Cytopathological evaluation of potential malignancy of duodenal gastrinoma using aspiration smears from two patients' resected tumors (NET G1, NET G2): A case report

Sporadic gastrin-producing neuroendocrine tumors (NETs) of the duodenum present with either Zollinger-Ellison syndrome or unspecific syndromes. Ki-67 scoring in cytopathology is an alternative approach for establishing the gastrinoma grade. Although the majority of NETs, including gastrinomas, occur in the duodenum, most research regarding the Ki-67 index is focused on tumors of pancreatic origin. To the best of our knowledge, there is no study on the Ki-67 index for cytological analysis of duodenal gastrinoma. The current report presents two cases of a 56-year-old man and a 66-year-old woman with NET G1 and G2 gastrinoma, respectively, arising in the duodenal bulb. The present report focused on the differences in nuclear pleomorphism and Ki-67 index between these two cases.

[Unrelated match bone marrow transplantation for severe aplastic anemia]

The results of unrelated bone marrow transplantation (BMT) is poor because of the rejection of bone marrow graft and graft versus host disease (GVHD). However, the rate of rejection has been reported to be decreased by intensive immuno-suppressive preconditioning regimens combined with total body irradiation (TBI). We report a case of an 18-year-old male with severe aplastic anemia who received a matched BMT from an unrelated donor. The pre-conditioning regimen included cyclophosphamide (50mg/kg) for 4 days, total lymphoid irradiation (TLI: 6Gy) and TBI (5Gy). GVHD (grade 1), hemorrhage cystitis and varicella occurred after BMT but were cured. His performance status is now 100% on the Karnofsky score at 10 months after BMT.

In vivo activities of aldose reductase inhibitors having a 1-(arylsulfonyl)hydantoin structure

Two potent aldose reductase inhibitors, 1-[(2,5-dichlorophenyl)sulfonyl]hydantoin (Di-Cl-PSH) and 1-[beta-naphthyl)sulfonyl]hydantoin (beta-NSH), were tested for usefulness in the treatment of diabetic and galactosemic complications in animal experiments. Both drugs were effective for the treatment of diabetic neuropathy characterized by decreased motor nerve conduction velocity, that is, slowing of tail and sciatic-tibial motor nerve conduction velocities in streptozocin-induced diabetic rats was prevented during 3 weeks by intubating Di-Cl-PSH or beta-NSH at 50 mg/kg/day. Lenticular vacuole formation in rats fed a 30% galactose diet was blocked completely for at least 2 weeks by oral administration of Di-Cl-PSH or beta-NSH at both 30 and 100 mg/kg/day, whereas all of the eyes of vehicle-treated rats showed vacuole formation by day 4 on the galactose diet. The ED50 values of Di-Cl-PSH and beta-NSH for inhibition of sorbitol accumulation in the sciatic nerve and lens of streptozocin-induced diabetic rats were also estimated; the values of Di-Cl-PSH and beta-NSH were 1.1 and 3.4 mg/kg/day, respectively, for inhibition in the sciatic nerve and 4.8 and 16.0 mg/kg/day, respectively, for that in the lens. This study indicates that Di-Cl-PSH and beta-NSH have high potential for future clinical use as aldose reductase inhibitors.

[Cholecystolithotripsy using extracorporeal shock waves]

Extracorporeal shock-wave lithotripsy (ESWL) was first applied for calculi of the bile duct system in 1985. Recent improvement of the crushing apparatus has enabled us to crush the biliary calculus more accurately than before, and moreover, to conduct the procedure without anesthesia, and to treat easily. We performed ESWL in 30 cases of calculus in the cholecyst using MPL-9000 (Dornier Co., Ltd.) which is said to be a crushing device of a new generation. Here, the study is presented. The results of crushing effect demonstrate the efficacy in 26 of 30 cases (87%), and disappearance rate in 18 cases (60%) at present after an average follow-up period of 4.4 months. The disappearance cases were mainly those with a single calculus (75% disappearance rate) or pure cholesterol calculus (100%). Concerning the complications, right upper abdominal pain which was expected to accompany excretion of the crunched fragments was recognized in 10 cases (33%), it was not seen in cases in which laparotomy or endoscopic papillotomy was performed.

The increase of non-MHC-restricted cytotoxic cells (gamma/delta-TCR-bearing T cells or NK cells) and the abnormal differentiation of B cells in Wiskott-Aldrich syndrome

The objective of this study was to analyze the configuration of the lymphocytes in Wiskott-Aldrich syndrome (WAS) by studying the surface antigens from nine cases using dual-color immunofluorescence analysis. All the patients showed the increase of non-MHC-restricted cytotoxic cells, namely CD3+ WT31- delta TCS1+ (gamma/delta-T cell receptor (TCR)-bearing cells) and/or CD16+ natural killer cells. The gamma/delta-TCR+ cells of WAS, however, were unique since they did not express CD5, which is present on ordinary gamma/delta-TCR+ cells. A reduced number of CD4+ cells and an increased percentage of CD11b+ Leu7+ cells within a CD8+ subset were observed in all cases. With regard to B cell subpopulations, most cases showed reduced Fc epsilon R2-bearing B cells, despite an elevated serum IgE.

Improvement of nerve conduction velocity in mutant diabetic mice by aldose reductase inhibitor without affecting nerve myo-inositol content

The sciatic motor nerve conduction velocity of mutant diabetic C57BL/Ks mice was significantly improved from 30.0 +/- 1.4 to 38.0 +/- 4.6 m/s by treatment with the aldose reductase inhibitor 1-[(beta-naphthyl)sulfonyl]hydantoin (30 mg/kg/d) for 2 weeks. The treatment, however, did not cause any significant change in myo-inositol concentration in the sciatic nerve. The results indicate that the ameliorating effect of the aldose reductase inhibitor on nerve conduction velocity in mutant diabetic mice is not due to alteration of myo-inositol content in the nerve.

Analysis of sorbitol, galactitol, and myo-inositol in lens and sciatic nerve by high-performance liquid chromatography

Accumulation of sorbitol or galactitol and depletion of myo-inositol in hyperglycemic conditions such as diabetes and galactosemia involve the activity of aldose reductase and are implicated in hyperglycemia-induced complications such as cataract and neuropathy. A high-performance liquid chromatographic method has been developed for the measurement of polyols in the lens and sciatic nerve of rats. This method comprises polyol extraction from tissues, lyophilization of extracts, derivatization of polyols by the reaction with phenylisocyanate, and HPLC of derivatives with detection at 240 nm. The time needed for each run is less than 25 min, which allows the testing of a large number of samples per day. Sensitivity is very high: as low as 0.5 nmol each of sorbitol, galactitol, and myo-inositol in lyophilized extracts of tissues can be determined. The present method offers a reliable tool to evaluate the in vivo activities of aldose reductase and its inhibitors.