Gamma-Ray Observation of the Cygnus Region in the 100-TeV Energy Region

We report observations of gamma-ray emissions with energies in the 100-TeV energy region from the Cygnus region in our Galaxy. Two sources are significantly detected in the directions of the Cygnus OB1 and OB2 associations. Based on their positional coincidences, we associate one with a pulsar PSR J2032+4127 and the other mainly with a pulsar wind nebula PWN G75.2+0.1, with the pulsar moving away from its original birthplace situated around the centroid of the observed gamma-ray emission. This work would stimulate further studies of particle acceleration mechanisms at these gamma-ray sources.

First Detection of sub-PeV Diffuse Gamma Rays from the Galactic Disk: Evidence for Ubiquitous Galactic Cosmic Rays beyond PeV Energies

We report, for the first time, the long-awaited detection of diffuse gamma rays with energies between 100 TeV and 1 PeV in the Galactic disk. Particularly, all gamma rays above 398 TeV are observed apart from known TeV gamma-ray sources and compatible with expectations from the hadronic emission scenario in which gamma rays originate from the decay of π^{0}'s produced through the interaction of protons with the interstellar medium in the Galaxy. This is strong evidence that cosmic rays are accelerated beyond PeV energies in our Galaxy and spread over the Galactic disk.

[Clinical observation of the relationship between the newborn hearing screening and ABO blood groups]

Objective:To analyze the relationship between ABO blood groups and otoacoustic emissions in full-term newborns, including the occurrence of SOAE and the amplitudes of DPOAE. Method:A total of eighty normal hearing female neonates were included in the study, with equal number of participants in each of the ABO blood group. Measurements of SOAE and DPOAE were collected from both ears of all participants. Result:The blood group O subjects showed significantly fewer SOAE occurrences and lower DPOAE amplitudes at 793 Hz, 1 257 Hz and 1 587 Hz than subjects with other three blood groups both in the left and right ears. Conclusion:The full-term neonates with blood group O have lower SOAE occurrence than other three blood group individual. The blood group O individuals have the lowest amplitude at 793 Hz, 1 257 Hz and 1 587 Hz of both ears.

First Detection of Photons with Energy beyond 100 TeV from an Astrophysical Source

We report on the highest energy photons from the Crab Nebula observed by the Tibet air shower array with the underground water-Cherenkov-type muon detector array. Based on the criterion of a muon number measured in an air shower, we successfully suppress 99.92% of the cosmic-ray background events with energies E>100  TeV. As a result, we observed 24 photonlike events with E>100  TeV against 5.5 background events, which corresponds to a 5.6σ statistical significance. This is the first detection of photons with E>100  TeV from an astrophysical source.

The cosmic ray energy spectrum measured with the new Tibet hybrid experiment

We have upgraded the new Tibet ASgamma experiment in China since 2014 to measure the chemical composition of cosmic rays around the knee. This hybrid experiment consist of an air-shower-core detector array (YAC-II) to detect high energy electromagnetic component, the Tibet air-shower array (Tibet-III) and a large underground water-Cherenkov muon-detector array (MD). We have carried out a detailed air-shower Monte Carlo (MC) simulation to study the performance of the hybrid detectors by using CORSIKA (version 7.5000), which includes EPOS-LHC, QGSJETII-04, SIBYLL2.1 and SIBYLL2.3 hadronic interaction models. The preliminary results of the interaction model checking above 50 TeV energy region are reported in this paper, and the primary proton and helium spectra in the energy range 50 TeV to 1015 eV was derived from YAC-I data and is smoothly connected with direct observation data at lower energies and also with our previously reported works at higher energies within statistical errors. The knee of the (P+He) spectra is located around 400 TeV. The interaction model dependence in deriving the primary (P+He) spectra is found to be small (less than 25% in absolute intensity, 10% in position of the knee), and the composition model dependence is less than 10% in absolute intensity.

Test of the hadronic interaction models SIBYLL2.3, EPOS-LHC and QGSJETII- 04 with Tibet EAS core data

A hybrid experiment has been started by the ASγ experiment at Yangbajing (4300m a.s.l.) in Tibet since May 2009, that consists of a high-energy air-shower-core array (YAC-I) and a high-density air-shower array (Tibet-III). In this paper, we report our results to check the hadronic interaction models SIBYLL2.3, SIBYLL2.1, EPOS-LHC and QGSJETII-04 in the multi-tens TeV energy region using YAC-I+Tibet-III experimental data from May 2009 through January 2010. The effective live time is calculated as 106.05 days. The results show that the description of transverse momentum, inelastic cross-section and inelasticity for the 4 hadronic interaction models is consistent with YAC-I experimental data within 15% systematic errors range in the forward region below 100 TeV. Among them, the EPOS-LHC model is the best hadronic interaction model. Furthermore, we find that the H4a composition model is the best one below the 100 TeV energy region.

On the Solar Cycle Variation of the Solar Diurnal Anisotropy of Multi-TeV Cosmic-ray Intensity Observed with the Tibet Air Shower Array

We analyze the temporal variation of the solar diurnal anisotropy of the multi-TeV cosmic-ray intensity observed with the Tibet air shower array from 2000 to 2009, covering the maximum and minimum of the 23rd solar cycle. We comfirm that a remarkable additional anisotropy component is superposed on the Compton-Getting anisotropy at 4.0 TeV, while its amplitude decreases at higher energy regions. In constrast to the additional anisotropy reported by the Matsushiro experiment at 0.6 TeV, we find the residual component measured by Tibet at multi-TeV energies is consistent with being stable, with a fairly constant amplitude of 0.041% ± 0.003% and a phase at around 07.17 ± 00.16 local solar time at 4.0 TeV. This suggests the additional anisotropy observed by the Tibet experiment could result from mechanisms unrelated to solar activities.

Evaluation of the Interplanetary Magnetic Field Strength Using the Cosmic-Ray Shadow of the Sun

We analyze the Sun's shadow observed with the Tibet-III air shower array and find that the shadow's center deviates northward (southward) from the optical solar disk center in the "away" ("toward") interplanetary magnetic field (IMF) sector. By comparing with numerical simulations based on the solar magnetic field model, we find that the average IMF strength in the away (toward) sector is 1.54±0.21_{stat}±0.20_{syst} (1.62±0.15_{stat}±0.22_{syst}) times larger than the model prediction. These demonstrate that the observed Sun's shadow is a useful tool for the quantitative evaluation of the average solar magnetic field.

Probe of the solar magnetic field using the "cosmic-ray shadow" of the sun

We report on a clear solar-cycle variation of the Sun’s shadow in the 10 TeV cosmic-ray flux observed by the Tibet air shower array during a full solar cycle from 1996 to 2009. In order to clarify the physical implications of the observed solar cycle variation, we develop numerical simulations of the Sun’s shadow, using the potential field source surface model and the current sheet source surface (CSSS) model for the coronal magnetic field. We find that the intensity deficit in the simulated Sun’s shadow is very sensitive to the coronal magnetic field structure, and the observed variation of the Sun’s shadow is better reproduced by the CSSS model. This is the first successful attempt to evaluate the coronal magnetic field models by using the Sun’s shadow observed in the TeV cosmic-ray flux.

