Search

The risk management with regard to endoscopic sphincterotomy (EST) techniques should be considered in clinical practice. Therefore, early complications of the ordinary EST, wire-guided EST, and needle-knife EST were retrospectively studied in 227 patients with biliopancreatic diseases in our hospital. An early complication rate was encountered in 7.5% of patients and there was no death; pancreatitis in 4.8%, bleeding in 0.9%, cholangitis in 0.9%, cholecystitis in 0.4%, and perforation in 0.4%. Statistically, there were no significant differences among the three EST techniques, while the complication rate of the needle-knife EST was higher than that of the ordinary EST and wire-guided EST. We suggest that the condition of the patient, anatomic variations, and the skill of the endoscopist influence risk factors of EST. However, further prospective multicenter studies are needed to clarify risk factors for early complications of EST.

Localisation of the acrosome reaction inducing activity in egg-jelly was examined in the newt, Cynops pyrrhogaster. The jelly has six layers: the J0, J1, J2, J3, J4 and st layers. Jelly was mechanically dissected and placed on a Millipore filter. When sperm were added from the outer surface side of the jelly, most of them exhibited the acrosome reaction after passing through the jelly. When egg-jelly was divided into four layers, strong activity for the induction of acrosome reaction was detected in the outer layers, J4+st. These findings suggest that the acrosome reaction is induced by a substance in the outer layers of the egg-jelly. Among jelly components separated by SDS-PAGE, a fraction of more than 500 kDa in molecular weight induced the acrosome reaction. Wheat germ agglutinin (WGA), Griffonia simplicifoliar agglutinin 1 (GS-1), Maclura pomifera agglutinin (MPA) and Arachis hypogaea agglutinin (PNA) inhibited the induction of the acrosome reaction by jelly extract, and WGA did so in a dose-dependent manner. Those lectins precipitated some molecules of over 500 kDa. These results suggest that the acrosome reaction is induced by the high molecular-weight components of egg-jelly in C. pyrrhogaster.

Introduction Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been accepted as an effective tool of diagnosis and staging for patients with known or suspected recurrent colorectal cancer. Methods This study is to analyze the clinical significance of FDG-PET on the diagnosis and indication of surgical intervention for recurrent colorectal cancer. Consecutive 48 patients, with known or suspected recurrence of colorectal cancer based on elevation of tumour markers or abnormal findings on the follow-up CT image, underwent FDG-PET for 70 times between December 2003 and August 2009. Patients were aged between 35 and 89 years (median 48); 27 were male, 16 were Duke9s A or B stage, and 26 had a history of colon cancer. The average of recurrence was two times (range 1–6). The average period between operation and first FDG-PET was 25 months (range 1–89). Of 48 cases 42 had elevated serum CEA or CA19-9 (91.3%). For each case the diagnosis of FDG-PET image was compared with that of CT image and the final diagnosis. Results 48 patients were divided into these three groups according to the purposes of FDG-PET; to identify recurrent colorectal cancer by FDG-PET (identification group, n=5), to determine malignancy and disease spread (disease spreading group, n=37), and to evaluate the possibility of surgical intervention in recurrence-confirmed cases (follow-up group, n=6). In the identification group, FDG-PET solely could identify recurrence and indicate operation for 4 cases (7 times). One of three cases shows disease-free survival for 33 months after common iliac replacement operation. In the disease spreading group, 23 cases with localised disease spread by FDG-PET findings were indicated operation, 14 cases with diffused disease spread were judged as contraindication of operation. The median survival period after recurrence of operation series was longer than that of contraindication series (36 months vs 22 months). In the follow-up group, FDG-PET could detect lesions of whole body at one study and one was indicated for salvage operation for liver metastasis. FDG-PET showed to be false-positive in one case and false-negative in three. Totally, the sensitivity of FDG-PET was 95.7% and its accuracy was 94.2%, whereas those of CT were 87.1% and 87.1%, respectively. Conclusion FDG-PET could visualise a malignant lesions at earlier stage, and was an effective modality to evaluate not only disease spread but distant metastasis for recurrence of colorectal cancer. In this study, we first demonstrated that FDG-PET oriented surgical indication has clinical importance for recurrent colorectal cancer.

