A total of 211 patients with gastric cancer in the upper third of the stomach were clinicopathologically evaluated. Of the 211 patients, 82 had esophageal infiltration and 129 did not. These two groups were compared. The study on patients who had undergone resection and radioisotope (99mTc-phytate) uptake testing revealed that it was important to dissect the lymph nodes (predominantly nodes 7, 9, 11, and 16) during surgery in the patients with gastric cancer plus esophageal infiltration. When cancer infiltration of the esophagus exceeds 1 cm, the preferred surgical procedure is lower esophagectomy and total gastrectomy with abdominal and intrathoracic lymphadenectomy via the left thoracoabdominal approach. When residual cancer is suggested in the more proximal esophageal stump due to intramural metastasis from vascular invasion, rapid pathologic diagnosis should be made by frozen sections during surgery and then subtotal esophagectomy by blunt removal of the esophagus proximally from the aortic arch using a left thoracotomy considered.

Carcinoma↗

PubMedDate not supplied

Deleterious effects of digitalis on reperfusion-induced arrhythmias and myocardial injury in ischemic rat hearts: possible involvements of myocardial Na+ and Ca2+ imbalance.

Isolated rat hearts were made ischemic for 25 min after an initial recirculating perfusion, followed by 30 min of reperfusion. In some hearts, interventions including administration of ouabain and/or high [K+] in the buffer were performed during the first 10 min of reperfusion. During ischemia, intracellular Na+ (Nai) increased from 15 to 64 mumol/g dry weight (dwt). During reperfusion, Nai declined rapidly (at 10 min of reperfusion: 48 mumol/g dwt, at 30 min: 25 mumol/g dwt) and regular rhythm was recovered within 10 min in hearts without any intervention during reperfusion. 45Ca2+ uptake increased from 0.8 to 7.5 mumol/g dwt after 30 min of reperfusion. Ventricular function recovered by 45%. A 10-min perfusion with 10 or 50 microM of ouabain increased Nai (17 to 21 or 27 mumol/g dwt) with increased left-ventricular (LV) contractile function, but these effects were reversed by combination of high perfusate [K+] (20 mM) in non-ischemic hearts. A 10-min reperfusion with ouabain retarded or stopped the decline in Nai (at 10 min of reperfusion: 54 or 63 mumol/g dwt, at 30 min: 32 or 40 mumol/g dwt). These amounts of ouabain also increased the incidence of ventricular tachyarrhythmias during reperfusion to 30% or 50%, and increased the duration of ventricular fibrillation from 6.5 to 11.5 or 18.0 min. 45Ca2+ uptake reached to 8.8 or 10.0 mumol/g dwt, and function recovered only 35% or 28%. When high perfusate [K+] was combined with ouabain during reperfusion, the retarded decline in Nai, augmented 45Ca2+ uptake, and reduced recovery of function caused by ouabain alone were attenuated. These results suggest that digitalis has toxic effects on reperfused ischemic hearts by inhibition of rapid active outward transport of previously elevated Nai and potentiation of Ca2+ overload.

Animals↗

PubMedDate not supplied

Thermal laser-assisted angioplasty of renal artery stenosis for renovascular hypertension.

Percutaneous transluminal laser-assisted angioplasty of a renal artery stenosis was performed in a 16-year-old woman with renovascular hypertension. The stenotic portion of the renal artery was predilated by delivering Nd-YAG laser energy to the terminal tip of a laser catheter. Although the luminal diameter did not increase sufficiently with laser angioplasty alone, it allowed passage of the balloon catheter and subsequent successful balloon angioplasty. Immediately after dilatation, the patient's blood pressure fell to normal, and plasma renin activity decreased. There were no serious complications. Thermal laser angioplasty seems to be an effective adjunct technique for the treatment of severe renal artery stenosis which does not allow initial passage of a balloon catheter.

Adolescent↗

PubMedDate not supplied

Regulation and function of central nervous system chemokines.

