OBJECTIVE: The purpose of our study was to quantify arterial and portal hepatic arterial blood flows. MATERIALS AND METHODS: Four models were developed using PET. The first model consisted of the components of the liver and the portal system. The second applied "curve analysis" to this model. The third model introduced a portosystemic shunt factor, whereas the last model introduced a coefficient for circulation time within the portal organs. In 51 patients (34 men and 17 women), PET scans of the liver were performed using the H2 15O dynamic method. RESULTS: Under all four models, the arterial and portal hepatic arterial blood flows of 504 regions of interest were calculated using the nonlinear least-squares method, and results were compared by the sum of the squares of errors. Additionally, results from the H2 15O dynamic method were compared by results from the C15O2 steady-state method. CONCLUSION: Of the four models, the last model produced curves with the best fit. When hepatic blood flow was quantified using PET and the H2 15O dynamic method, a model applying "curve analysis" and components related to portosystemic shunting and circulation time was found to be most accurate.

Administration, Inhalation↗

PubMedDate not supplied

Serial high resolution CT findings in nonspecific interstitial pneumonia/fibrosis.

PURPOSE: The purpose of this work was to evaluate the radiographic and serial high resolution CT (HRCT) findings in patients with nonspecific interstitial pneumonia/ fibrosis (NSIP). METHOD: We identified 15 patients with biopsy-proven NSIP. Radiography and initial and follow-up CT findings were reviewed. RESULTS: Predominant radiographic findings were bilateral infiltrates distributing in the middle and lower lung zones and decreased lung volumes. At initial CT, predominant patterns were peribronchovascular interstitial thickening (n = 6), parenchymal bands (n = 8), intralobular interstitial thickening (n = 12), and traction bronchiectasis (n = 14). Mixed pattern of ground-glass opacity and consolidation (n = 11) were predominant findings of increased lung opacity. At follow-up CT in 14 cases, the abnormalities had disappeared completely in 3, improved in 9, persisted in 1, and worsened in 1. CONCLUSION: The pulmonary abnormalities observed in NSIP on HRCT can disappear or be diminished in most cases after corticosteroid therapy. Intralobular interstitial thickening and traction bronchiectasis, which have been considered to be indicators of irreversible fibrosis, also show favorable responses.

Adult↗

PubMedDate not supplied

Activation of intracellular neutrophil elastase in the transplantation of ischemic liver.

Ischemia-reperfusion injury is an important cause of primary nonfunction of transplanted organs, and neutrophil elastase has been implicated in the pathophysiology of ischemia-reperfusion injury. We assessed the kinetics of intracellular neutrophil elastase (INE) activity in canine liver transplantation. Mongrel dogs underwent orthotopic whole-liver transplantation. The animals in group I (n = 6) received fresh liver grafts, and all of the dogs survived longer than 24 h. The animals in group II (n = 5) received liver grafts injured by 30 min of warm ischemia. Only 1 animal survived longer than 24 h after reperfusion. A significant increase in the serum ALT and LDH levels was observed in group II after reperfusion of the graft. Isolated peripheral neutrophils were homogenized, and the neutrophil elastase activity in the supernatant was determined by using a spectrophotometric assay. The INE activity was expressed as the neutrophil elastase value per 1 x 10(10) peripheral neutrophils. In group I, the INE activity 10 min and 2 h after reperfusion was 7.6 +/- 2.6 and 6.1 +/- 2.4 U, respectively. In group II, this activity was 25.9 +/- 7.4 and 44.3 +/- 23.7 U, respectively. There was a significant correlation between serum LDH levels and INE activity 10 min after reperfusion (gamma = 0.70, p < 0.02). In conclusion, the INE activity increased more sharply after the reperfusion of ischemically injured liver grafts. The INE activity correlates with serum LDH levels immediately after reperfusion, suggesting that the increase in the INE activity depends on the severity of ischemic damage.

Alanine Transaminase↗

PubMedDate not supplied

The pupillary light reflex in borderline diabetics.