This paper describes nongrounded common-mode equivalent circuit for a motor driven by a voltage-source PWM inverter. When the capacitance of the rotor was small, the phenomenon that polarity of the common mode voltage and shaft voltage reversed was observed. In order to model this phenomenon, the bridge type equivalent circuit is proposed. It is verified with the calculation and experiment that shaft voltage values and polarity are accurately calculated with the proposed equivalent circuit.

We developed three new assay methods: an antialgal test using the diatoms, Nitzschia closterium and Naviculla sp.; a growth-inhibition assay against invertebrate larvae of Musculista senhousia; and an assessment of the residual amount of tested samples on conventional submerged assay plates used for screening antifouling substances. A combination of these assay procedures with the antimicrobial assay previously reported resulted in establishing a laboratory-maching, more reliable and time-saving assay system for antifouling substances.

Sympathetic paragangliomas are rare neuroendocrine tumors.Patients with progressive metastatic tumors are currently treated with systemic chemotherapy. We had a metastatic paraganglioma with good response to combination of cyclophosphamide, vincristine and dacarbazine(CVD). A 53-year-old woman underwent tumor resection of retroperitoneal paraganglioma in 2005. She had a repeat surgery of recurrence lesion in 2008. 2012, she had back pain, and computated tomography and MRI showed multiple bone metastasis.Radiation and CVD chemotherapy resulted in tumor regression and marked improvement of clinical symptoms. The combined chemotherapy with CVD appears to be effective for progressive metastatic paragangliomas.

Photoluminescent silica flakes were newly synthesized from silicon tetrachloride (SiCl4) by reflux in N,N-dimethylformamide (DMF) without the use of any surfactants or other additives. Photolumines...

This study was carried out to investigate the possible role of adhesion molecules in the histamine release from human basophils primed with recombinant IL-3 (rIL-3). Anti-IgE monoclonal antibody (0.1 microgram/ml) did not induce apparent histamine release by itself, however, remarkable histamine release was induced from rIL-3-primed human basophils triggered by anti-IgE. Bear-1 (anti-CD11b monoclonal antibody) inhibited the histamine release enhanced by rIL-3, however SPV-L7 (anti-CD11a monoclonal antibody) or CLB-LFA1/1 (anti-CD18 monoclonal antibody) did not inhibit the histamine release enhanced by rIL-3 at all. The present study suggests that alpha-chain of Mac-1 is involved in the priming effect of IL-3 to increase histamine release from human basophils.

A case of granulocyte colony-stimulating factor (G-CSF)-producing small-cell carcinoma of the uterine cervix is described. In a 70-yr-old woman, clusters of small cells with hyperchromatic nuclei at a high nuclear/cytoplasmic ratio were detected cytologically in the cervix. These clusters were diagnosed as a small-cell neuroendocrine carcinoma by the concomitant use of Grimelius staining and immunohistochemical staining, in addition to electron microscopic observation. This patient showed a significant increase in peripheral leukocytes, despite the absence of infectious signs. Immunohistochemical findings, together with a high blood G-CSF level, suggested the production of G-CSF from the tumor. Consistent with the knowledge that both small-cell carcinoma and G-CSF-producing tumors have a poor prognoses, the patient had no or partial response to therapies performed, and died from the cancer 11 mo after it was diagnosed. This case strongly indicates the need for early diagnosis of this type of tumor, based on cytological features.

We have synthesized many pyrimidine amide derivatives. Novel pyrimidine bis-glycolic amide derivatives showed moderate inhibition in the rat passive cutaneous anaphylaxis (PCA) assay by oral administration. Among these compounds, 2,4-bis(methoxyacetylamino)-6-piperidinopyrirnidine ( 2i ) exhibited significant inhibition. However the compound ( 2i ) did not inhibit antigen-induced histamine or SRS-A release from lung fragments of the guinea-pig at less than 10 −4 M. Derivatives of 2i have also notable or moderate activity in the rat PCA assay. Compound 2h which has no oxygen atom at the α-position of the amide carbonyl group and, compound 17 which has no amide carbonyl group, showed no inhibition in the rat PCA assay. We supposed that both the amide carbonyl group and the oxygen atom at α-position of the amide carbonyl group play an important role in inhibiting the rat PCA reaction. These pyrimidine bis-glycolic amide derivatives have a novel structure and unique activity which suggests they may be potentially useful in the treatment of allergic diseases.

