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The aim of this study was to assess the CT findings that characterise haemoptysis in patients with chronic pulmonary aspergillosis (CPA). We retrospectively identified 120 consecutive patients with CPA (84 men and 36 women, 17–89 years of age, mean age 68.4 years) who had undergone a total of 829 CT examinations between January 2007 and February 2017. In the 11 patients who underwent surgical resection, CT images were compared with the pathological results. The scab-like sign was seen on 142 of the 829 CT scans, specifically, in 87 of the 90 CT scans for haemoptysis and in 55 of the 739 CT scans obtained during therapy evaluation. In 48 of those 55 patients, haemoptysis occurred within 55 days (mean 12.0 days) after the CT scan. In the 687 CT scans with no scab-like sign, there were only three instances of subsequent haemoptysis in the respective patients over the following 6 months. Patients with and without scab-like sign differed significantly in the frequency of haemoptysis occurring after a CT scan (p

In this article, I shall explore how Gregory of Tours, the Gallic sixth-century historian and bishop, understood the persecution in Lugdunum (present-day Lyon) in 177. In Libri historiarum decem and Liber in gloria martyrum, Gregory briefly describes the persecution and names the martyrs, including Irenaeus, the bishop of Lugdunum. According to ancient historians, however, Irenaeus was not a martyr. It has been established that Gregory’s list of martyrs was derived from Eusebius’ Antiquorum martyriorum collectio, of which only fragments had survived in Gregory’s time. In addition, the translation of Eusebius’ Historia ecclesiastica into Latin by Rufinus altered the passage referring to Antiquorum martyriorum collectio. Given the corruption of texts that occurred during late antiquity and the early Middle Ages, another image of the persecution in Lugdunum formed in the eyes of Gregory.

Patient: Male, 57-year-old Final Diagnosis: Febrile neutropenia Symptoms: Fever Medication: Nivolumab Clinical Procedure: Chemotherapy Specialty: Oncology Objective: Adverse events of drug therapy Background: Nivolumab is a human IgG4 monoclonal antibody against human programmed cell death 1 (PD-1). It has demonstrated efficacy against metastatic non-small cell lung cancer (NSCLC). Treatment with nivolumab is sometimes associated with immune-related adverse events (ir AEs) in patients. These specific ir AEs include pneumonitis, hypothyroidism, dermatitis, enterocolitis, hepatitis, and neuropathy. However, hematological toxicity is rare. Case Report: A 57-year-old man with lung adenocarcinoma, with brain and adrenal gland metastases, was therefore started on nivolumab therapy as third-line treatment. After administration of the second dose with nivolumab, grade 3 febrile neutropenia (FN) and grade 2 liver dysfunction developed in the patient. The patient was started to on intravenous antibiotics, granulocyte colony-stimulating factor (G-CSF), and corticosteroids. Neutrophil counts and liver function gradually improved, and corticosteroids were tapered over 6 weeks. However, the patient was re-treated with G-CSF because the neutrophil counts decreased again. Conclusions: Care needs to be taken with such patients because neutropenia due to treatment with nivolumab can recur, as well as other ir AEs.

In 177 AD, the persecution of Christians in Lugdunum increased. The sole extant account of this persecution is a letter preserved in Eusebius’s Ecclesiastical History. However, because of his daring excerpting and muddled terminology, the understanding of the situation of martyrs and confessors of Lugdunum is confusing. In addition, another source about the persecution, Collection of the Ancient Martyrs, was scattered. The purpose of this article is to organize the situation of the martyrs’ deaths and to validate how Eusebius recorded the martyrs and the confessors. For this purpose, I compared the fragments of the martyrs’ lists preserved in the Martyrology of Pseudo-Jerome, the Mar­tyrology bearing the name of Bede, several Passions, Glory of the Martyrs by Gregory of Tours, and Ecclesiastical History by Eusebius. Besides, I analyse the categories of martyrs in the reconstructed list of the martyrs of Lugdunum. As a result, it clarifies the way Eusebius constructed the list of martyrs. This article also contributes to the understanding of the terminology and documentation concerning martyrs and confessors in early Christian documents.