Computerized IR videopupilography, using an open-loop photic stimulator, was used to compare the reflexes of borderline diabetics with overt non-insulin-dependent diabetics and with age- and sex-matched non-diabetic healthy controls. The patients were all male, aged 41-59 years. Overt non-insulin-dependent diabetics in their 40s had a smaller pupillary area and pupillary diameter prior to photic stimulus compared with borderline diabetics and healthy controls. Overt non-insulin-dependent diabetics in their 50s had a lower pupillary area and pupillary diameter prior to photic stimulus, maximum velocity and acceleration of constriction and maximum velocity of dilation than did borderline diabetics or controls. The only abnormality observed among borderline diabetics compared to controls was a smaller amplitude of constriction in response to light in patients in their 50s. Amplitude of constriction in response to light and velocity of constriction measurements of borderline diabetics, however, were considerably more frequently abnormal than were those of controls. The frequency of abnormal pupillary diameter prior to photic stimulus, maximum velocity of dilation and acceleration of constriction was higher in overt non-insulin-dependent diabetics than in borderline diabetics. The results indicate that borderline diabetics have autonomic neuropathy before the disease becomes overt. The importance of the pupillary light reflex examination is discussed.

Adult↗

PubMedDate not supplied

Clonogenic colony-forming ability of flow cytometrically isolated hepatic progenitor cells in the murine fetal liver.

Stem cells are defined as cells having multilineage differentiation potential and self-renewal capability. Hepatic stem cells have aroused considerable interest not only because of their developmental importance but also for their therapeutic potential. However, their presence in the liver has not yet been demonstrated. With the use of a fluorescence-activated cell sorter (FACS) and monoclonal antibodies, we attempted to ascertain whether hepatic stem cells are present in the murine fetal liver. For this purpose, we optimized a cell isolation technique for FACS sorting of fetal liver cells. When isolated CD45 TER119 cells (the non-blood cell fraction in the fetal liver) were tested for their clonogenic colony-forming ability, mechanical dissociation (pipetting) was the most suitable cell isolation technique for FACS sorting. We confirmed that these colonies contained not only cells expressing hepatocyte markers but also cells expressing cholangiocyte markers. To identify hepatic stem cells, studies must focus on CD45TER119- cells in the murine fetal liver.

Animals↗

PubMedDate not supplied

Heterogeneity of acute myeloblastic leukemia without maturation: an ultrastructural study.

We demonstrated by ultrastructural examination that the leukemic blasts of 13 patients with acute myeloblastic leukemia (AML) without maturation (M1 in the French-American-British classification) showed heterogeneous features. In 7 patients, the leukemic blasts had a high level of light microscopic myeloperoxidase positivity (> 50%). Ultrastructurally, the cells were myeloblast-promyelocytes with 100% myeloperoxidase positivity, and these 7 patients appeared to have typical AML. In contrast, the remaining 6 patients had leukemic blasts with a low myeloperoxidase positivity (< 50%) and heterogeneous features. Three had ultrastructural features of myelomonocytic or monocytic lineage, 1 had myelomonocytic cells associated with megakaryoblasts, and 1 had undifferentiated blasts. The former group had a better prognosis than the latter, indicating that ultrastructural analysis of M1 leukemia may help predict the response to therapy.

Adolescent↗

PubMedDate not supplied

Preparation of ferulic acid and its application for the synthesis of cancer chemopreventive agents.

We suggest that chemical raw materials can best be obtained from natural resources. Ferulic acid is easily prepared in large quantities from rice bran pitch, a blackish brown waste oil with high viscosity, discharged in the process of the rice bran oil production. As an application of ferulic acid, potential cancer chemopreventive agents could be synthesized using organic synthetic methods.

Anticarcinogenic Agents↗

PubMedDate not supplied

Influence of ethyl 3-(4'-geranyloxy-3'-methoxyphenyl)-2-propenoate (EGMP) on early stage colon carcinogenesis in rats treated with azoxymethane (AOM).