A series of m-bis(glycoloylamino)benzene derivatives was synthesized by treatment of the corresponding m-diaminobenzene derivatives with glycoloyl chloride derivatives in pyridine. Hydrolysis of acetyl compounds gave hydroxy derivatives, from which other acyl derivatives could be synthesized. These compounds were tested in the rat PCA (passive cutaneous anaphylaxis) assay by oral administration. Benzonitrile derivatives (4c, 5c, 6c, 4h, 5h) exhibited notable inhibition in this assay. Compounds 5c and 6c also showed remarkable inhibition of eosinophil adhesion to TNF- (tumor necrosis factor) alpha-treated HUVEC (human umbilical vein endothelial cells) in the range of 10(-8)-10(-5) M. Compound 5c is now under investigation in Japan as TYB-2285 (Figure 1) for asthma and atopic dermatitis in phase II clinical studies.

1. The effect of a new antiasthmatic drug, TYB-2285 [3,5-bis (acetoxyacetylamino)-4-chlorobenzonitrile], on dual bronchoconstriction and airway hyperreactivity in actively sensitized guinea pigs was investigated. 2. Immediate and late bronchial responses were induced at 1-10 min and 4-7 hr after antigen inhalation, respectively. Guinea pigs were pretreated with TYB-2285 (300 mg kg(-1) PO, as a single dose or consecutively for 7 days). 3. The immediate bronchial response was inhibited only by a multiple administration of TYB-2285. Late bronchial response was inhibited by both administration methods. 4. The numbers of eosinophils, neutrophils and macrophages, but not lymphocytes, in the bronchoalveolar lavage fluid were increased at 4 hr after antigen inhalation. TYB-2285, given singly and consecutively, decreased the numbers of total cells, eosinophils, neutrophils and macrophages. 5. Sensitized guinea pigs showed significant airway hyperreactivity to inhaled histamine. This airway hyperresponsiveness was reversed by a single administration of TYB-2285. 6. Luminol-dependent chemiluminescence of airway-infiltrated cells was slightly inhibited by TYB-2285 (20 microg ml(-1)). 7. The present study shows that TYB-2285 inhibits late asthmatic response and airway hyperresponsiveness, presumably by inhibiting the accumulation and activation of eosinophils and other inflammatory cells.

1. The effect of TYB-2285, a novel anti-inflammatory drug, was investigated on passive peritoneal anaphylaxis in rats, and compared with disodium cromoglycate (DSCG), amlexanox, ketotifen fumarate and tranilast. 2. As parameters of passive peritoneal anaphylaxis, histamine release into the peritoneal cavity and capillary permeability elicited by ascitis were measured. 3. TYB-2285 (10 mg/kg), when given intraperitoneally at 0.5, 1 and 2 min before antigen challenge, inhibited anaphylactic histamine release by 36.2%, 57.5% and 52.6%, respectively. TYB-2285 also inhibited capillary permeability by 20.9%, 57.6% and 49.0%, respectively. 4. DSCG (10 mg/kg), given intraperitoneally 0.5 min before challenge, inhibited histamine release and capillary permeability by 79.6% and 57.6%, respectively. 5. Amlexanox (10 mg/kg), given intraperitoneally 0.5 min before challenge, inhibited histamine release and capillary permeability by 85.6% and 74.8%, respectively. 6. A time-course study showed that TYB-2285 (30 mg/kg) was effective for 30 min after oral administration. A dose–response study suggested that the inhibitory effect of TYB-22585 (postoperatively) on histamine release during PPA reached a plateau at 10 mg/kg. 7. In passive peritoneal anaphylaxis in vitro, TC-1121 and TC-1122, metabolites of TYB-2285, inhibited antigen-induced histamine release at 10−7 to 10−5 M in a dose-dependent manner, whereas TYB-2285 itself and other major metabolites of TYB-2285, TC-286 and TC-326, did not inhibit histamine release, even at 10−4 M.