The aim of this study was to assess the CT findings that characterise haemoptysis in patients with chronic pulmonary aspergillosis (CPA).We retrospectively identified 120 consecutive patients with CPA (84 men and 36 women, 17-89 years of age, mean age 68.4 years) who had undergone a total of 829 CT examinations between January 2007 and February 2017. In the 11 patients who underwent surgical resection, CT images were compared with the pathological results.The scab-like sign was seen on 142 of the 829 CT scans, specifically, in 87 of the 90 CT scans for haemoptysis and in 55 of the 739 CT scans obtained during therapy evaluation. In 48 of those 55 patients, haemoptysis occurred within 55 days (mean 12.0 days) after the CT scan. In the 687 CT scans with no scab-like sign, there were only three instances of subsequent haemoptysis in the respective patients over the following 6 months. Patients with and without scab-like sign differed significantly in the frequency of haemoptysis occurring after a CT scan (p0.0001). Pathologically, the scab-like sign corresponded to a fibrinopurulent mass or blood crust.The scab-like sign should be considered as a CT finding indicative of haemoptysis.• Haemoptysis is commonly found in patients with CPA. • A CT finding indicative of haemoptysis in CPA patients is described. • Scab-like sign may identify CPA patients at higher risk of haemoptysis.

SUMMARY. Immunosuppressive acidic protein (IAP) suppresses several immune responses in vivo and in vitro , and high preoperative IAP levels could predict the impairment of the host's immunity. In this study prognostic significance of preoperative IAP levels was investigated in 68 esophageal cancer patients with curative resection and eight with non-curative resection. The curative group had significantly lower levels than the non-curative group (432 ± 183 mg/mL vs. 739 ± 235 mg/mL, P < 0.0001). The IAP levels were associated with T-status (P < 0.0001), lymphatic invasion (P < 0.05), and p-stages (P < 0.0001). When 5-year survival rate of patients with curative resection was compared by setting various cutoff values of IAP between high and low IAP groups, several cutoff points (400-580 mg/mL) were revealed to be significantly associated with survival. Setting cutoff value of IAP to 560 mg/mL resulted in a most significant difference of 5-year survival rate of patients between the high and low IAP groups (13.9% and 61.5%, P < 0.0001). These data indicate that pre-operative IAP level is a useful parameter to predict the prognosis of esophageal cancer patients after curative resection.

Background. To determine the significance of bone marrow disseminated tumor cells in gastric cancer, we investigated the mRNA expression levels of carcinoembryonic antigen (CEA), cytokeratin 19 (CK19), and cytokeratin 20 (CK20) using the real-time quantitative reverse-transcription polymerase chain reaction (RQ-PCR). Methods. Bone marrow samples were aspirated from the sternum at the time of surgery in 65 patients with resectable gastric cancer. Total RNA was extracted from bone marrow; and the expression levels of CEA, CK19, and CK20 mRNA were determined by RQ-PCR using an ABI PRISM 7000 and quantified against the GAPDH mRNA level. Results. The detection limits of these genes were determined in the gastric cancer cell line MKN-45 and the colon cancer cell line C-1, which had been serially diluted in peripheral blood mononuclear cells (PBMCs). A rate of 1 cancer cell/ million PBMCs was obtained by detecting CEA and CK19 mRNA in MKN-45 and by detecting CK20 mRNA in C-1. In the clinical samples, only 1 of the 65 gastric cancer patients (1.5%) who had stage IV disease was positive for CEA, CK19, and CK20 mRNA; none of CEA, CK19, or CK20 mRNA was positive in the remaining 64 patients. No significant correlation was observed between disseminated cancer cells in bone marrow and clinicopathological features, including simultaneous or metachronous hepatic metastasis and patient survival. Conclusion. The incidence of disseminated cancer cells in bone marrow in our study appears low, unlike that in previous reports. The significance of disseminated cancer cells in bone marrow may also be quite low in gastric cancer.

症例は59歳の女性で, 健康診断の上部消化管内視鏡検査にて胃体中部大彎に約10mmの隆起性病変を指摘され, 生検にて胃カルチノイドと診断された. 血液検査では血清ガストリン値が2,069pg/mlと高値であった. 超音波内視鏡検査では粘膜下層までの浸潤が認められた. 胃カルチノイドの診断で手術を施行. 術中色素法によるセンチネルリンパ節 (sentinel node; 以下, SNと略記) 生検にて, SNがNo4dに2個同定され, 1個に転移が認められた. 幽門側胃切除術およびD2リンパ節郭清を施行した. 病理組織検査にて腫瘍は長径9mmで深達度がSM2であり, SNとして同定されたリンパ節以外にリンパ節転移は認めなかった. 胃粘膜に慢性萎縮像は認めなかった. 術後血清ガストリン値は正常化した. sm胃カルチノイドではsm胃癌と同等のリンパ節転移が認められることから, SN生検は術中の正確なリンパ節転移診断法として有用であると思われる.

