BACKGROUND: The bcl-2 proto-oncogene is a known inhibitor of apoptosis that may allow the accumulation and propagation of cells containing genetic alterations. METHODS: An immunohistochemical study was performed to examine the role of BCL-2 protein expression in normal colonic mucosa, adenoma, and adenocarcinoma. RESULTS: BCL-2 was present in the crypt base of normal mucosal glands, while diffuse expression of protein product was observed in 69 cases (65.1%) of adenoma and 29 cases (60%) of adenocarcinoma (p > 0.5). A diffuse expression pattern was often noted in adenomas of the tubular type, solitary lesions, small lesions (< 1 cm), and those with mild glandular dysplasia (p < 0.05, respectively). There was, however, no apparent difference as to location, Yamada type of gross appearance, and gender of patients (p > 0.05, respectively). Patterns of BCL-2 expression did not correlate with the biologic indicators of adenocarcinoma (p > 0.1, respectively). CONCLUSIONS: Our results support that bcl-2 may play an important role in the early stage of the adenoma-carcinoma sequence. Down-regulation of bcl-2 is associated with the risk of malignant transformation for colorectal adenoma.

Adenocarcinoma↗

PubMedDate not supplied

Cardiac biopsy of stomach may improve the detection of H. pylori after dual therapy.

BACKGROUND/AIMS: To determine whether gastric cardia biopsy may improve the detection of Helicobacter pylori (H. pylori) before and after eradication therapy. METHODOLOGY: A total of 150 dyspeptic patients with H. pylori infection completing a 2-week course of dual therapy (amoxicillin plus omeprazole) were studied. Endoscopy was carried out at the initial stage and 4 weeks after the completion of dual therapy. During each endoscopy, gastric biopsies were sampled in order from cardia, lower body, and antrum and stored separately to survey the distribution of H. pylori by histology. RESULTS: Before treatment, 88% (132/150) of the study cases had H. pylori found in antrum and 3.3% (5/150) of cases presented with bacteria only in cardia. After treatment, 38 cases had failure of dual therapy. The detection rates of H. pylori by biopsies without cardia decreased after the dual therapy (by antrum only: 88% to 60.5%, p < 0.05; antrum and body: 96.7% to 81.6%, p < 0.05). In contrast, the incidence of patients with only cardia involvement by H. pylori significantly increased from 3.3% (5/150) before to 18.4% (7/38) after treatment (p < 0.01). Among the 7 patients with H. pylori only in cardia after dual therapy, 3 cases had recurrent dyspepsia during follow-up because of no further anti-H. pylori therapy. Two of these 3 cases disclosed diffuse bacterial involvement in antrum and body besides cardia; the last case later had a positive result of urea breath test. CONCLUSIONS: Biopsy obtained from gastric cardia can improve the detection rate of H. pylori especially after dual therapy, which encounters antibiotics with possible sanctuary sites here. Thus, it will be useful to prevent over diagnosis of H. pylori eradication.

Adult↗

PubMedDate not supplied

[Percutaneous catheterization of internal jugular vein].

Percutaneous catheterization of internal jugular vein has been recognized as a valuable procedure during special conditions which need either a central venous pressure monitoring or a route for intravenous infusion either on a long term or short term basis. In our hospital we had 27 patients who had undergone 32 percutaneous internal jugular vein catheterizations over a period of 19 months. Patients' age ranged from 10 days to 13 year-old. Among these 27 patients, 20 were less than 1 year-old. Overall successful punctures were achieved in 87.5% of attempts. There was no case complicated with pneumothorax, hematoma, air embolization, pericardial tamponade or Horner's syndrome following the procedure. 68.7% of the procedure were done under emergency situation when peripheral venous route were inaccessible. In our experience, this procedure is a highly useful method of obtaining venous line in patient with inaccessible peripheral venous route.

Adolescent↗

PubMedDate not supplied

Immature mediastinal teratoma in early infancy: report of one case.