Objectives : To determine the efficacy of a miniaturized dumbbell test procedure designed to more easily identify defect(s) in bonded dentine test specimens. Methods : Extracted human dentine substrates were pre-conditioned with 10-3 solution for 10, 30 or 60 s prior to dentine bonding with 4-META/MMA-TBB resin. Miniaturized dumbbell-shaped test specimens were prepared from the resin bonded samples. After 24 h storage in 37 °C water, the specimens were tensile-loaded to failure. Fractured surfaces and cross-sections were examined and compared under scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Results : Cohesive failure within the bonding resin was observed in specimens pre-conditioned for 10 s. The tensile bond strength of these was excellent. Bond strengths of specimens that were pre-conditioned for 30 and 60 s were significantly lower, and defects in these specimens, formerly difficult or impossible to identify, were readily identified under SEM and TEM microscopy. Conclusion : The proposed method of tensile stressing to failure and microscopically examining fractured miniaturized dumbbell-shaped test specimens is a simple and reproducible test procedure. The protocol is capable of clearly elucidating defective resin infiltration of demineralized dentine in bonded interfaces. These defects are difficult to visualize by conventional and/or ISO recommended methods.

BACKGROUND Cyclins and wild-type p53 are prime cell cycle regulators and may be involved in tumorigenesis. Cyclin E is a late G1 cyclin and its abnormalities have been reported in several cancers. The authors investigated the correlation between cyclin E expression and progression of gastric carcinoma. METHODS The expression of cyclin E and p53 proteins was investigated retrospectively in 116 patients with gastric carcinoma. Immunohistochemical staining of the paraffin sections was performed using monoclonal antibodies to cyclin E and p53. RESULTS The total cyclin E positive rate was 44.0% (51 of 116) of all cases, 26 of which were strongly positive. Strong cyclin E expression frequently was observed in deeply invasive tumors, tumors with lymph node metastasis, and tumors of advanced stage. The incidence of p53 expression was higher in the cyclin E positive tumors than in the other tumors. With regard to prognosis, patients whose tumors had both strong positivity for cyclin E and positivity for p53 had significantly poorer prognosis. In multivariate analysis, the combined variable of cyclin E and p53 was an independent prognostic indicator together with serosal invasion and tumor size. CONCLUSIONS These data suggest the cyclin E expression correlates with p53 expression and may contribute to the progression of gastric carcinoma. The combined variable of cyclin E and p53 expression could be a useful prognostic indicator in patients with gastric carcinoma. Cancer 1998;82:1238-43. © 1998 American Cancer Society.

The pontine parabrachial and Kolliker-Fuse nuclear complex (NPB-KF) has been assumed to be the anatomical location of the pneumotaxic center (11). It contains high density of respiratory neurons with various discharge patterns (3, 6). Destruction or electrical stimulation of this area is known to produce profound changes in the respiratory rhythm (5, 24, 25). It is suggested that the NPB-KF exerts its effects by specifically modulating the activity of the medullary inspiratory ‘off-switch’ mechanism, which terminates inspiration and ensures the phase transition from inspiration to expiration (8, 9). However, axonal projections from the NPB-KF to the medullary structures specifically involved in the inspiratory ‘off-switch’ effects have not been well delineated. Previous studies by us demonstrated that the nucleus raphe magnus, a structure involved in the inspiratory ‘off-switch’, received strong axonal projections from the NPB-KF area (1, 21, 22). Another possible neuron group which may transmit the function of the NPB-KF is the Botzinger complex (Bote). The Bot. c. is known as a group of expiratory neurons in the vicinity of the retrofacial nucleus (14, 19). Most of those neurons have an augmenting firing pattern and widespread inhibitory connections to the medullary inspiratory premotor neurons (10, 12, 18). Recent studies by Smith et al. (20) and us (23) with the retrograde WGA-HRP tracing method revealed that the Bot. c. received strong projections from the lateral NPB and the KF. These studies suggest that these projections are composed of axons from the pontine respiratory and/or non-respiratory neurons which would modulate the activities of expiratory neurons in the Bot. c.