症例は72歳,男性. 2日前から持続する腹痛および嘔吐を主訴に当院受診.血液検査にて貧血を認め,腹部造影CT検査では腸間膜血腫および腹腔内出血が疑われた.腹部外傷の既往は認めなかった.同日は全身状態が安定していたため経過観察入院とした.翌日,貧血の進行を認め,腹部血管造影検査を施行した.中結腸動脈左枝に狭窄・蛇行・造影剤の血管外漏出を認めたため,腸間膜血腫の診断にて同日緊急手術を施行した.横行結腸間膜内に手拳大の血腫を認め,中結腸動脈左枝に広汎な血栓を認めた.動脈性に出血していた中結腸動脈左枝の辺縁動脈を止血し,横行結腸切除を施行した.病理組織学的検査にて中結腸動脈左枝の辺縁動脈に連続した血栓を認めた.術後精査にて抗カルジオリピン抗体が2回陽性となり,抗リン脂質抗体症候群に合併した腸間膜血腫と診断された.現在,血栓症の再発予防としてアスピリンを内服中であるが,再発を認めていない.

To seek for a candidate gene that would regulate tumour progression and metastasis in gastric cancer, we investigated gene expression profiles by using DNA microarray. Tumour tissue and adjacent normal tissue were obtained from 21 patients with gastric cancer and then examined for their gene expression profiles by the Gene Chip® Human U95Av2 array, which includes 12 000 human genes and EST sequences. A total of 25 genes were upregulated and two genes were downregulated by at least four-fold in the tumour tissue. In a further analysis according to lymph node metastasis, the expressed levels of maspin, as well as carcinoembryonic antigen and nonspecific crossreacting antigen were significantly higher in tumours with lymph node metastasis than in those without it. Maspin expression in 85 gastric cancer patients was further investigated by using immunohistochemistry. Maspin expression was not observed in normal gastric epithelia without intestinal metaplasia. In contrast, maspin was expressed in 74 of 85 tumour tissues. There was a significant correlation between the incidence of maspin-positive tumour staining and lymph node metastasis. These results suggest that maspin has a potential role for tumour metastasis in gastric cancer.

This study was designed to investigate the role of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), and thymidine phosphorylase (TP) in tumor progression and sensitivity to 5-fluorouracil (5-FU).A total of 275 tumor samples from 275 patients with gastric cancer were utilized in this study. TS activity was determined in 130 samples by 5-fluorodeoxyuridine monophosphate binding assay. DPD activity was measured in 140 samples by radioenzymatic assay, and TP protein level was determined in 157 samples by an enzyme-linked immunosorbent assay (ELISA) system. These parameters were compared with several clinicopathologic factors and sensitivity to 5-FU determined by in-vitro ATP assay. The antitumor activities of 5-FU, uracil plus tegafur (UFT), and 1M tegafur--0.4 M 5-chloro-2,4-dihydroxypyridine--1 M potassium oxonate (S-1 [TS-1]) were also compared, using three human gastric cancer xenografts in nude mice.There was no correlation between either TS or TP and sensitivity to 5-FU. However, a weak inverse correlation was found between DPD activity and sensitivity to 5-FU. High DPD activity in tumor resulted in poor prognosis, especially in patients who received 5-FU-based adjuvant chemotherapy. Although TP was significantly correlated with depth of tumor invasion and with lymphatic and venous invasions, TP alone had no impact on survival. On the other hand, TS, as well as peritoneal, hepatic, and lymph node metastases, was selected as an independent prognostic factor in gastric cancer. In the animal model, there was no significant difference in antitumor activities among the drugs in a tumor with low DPD activity. However, S-1 showed superior antitumor activity to 5-FU or UFT in tumors with high DPD activity.DPD is considered to be a most important predictive factor of 5-FU sensitivity. The use of DPD inhibitory fluoropyrimidines is strongly recommended for tumors with high DPD activity.

