in the increased stress at the adjacent segment after surgery and the change of segmental motion pattern. Symptoms usually developed within the first 5 years after fusion. Diagnosis depends on the clinical manifest and X-ray examination. Surgical intervention should be indicated if the conservative therapy failed, and decompression and fusion were most commonly applied.

Hepatocellular adenoma and focal nodular hyperplasia: a series of 24 patients with clinicopathological and radiological correlation

OBJECTIVE

To investigate two rare benign lesions, hepatocellular adenoma (HCA) and focal nodular hyperplasia (FNH), and evaluate differential diagnosis.

METHODS

Twenty-four consecutive patients with presumed HCA and FNH were studied at the Liver Cancer Institute from January 1996 to May 1999. Preoperative assessment included clinical evaluation, symptoms and laboratory tests. New imaging techniques were prospectively appraised in addition to usual techniques. All had hepatic resections and follow-up. Histologic examination of surgical specimens was obtained in all cases.

RESULTS

In every instance, FNH was an incidental finding. FNH consists of nodular aggregates of cytologically normal hepatocytes with foci of intranocular bile duct proliferation. In this series, patients with HCA had larger tumors and more often were symptomatic but the occurrence was unrelated to oral contraceptive steroids (OCS) usage. Intralesional hemorrhage or necrosis is common, and was seen in 75% of cases. The best imaging procedure in the diagnosis of FNH was MRI. Color Doppler US was a useful adjunct, but CT lacked specificity, making histological diagnosis mandatory. All patients underwent tumor resected were tumor--free during the follow-up.

CONCLUSIONS

FNH is a distinct histopathologic entity, and is distinguishable from HCA. FNH is a hyperplastic response by the liver parenchyma to a pre-existing arterial malformation. HCA is a liver neoplasia and has the potential of malignant transformation to HCC. Based on these findings, we believe that if the clinical suspicion of HCA or FNH is strong, resection is usually the best approach if technically feasible and histologic diagnosis is mandatory.