In patients with carcinoma of the bile duct, a primary tumor with tumor spread along the bile duct is frequently shown as a stricture of the bile duct with ductal irregularity and rigidity on ERCP. In patients in whom histological diagnosis is necessary, larger caliber peroral cholangioscopes with a larger working channel should be chosen because they have the advantage of simultaneous biopsy diagnosis. However, peroral cholangioscopy (POCS) has limitations to inspect mucosal tumor spread along the upstream ducts due to the tight stricture, to obtain sufficient biopsy material for confirming the diagnosis, and to identify submucosal tumor spread. With further improvement of techniques, the combined use of POCS with biopsy under direct vision and intraductal ultrasonography (IDUS) is expected to be the best way in the diagnosis of biliary tumors.

Introduction Pivotal treatment for localised recurrent colorectal cancer is surgical resection. Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been accepted as an effective tool to identify disease localizations for patients with known or suspected recurrent colorectal cancer. This study is to analyse the survival benefit of FDG-PET on the diagnosis and indication of surgical intervention for Methods Consecutive 61 patients, with known or suspected recurrence of colorectal cancer based on elevation of tumour markers or abnormal findings on the follow-up CT image, underwent FDG-PET for 85 times between December 2003 and September 2009. Patients were aged between 39 and 94 years (median 66); 35 were male, 22 were Duke’s A or B stage, and 31 had a history of colon cancer. The average period between operation and first FDG-PET was 24 months (range 4–114). Of 61 cases 50 had elevated serum CEA or CA19–9 (82.0%). For each case the diagnosis of FDG-PET image was compared with that of CT image and the final diagnosis. Results Recurrence developed 2 times in average (range 1–6). Of 61patients five were identified recurrence by FDG-PET solely and indicated operation for 7 times. One of four shows disease-free survival for 70 months after common iliac replacement operation. FDG-PET showed one false – positive and three false – negative findings. Totally, the sensitivity of FDG-PET was 93.3% and its accuracy was 91.8%, whereas those of CT were 85.0% and 83.6%, respectively. Of 61patients 19 had diffused disease spread by FDG-PET findings and were judged as contraindication of operation and the other 42 with localised disease spread received operation for 90 times (liver 28, lung 14, local 37, local with distant meta 5, etc.). Cumulative 1-year and 3-year survival ratios of operation cases after first recurrence were 95% and 80%, whereas, those of contraindication cases were 60% and 25%, respectively. At present, the median survival period after recurrence of operation cases was longer than that of contraindication cases ( 37months v.s. 13months ). Our results suggested that one FDG-PET oriented operation roughly corresponded to one year survival benefit with restart. Conclusion Conclusion: FDG-PET could identify malignant lesions at earlier stage, and was an effective modality to evaluate not only disease spread but distant metastasis for recurrence of colorectal cancer. In this study, we first concretely demonstrated that FDG-PET oriented surgical indication had survival benefit for recurrent colorectal cancer. Disclosure of Interest None Declared

Background. E-cadherin plays a crucial role in cell-cell adhesion in epithelial tissues. Recent studies have shown a correlation between decreased E-cadherin expression and cancer cell detachment. Methods. The expression of E-cadherin was immunohistochemically analyzed using antihuman E-cadherin antibody in 121 cases of human gastric carcinoma. Results. In noncancerous areas, the epithelial cells, including those with intestinal metaplasia, were stained positively in the plasma membrane. In contrast, E-cadherin expression of the cancer cells varied from case to case in primary and secondary sites. Tumors with a decrease in E-cadherin occurred significantly more frequently in undifferentiated adenocarcinoma (P < 0.05) and scirrhous type (P < 0.01). The rate of E-cadherin-negative tumors was higher in patients with peritoneal metastasis (P < 0.01) or in those with distant lymph node metastasis (P < 0.01), though the tumors with liver metastasis had relatively positive E-cadherin expression. Patterns of initial recurrence had similar results. Reduction or loss of E-cadherin expression correlated with shorter survival in patients after curative operation regardless of stage of disease. Conclusions. The decreased E-cadherin expression correlates with dedifferentiation, infiltrative tumor growth, distant metastasis, and poor survival for patients with gastric carcinoma. Thus, immunohistochemical study of E-cadherin may have clinicopathologic value for patients with gastric carcinoma. Cancer 1995; 76:2193–201.