A microplate-based screening assay for neuraminidase inhibitors

Neuraminidase (NA) represents a highly promising new target for drug development in influenza virus genes. Rapid screening of enzyme inhibitors is a key method for the identification of leading compounds. In order to speed up the screening for enzyme inhibitors of natural and synthetic origin, effective and fast assays are needed. 2'-(4-Methylumbelliferyl)-α-D-N-acetylneuraminic acid (4-MUNANA) was selected as substrate for development of a microplate-based assay. The enzymatic reaction conditions were optimized as follows: in a 100 μL reaction mixture, the final concentrations were 32.5 mM sodium acetate (pH 3.5), 20 μM 4-MUNANA, 0.005% (w/v) bovine serum albumin, and 0.42 μg/mL NA. In the study, the doseresponse relationship of oseltamivir carboxylate to NA activity was observed. In addition, an overall Z' value of 0.8 proved the systems robustness and potential for screening. The assay system developed will be a valuable tool to discover new structures for the therapeutic inhibition of NA used to treat Influenza.

Anisotropy and Corotation of Galactic Cosmic Rays

The intensity of Galactic cosmic rays is nearly isotropic because of the influence of magnetic fields in the Milky Way. Here, we present two-dimensional high-precision anisotropy measurement for energies from a few to several hundred teraelectronvolts (TeV), using the large data sample of the Tibet Air Shower Arrays. Besides revealing finer details of the known anisotropies, a new component of Galactic cosmic ray anisotropy in sidereal time is uncovered around the Cygnus region direction. For cosmic-ray energies up to a few hundred TeV, all components of anisotropies fade away, showing a corotation of Galactic cosmic rays with the local Galactic magnetic environment. These results have broad implications for a comprehensive understanding of cosmic rays, supernovae, magnetic fields, and heliospheric and Galactic dynamic environments.

Stage migration influences on stage-specific survival comparison between D1 and D3 gastric cancer surgeries

AIMS

We evaluate the influency stage migration in a randomised trial comparing D1 (N 1 lymphadenectomy) and D3 (N 1, 2 and 3 lymphadenectomy) dissections.

METHODS

Two hundred and thirteen curatively resected patients were analysed, with this TNM data.

RESULTS

After applying D3 patients' data according to simulated D1 staging, D3 resections were associated with up-staging to N2-3 levels in 8% of patients according to the N stage. The likelihood of N-status migration increased with increasing depth of invasion into the gastric wall. The increases in the calculated survival rate after stage migration on known 5-year survival rates were: 2% in stage IB, 1% in stage II, 4% in stage IIIA, and 1% in stage IIIB.

CONCLUSIONS

Stage migration secondary to meticulous lymph node dissection affects stage-specific survival rates. True therapeutic survival benefit of D3 resection can only be assessed in this context.

Soil quality evolution after land use change from paddy soil to vegetable land

A survey was done in 15 typical villages, 150 soil and 86 vegetable plant samples were taken in Jiaxin prefecture of the Taihu Lake region, northern Zhejian province. Results indicate that after 15-20 years land use changed from the paddy rice-wheat (or oilseed rape) double cropping system, to a continuous vegetable land has caused soil quality dramatic change. (1) Acidification: average soil pH was 5.4; about 61% of total samples were pH < 5.5. It was 0.9 units lower than 10 years ago with same upland vegetable cultivation and was 1.2 units lower than soil pH of paddy rice-wheat (or oilseed rape) rotation. (2) Fertilizer salt accumulation: the average salt content was 0.28%, among these about 36.2% of the total samples contained more than 0.3%. (3) Nitrate N and available phosphorus (P) over accumulation: on average it was 279 mg NO3-N/kg, and 45-115 mg P/kg. Nitrate N four times higher and available P 4-10 times more than it is in present paddy rice-wheat rotation soils respectively. This has caused wide concern because of possible groundwater and well drinking water pollution by leached nitrate N and the P losses to water by runoff from vegetable lands induce surface water eutrophication.

Antisense oligonucleotides modulate high glucose-induced laminin overexpression and cell proliferation: a potential for therapeutic application in diabetic microangiopathy

Vascular basement membrane (BM) thickening is a prominent and characteristic lesion of diabetic microangiopathy. Studies suggest that increased synthesis of laminin, a BM component, is associated with the development of thickened BM in diabetic vessels. In this study, we evaluated whether an interventive strategy using laminin antisense phosphorothioate oligonucleotides (Lam AS-oligos) could specifically inhibit high-glucose-induced laminin gene overexpression in vascular endothelial cells and normalize cell proliferation. Rat endothelial cells grown in high-glucose (30 mM) medium for 7 days showed increased laminin mRNA and protein level (195% +/- 28% of control, p < 0.05; 143% +/- 26% of control, p < 0.05, respectively) and reduced cell number (79% +/- 6% of control, p < 0.05) compared with cells grown in normal (5 mM) glucose medium. When cells grown in high-glucose medium were transfected with 0.4 microM Lam AS-oligos for 48 hours in the presence of 8 microM lipofectin, the laminin mRNA and protein level decreased (121% +/- 19% and 99% +/- 15% of control, respectively), and the cell number was restored to near normal level (93% +/- 7% of control). The results indicate that the antisense strategy is effective in selectively reducing laminin overexpression and improving endothelial cell proliferation under high-glucose conditions. Thus, the As-oligos may be potentially useful for preventing the development of thickened vascular BM in diabetic microangiopathy.

Colorectal cancer in patients 20 years old or less in Taiwan

BACKGROUND

Colorectal cancer (CRC) is predominantly a disease of the elderly population, but it sometimes occurs in young patients. The diagnosis of CRC in youngsters is often overlooked by physicians or presentation may be delayed.

METHODS

With assistance from the cancer registry center of Taipei Veterans General Hospital, we collected data on all types of colorectal malignancy, including carcinoma, adenocarcinoma, or lymphoma in patients aged 20 or younger. All available medical charts and pathologic specimens were reviewed in detail.

RESULTS

A total of 28 cases were analyzed. The leading presenting symptom was abdominal pain (92%). The locations of the primary tumors were evenly distributed, and the major histologic type was predominantly adenocarcinoma. However, the proportion of mucinous adenocarcinoma was higher than that in the older population. Most of the cases were advanced (11 tumors were classified as Dukes stage C and another 11 as Dukes stage D). The overall 5-year survival rate was 21%.

CONCLUSIONS

Despite the rarity of CRC during the first two decades of life, physicians need to be aware of the possibility and to evaluate suggestive signs and symptoms by colonoscopy or barium enema. Family history of CRC, inflammatory bowel disease, previous polyps, or familial polyposis did not play a crucial role in this group of young patients.

Expression of aminopeptidase N in bile canaliculi: a predictor of clinical outcome in biliary atresia and a potential tool to implicate the mechanism of biliary atresia

BACKGROUND

Only a few studies on extrahepatic biliary atresia (BA) have reported that the morphological changes of bile canaliculi could predict the clinical outcome after portoenterostomy and provide differential diagnosis of neonatal jaundice. Aminopeptidase N (APN) is an ectoenzyme of bile canaliculi that is involved in bile secretion. In this study, we tried to see whether APN of bile canaliculi had a significant role in BA.

PATIENTS AND METHODS

We used monoclonal antibody 9B2 to compare the expression of APN in livers with BA, neonatal hepatitis, and choledochal cysts, as well as in nontumorous portions of pediatric hepatic livers with tumors. The expression of APN in fetuses, preterm babies, and term neonates was also studied.

RESULTS

A high degree of 9B2 expression in BA was closely related to poor outcome. Cholestasis in choledochal cysts, rather than neonatal hepatitis, made 9B2 expression stronger. Increasing expression of 9B2 from fetuses to neonates was noted and the degree of 9B2 expression was similar between term neonates and nontumorous portions of pediatric livers with tumors. Interestingly, some cases of BA had 9B2 expression like that of preterm babies.