The influence of ethyl 3-(4'-geranyloxy-3'-methoxyphenyl)-2-propenoate (EGMP) on the initiation and post-initiation stages of colon carcinogenesis was investigated in male F344 rats treated with azoxymethane (AOM). In experimental protocol 1, EGMP was given in the diet at 0.1 or 0.2% for 1 week together with two s.c. 15 mg/kg body weight injections of AOM on days 1 and 7 (initiation period). In protocol 2, the test compound was administered starting at week 3(post initiation stage), and in protocol 3, the test compound was given throughout the experimental period(whole stage). Sacrifice and quantitation of aberrant crypt foci (ACF) was performed at the end of week 5. Dose-dependent decreases in numbers of ACF were noted with both cases of post-initiation and whole period exposure (protocol 2 and 3), large size lesions considered most likely to be precursor lesions also being significantly reduced in the protocol 2(4-9 crypt size total with the 0.2% dose group, 48.9% and 59.6% of control values, respectively). No effects on body or liver weights were evident. The present results thus suggest that EGMP might find application as a chemopreventive agent against colon tumor development.

Animals↗

PubMedDate not supplied

Malignant endocrine carcinoma of the stomach.

Small cell carcinoma and small portions of poorly differentiated adenocarcinoma of the stomach sometimes differentiate into secretory cells. We experienced a pure endocrine carcinoma of the stomach. The patient, who had a giant mass in the greater curvature of the body of the stomach and regional lymph node metastasis, underwent total gastrectomy. Immunohistologic staining of the resected specimens revealed that the tumor was an endocrine carcinoma. The tumor cell shape in the present case was polygonal or oval and the cell size was relatively large. The cell nucleus was coarse chromatic and nucleoli were seen, whereas, the nucleus of small cell carcinoma often shows a fine chromatic pattern and nucleoli are not seen. On the basis of these findings, the present case was considered to be a pure endocrine carcinoma which was not classified as a small cell carcinoma.

Biomarkers, Tumor↗

PubMedDate not supplied

Combined resection of the involved organs in T4 gastric cancer.

BACKGROUND/AIMS: It remains controversial whether extended surgeries for gastric cancer can improve the postoperative survival rate. This study was designed to evaluate the effectiveness of a combined resection of the involved organs for improving the survival of gastric cancer patients. METHODOLOGY: Of the 1600 patients treated at our Department, from 1969-1993, 231 patients were found to have evidence of adjacent organ spread at laparotomy. Of the 231 patients, 174 underwent a combined resection of the adjacent organs with a gastrectomy due to direct invasion of these organs by the gastric cancer. The clinicopathological characteristics of 231 patients who had adjacent organ spread were compared retrospectively with 495 patients who had no adjacent organ spread. RESULTS: Although the postoperative survival rate of those patients who underwent a gastrectomy with a combined resection of the involved organs was poor, 14 patients survived for 5 years or longer after the surgery. The clinicopathologic factors characteristic of these 14 surviving patients were a lesser extent of lymph node metastasis and high operative curability. CONCLUSIONS: A combined resection of the involved organs with a gastrectomy should be performed when lymph node metastasis is not evident.

Adult↗

PubMedDate not supplied

Hepatic resection for metastatic tumors from noncolorectal carcinoma.

BACKGROUND/AIMS: The role of liver resection for hepatic metastases from noncolorectal carcinomas has yet to be clarified. The present study examines a single institutional experience of hepatic resection for noncolorectal metastases. METHODOLOGY: From January 1987 to March 1999, 14 patients underwent curative resection for liver metastases from noncolorectal carcinomas. Records of these patients were reviewed. RESULTS: Resections were performed for liver metastases from gastric cancers (n = 8), pancreatic cancers (n = 2), and cancers of bile duct, the papilla of Vater, kidney, and breast (n = 1, each). Six patients (5 with gastric cancers and 1 with pancreas cancer) presented with synchronous disease and 8 with metachronous disease. In the gastric cancer patients, there are 2 disease-free survivors (26 and 53 months) in the metachronous group, though all of the 5 patients with synchronous disease died within 29 months. All of the 4 patients with pancreatobiliary carcinomas died within 2 years. One case of breast cancer and another of renal cell cancer are alive without disease at 49 and 9 months, respectively. CONCLUSIONS: For metastases from gastric cancers, better survival after hepatic resection is expected in metachronous cases than in synchronous cases. Hepatic resection may afford little benefit for patients with liver metastases from pancretobiliary cancers.