1. 1. Exposure of sensitized Brown Norway (BN) rats to ovalbumin aerosol induced a remarkable and a sustained accumulation of eosinophils into broncho-alveolar lavage (BAL) fluid. 2. 2. When male BN rats, sensitized by i.m. injection of ovalbumin and i.p. injection of killed Bordetella pertussis, were exposed to the antigen on day 14, eosinophils accumulated into BAL fluid, maximal 48 hr after antigen exposure. This accumulation of eosinophils was inhibited completely by administration of cyclosporin A (Cs A, 50 mg/kg/day) during induction phase, whereas it was inhibited slightly by administration of CsA (50 mg/kg) during the effector phase. 3. 3. When BN rats were sensitized by weekly exposure of ovalbumin, eosinophils accumulated into BAL fluid, maximal 48 hr after the third exposure of antigen. The accumulation of eosinophils by this method was observed only in female rats and was inhibited completely by administration of CsA (50 mg/kg) during induction phase, whereas it was inhibited slightly by administration of CsA (50 mg/kg) during effecter phase. 4. 4. The present study demonstrates similarities and differences between two models of eosinophilia and also suggests increased function of T cells in BN rats.

3H-paroxetine is regarded as a better ligand for the serotonin (5-hydroxytryptamine; 5-HT) uptake site than 3H-imipramine. In the present study, platelet 14C-5-HT uptake and 3H-paroxetine binding were simultaneously measured in 12 control subjects. There was a significant positive correlation between the individual Bmax value for 3H-paroxetine binding and the Vmax value for 14C-5-HT uptake. Platelet 3H-paroxetine binding was also determined in 21 drug-free patients who satisfied DSM-III-R criteria for major depression and 21 control subjects. A negative correlation was found between the Bmax values for 3H-paroxetine binding with age in control subjects. There was no change in 3H-paroxetine binding in depressed patients compared with control subjects. Our results indicated that 3H-paroxetine was a good ligand for evaluating 5-HT uptake sites, and the influence of age ought to be taken into consideration in the study of 3H-paroxetine binding. The present study indicated that there was no change in 5-HT uptake sites in platelets from depressed patients.

Polymers with phospholipid polar groups, 2-methacryloyloxyethyl phosphorylcholine (MPC) polymers, have excellent nonthrombogenic properties. The effects of adsorption of phospholipids on platelet adhesion and activation on the MPC copolymer with n-butyl methacrylate (BMA) were investigated with particular attention to the structure of the phospholipids adsorbed onto the polymer surface. The electrical nature of the phospholipids adsorbed on the polymer surface affected the thrombogenicity of the polymer. On the MPC polymer surface treated with an aqueous liposomal solution of acidic phospholipids, phosphatidylserine, platelet adhesion and activation occurred to a greater extent when compared to a poly(MPC-co-BMA) surface. However, on the MPC polymer surface treated with electrically neutral phosphatidylcholines, reduced thrombogenicity could be observed. Therefore, the adsorption of the phosphatidylcholines was an important factor in reducing the thrombogenicity on the polymers. Moreover, by comparison of the poly(MPC-co-BMA) to a poly(BMA), platelet adhesion and activation on these polymer surfaces depended on the adsorption state of the phosphatidylcholines. The amount of phosphatidylcholine adsorbed on the poly(MPC-co-BMA) increased with an increase in the MPC mole fraction of the copolymer. This indicates that the MPC moieties have affinity for the phosphatidylcholines. We conclude that the poly(MPC-co-BMA) can adsorb large amounts of phosphatidylcholines and that these phospholipids organize themselves. The organized adsorption layer of the phosphatidylcholines on the surface, which construct biomembrane-like surfaces, can reduce platelet adhesion and activation effectively.