CONCLUSIONS

APN of bile canaliculi progressively develops from fetuses to neonates and is well developed in neonates. APN can be induced to stronger expression by obstructive jaundice. The amount of expression of APN of bile canaliculi in BA is a predictor of clinical outcome and may be a tool for implicating the mechanism of BA.

Is submucosal epinephrine injection necessary before polypectomy? A prospective, comparative study

BACKGROUND/AIMS

Polyps of the gastrointestinal tract are usually removed due to their link to bleeding, obstruction and malignancy. However, complications may occur following polypectomy. The aim of this study was to assess whether submucosal epinephrine injection before polypectomy could reduce the incidence of bleeding and perforation.

METHODOLOGY

Between June 1997 and November 1999, patients with sessile polyps of the gastrointestinal tract found in our endoscopic unit were randomized to receive submucosal epinephrine injection (epinephrine group) or no injection (control group) before polypectomy. In the epinephrine group, epinephrine (1:10,000) was injected surrounding the stalk of the polyp until the mucosa was blanched and bulged. The patients were observed for complications in the following month.

RESULTS

A total of 120 patients with 151 sessile polyps were enrolled in this study. In the epinephrine group, 75 polyps (n = 68) were randomized to receive epinephrine injection before polypectomy. In the control group, 76 polyps (n = 61) underwent polypectomy without epinephrine injection. In both groups, there was no significant difference in clinical features including the sizes of the polyps and their stalks, the location of polyps and the pathological diagnosis. There were a total of nine episodes of post-polypectomy hemorrhage, two in the epinephrine group and seven in the control group (2/75 vs. 7/76) (P = 0.07). One case in the epinephrine group experienced delayed bleeding (4 days later). Immediate hemorrhage occurred less in the epinephrine group than that in the control group (1/75 vs. 7/76, P = 0.03). There was one case of perforation in each group.

CONCLUSIONS

Epinephrine injection prior to polypectomy is effective in preventing immediate bleeding.

A genome-wide study of microsatellite instability in advanced gastric carcinoma

BACKGROUND

Microsatellite instability (MSI) has been described in many human carcinomas, including gastric carcinomas (GCs). There are inconsistent findings regarding the association of MSI with various subsets of GC with specific clinicopathologic features. The objective of this study was to define MSI in advanced GC at a genome-wide level and to evaluate the clinical relevance of MSI in these patients.

METHODS

Forty-one gastric adenocarcinomas with serosa invasion (T3) were analyzed at 59 loci that detected at least one site per arm of each autosome in human genome. The expression patterns of mismatch repair proteins hMLH1 and hMSH2 were examined by immunohistochemistry. Comparisons were made by categorizing tumors into three groups: tumors with MSI at multiple loci (at more than three loci), tumors with MSI at low level (at one to three loci), and microsatellite-stable (MSS) tumors. Clinical significance of MSI in advanced GC was evaluated. The relative rates of hypermutability of the 59 markers also were determined.

RESULTS

A significant association was found between tumors with MSI at multiple loci and the expanding type of tumor growth by Ming's histologic classification (P = 0.001), whereas tumors with MSI at low level and MSS tumors are clinicopathologically indistinguishable. The 59 dinucleotide repeat markers displayed varying degrees of susceptibility toward genetic instability. The relative rates of hypermutability of these markers were consistent with a normal distribution pattern in which the frequency of unstable tumors detected at different chromosomal loci varied from 0% to 20%.

CONCLUSIONS

The authors' results showed that advanced GC with MSI at multiple loci progress preferentially in an expanding mode, supporting the notion that high MSI tumors and low MSI/MSS tumors evolve through different genetic pathways. Thus, microsatellite testing may have clinical utility as a favorable prognostic marker.

A genome-wide study of microsatellite instability in advanced gastric carcinoma

BACKGROUND

Microsatellite instability (MSI) has been described in many human carcinomas, including gastric carcinomas (GCs). There are inconsistent findings regarding the association of MSI with various subsets of GC with specific clinicopathologic features. The objective of this study was to define MSI in advanced GC at a genome-wide level and to evaluate the clinical relevance of MSI in these patients.

METHODS

Forty-one gastric adenocarcinomas with serosa invasion (T3) were analyzed at 59 loci that detected at least one site per arm of each autosome in human genome. The expression patterns of mismatch repair proteins hMLH1 and hMSH2 were examined by immunohistochemistry. Comparisons were made by categorizing tumors into three groups: tumors with MSI at multiple loci (at more than three loci), tumors with MSI at low level (at one to three loci), and microsatellite-stable (MSS) tumors. Clinical significance of MSI in advanced GC was evaluated. The relative rates of hypermutability of the 59 markers also were determined.

RESULTS

A significant association was found between tumors with MSI at multiple loci and the expanding type of tumor growth by Ming's histologic classification (P = 0.001), whereas tumors with MSI at low level and MSS tumors are clinicopathologically indistinguishable. The 59 dinucleotide repeat markers displayed varying degrees of susceptibility toward genetic instability. The relative rates of hypermutability of these markers were consistent with a normal distribution pattern in which the frequency of unstable tumors detected at different chromosomal loci varied from 0% to 20%.

CONCLUSIONS

The authors' results showed that advanced GC with MSI at multiple loci progress preferentially in an expanding mode, supporting the notion that high MSI tumors and low MSI/MSS tumors evolve through different genetic pathways. Thus, microsatellite testing may have clinical utility as a favorable prognostic marker.

A genome-wide study of microsatellite instability in advanced gastric carcinoma

BACKGROUND

Microsatellite instability (MSI) has been described in many human carcinomas, including gastric carcinomas (GCs). There are inconsistent findings regarding the association of MSI with various subsets of GC with specific clinicopathologic features. The objective of this study was to define MSI in advanced GC at a genome-wide level and to evaluate the clinical relevance of MSI in these patients.

METHODS

Forty-one gastric adenocarcinomas with serosa invasion (T3) were analyzed at 59 loci that detected at least one site per arm of each autosome in human genome. The expression patterns of mismatch repair proteins hMLH1 and hMSH2 were examined by immunohistochemistry. Comparisons were made by categorizing tumors into three groups: tumors with MSI at multiple loci (at more than three loci), tumors with MSI at low level (at one to three loci), and microsatellite-stable (MSS) tumors. Clinical significance of MSI in advanced GC was evaluated. The relative rates of hypermutability of the 59 markers also were determined.

RESULTS

A significant association was found between tumors with MSI at multiple loci and the expanding type of tumor growth by Ming's histologic classification (P = 0.001), whereas tumors with MSI at low level and MSS tumors are clinicopathologically indistinguishable. The 59 dinucleotide repeat markers displayed varying degrees of susceptibility toward genetic instability. The relative rates of hypermutability of these markers were consistent with a normal distribution pattern in which the frequency of unstable tumors detected at different chromosomal loci varied from 0% to 20%.

CONCLUSIONS

The authors' results showed that advanced GC with MSI at multiple loci progress preferentially in an expanding mode, supporting the notion that high MSI tumors and low MSI/MSS tumors evolve through different genetic pathways. Thus, microsatellite testing may have clinical utility as a favorable prognostic marker.