To evaluate intestinal motility after 80% massive distal small bowel resection (MSBR), we continuously monitored interdigestive and postprandial bowel motility using bipolar electrodes and/or contractile strain gage force transducers in conscious beagle dogs before, and at 0-4 weeks and 8-13 months after the surgery. Fasting duodenal migrating myoelectric (or motor) complexes (MMCs) occurred at longer intervals in the short-term after 80% MSBR than in controls, and were simulated in long-term that in controls. MMCs arising from the duodenum were often migrated to the proximal jejunum, the jejunum above the anastomosis, and to the terminal ileum beyond the anastomosis. The velocity of duodenal MMC propagation was slowed in every intestinal segment in the short-term, and had not recovered even long after the operation. The duration of the postprandial period without duodenal MMCs was prolonged significantly in the short-term, and still remained longer in the long-term than in controls. These findings suggest that changes in gut motility after MSBR tend to compensate for the shorter intestine and maintain small bowel absorption early postoperatively, and adaptations of motility would occur over the long-term to increased intestinal absorption.

円筒形の側壁を有するPCタンクに, 地震時動液圧などの軸に対して逆対称な荷重が作用した場合の断面力を求めるのに, 円筒シェルの基礎式を構成する釣合式のうちの一つを, 大域的なモーメントの釣合式で置き換えることによって, タンク側壁の法線方向の変位に関する常微分方程式を導いた. さらに, このようにして得られた微分方程式は上下ばねおよび回転ばねによって支えられたはりの変形を支配するそれに等価であることを示し, 従来から広く用いられている骨組構造解析用のプログラムを利用して, 容易に数値解析できることを示した.

Dendritic cells (DCs) are potent antigen-presenting cells that are central to the regulation, maturation, and maintenance of the cellular immune response against cancer. In contrast, CD4(+)CD25(+) regulatory T cells (Tregs) play a central role in self-tolerance and suppress antitumor immunity. In this study, we investigated the clinical significance of mature CD83(+) DCs and Foxp3(+) Tregs in the primary tumor and regional lymph nodes from the viewpoint of the two opposing players in the immune responses.We investigated, immunohistochemically, the density of CD83(+) DCs and Foxp3(+) Tregs in primary lesions of gastric cancer (n = 123), as well as in regional lymph nodes with (n = 40) or without metastasis (n = 40).Decreased density of CD83(+) DCs and increased density of Foxp3(+) Tregs were observed in the primary tumor and metastatic lymph nodes. Density was significantly correlated with certain clinicopathological features. Poor prognosis was observed in patients with a low density of CD83(+) DCs and a high density of Foxp3(+) Tregs in primary lesions. For patients with metastatic lymph nodes, the density of CD83(+) DCs in negative lymph nodes was found to be an independent prognostic factor by multivariate analysis.The density of CD83(+) DCs and Foxp3(+) Tregs was inversely correlated with tumor progression and reflected the prognosis of gastric cancer.

In our blood center, we have been screening red cells of donors with various antibodies (monoclonal antibodies, human antisera), Ulex lectin and 2 M urea by the use of Groupamatic-2000 machine and manual technique. We detected 522 donors of the rare phenotype bloods (Rh-positive —Oh: 1, para-Bombay: 2, -D-: 11, Lu (a-b-)·In (Lu): 2, Ko: 10, McLeod-like: 2, Jk (a-b-): 16, SS: 56, Fy (a-b+): 150, Di (a+b-): 53, Jr (a-): 36;Rh-negative— Rhmod: 2, SS: 32, Fy (a-b+): 119, Di (a+b-): 20, Jr (a-): 10).These donors did not contain any irregular antibody in their sera except 1 Bombay and 2 para-Bombay phenotype donors. On the other hand, only 55 rare phenotype donors were detected by antibody screening. Consequently, we are confident that the screening of the rare phenotypes using Groupamatic-2000 machine with monoclonal antibodies is very useful and clinically significant.Our blood center shipped 749 total units of the rare phenotype bloods including 683 units (91.2%) of frozen and thawed red cells from April 1, 1985 to March 31, 1992. Total units shipped of the rare phenotype bloods by all the Japanese Red Cross Blood Centers amounted to 4, 558. Especially, the ratio of Jr (a-) to the total units was 49.3%. Three thousand six hundred and eighteen (79.4%) of the 4, 558 units shipped were frozen thawed red cells.