1. The present study was carried out to investigate the effect of TYB-2285 [3,5-bis(acetoxyacethylamino)-4-chlorobenzonitrile] on histamine release from persisting cells (P-cells) primed with interleukin-3-containing conditioned medium (IL3-CM). 2. IL3-CM enhanced antigen-induced histamine release from P-cells, although IL3-CM did not affect spontaneous histamine release. 3. TYB-2285 inhibited antigen-induced histamine release in the presence of IL3-CM, although it did not inhibit histamine release in the absence of IL3-CM. 4. The enhancement of histamine release by IL3-CM was reproduced by recombinant IL-3 (1-100 U/ml). 5. These results demonstrate that TYB-2285 inhibits the histamine release primed with IL-3 and also suggests that TYB-2285 might regulate allergic inflammation in vivo by the suppression of mediator release primed with IL-3.

We applied Pylorus-preserving gastrectomy(PPG) to cases of early gastric cancer at the middle third of the stomach. The patients were operated on between 1989 and 1992 and reconstructed with the following procedures: 24 cases with PPG and 23 cases with Billroth I(B-I). In comparison with B-I, PPG involved fewer incidences of the dumping syndrome, reflux esophagitis and gastritis of the residual stomach, and showed a more normal pattern on oral glucose tolerance test(OGTT) and gastrin secretion test. Thus PPG should be considered a physiologically advantageous procedure for early gastric cancer at the middle third of the stomach.

This paper describes a rare case of adenocarcinoma located in the middle portion of the esophagus with liver metastasis. An 80-year-old man was admitted to our hospital with dysphagia and vomiting, following which an upper gastrointestinal series and esophagoscopy located an elevated-type carcinoma in the middle thoracic esophagus. Computed tomography revealed an esophageal tumor invading the left atrium and aorta, and multiple intrathoracic lymph node swellings, and an ultrasonograph of the liver showed multiple liver metastases. The serum carcinoembryonic antigen, carbohydrate antigen 19-9, and squamous cell carcinoma-related antigen levels were normal, but the serum alpha-fetoprotein (AFP) level was 351.5 ng/ml. The patient died 124 days after undergoing an esophageal bypass operation. On post-mortem histological examination, the original esophageal tumor was diagnosed as a poorly differentiated adenocarcinoma without a squamous component and immunohistochemical staining for AFP showed positive granules in the cytoplasm. All the metastatic nodules, including the lymph nodes, liver, spleen, and lungs, showed the same histological type and AFP-staining pattern as the original esophageal tumor. To our knowledge, this is the first case of AFP-producing esophageal carcinoma to be reported in Japan.

Expression of sialosyl Tn antigen (STN) of surgically resected spesimens in human gastric cancers, using the monoclonal antibody (TKH-2), was evaluated immunohistochemically in 42 patients measured serum STN level and in 45 patients with advanced cancer followed over five years after gastrectomy. Staining intensity was graded as follows: (-), less than 5% of cancer lesion; (+), 5–50%; (++), more than 50%. STN was mainly stained in cell membranes and cytoplasm, and the positive rate was 57.2%, which was higher than that of serum STN level. The positive rate of STN in differentiated adenocarcinoma was higher than in undifferentiated adenocarcinoma. Advanced cases indicated a tendency to express in more cancer lesion than did early cases. The estimate 5-year survival in advanced cases was better in negative cases than in positive cases. These results suggest that STN is available for a useful tumor marker in advanced case of gastric cancer.