Struma ovarii mimicking a benign multicystic ovarian tumor: MR imaging in one case

Struma ovarii is a rare form of mature teratoma of the ovary. A case of struma ovarii is presented with magnetic resonance (MR) imaging and pathologic findings. MR imaging showed a multiloculated cystic adnexal mass with well-defined margin and septum. Internal cystic spaces presented homogeneous signal intensity of fluid content in both T1-weighted and T2-weighted images. Subtle contrast enhancement was depicted in internal septi. Imaging features were indistinguishable from benign multicystic ovarian tumor, and different from the reported cases in the literature.

Expression of fas ligand on bile ductule epithelium in biliary atresia--a poor prognostic factor

PURPOSE

The aim of this study was to investigate the possible role of Fas and Fas ligand system in biliary atresia.

METHODS

Immunohistochemical stains of Fas and Fas ligand (FasL) and in situ hybridization of Fas ligand messenger RNA (mRNA) were performed on paraffin-embedded liver specimens of 36 biliary atresia, 6 choledochal cysts, and 14 nontumorous parts of pediatric liver tumors. Apoptosis was detected by terminal deoxynucleotidyl transferase deoxy-UTP nick end labeling (TUNEL). The grade of liver fibrosis and results of bile drainage on the patients with biliary atresia were compared with the results of FasL expression.

RESULTS

Fas protein was positive on the hepatocytes and bile ductule epithelia of all the livers examined and also positive on some monocytes around the portal area in all the biliary atresia patients. FasL protein was positive on bile ductule epithelia in 10 biliary atresia patients and also positive on some monocytes in most of the biliary atresia patients. Positive signals of FasL mRNA were noted on hepatocytes in 4 biliary atresia, bile ductule epithelia in 19 biliary atresia patients, and some monocytes in most of the biliary atresia patients. Apoptotic nuclei were present among monocytes in all the biliary atresia livers but present among bile ductule epithelia only on the BA with positive FasL mRNA signals on ductule epithelium. The fibrosis grade was similar between biliary atresia with positive FasL mRNA signals and negative signals. The bile drainage was better in the biliary atresia without positive FasL mRNA signals.

CONCLUSIONS

Fas ligand expression on bile ductule epithelia in biliary atresia may be induced to counterattack the infiltrating lymphocytes. Although the factors for post-Kasai bile drainage are multiple, the authors suggest Fas ligand expression on bile ductule epithelia may be a poor prognostic factor by playing a role in the continuous damage and obliteration of intrahepatic bile ducts after Kasai operation.

Prognostic significance of heat shock protein-27 expression in hepatocellular carcinoma and its relation to histologic grading and survival

BACKGROUND

The expression of heat shock protein-27 (HSP-27) has been detected in some human tumors. In this study the authors investigated HSP-27 expression in patients with hepatocellular carcinoma (HCC) and examined its prognostic significance.

METHODS

Expression of HSP-27 was studied in 58 HCC and adjacent noncancerous liver tissues by immunohistochemical stain. The relation between its expression and eight known prognostic factors was evaluated.

RESULTS

Of the 58 HCC tissues studied, the presence of HSP-27 was demonstrated in 45 tissues (77.6%); low expression (</= 25%) was demonstrated in 17 tissues and high expression (> 25%) was demonstrated in 28 tissues. A significantly higher distribution of HSP-27 expression in HCC tissues compared with adjacent noncancerous liver tissues was obtained (P < 0.0001). Patients with high HSP-27 expression had a significantly higher histologic tumor grade than those with low HSP-27 expression (P = 0.001). The 5-year disease free survival rate of patients with high HSP-27 expression was 21.4% versus 59.3% for patients with low HSP-27 expression (P < 0.001). A similar relation was observed with overall survival (33.3% vs. 64. 8%; P = 0.009). HSP-27 expression was also identified to be a significant and powerful prognostic indicator for disease free survival (odds ratio = 2.25; P = 0.034) and for overall survival (odds ratio = 2.72; P = 0.015).

CONCLUSIONS

The current study data suggest that HSP-27 expression is a powerful prognostic indicator and is related to histologic grade and survival of patients with HCC.

Prognostic significance of heat shock protein-27 expression in hepatocellular carcinoma and its relation to histologic grading and survival

BACKGROUND

The expression of heat shock protein-27 (HSP-27) has been detected in some human tumors. In this study the authors investigated HSP-27 expression in patients with hepatocellular carcinoma (HCC) and examined its prognostic significance.

METHODS

Expression of HSP-27 was studied in 58 HCC and adjacent noncancerous liver tissues by immunohistochemical stain. The relation between its expression and eight known prognostic factors was evaluated.

RESULTS

Of the 58 HCC tissues studied, the presence of HSP-27 was demonstrated in 45 tissues (77.6%); low expression (</= 25%) was demonstrated in 17 tissues and high expression (> 25%) was demonstrated in 28 tissues. A significantly higher distribution of HSP-27 expression in HCC tissues compared with adjacent noncancerous liver tissues was obtained (P < 0.0001). Patients with high HSP-27 expression had a significantly higher histologic tumor grade than those with low HSP-27 expression (P = 0.001). The 5-year disease free survival rate of patients with high HSP-27 expression was 21.4% versus 59.3% for patients with low HSP-27 expression (P < 0.001). A similar relation was observed with overall survival (33.3% vs. 64. 8%; P = 0.009). HSP-27 expression was also identified to be a significant and powerful prognostic indicator for disease free survival (odds ratio = 2.25; P = 0.034) and for overall survival (odds ratio = 2.72; P = 0.015).

CONCLUSIONS

The current study data suggest that HSP-27 expression is a powerful prognostic indicator and is related to histologic grade and survival of patients with HCC.

Cecal volvulus: report of seven cases and literature review

BACKGROUND

Cecal volvulus is an abdominal emergency and delay in its diagnosis and treatment can result in severe complications. We reviewed these cases in order to increase the understanding of cecal volvulus (CV) to promote early diagnosis and better management.

METHODS

In this retrospective study of seven patients (all male; mean age +/- standard deviation, 63.4 +/- 17.3 years) over a 16-year period, we reviewed radiographs, for diagnostic accuracy, and the results of surgical procedures for better future management.

RESULTS

The symptoms of CV related to obstruction had a mean of duration of 6.85 days (range, 2-20 days). The preoperative diagnosis rate was 57.1%. Three types of CV (bascule, clockwise and counterclockwise) were found. There were three treatment failures resulting in two deaths. There were two cases of metachronous volvulus, one in the sigmoid colon and one in the small intestine.

CONCLUSIONS

Resection is indicated for gangrene or perforation and is highly suggested in underlying bowel disease or recurrent operative procedures. For uncomplicated viable CV, cecopexy provides fair results. Metachronous volvulus should always be considered when obstruction recurs.

Human gastric cancer kinase profile and prognostic significance of MKK4 kinase

Alterations of protein tyrosine kinase are often associated with uncontrolled cell growth and tumor progression. Knowledge of the overall expression pattern of tyrosine kinases should prove beneficial in understanding the signaling pathways involved in gastric cancer oncogenesis and in providing possible biomarkers for gastric cancer progression. To establish a general tyrosine-kinase expression profile, degenerated polymerase chain reaction primers designed from the consensus catalytic kinase motifs were used to amplify protein tyrosine kinase molecules from gastric cancer tissues. We observed more than 50 tyrosine and serine/threonine kinases from matching pairs of gastric cancer tissue and normal mucosa. Based on this new kinase profile information, we selected the MKK4 gene for further immunohistochemical studies. Statistical analysis of MKK4 protein expression and clinicopathological features indicated that MKK4 kinase expression could serve as a significant prognostic factor for relapse-free survival and for overall survival. We demonstrated a simple and sensitive method for establishing protein tyrosine-kinase expression profiles of human gastric cancer tissues as well as for discovering novel and useful clinical biomarkers from such kinase expression profiles.

