[A case of synchronous resection of double cancers in the lung and stomach through median sternotomy and abdominal incision].

A 72-year-old male was admitted to our clinic for the treatment of early stomach cancer. A chest X-ray film on admission showed a mass in the right lung field. CT scan and transbronchoscopic lung biopsy revealed lung cancer (C-T2N2M0-stage IIIA).

Dilatation mechanism of balloon angioplasty in children: assessment by angiography and intravascular ultrasound.

Purpose: Little information is available about the dilatation mechanism in children. This prospective study aimed to (1) evaluate the dilatation mechanism of balloon angioplasty in children with arterial stenosis, and (2) compare the morphological changes seen by intravascular ultrasound (IVUS) and angiography.

Methods: Twenty consecutive patients, who had undergone a total of 23 procedures, were examined before and immediately after balloon angioplasty with a 4.

Retrograde cerebral perfusion exceeding 120 minutes in aortic arch reconstruction: a report of two cases.

The time limits for retrograde cerebral perfusion (RCP) during aortic arch reconstruction have yet to be clarified. We herein present two cases with periods of RCP exceeding 120 min during aortic reconstruction; both patients recovered uneventfully with no neurological deficits. These data suggest that RCP, as an adjunct to hypothermic circulatory arrest, may prolong the circulatory arrest time and thus prevent ischemic injury of the brain, even when RCP exceeds 120 min.

Physico-chemical Properties of Fatty Acids for Assessing the Threshold Concentration to Enhance the Absorption of a Hydrophilic Substance.

The effects of natural and non-natural fatty acids on enhancing the absorption of a hydrophilic marker through a human epithelial cell (Caco-2) monolayer were measured to elucidate the properties of the fatty acids. Fatty acids from C9 to C14 enhanced the absorption depending on the concentration and the carbon chain length. Those fatty acids with longer chains gave a higher permeability coefficient at low concentrations and a lower toxicity than those with shorter chains.

Global epidemiology of sarcoidosis. What story do prevalence and incidence tell us?

Textbooks of clinical medicine often begin with "epidemiology" of the disease by describing the distribution of patients' characteristics in terms of age, gender, race, and so on. As a result, many clinicians erroneously think the description of such distribution is a role only for epidemiology. The real role of epidemiology, however, is to search for the determinants of and ways to prevent the disease.

Histopathological studies on spontaneous occlusion of the circle of Willis (cerebrovascular moyamoya disease).

Spontaneous occlusion of the circle of Willis (cerebrovascular Moyamoya disease; SOCW) was first described by Japanese surgeons and is thought to have a high incidence in the Japanese population. SOCW is characterized by the angiographical findings of the obstructive vascular lesions around the terminal portions of the internal carotid arteries and the formation of abnormal vascular networks visualized in the arterial phase without any definite underlying conditions. Here, we present a detailed histopathological observation of 31 autopsy cases with SOCW to discuss its etiology which is still a matter of dispute.

Dissemination in Japanese hospitals of strains of Staphylococcus aureus heterogeneously resistant to vancomycin.

Background: Since the discovery of the vancomycin-resistant Staphylococcus aureus (VRSA) strain Mu50 (minimum inhibitory concentration [MIC] 8 mg/L), there has been concern about the potential spread of such strains throughout Japanese hospitals. Two important questions need to be answered: (1) what is the prevalence of VRSA, and (2) by what mechanism does vancomycin resistance occur.

Methods: The vancomycin susceptibilities of three methicillin-resistant S aureus (MRSA) strains (Mu50, Mu3, and H1) and the methicillin-susceptible S aureus type strain FDA209P were compared by MIC determinations and population analysis.

Malignant fibrous histiocytoma of the cecum: report of a case and review of the literature.

Malignant fibrous histiocytoma (MFH) of the gastrointestinal tract is extremely rare. Here we report a case of MFH of the cecum and review other cases of large bowel MFH in the literature. A 64-year-old man had a large tumor mass in the cecum associated with multiple small peritoneal implants.

