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In a newly established model of unilateral, irradiation (IR)-induced injury we compared the outcome after IR to the immature and juvenile brain, using rats at postnatal days 9 or 23, respectively. We demonstrate that (i) the immature brains contained more progenitors in the subventricular zone (SVZ) and subgranular zone (SGZ) compared with the juvenile brains; (ii) cellular injury, as judged by activation of caspase 3 and p53, as well as nitrotyrosine formation, was more pronounced in the SVZ and SGZ in the immature brains 6 h after IR; (iii) the number of progenitor and immature cells in the SVZ and SGZ decreased 6 h and 7 days post-IR, corresponding to acute and subacute effects in humans, respectively, these effects were more pronounced in immature brains; (iv) myelination was impaired after IR at both ages, and much more pronounced after IR to immature brains; (v) the IR-induced changes remained significant for at least 10 weeks, corresponding to late effects in humans, and were most pronounced after IR to immature brains. It appears that IR induces both an acute loss of progenitors through apoptosis and a perturbed microenvironment incompatible with normal proliferation and differentiation, and that this is more pronounced in the immature brain.

ADHESION YOSHIKO KOMOTO, TAKSHI SHIMIZU, KOICHIRO SHIMOYA, KENSHI WASADA, HIROTSUGU FUKUDA, ON FUKUI, SHUSAKU HAYASHI, HIROAKI TSUBOUCHI, MITSUNORI SHIOJI, NAO OKISHIRO-OURA, YUJI MURATA, Osaka University Graduate School of Medicine, Suita, Osaka, Japan, Shimizu Women’s Clinic, Takarazuka, Hyogo, Japan OBJECTIVE: The importance of peritoneal closure at cesarean section is still controversial. To evaluate the incidence of adhesion formation following cesarean section and the association between adhesion formation and peritoneal closure, we examined the relationship between adhesion form and peritoneal closure. STUDY DESIGN: First cesarean sections were randomly performed with or without peritoneal closure between January 1999 and December 2002. When next repeated cesarean sections were performed, we determined the adhesion formation in the peritoneal cavity. The association between previous peritoneal closure and levels of adhesion, operation time, and complications were examined. RESULTS: There is no significant difference between patient characteristics of peritoneal closure group (C-group: n = 27) and non-closure group (NC-group: n = 23), such as maternal age, gestational weeks, and neonatal body weight. There is no difference between the rates of complications of both groups, such as fever, anemia, endometritis, wound infection, urinary tract infection, pneumonia, and ileus. The total blood loss of C-group is not different from that of NCgroup. The incidence of adhesion of C-group (10/27) is significantly higher than that of NC-group (2/23) (P ! .05). The incidence of severe adhesion (adhesiolysis before delivery) of C-group (6/27) is also significantly higher than that of NC-group (0/23) (P = .05). The mean of interval time of skin incision to delivery (I-D time) of C-group is 11.1 minutes and that of NC-group is 7.6 minutes. There is a significant difference between the I-D time of both groups (P ! .001). The mean of total operation time of C-group (46.7 minutes) is significantly longer than that of NC-group (39.7 minutes) (P ! .05). CONCLUSION: The present study demonstrates that surgical peritoneal closure results more advanced adhesion formation. The practice of non-closure of peritoneum should be performed at cesarean section.

To clarilify effects of H2 receptor antagonists on surgical treatment of peptic ulcers, operated cases of the disease for one decade were divided into each early and late 5 years, and comparatively investigated. The number of operative cases of peptic ulcers was decreased by 40% in the late period, however, no difference was noted in the number of emergency operations between both periods. A ratio of emergency to the total operative cases was increased to 62.6% in the late from 39.9% in the early period. No change in causative symptoms of hemorrhage and perforation was noted between both periods, but intractable ulcers were decreased to 28 cases (17.1%) in the late from 93 (33.7%) in the early period. A study of treatment history of late cases revealed that emergently operated cases were more common in untreated cases. Thirteen death cases (3.0%) within a month after surgery were found, which were all poor risk cases operated emergently and having complications. Important prognostic factors appear to include age, preoperative complication, preoperative shock, and time-lag from the onset of the disease to operation.