Prognostic significance of heat shock protein-27 expression in hepatocellular carcinoma and its relation to histologic grading and survival

BACKGROUND

The expression of heat shock protein-27 (HSP-27) has been detected in some human tumors. In this study the authors investigated HSP-27 expression in patients with hepatocellular carcinoma (HCC) and examined its prognostic significance.

METHODS

Expression of HSP-27 was studied in 58 HCC and adjacent noncancerous liver tissues by immunohistochemical stain. The relation between its expression and eight known prognostic factors was evaluated.

RESULTS

Of the 58 HCC tissues studied, the presence of HSP-27 was demonstrated in 45 tissues (77.6%); low expression (</= 25%) was demonstrated in 17 tissues and high expression (> 25%) was demonstrated in 28 tissues. A significantly higher distribution of HSP-27 expression in HCC tissues compared with adjacent noncancerous liver tissues was obtained (P < 0.0001). Patients with high HSP-27 expression had a significantly higher histologic tumor grade than those with low HSP-27 expression (P = 0.001). The 5-year disease free survival rate of patients with high HSP-27 expression was 21.4% versus 59.3% for patients with low HSP-27 expression (P < 0.001). A similar relation was observed with overall survival (33.3% vs. 64. 8%; P = 0.009). HSP-27 expression was also identified to be a significant and powerful prognostic indicator for disease free survival (odds ratio = 2.25; P = 0.034) and for overall survival (odds ratio = 2.72; P = 0.015).

CONCLUSIONS

The current study data suggest that HSP-27 expression is a powerful prognostic indicator and is related to histologic grade and survival of patients with HCC.

Pseudogastroparesis as a presentation of small-bowel malignancy

Establishing the diagnosis of small-bowel malignancy is sometimes an extremely difficult challenge owing to its non-specific symptoms. The mainstay of treatment is early recognition, diagnosis and surgical resection. The prognosis depends primarily on the degree of spread and stage at presentation. We present two cases with initially obscure presentations of a small-bowel tumour. One was a jejunal adenocarcinoma, but an initial upper gastrointestinal and small-bowel series did not disclose the lesion; the other was a primary ileal lymphoma, first thought to be diabetes mellitus gastroparesis. Therefore, a negative small-bowel series or presentation of a systemic disease-associated intestinal pseudo-obstruction or gastroparesis does not exclude the possibility of a small-bowel malignancy, if the clinical symptoms are not alleviated after prokinetic medications. The clinicians should further pursue the possibility of an obstructing lesion.

Oxidative stress is insignificant in N1S1-transplanted hepatoma despite markedly declined activities of the antioxidant enzymes

It has been proposed that persistent oxidative stress accounts for the increased levels of DNA damage in cancer tissues. We have examined the profile of anti-oxidant enzymes in a transplanted hepatic tumor model by injecting N1S1 rat hepatoma cells into the liver of Sprague-Dawley rats. The transplanted N1S1 tumors displayed characteristics resembling human hepatocellular carcinoma. The immunoreactivities of catalase (CAT), manganese-superoxide dismutase (Mn SOD), copper/zinc-SOD (Cu/Zn SOD), and glutathione peroxidase (GPx) were found to decrease significantly. The enzyme activity in tumors decreased 26.2-, 4.2-, 4.5-, and 5.4-fold for CAT, Mn SOD, Cu/Zn SOD, and GPx, respectively, relative to those in normal liver tissue from the same animals. In contrast, the mRNA levels of CAT and GPx in tumors decreased only 5- and 2-fold, respectively, and the mRNA levels of Cu/Zn SOD and Mn SOD showed either no change or an increase as compared to those of normal liver tissue. The contents of 8-hydroxy-2'-deoxyguanosine (8-OH-dG) and thiobarbituric acid-reactive substances (TBARS) were comparable to those of normal controls. Furthermore, mitochondrial production of superoxide in tumors was 4 times lower than that in normal tissues. In conclusion, the data indicate that the reduced activities of anti-oxidant enzymes in the N1S1 tumor did not cause significant oxidative stress.

The role of MIB-1 index in the prognosis of resectable pancreatic head cancer

BACKGROUND/AIMS

Cell kinetics are important indicators of the biological behavior of various human tumors. In this study, we evaluated the prognostic values of the proliferative factors including MIB-1 index, DNA ploidy and S-phase fraction, and further determined the independent prognostic factors in pancreatic head cancer after pancreatoduodenectomy.

METHODOLOGY

Patients with pancreatic head cancer undergoing pancreatoduodenectomy were included. Cell proliferative parameters including MIB-1 index, DNA ploidy and S-phase fraction measured by flow cytometry were evaluated and compared with the conventional clinicopathologic factors.

RESULTS

There were 21 resectable pancreatic head cancers. By univariate analysis MIB-1 index, cell differentiation and lymphovascular invasion were significant prognostic factors. The 5-year survival rate was 22.2% for overall patients and 29.2% for patients with MIB-1 < or = 11%, while it was 0% for MIB-1 index > 11%, p=0.011. Tumors without lymphovascular invasion had significantly better prognosis than those with lymphovascular invasion (median survival: 38 vs. 10 months, p=0.009). The median survival was significantly longer for well-differentiated cancers than for moderately and poorly differentiated cancers (44 vs. 11 and 9 months, p=0.038). There was no correlation between the MIB-1 index and the other 2 conventional prognostic factors. After multivariate analysis, only the MIB-1 index emerged as the independent prognostic factor.

CONCLUSIONS

MIB-1 index played a significant role in the prognosis of the resectable pancreatic head cancer and could potentially complement the conventional factors in predicting the prognosis and determining the optimal treatment strategy. MIB-1 index was also an important independent prognostic factor.

tie-1 protein tyrosine kinase: a novel independent prognostic marker for gastric cancer

Protein tyrosine kinases (PTKs) are a major class of proto-oncogenes that are involved in tumor progression. The purpose of this study was to establish a comprehensive PTK expression profile in gastric cancers, with the objective of identifying possible biomarkers for gastric cancer progression. We have designed degenerate primers according to the consensus catalytic motifs to amplify PTK molecules from gastric cancers by reverse transcriptase-PCR methods. The PTK expression profile was established by sequencing analysis of the cloned PCR products. We have identified 17 PTKs from a gastric adenocarcinoma. Two receptor PTKs, tie-1 and axl, were selected for in situ immunohistochemistry studies because of their higher expression level and their described roles in adhesion, invasion, and angiogenesis. Among the 97 gastric adenocarcinoma tissues examined, we observed positive immunohistochemical staining of tie-1 PTK in 69 and positive staining of axl kinase in 71 tissues. Statistical analysis with clinicopathological features indicates that tie-1 kinase expression is inversely correlated with patients' survival, whereas axl fails to show similar clinical significance. Our results illustrate the utility of tyrosine kinase gene family profiling in human gastric cancers and show that tie-1 tyrosine kinase may serve as a novel independent prognostic marker for gastric adenocarcinoma patients.

Esophageal reconstruction by jejunal transfer

Forty-five esophageal reconstructions were carried out using a free or pedicled transfer of jejunal segments. Thirty were performed for benign stenosis or atresia, and 13 were performed for malignancy. The remaining two were used to repair anastomotic leakage or fistulization resulting from prior esophagogastrostomy. Average anastomotic arterial and venous diameters were 1.2 mm and 3.0 mm respectively. Of the 45 reconstructions, 44 were successful; the single failure was the result of tearing of the mesenteric arcade. There were four fatalities. Jejunal transfer is an effective method of esophageal reconstruction.