Immature mediastinal teratomas are rare, found in only 1% of all mediastinal teratomas; those occurring in the neonatal period are even more rare. A male baby suffering from tachypnea, weak crying and hoarseness since birth was noted, from a chest radiograph, to have a superior mediastinal mass. This mass enlarged progressively to an extent that the airway was threatened by one month of age. After resuscitation, intubation and mechanical ventilation, the infant became respirator-dependent. Chest computed tomography and ultrasonography revealed a heterogeneous cystic tissue mass containing focal calcifications. A well-encapsulated tumor, measuring 6 x 4 x 4 cm in size, located anterior to the thymus, was successfully removed at 58 days of age. The pathology showed an immature teratoma. After operation, respiratory distress dramatically improved. However, a superior mediastinal mass reappeared on a chest roentgenogram four months later. After a short course of chemotherapy, the infant received another operation to excise a mass composed of hypertrophic thymic tissue and a small nodular mature teratoma. The patient has remained well for more than nine months now.

Humans↗

PubMedDate not supplied

Shone's anomaly: report of one case.

A two-month-old female infant presented with intractable congestive heart failure and cyanosis, present since the neonatal period. The echocardiogram and angiogram showed a parachute mitral valve, aortic and subaortic stenosis, perimembranous type ventricular septal defect, mild aortic coarctation and patent ductus arteriosus. Unfortunately, the patient expired two days after surgical angioplasty for coarctation of the aorta. The autopsy proved a typical case of Shone's anomaly.

Aortic Coarctation↗

PubMedDate not supplied

Molecular biology of human ovarian cancer.

It has been proposed that epithelial ovarian cancers are of unifocal origin and arise from a single cell. Many alterations occur during the multistep carcinogenesis including interaction of peptide growth factors, activation of protooncogenes, and loss of tumor-suppressor genes. Increased activity of TGF-alpha and decreased activity of TGF-beta may contribute to the development of many ovarian cancers. Loss of TGF-beta responsiveness has been associated with the downregulation of c-myc expression in the development of ovarian cancer. Alternative expression of many oncogenes including ras, erbB2 and c-myc, were detected in many studies. p53 mutation was detected in 50% of advanced ovarian cancer, suggesting that loss of tumor-suppressor gene function facilitates transformation. Serum parameters like AFP, CEA, CA-125, IAP, LDH, SA, TGF-alpha, and M-CSF have been used as ovarian tumor markers. None of these biochemical markers is presently consistent and specific enough to be an early detection for ovarian cancers.

Biomarkers, Tumor↗

PubMedDate not supplied

The influence of incubator wall on the irradiation intensity of phototherapy.

A clear dose-response relationship has been demonstrated between the irradiance and the effectiveness of phototherapy. This study is designed to detect if there is any difference in irradiance between the inside and outside of different types of incubators. Forty-four incubators of two different types and with ages up to 18 years were included. In comparison with the measurement taken outside an incubator, the mean spectral irradiance detected within a single-walled incubator was significantly decreased (p < 0.001) while that detected within a double-walled incubator was slightly increased (p = 0.014). The reduction of spectral irradiance within an incubator correlated with the degree of incubator wall damage with a maximal loss of 15%. However, the irradiance did not correlate with the age of the incubator. In conclusion, the spectral irradiance received within an incubator was influenced by the type of incubator and the wall damage. Measuring the irradiance within an incubator prior to phototherapy should be emphasized, especially for those incubators with severely damaged walls.

Dose-Response Relationship, Radiation↗

PubMedDate not supplied

Prolonged fever in children.

During a four-year period, 86 children with fever lasting for at least 6 days without diagnosis at admission after initial physical examination and preliminary laboratory tests were included in a retrospective analysis. Their ages ranged from 2 months to 16 years, and there were 55 males and 31 females. Bacterial infections occurred in 19 patients (22%), viral infections in 17 (20%), mycoplasmal infections in 3 and malaria in 1. Collagen vascular diseases were diagnosed in 13 children (15%), including 7 juvenile rheumatoid arthritis and 5 systemic lupus erythematosus. Thirteen children (15%) had neoplastic or hematological diseases, including leukemia, lymphoma, myelodysplastic syndrome, and neuroblastoma. The fevers of the other 14 patients (16%) were attributed to central fever. The overall diagnostic rate was 98%. Twenty-two children had a poor outcome, including 6 children with collagen vascular diseases and 12 with neoplasms. Diagnoses were made mainly through a complete medical history, meticulous physical examination, regular laboratory tests, and an observation of clinical course. Invasive tissue studies can be fruitful when used appropriately and should be considered for specific indication only.

Adolescent↗