Aged↗

PubMedDate not supplied

Safety and utility of autologous blood transfusion for resection of metastatic liver tumor.

BACKGROUND/AIMS: The purpose of this study was to evaluate the safety and efficacy of predeposit autologous blood transfusion for resection of hepatic metastases. METHODOLOGY: We examined stored blood from 25 patients with advanced colorectal or gastric cancer for carcinoembryonic antigen mRNA using reverse-transcriptase-polymerase chain reaction assay to detect cancer cell in the autologous blood. We also retrospectively evaluated no transfusion (A, n = 44), autologous transfusion (B, n = 15), and homologous transfusion groups (C, n = 26) for perioperative liver function and long-term outcome after undergoing resection of liver metastases. RESULTS: In 5 of 25 patients, carcinoembryonic antigen mRNA was detected immediately after blood donation and after 7 days of storage, but not after 14-21 days of storage. The cumulative 5-year survival rates for groups A, B, and C were not different. However, disease-free survival with colorectal liver metastases was significantly higher in group A than in group C (P = 0.019). Total bilirubin concentrations in group C on the first postoperative day were also significantly higher than group A (P = 0.025). CONCLUSIONS: Stored autologous blood may contain cancer cells, but these decrease or disappear after storage for more than 7 days. For hepatic resection of metastases, transfusion avoidance yields the optimal outcome.

Aged↗

PubMedDate not supplied

Safety and advantage of perioperative autologous blood transfusion in hepatic resection for hepatocellular carcinoma.

BACKGROUND: The safety and advantages of perioperative autologous blood transfusion (ABT) were evaluated on hepatectomy for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Blood samples were obtained and stored from 30 patients with HCC. HCC cells were investigated by the presence of AFPmRNA using RT-PCR after storage. We also reviewed postoperative liver function and the long-term outcomes of 138 patients who underwent hepatectomy receiving ABT compared with patients receiving homologous blood transfusion (HBT) and patients without blood transfusion. RESULTS: AFPmRNA was not detected in all samples stored for more than 14 days. Postoperative ALT, AST and total bilirubin in the HBT group were significantly higher than those of other groups. Patients in the HBT group had significantly lower survival rates than patients in the ABT group. CONCLUSION: ABT was safe after storage and it had advantages compared with HBT with regard to postoperative liver function and survival rate after the hepatectomy for HCC.

Blood Transfusion, Autologous↗

PubMedDate not supplied

Rigidity of three different types of mandibular major connector through vibratory observations.

PURPOSE: The purpose of this study was to investigate the vibration characteristics of three different designs of mandibular major connectors in vitro by observing modal animation, decay rate, and maximum amplitude. MATERIALS AND METHODS: Three removable partial denture frameworks--lingual bar, Kennedy bar, and lingual plate--were studied. They were excited by a shaker, and the frequency response functions were recorded on a Fast Fourier Transformational analyzer to identify their modal shapes. Natural frequency and animation of motion at each natural mode of vibration of the three frameworks were observed. In addition, transient response simulations were recorded, and decay rates and maximum amplitude of the resultant transient response waves were computed. RESULTS: The mean decay rate calculated from all the measurement points of the lingual bar, Kennedy bar, and lingual plate was 3.10 s-1 (standard deviation [SD] 0.07), 2.42 s-1 (SD 0.04), and 2.01 s-1 (SD 0.03), respectively. Significant differences in decay rate were found among all pairs (P < .001). Maximum amplitude of the direct and indirect retainers at the nonimpacted side also differed (P = .008). CONCLUSION: All three designs demonstrated no elastic deformation at each natural mode of vibration. In terms of vibration analysis, the lingual bar demonstrated the maximum decay rate and the minimum maximum amplitude of the direct and indirect retainers, both on impacted and nonimpacted sides, indicating that the lingual bar will dissipate the energy through vibration faster than the other designs. Hence, the possibility of creating harmful effects to the oral tissue is lesser.

Analysis of Variance↗