Diagnosis and treatment of cystic lymphangioma of the ascending colon by laparoscopic-assisted surgery: a case report

Lymphangioma of the colon is a rare disease. Its clinical silence and absence of specific symptoms and signs make it difficult to diagnose preoperatively. We present a case of cystic lymphangioma of the ascending colon associated with constipation in a 72-year-old man and review the pertinent literature. The patient underwent laparoscopic-assisted segmental resection of the colon. The characteristic histologic appearance of cystic lymphangioma provided the definitive diagnosis. The recovery course was uneventful. Two years postoperatively, the patient was symptom-free and without evidence of tumor recurrence.

Prognostic value of MIB-1 index and DNA ploidy in resectable ampulla of Vater carcinoma

OBJECTIVE

To evaluate the prognostic value of the proliferative factors, MIB-1 index, DNA ploidy, and S-phase fraction, and further to determine the independent prognostic factors in ampulla of Vater carcinoma after pancreaticoduodenectomy.

SUMMARY BACKGROUND DATA

Cell kinetics are important indicators of the biologic behavior of various human tumors, but only a few authors have reported the application of cell proliferative factors in ampulla of Vater carcinoma.

METHODS

Patients undergoing pancreaticoduodenectomy for ampulla of Vater carcinoma were included. Proliferative factors, MIB-1 index, and DNA contents, measured by flow cytometry, were evaluated and compared with the conventional clinicopathologic factors.

RESULTS

Ninety resectable ampulla of Vater carcinomas were included. By univariate analysis, MIB-1 index, DNA ploidy, S-phase fraction, stage, and lymph node status were significant prognostic factors. The 5-year survival rate was 40.7% for tumors with MIB-1 index < or =15% and 0% for those with MIB-1 index >15%. Diploid tumors had a significantly better prognosis than aneuploid. Outcomes of stage I and II tumors were more favorable than those of stage III and IV. After multivariate analysis, MIB-1 index, DNA ploidy, and stage remained as the independent prognostic factors. Among the three independent prognostic factors, MIB-1 index was the most powerful.

CONCLUSIONS

Both MIB-1 index and DNA ploidy provide important prognostic value and potentially complement the conventional prognostic factors in resectable ampulla of Vater carcinoma. MIB-1 index is the most powerful independent prognostic factor.

Influence of Helicobacter pylori on gastric secretion and gastrin release in normal Chinese subjects

BACKGROUND

Controversy exists concerning the influence of Helicobacter pylori on gastric secretion. Hyper-, normo- and hyposecretion of gastric acid in normal subjects with H pylori infection have been reported, although there is no such report for Chinese subjects. The goal of this study was to identify the effect of H pylori on gastric secretion in normal Chinese subjects.

METHODS

Twenty normal subjects with a normal upper gastrointestinal tract by endoscopy were recruited. H pylori status was assayed by a rapid urease test. Gastric secretion and gastrin release were also measured.

RESULTS

Among the subjects studied, nine were infected with H pylori. All enrolled subjects were males. Age and body weight were similar between both groups. No significant difference was found in basal acid output, maximal acid output, basal pepsin output or maximal pepsin output between the H pylori-positive group (median, 1.1 mmol/hour, 95% confidence interval 0.2-3.6 mmol/hour; 8.0, 3.0-18.3 mmol/hour; 0, -1.3-11.2 mmol/hour; and 4.1, -4.2-59.3 mmol/hour, respectively) and the H pylori-negative group (2.5, -1.3-11.3 mmol/hour; 12.2, 8.7-26.9 mmol/hour; 4.3, 1.8-13.5 mmol/hour; and 14.8, -5.7-73.0 mmol/hour, respectively). Serum basal gastrin and pepsinogen I concentration were 63.5, 50.0-78.6 pg/ml and 75.1, 50.6-89.8 ng/ml in the H pylori-positive group, and 65.9, 50.2-79.8 pg/ml and 79.1, 59.5-120.1 ng/ml in the H pylori-negative group (p > 0.05).

CONCLUSIONS

H pylori plays no role in the gastric secretion and gastrin release in normal Chinese subjects.

Hepatocyte growth factor and Met/HGF receptors in patients with gastric adenocarcinoma

Overexpression and amplification of Met/HGF receptor has been detected in gastric cancer tissues and cell lines. In this study hepatocyte growth factor (HGF) and Met/HGF receptors were localized in 32 gastric cancer and adjacent normal gastric tissues by the avidin-biotin-peroxidase complex technique. HGF (87.5%) and Met/HGF receptors (68.8%) were demonstrated in gastric cancer tissues. A high positive rate of HGF (87.0%) and Met/ HGF receptors (82.6%) presented in intestinal type gastric cancer. HGF immunoreactivity in gastric cancer tissues was a significant and powerful prognostic indicator (relative risk 15.9; p=0.01). These data suggest that HGF and Met/HGF receptors are involved in the morphogenesis of intestinal type gastric cancer. HGF may have other mechanism that favor gastric cancer spread and independently affect survival.

Prolonged survival in a nasopharyngeal carcinoma patient with multiple metastases: a case report and review of the literature

Nasopharyngeal carcinoma is a common cancer in South East Asia. In the early stages, radiotherapy alone may achieve sustained control, but once metastasis occurs, it becomes an incurable disease with limited survival time. We report a case of nasopharyngeal carcinoma, initial stage T4N0M0, diagnosed in 1985 in a patient aged 36 years who received 70 Gy radiotherapy to the head and neck region. In 1988, relapse occurred with multiple lung metastases. The patient received many chemotherapy regimens with a very good response, including near complete remission with the first treatment regimen of cisplatin, 5-fluorouracil and leucovorin for lung metastases, and with the fifth chemotherapy regimen of ifosfamide as a single agent. After ifosfamide treatment, there was residual fibrotic change in the lung and complete disappearance, lasting for almost a year, of the liver and bone lesions. The patient eventually died in July 1995 due to progressive disease. Prolonged survival after mainly thoracic metastasis is possible in patients with nasopharyngeal carcinoma, especially if the tumor is chemo-responsive.

Prognostic indicators for survival after curative resection for patients with carcinoma of the stomach

This study aims to determine prognostic indicators among patient-, tumor-, and treatment-related factors of gastric cancer patients. A total of 510 patients who underwent curative gastric resection were studied. Univariate analysis of patient-related factors showed a significantly lower survival in patients with a history of obstruction, hypoalbuminemia, and anemia. Tumor-related factors including gross appearance, location, and size of tumor; depth of cancer invasion; level, number, and frequency of lymph node metastasis; stromal reaction and tumor growth pattern; and histological classification all significantly affected survival. Surgical treatment related factors such as total or distal subtotal gastrectomy, extent of lymphadenectomy, and combined resection of adjacent organ(s) showed a statistically significant adverse influence on survival. Multivariate analysis identified only four tumor-related factors-number of metastatic lymph nodes, depth of cancer invasion, stromal reaction, and gross appearance of the tumor-as independently affecting survival. These findings suggest that only four tumor-related factors were prognostic indicators in patients with gastric cancer.