In this paper, we discuss the potential involvement of a new family of cytokines, termed chemokines, in CNS inflammatory pathology. Chemokines are a family of proinflammatory cytokines which are able to stimulate target-cell-specific directional migration of leukocytes. Because of this feature, chemokines may be potent mediators of inflammatory processes. We have previously reported observations indicating that chemokines may be involved in the process of lesion formation during autoimmune inflammation within CNS, and, in particular, are likely participants in the process of influx of inflammatory cells into the CNS parenchyma. We observed also that mechanical injury of brain and subsequent post-traumatic inflammation may in part be mediated by chemokines. Chemokines undoubtedly co-operate with cell-associated adhesion molecules during recruitment of leukocytes from blood to CNS. The sequential expression of soluble and membrane-bound signals for leukocyte migration is an intricate process that can be interrupted by a variety of strategies. Our data suggest that chemokines may represent a promising target for future therapy of inflammatory conditions, including CNS inflammation resulting from varied insults.

Animals↗

PubMedDate not supplied

Suicidal gene therapy for pleural metastasis of lung cancer by liposome-mediated transfer of herpes simplex virus thymidine kinase gene.

Pleural metastasis is one of the most common complications in lung cancers. However, no effective therapy for pleural metastasis has been established thus far. We have constructed a metastatic model of non-small cell lung cancer (NSCLC) by injecting human NSCLC cell lines directly into the left pleural cavity of BALB/c nude mice. Because this model is easy to construct and the results are reproducible, we used this model for a preclinical evaluation of gene therapy for pleural metastasis of NSCLC. We took the novel approach of in vivo lipofection of a suicidal gene to lung cancer cells metastasized to the pleural cavity. A human lung cancer cell line, PC14, was inoculated into the pleural cavity of nude mice. After 1 day, a herpes simplex virus thymidine kinase gene expression plasmid was injected intrapleurally as a DNA-liposome complex, and ganciclovir was subsequently administered for 8 days. The survival rates of the ganciclovir-treated group were significantly better than those of the control groups. Flow cytometric analysis using a green fluorescent protein expression plasmid suggested that the transfection efficiency in the pleural cavity was 13.6%. Moreover, due to a bystander effect with PC14 cells, 10% of the gene transfer efficiency was sufficient to eradicate or suppress pleural metastasis. This preclinical study suggests the therapeutic feasibility of an in vivo lipofection-based suicidal gene/prodrug strategy for pleural metastasis of NSCLC.

Adenocarcinoma↗

PubMedDate not supplied

Endoscopic mucosal resection using a cap: techniques for use and preventing perforation.

Endoscopic mucosal resection (EMR) is one of several local treatments that provide a specimen for histopathological analysis. The authors developed a technique of EMR using a transparent plastic cap (EMRC) in 1992. By using the EMRC procedure, any part of the gastrointestinal tract mucosa can be easily accessed. The technical details of EMRC are described. The authors have performed EMR in 380 cases of gastrointestinal lesions. The most serious complication may be perforation. Two perforations (one in the esophagus and one in the colon) have occurred. By evaluating recorded videotapes, it was determined that the lack of submucosal saline injection was the major cause. Therefore, large volume injection, which creates a large bleb and potentially reduces the risk of perforation, is recommended. Furthermore, target mucosa should be strangulated at the middle part of the created bleb (never strangulated at the base). Particularly in the colon, injecting a sufficient volume of saline and controlling the power of suction are extremely important, because the cap on the colonoscope is relatively large in size.

Digestive System Surgical Procedures↗

PubMedDate not supplied

Modulation of multidrug resistance by cepharanthine in fresh human gastrointestinal tumor cells.

Resistance to doxorubicin (DOX) is mainly due to the effect of P-glycoprotein encoded by the multidrug resistance (MDR) gene. Cepharanthine (CEP) has been shown to circumvent multidrug resistance in P-glycoprotein-expressing cell lines. In the present study, we investigated the augmentation of DOX sensitivity by CEP using an MTT assay, and assessed the correlation between DOX sensitivity and P-glycoprotein expression by flow cytometry, in highly purified fresh human tumor cells obtained from 73 cancer patients. DOX sensitivity was decreased in proportion to P-glycoprotein expression. The cytotoxicity of DOX was increased by CEP in tumor cells possessing low DOX sensitivity. Moreover, there was a significant correlation between the effect of CEP on cytotoxicity and P-glycoprotein expression. Thus, CEP might be able to circumvent DOX resistance in cancer patients.

ATP Binding Cassette Transporter, Subfamily B, Mem↗