Claudin, occludin, and zonula occludens (ZO)-1 are known as tight-junction-associated proteins. The aim of this study was to examine the expression of these proteins in gastric carcinoma. Gastric cancer tissues (n = 124) were obtained from 124 patients who underwent gastrectomy at our hospital between January 2000 and December 2004. The expression of the above tight-junction-associated proteins in carcinoma, normal mucosa, and metaplastic epithelium was examined using immunohistochemistry. In addition, the expression of claudin-4 mRNA was examined in fresh frozen tissue obtained from 34 patients. Significant correlations were seen between the expression of claudin-4, occludin, and ZO-1. In regard to claudin-4, significant correlations were seen between the expression of claudin-4 evaluated by immunohistochemistry and the expression of claudin-4 mRNA. Claudin-4 expression was significantly decreased in tumors with undifferentiated-type adenocarcinoma, advanced T stage, lymph node metastasis, and peritoneal metastasis. Occludin and ZO-1 expression was significantly decreased in tumors with undifferentiated-type adenocarcinoma. Overall survival was significantly shorter in patients with low claudin-4 expression. Cox multivariate analysis revealed that low claudin-4 expression was independently associated with significantly decreased overall survival. Tight-junction-associated proteins, particularly claudin-4, may play important roles in determining invasiveness, metastatic potential, and survival in gastric cancer.

The streptococcal preparation OK-432 induces maturation of T cells and dendritic cells (DCs). However, the mechanisms by which OK-432 induces DC maturation are not well understood.The effects of OK-432 and TNF-alpha on peripheral blood mononuclear cells (PBMCs) were compared. Antibody-based approaches were used to detect proteins characteristic of antigen-presenting cells and cytokines. Cytotoxicity was evaluated by measuring the release of LDH after incubation of effector and target cells. The TLR-4 levels were measured by real-time quantitative PCR.Changes in cell surface marker levels were detected in both treatment groups but OK-432 had a greater effect on induction of Th-1-type cytokines. Furthermore, TLR-4 mRNA was up-regulated in cells from two out of five patients in response to OK-432, but not in response to TNF-alpha.OK-432 has a more profound effect on human DCs than TNF-alpha and may act through multiple signaling pathways.

The patient was a 58-year-old man complaining of vomit and body-weight loss of 10 kg with advanced lower thoraco-abdominal esophageal cancer, which was 9 cm in length and with a maximum diameter of 5.5 cm on thoracic CT examination. Moderately differentiated squamous cell carcinoma diagnosed by pre-operative endoscopic biopsy. Low-dose FP therapy (continuous 5-FU div of 500 mg/day with intermittent CDDP div of 5 mg/day) was performed during 4 weeks as neoadjuvant chemotherapy. The side effect was little, and the tumor size was remarkably reduced. A histological complete response was diagnosed with no carcinoma cells evident in the resected specimen. The patient is alive and healthy with no relapse of the carcinoma 30 months after operation. We are first planning neoadjuvant chemotherapy, and then considering the additional radiotherapy after estimating the effect of chemotherapy. Low-dose FP therapy with low-dose cisplatin as a modulator does not show much side effect and is useful for esophageal cancer. We consider that the chemotherapy is more effective preoperatively than postoperatively because it preserves the feeding vessels for transporting the medicine to the focus of the disease.

High-intensity photoluminescence (PL) was obtained for as-prepared porous Si, which was produced by anodization at high concentrations of ethanol. When the porous Si was exposed to ambient air, oxygen rapidly oxidized the surface of the porous Si, and the PL showed a blue shift in wavelength with a slight decrease in intensity within a short time. In the meantime, oxidation with H{sub 2}O extended deep into the porous Si layer through rupturing Si-Si, and the PL showed a gradual increase in intensity with almost no change in the spectra.

The room‐temperature photoluminescence and structure were studied concerning porous silicon which was exposed to ambient air. Water vapor in ambient air gradually oxidized the surface of the porous silicon with developing Si—O—Si bonds. This room‐temperature oxidation progressively replaced an unstable H‐passivated surface with a more stable O‐passivated surface, dramatically increasing the intensity of the photoluminescence.

Silicon dioxide thin films were prepared by a low‐temperature atmospheric‐pressure chemical vapor deposition method. The raw materials were tetrakis(diethylamino)silane and ozone in oxygen gas. The amorphous films were obtained at a substrate temperature above 200 °C. The films were superior in chemical stability and hardness to the films which were prepared from tetraethoxysilane and ozone.