Intestinal-type tumour in resected gastric remnant cancer

Lauren's intestinal type of gastric cancer was proposed to be dependent on long-term environmental factors and is always preceded by chronic premalignant change. A cohort study was performed and demonstrated an increased cancer risk of gastric remnant after gastric surgery for benign disease. It is generally believed that after gastrectomy the residual stomach has an environmental change and, thus, enters a neoplastic process. Based on the carcinogenic theory of intestinal-type tumour, it would be of interest to know whether the intestinal-type tumour is more common in gastric remnant cancer. Forty patients with gastric remnant cancer had gastrectomy in the Veterans General Hospital-Taipei. Another 683 patients with primary gastric carcinoma underwent resection and were used as controls. The clinical characteristics, tumour stage and intestinal-type tumour were analysed in gastric remnant cancer and were compared with the various portions of primary gastric carcinoma. Although the overall distribution of intestinal-type carcinoma in gastric remnant (45%) was no different to that of any other portion of stomach cancer, intestinal-type carcinoma was more common in the early stage of gastric remnant (73%) and distal stomach (73%), but not in the proximal stomach (50%), which was supposed to have the same characteristics as the gastric remnant because of identical anatomic location. More than expected, intestinal-type carcinoma in early gastric remnant cancer together with a long incubation interval between primary surgery and later tumour occurrence were compatible with the theory of carcinogenesis of intestinal-type carcinoma.

Effect of intermittent cigarette smoke inhalation on tibial lengthening: experimental study on rabbits

We investigated the effect of intermittent cigarette smoke inhalation on the bone healing of tibial lengthening in rabbits. Thirty-eight male rabbits were divided into two groups of 19 animals each. The first group went through intermittent cigarette smoke inhalation, and the second group did not go through intermittent cigarette smoke inhalation. Each animal's right tibia was lengthened 5 mm using an uniplanar lengthening device. Five animals of each group were killed at 4, 6, and 8 weeks postoperatively for biomechanical testing, and one animal of each group was killed at 2, 4, 6, and 8 weeks postoperatively for histologic study. Using the contralateral nonoperated tibia as an internal control, we found that torsional strength of the lengthened tibia of the smoke inhalation group was decreased significantly compared with the non-smoke inhalation group. The mean percent of maximal torque at 4, 6, and 8 weeks were 22.0, 66.3, and 78.6%, respectively, in the smoke inhalation group, whereas the mean percent of maximal torque were 48.0, 84.1, and 90.8% %, respectively, in non-smoke inhalation group (one-tailed t test, p < 0.01, p < 0.01, and p < 0.05 at 4, 6, and 8 weeks, respectively). Our histologic observations revealed that the granulation tissue resorption, bone formation, and remodeling were delayed in smoke inhalation group. The results of this study suggest that intermittent inhalation of cigarette smoke delays, but does not prevent, the bone healing in tibial lengthening.

Adaptations of ligamentum teres in ischemic necrosis of human femoral head

Little is known about the biomechanical properties of human ligamentum teres. To more fully understand the ligamentum teres, its dimensions and mechanical properties were measured in 22 cases of acute fracture of the femoral neck and 21 cases of ischemic necrosis of the femoral head. The specimens first were preconditioned and then loaded to failure with a testing machine at a fast strain rate of 100% s(-1). The ischemic necrosis group had a significantly larger volume (3.09 +/- 1.81 ml versus 1.30 +/- 0.62 ml) and cross section area (65.3 +/- 59.1 mm2 versus 30.6 +/- 27.2 mm2) than did the acute fracture group. The former also had a significantly greater ultimate load (234 +/- 168 N versus 130 +/- 111 N) and strain energy to failure (1.22 +/- 1.04 J versus 0.41 +/- 0.39 J), but a significantly smaller linear modulus (4.72 +/- 3.31 MPa versus 8.69 +/- 7.97 MPa) than did the latter. Histologic studies showed differences in the amount of organized collagen and components of subsynovial tissue between the 2 groups. Mechanical and morphologic adaptations of the ligamentum teres in a group of ischemic femoral heads are described, and a possible biomechanical role is suggested for the ligamentum teres in the hip joint in conjunction with the ischemic necrosis of the femoral head.

Defective mitochondrial oxidative phosphorylation in varicocele-bearing testicles

OBJECTIVES

Our previous study revealed a decreased blood flow in varicocele-bearing testicles. For further understanding of the possible mechanism of varicocele-induced infertility, we investigated the changes in energy metabolism in varicocele-bearing testicles.

METHODS

Partial ligation of the left renal vein was performed in 40 Wistar rats to induce dilation of the internal spermatic vein, and sham operations were performed in 20 other age-matched Wistar rats serving as controls. Orchiectomy was done at 1, 2, 4, and 6 months after induction of varicocele (or sham operation) in both groups. The histologic changes in the testicles were evaluated under the light microscope. The concentration of adenine nucleotides was determined by high-performance liquid chromatography, and various enzyme activities of mitochondria were determined by a spectrophotometer.

RESULTS

Histologic studies of varicocele-bearing testicles showed a lower Johnsen score (8.5 +/- 0.7 versus 9.3 +/- 0.5) and a decreased mean testicular tubular diameter (280.0 +/- 3.2 versus 295.0 +/- 1.4 microns) compared with the testicles in the sham-operated group. The energy charge decreased from 0.71 +/- 0.04, 0.70 +/- 0.03, 0.69 +/- 0.06, and 0.64 +/- 0.03 to 0.62 +/- 0.08, 0.59 +/- 0.05, 0.58 +/- 0.05, and 0.56 +/- 0.02 at 1, 2, 4, and 6 months, respectively. The reduced nicotinamide-adenine dinucleotide-cytochrome c reductase activities were decreased from 136.6 +/- 4.9, 127.3 +/- 10.7, 121.6 +/- 7.8, and 118.9 +/- 8.5 to 96.3 +/- 13.9, 95.6 +/- 27.8, 88.3 +/- 13.8, and 80.4 +/- 8.7 nmol/min/mg of protein, respectively; the succinate-cytochrome c reductase activities were decreased from 50.4 +/- 2.7, 49.0 +/- 4.7, 49.6 +/- 7.1, and 42.6 +/- 1.6 to 40.3 +/- 7.3, 41.0 +/- 11.5, 40.2 +/- 5.7, and 32.0 +/- 1.3 nmol/min/mg of protein, respectively; and the cytochrome c oxidase activities were decreased from 361.2 +/- 23.4, 350.3 +/- 25.5, 223.5 +/- 12.9, and 194.1 +/- 18.3 to 253.7 +/- 32.9, 256.4 +/- 38.8, 178.2 +/- 15.7, and 147.1 +/- 17.2 nmol/min/mg of protein at 1, 2, 4, and 6 months, respectively.

CONCLUSIONS

We thus suggest that defective energy metabolism plays an important role in the impairment of spermatogenesis of varicocele-bearing testicles.

Morphological change in the urothelium after electrohydraulic versus pulsed dye laser lithotripsy

OBJECTIVE

To observe morphological changes in the urothelium after exposure to laser beam and electrohydraulic spark.

MATERIALS AND METHODS

The pulse dye laser lithotripter (MDL-2, Candela Corporation, Boston, USA) and the electrohydraulic lithotripter (AEH-2, Circon ACMI Corporation Stamford, USA) were used directly on the bladder mucosa in six pigs. Immediately after treatment, the bladder mucosa was prepared for light microscopic and scanning electron microscopic examination.

RESULTS

Both electrohydraulic spark and laser beam caused mucosal denudation, submucosal swelling and haemorrhage. There was a positive correlation between the degree of urothelial damage and the power and pulse numbers applied.

CONCLUSION

Direct contact of the urothelium in patients treated with laser beam or electrohydraulic spark should be avoided.