Immunohistochemical and ultrastructural investigation of the human vestibular dark cell area: roles of subepithelial capillaries and T lymphocyte-melanophage interaction in an immune surveillance system.

Background: The aim of the present study was to morphologically characterize the structure of the subepithelial blood vessels in the dark cell area of the human vestibular organs, and to determine whether immunocompetent cells such as macrophages and lymphocytes could be found around these small blood vessels.

Materials And Methods: All 31 surgical specimens (semicircular canals and utricles) were obtained from patients with vestibular schwannoma. Formalin fixed specimens were stained with hematoxylin and eosin (H&E), and with antibodies to von Willebrand Factor (vWF), leukocyte common antigen (LCA), and UCHL-1, and were examined with light microscope.

[Descending necrotizing mediastinitis secondary to retropharyngeal abscess--a case report].

A 69-year-old man complained of a sore throat, neck swelling, and disturbance of swallowing with dyspnea. He underwent tracheostomy and cervical drainage. The plain chest roentgenogram and CT scans suggested mediastinitis, so he was transferred to our hospital.

Long-term effects of water-soluble corn bran hemicellulose on glucose tolerance in obese and non-obese patients: improved insulin sensitivity and glucose metabolism in obese subjects.

We examined the effect of soluble corn bran hemicellulose (CBH, 10 g/day) on glucose control and serum insulin in three groups: patients with impaired glucose tolerance (IGT) with (20 subjects) or without (8 subjects) obesity and with healthy non-obese controls (10 subjects). Long-term supplementation (6 months) with CBH decreased the post oGTT curve for patients with impaired mild Type II diabetes, but not that for the controls. Hemoglobin A1c decreased significantly during CBH supplementation in the obese patients, while the fasting glucose level decreased in all three groups, although not significantly.

Complications after cyst excision with hepaticoenterostomy for choledochal cysts and their surgical management in children versus adults.

The aim of this study was to review the cases 200 children and 40 adults who had cyst excision combined with hepaticoenterostomy (CEHE) for choledochal cyst, with particular emphasis on post-CEHE complications and their surgical management. Patients who had CEHE at the age of 15 years or less were defined as children, and those aged 16 years or older were defined as adults. The mean age when patients became initially symptomatic was 3 years in children and 26 years in adults.

A hybrid carcinoma: adenoid cystic carcinoma and salivary duct carcinoma of the salivary gland. An immunohistochemical study.

Hybrid tumours of the salivary glands are very rare entities composed of two different tumours, each of which conforms with an exactly defined category. We describe an unusual hybrid carcinoma of the palate; it was comprised of an adenoid cystic carcinoma and a salivary duct carcinoma with a transitional region. These two different compartments showed different characteristics as regards cellular differentiation, proliferative activity, and expression of oncogene and tumour suppressor oncogene proteins, as revealed by using markers for muscle actin, keratin, vimentin, S-100 protein, GFAP, Ki-67, p53, and c-erbB-2 proteins.

Expression of interstitial collagenase (matrix metalloproteinase-1) in gastric cancers.

The expression of matrix metalloproteinase-1 (MMP-1) gene and the presence of MMP-1 protein in gastric cancer were examined by in situ hybridization and immunohistochemistry. Expression of the interstitial collagenase (MMP-1) gene was detected within the stroma of the neoplastic glands, and infiltration of eosinophils was observed to be associated with regions of MMP-1 gene expression. The degree of eosinophilic infiltration correlated with the level of MMP-1 mRNA expression.

Retrograde cerebral perfusion through antero-axillary thoracotomy in the aortic arch surgery.

Objective: We have recently found that left antero-axillary thoracotomy provides an ideal view of aortic arch and makes the direct cannulation to superior vena cava possible for retrograde cerebral perfusion during circulatory arrest.