To evaluate the functioning and effectiveness of a 20-cm reversed jejunal segment after 75-80% massive small bowel resection (MSBR), and whether migrating polarity changes or not, we continuously measured the postoperative bowel motility (using bipolar electrodes and/or contractile strain gage force transducers) in interdigestive and postprandial conscious dogs in short- (2-5 weeks) and long-term (6-10 months) after surgery. The fasting migrating myoelectric (or motor) complex (MMC) arising from the duodenum was often interrupted at the jejunum above the proximal anastomosis and did not migrate smoothly to the reversed segment or terminal ileum. In addition, brief small discordant contractions were frequent in the jejunum above the proximal anastomosis and the proximal part of the reversed segment. The duodenal MMCs predominantly propagated to the ileum through the inherent anatomic continuity of the bowel. These findings of the MMC propagation pattern are very similar in short- and in long-term after surgery. The duration of the postprandial period without duodenal MMC activity was markedly longer in short-term, but shorter in long-term (both were significantly longer than in controls). Marked dilatation of the jejunum and reversed jejunal segment was noted across the proximal anastomosis. These results suggest that the transit time and passage of intestinal contents can be delayed and stagnated for at least 10 months after MSBR with a 20-cm reversed jejunal segment. Although, reports on the polarity of peristalsis in the reversed segment in long-term followup have been contradictory in both experimental and clinical studies, this results support the conclusion that the reversed jejunal segment maintains its inherent propagative polarity and pattern over a long postoperative period.

Electrogastrography (EGG) measures the myoelectric and motor activity of the stomach as detected by cutaneous electrodes attached to the epigastrium. The specific frequency of gastric activity is thought to be 3 cycles per minute (cpm) as determined by spectral analysis. EGG was performed to evaluate gastric motor function in 13 patients (mean age 11.6 ± 2.90 years) who had undergone operative repair of a gastric rupture. The EGG results were compared with those of 8 normal, age-matched controls (mean age 9.25 ± 2.14 years). The mean frequency (MSF) (2.84 ± 0.067 cpm) of the postprandial EGG spectra of 5 patients with ruptures at or along the greater curvature was significantly lower (P

To evaluate the long-term function and effective motility of a reversed jejunal segment after extensive small bowel resection, the authors continuously measured postoperative bowel motility during interdigestive and postprandial periods in conscious dogs 6 to 10 months after surgery. The long-term findings were compared with previously reported short-term results measured 2 to 4 weeks after the operation. In the long-term follow-up dogs with a 20-cm reversed jejunal segment constructed after extensive (75% to 80%) small bowel resection, the fasting duodenal migrating myoelectric (or motor) complex (MMC) was often interrupted in the jejunum above the reversed segment, and did not migrate smoothly to the reversed segment or terminal ileum. The MMCs arising from the duodenum predominantly propagated to the ileum through the inherent anatomic continuity of the bowel. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum, above the proximal anastomosis. These findings are similar to those of the MMC propagation pattern noted 2 to 4 weeks after surgery. However, the postprandial duration without duodenal MMC activity was significantly shorter in the dogs with long-term follow-up than in those with short-term follow-up (both were longer than in control dogs). Marked dilatation of the jejunum and reversed jejunal segment was noted across the proximal anastomosis. These results suggest that the transit time and passage of intestinal contents can be delayed and stagnated for at least 10 months after extensive small bowel resection with a 20-cm reversed jejunal segment. Although reports on the polarity of peristalsis in the reversed segment in long-term follow-up have been contradictory in both experimental and clinical studies, this research supports the conclusion that the reversed jejunal segment maintains its inherent propagative polarity and pattern over a long postoperative period.

The introduction of mass screening (MS) has increased the number of patients who have been detected in the early clinical stages as well as the total number of patients who have been detected with neuroblastoma (NB). We investigated the problems of MS by DNA content analysis of NB in 89 patients treated at Niigata University Hospital. Surgical materials were available for 73 of the 89 patients. Of the 27 patients who received MS, 16 NBs were detected and 11 were not. The numbers of patients in the early clinical stages (I, II) were 7 (15.2%) before the introduction of MS an 10 (37.0%) thereafter (P

Ninety-nine consecutive asymptomatic blood donors positive in a first-generation hepatitis C virus antibody assay were tested with second-generation assays. Eighty-six donors were reactive (group A), two were indeterminate (group B), and 11 were non-reactive (group C). Hepatitis C virus RNA was detected in sera from all cases in groups A and B, and in 6 (55%) of the 11 group C cases. The concentration of serum hepatitis C virus RNA was low in groups B and C (range 104–105.5 copies/ml), whereas it was high in the nine group A cases tested (range 107–109 copies/ml). The results indicate that reactivity in second-generation assays for hepatitis C virus antibodies correlates with virus replication, but they are not sensitive enough to screen hepatitis C virus carriers with low viremia.