The hemocompatibility of a polymer containing a phospholipid polar group, poly(2-methacryloyloxyethyl phosphorylcholine (MPC)-co-n-butyl methacrylate(BMA)), with human whole blood was evaluated. When human whole blood without an anticoagulant was contacted with polymers, the blood cell adhesion and aggregation on the polymer without the MPC moiety was extensive, and considerable fibrin deposition was observed. This phenomenon was suppressed with an increase in the polymer MPC composition. Thus, the MPC moiety in the copolymer plays an important role in the nonthrombogenic behavior of the copolymer. These results were also confirmed by the whole blood coagulation time on the polymer surface which was determined by Lee-White method. The adsorption of phospholipids and proteins from human plasma on poly(MPC-co-BMA) was investigated to clarify the mechanism of the nonthrombogenicity observed with the polymer. The amount of phospholipids was increased; whereas, adsorbed proteins were decreased with an increase in the MPC composition. From these results, we concluded that the phospholipids adsorbed on poly(MPC-co-BMA) play the most important role in the nonthrombogenicity of the MPC copolymer. © 1992 John Wiley & Sons, Inc.

The potential for liver metastasis in addition to the transplantability and doubling time of alpha-fetoprotein(AFP)-producing and non-AFP-producing human gastric carcinomas were studied in nude mice. The potential for liver metastasis was analyzed histopathologically from intrasplenic injections of tumor cell suspensions prepared from subcutaneous tumors. Tumor fragments prepared aseptically from 15 AFP-producing and 140 non-AFP-producing gastric cancers were subcutaneously transplanted into nude mice with transplantability rates of 80% (12/15 cases) and 50% (70/140 cases), respectively. The mean tumor doubling times in the first generation were 10.6 days for AFP-producing and 13.2 days for non-AFP-producing gastric carcinomas. Serially transplantable tumor lines in nude mice were established from six AFP-producing and 10 non-AFP-producing carcinomas. When tumor cell suspensions prepared from the subcutaneous tumors were injected into spleens, all six AFP-producing carcinomas (two poorly differentiated and four tubular adenocarcinomas) but only four out of the 10 non-AFP-producing carcinomas (two poorly differentiated adenocarcinomas, one mucinous carcinoma and one papillary adenocarcinoma) demonstrated a potential for liver metastasis. The results indicate AFP-producing gastric carcinomas to possess a higher potential for liver metastasis than do non-AFP-producing carcinomas, a distinguishing feature which thus reflects a poor prognosis.

Anticoagulation levels during cardiopulmonary (CP) bypass vary widely. Therefore, monitoring anticoagulation responses to heparin by repeated anticoagulation testing is mandatory during CP bypass. Until recently Activated Coagulation Time (ACT) has been used. Activated partial thrombin time (APTT) and prothrombin time (PT) have seldom been used for monitoring heparin-induced anticoagulation because former APTT and PT methods took too much time, required a lot of skills to carry out, and the amount of sample needed was too much. After heparin reversal APTT and PT are considered to be a more accurate way of monitoring the patient than ACT. We wanted to evaluate the use of the 512 as a monitor during cardiac surgery operations and to investigate the effect of Fresh Frozen Plasma (FFP) on APTT and PT after CP bypass.

The development of an allergic bronchoconstriction model in rats is described. In actively sensitized Donryu strain rats, there was a remarkable biphasic increase in airway resistance within 10 min after antigen challenge on day 9 to day 21. The increase in airway resistance, correlated with the IgE titer and the dose of antigen, was inhibited by disodium cromoglycate (DSCG) or by aminophylline. This bronchoconstriction was remarkably blocked by methysergide (25 and 100 μg/kg) while pyrilamine inhibited it partially at the same dose. Serotonin (> 30 μg/kg) but not histamine (< 1,000 μg/kg) induced a bronchoconstriction. FPL-55712 (1, 10 mg/kg) inhibited it significantly. The content of thromboxane B2 (TxB2) in plasma increased during the bronchoconstriction while the content of peptide-leukotrienes (p-LTs) in plasma did not increase significantly. OKY-046 inhibited not only allergic bronchoconstriction but also the increase in TxB2 levels in plasma. The late phase of the bronchoconstriction was more susceptible to OKY-046. In conclusion, this model seems to be useful for the screening of antiasthma drugs because of a relationship with the dose of antigen, IgE titer and the susceptibility to an antiallergic drug or a bronchodilator. It is demonstrated that the major part of this allergic bronchoconstriction depends on serotonin, and it is also suggested that thromboxane A2 may play an important role in the late phase of the bronchoconstriction.