Method: Twelve patients with distal aortic arch aneurysm or aortic dissection underwent the repair of aortic arch through this approach. Mean duration of retrograde cerebral perfusion was 41 min.

[Concealed infective endocarditis].

The occurrence of concealed infection or "natural remission" in infective endocarditis was investigated microscopically in 35 consecutive patients (36 valves) with infective endocarditis (between April 1987 and May 1995). Four patients were considered as having concealed or silent infective endocarditis. Preoperative diagnosis of these patients was mitral valve prolapse, rheumatic aortic valve stenosis with insufficiency, aortic valve prolapse and hypertrophic cardiomyopathy, respectively.

Endoscopic monitoring of operative procedures during cardiac surgery.

Both intracardiac repair and fine anastomotic procedures are hard to visualize in the sterile operative field. To overcome this problem, we have recently developed an endoscope video system for intraoperative monitoring in open heart surgery. The endoscope can be introduced into the cardiac cavity in a sterile fashion and thus be used to visualize intracardiac lesions as well as the operative procedures.

Differentiating agent, hexamethylene bisacetamide, inhibits neointimal formation after vascular injury.

Background: Hexamethylene bisacetamide (HMBA), a potent differentiating agent of transformed cell lines, has been reported to affect phenotypic modulation and suppress proliferation of vascular smooth muscle cells (VSMCs). The effects of HMBA on the growth of VSMCs were studied in the rat carotid injury model.

Methods: HMBA was added to culture medium of VSMCs explanted from aorta of Sprague Dawley rats and the cell number was counted after 5 days of incubation.

Temporal alterations of endothelial-vasodilator functions in lung injury induced by monocrotaline.

To assess the time course of alterations in pulmonary endothelial vasodilator functions during pathological development of pulmonary hypertension (PH) and right ventricular hypertrophy (RVH), we examined changes in serotonin (5-HT) removal rates and the production of prostacyclin (PGI2) and nitric oxide (NO) in isolated rat lungs harvested at various times after single exposure to monocrotaline (MCT). We assessed the generation of vasodilator substances under conditions of both the absence and the presence of 5-HT in lungs perfused with blood-free solution. Major findings included: (i) remodeling of the pulmonary vasculature associated with RVH evident 14 days after MCT injection; (ii) the capacity for 5-HT removal was suppressed at day 1 and 7 but had been restored by day 14 after MCT exposure; (iii) basal PGI2 production in the absence of 5-HT was augmented at day 1 but had returned to control levels in lungs harvested 7 or 14 days postinjection of MCT; (iv) PGI2 production evoked by 5-HT was suppressed in MCT lungs obtained at all time points examined; (v) basal NO production was suppressed at day 1 but enhanced at day 7 and 14 in MCT lungs; (vi) NO production elicited by 5-HT stimulation in 1-day-MCT lungs was obviously suppressed while that in 7- and 14-day-MCT lungs had been restored to the control level.

Ascending aorta to supraceliac abdominal aorta bypass for coarctation of the aorta in an adult.

We present herein a case of ascending aorta to supraceliac abdominal aorta bypass for coarctation of the aorta in a 46-year-old woman with a history of hypertension. Because of severe calcification of the coarctation segment, we performed an ascending aorta to supraceliac abdominal aorta bypass instead of a conventional resection and anastomosis of the coarctation segment. Following surgery, the patient's blood pressure normalized, and she was discharged on the 14th postoperative day without any complications.

Assay of gamma-glutamyl transpeptidase activity in amniotic fluid offers a possible prenatal diagnosis of biliary atresia in the rat model.

Muller et al. analysed gamma-glutamyl transpeptidase (GGTP) activity in the amniotic fluid of more than 2000 pregnant women for a prenatal diagnosis. They reported that at 18-19 weeks' gestation, two fetuses associated with lower amniotic fluid GGTP levels were diagnosed after birth as having biliary atresia (BA).