DNA ploidy as a major prognostic factor in resectable ampulla of Vater cancers

The archival paraffin-embedded specimens from 63 ampulla of Vater cancers after pancreaticoduodenectomy between 1965 and 1991 were analyzed by flow cytometry. Of the 63 cancers, 31 (49.2%) were diploid DNA cancers and 32 (50.8%) were aneuploid. Patients with diploid DNA cancer had a median survival time of 159.0 months, and patients with aneuploid DNA cancer had 24.0 months. This difference is statistically significant (P = 0.0257). The aneuploid group did have a poorer prognosis than the diploid group. The multivariate analysis demonstrated that DNA ploidy was an independent and very important prognostic factor, even stronger than the stage and lymph node status. There was a tendency toward higher values of S-phase fraction, proliferative index, and total aneuploid DNA fraction in the shorter survival groups, but they were of no statistical significance. These data suggest that DNA ploidy appears to be the most important and the only pre-operative predictor of prognosis in resectable ampulla of Vater cancers since endoscopic biopsy is feasible.

Response of immature bone-ligament junction to a high-fat-sucrose diet

A high-fat-sucrose diet can adversely affect calcium absorption, and thus bone-ligament junction strength may be compromised. To test this premise we examined the influence of a high-fat-sucrose diet on the femur-medial collateral ligament-tibia complex of rats. The mechanics and geometry of this bone-ligament-bone complex were measured, and the histomorphometry of the distal bone-ligament junction (tibial-medial collateral ligament) was examined. After 10 weeks the high-fat-sucrose and control (low-fat, complex-carbohydrate) diet groups showed no difference in medial collateral ligament cross-sectional area, but the mechanical integrity of high-fat-sucrose bone-ligament-bone complex was significantly less than the controls; for example, the maximum and failure loads were significantly less (30%) with the high-fat-sucrose diet. Cell density was also significantly less in the medial collateral ligaments of those rats on the high-fat-sucrose diet. Diets with relatively high proportions of fat and sucrose are not uncommon in North American and European nations, but little is known about the effects that these diets may have on growing bone and fibrous connective tissues. The results from the current study provide both a caution and a stimulus. The caution arises from the pronounced and adverse effects that a diet rich in fat and sucrose can have on the mechanical properties and structure of bone-ligament junctions in growing animals. The stimulus provided by these results is to examine the long-term consequences of such a diet on bone-ligament integrity and to assess the implications of a high-fat-sucrose diet for humans.

Differential response of rat limb bones to strenuous exercise

We examined the influence of a strenuous exercise regimen on tibial and metatarsal bones to show not only how the geometric, histological, and mechanical properties of immature bone respond to strenuous exercise but also how long bones within the same limb may respond differentially to exercise. Female Sprague-Dawley rats (8 wk old) were divided randomly into two groups: a sedentary control (n = 15) and an exercised group (n = 15). The exercise intensity was 80-90% of maximum oxygen capacity 5 days/wk for 10 wk. Mechanical properties of tibia and second metatarsus (MT) were determined with three-point bending, and contralateral bones were used for geometric and histological analyses. Length and middiaphyseal cross-sectional geometry of the exercised tibiae were significantly less than controls, but material properties were not different. The exercised tibiae had significantly lower structural properties (e.g., loads at the proportional limit and maximum and energy at failure load). The middiaphyseal dorsal cortex of exercised MT was significantly thicker than controls, but tensile stress at the proportional limit and elastic modulus of exercised MT were significantly less than controls. The average number of osteons and osteocytes per unit area of the tibial middiaphysis was significantly greater in the exercised group--especially in lateral and posterior cortices. The number of osteons and osteocytes per unit area in the MT, however, was significantly less in the exercised group. The differential effects of strenuous exercise on tibia and MT suggest that local loading and bone-specific responses have important roles in modulating the response of immature bone to strenuous exercise.

Differential response of rat limb bones to strenuous exercise

We examined the influence of a strenuous exercise regimen on tibial and metatarsal bones to show not only how the geometric, histological, and mechanical properties of immature bone respond to strenuous exercise but also how long bones within the same limb may respond differentially to exercise. Female Sprague-Dawley rats (8 wk old) were divided randomly into two groups: a sedentary control (n = 15) and an exercised group (n = 15). The exercise intensity was 80-90% of maximum oxygen capacity 5 days/wk for 10 wk. Mechanical properties of tibia and second metatarsus (MT) were determined with three-point bending, and contralateral bones were used for geometric and histological analyses. Length and middiaphyseal cross-sectional geometry of the exercised tibiae were significantly less than controls, but material properties were not different. The exercised tibiae had significantly lower structural properties (e.g., loads at the proportional limit and maximum and energy at failure load). The middiaphyseal dorsal cortex of exercised MT was significantly thicker than controls, but tensile stress at the proportional limit and elastic modulus of exercised MT were significantly less than controls. The average number of osteons and osteocytes per unit area of the tibial middiaphysis was significantly greater in the exercised group--especially in lateral and posterior cortices. The number of osteons and osteocytes per unit area in the MT, however, was significantly less in the exercised group. The differential effects of strenuous exercise on tibia and MT suggest that local loading and bone-specific responses have important roles in modulating the response of immature bone to strenuous exercise.

Ambient level ozone effects on subpopulations of thymocytes and spleen T lymphocytes

The effects of ozone on thymocyte and spleen T lymphocyte subpopulations were studied. Balb/c mice were exposed to clean air or to 0.3 +/- 0.05 ppm ozone for 1-3 wk. Thymocytes and spleen T cells were stained with fluorochrome conjugated monoclonal antibodies against surface differentiation markers and/or propidium iodide for deoxyribonucleic acid (DNA). The cells were then analyzed by fluorescence activated cell sorter. The percentages of certain thymocyte and spleen T lymphocyte subtypes and DNA synthesizing spleen T cells were lower following 1 wk of ozone exposure. After 3 wk exposure, the thymocyte percentages were higher in ozone-exposed mice, whereas the absolute number remained lower, and spleen T lymphocytes showed no changes. The findings suggest that short-term ozone inhalation can affect the T cell immune system adversely, particularly the CD4+ cells.

Effects of a high fat-sucrose diet on cortical bone morphology and biomechanics

High fat-sucrose (HFS) diets can reportedly produce glucose intolerance and hyperinsulinemia that may indirectly have deleterious effects on bone. The effects of a high-fat diet on calcium absorption, bone calcium content, and bone mechanical properties, however, remain controversial. Thus, we examined the morphological and biomechanical adaptations in limb bones of rats that were fed a HFS diet. Female Sprague-Dawley rats (8 weeks old) were randomly assigned to two groups, either a control group (n = 9) fed a standard diet (low-fat complex-carbohydrate) or an experimental group (n = 9) fed a HFS diet for 10 weeks. The right tibia and second metatarsus (MT) were fractured in three-point bending, and contralateral bones were used for morphological and histological analyses. HFS tibias had significantly lower maximum load and failure energy, and tensile stress at the proportional limit for both HFS tibia and MT was significantly less than controls. In addition, the elastic modulus and density of the HFS MT was significantly lower than controls. Geometry of the tibial mid-diaphysial cross section did not differ for the two diets, but the cortical cross-sectional area of HFS MT increased significantly compared to control MT. The total number of osteons in the mid-diaphysis of HFS MT decreased, but tibial and MT porosities did not change with the HFS diet. Our results suggest that the deleterious effects of the HFS diet may be more related to changes in the material properties of the cortical bone rather than to osteoporotic changes in the bone.