We assessed hepatitis C virus (HCV) infection in 99 asymptomatic blood donors positive using a first-generation HCV antibody assay. When tested with second-generation assays, 86 (87%) donors were reactive (group 1), 2 (2%) were indeterminate (group 2), and 11 (11%) were non-reactive (group 3). Viraemia was revealed by polymerase chain reaction in all group 1 cases. The 2 group 2 cases and 6 (55%) group 3 cases were also viraemic. Viraemia was confirmed by a branched DNA assay in the 2 group 2 cases and 4 (36%) group 3 cases. Serum HCV RNA levels were further studied using a competitive reverse transcription-polymerase chain reaction assay. All cases in groups 2 and 3 were low viraemic (range 10(4)-10(5.5) copies/ml) compared with the 9 group 1 cases examined (range 10(7)-10(9) copies/ml). No correlation was evident between viraemic levels and antibody cut-off index in the first-generation assay. These findings indicate the possibility that low levels of viraemia can occur in individuals non-reactive in second-generation HCV antibody assays.

To clarify the postnatal developmental changes of the motor activity of the gastrointestinal tract, the frequency and amplitude of spontaneous intraluminal pressure of the isolated stomach, duodenum, jejunum, and ileum of the 1- to 5-week-old rat and adult (over 12 weeks old) were examined in vitro. The spectral frequencies of the spontaneous motor activity of 1- to 2-week-old rat were significantly lower than those of the adult. They became similar to the values of the adult at 3-4 weeks after birth. The amplitudes of spontaneous motor activity of 1- to 3-week-old rats were significantly smaller than those of adults. They became similar to the values of adults at 4 weeks after birth. Body weight, stomach wet weight and the length of the total intestine increased gradually and they were still below the values of the adult even at 5 weeks after birth. The stomach was filled with just milk until the end of 2 weeks. However, by the end of 3-4 weeks, milk and solid food were found in the stomach. By the end of 5 weeks, just solid food was seen in the stomach. Therefore, the motor activity of the gastrointestinal tract at birth seems immature and gradually develops postnatally. It seems to be mature by the end of 3-4 weeks after birth. Interestingly, the time of the pacemaker or motor maturity of the gastrointestinal tract according to spontaneous frequency or pacemaker activity and amplitude seemed almost consistent with the weaning time.

To evaluate the functioning and effectiveness of a reversed jejunal segment after extensive small bowel resection, we continuously measured the postoperative bowel motility (using bipolar electrodes and/or contractile strain gage force transducers) in interdigestive and postprandial conscious dogs at 2 to 5 weeks after surgery. The fasting duodenal migrating myoelectric (or motor) complex (MMC) occurred at markedly longer intervals in dogs with a 20-cm reversed jejunal segment created after 75% to 80% extensive small bowel resection (group 3) than in dogs that received extensive resection alone (group 2) or dogs that underwent construction of a reversed jejunal segment without bowel resection (group 1). The MMC arising from the duodenum was often interrupted at the jejunum above the proximal anastomosis and did not migrate smoothly to the reversed segment or terminal ileum in group 3. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum above the proximal anastomosis in group 3. The duration of the postprandial period without duodenal MMC activity was significantly prolonged in groups 2 and 3. These results suggest that the transit time and passage of intestinal contents were delayed and that the periodical MMC was disturbed in group 3. The delay of transit time was due to prolongation of the interval between duodenal MMCs, the interruption of MMC propagation at the jejunum above the proximal anastomosis, the dominance of MMCs that followed the inherent anatomical continuity of the bowel, and discordant movements across the proximal anastomosis. Functional obstruction could be a potential problem in a 20-cm reversed jejunal segment inserted after extensive small bowel resection.

We describe a male patient presenting with Currarino triad: a recto-urethral fistula, sacral bony deformity, and a presacral teratoma. Clinical screening of his family revealed three additional cases with incomplete forms of this association. Cytogenetic findings in the patient and his mother were normal. This case suggests that the occurrence of an anorectal malformation together with a sacral bony deformity should raise a physician's index of suspicion for associated presacral tumors, and that screening of the patient's family members with sacral radiographs is necessary.

15000 Background: A tight junction is one of components of intercellular junctional complexes and play an important role in maintaining barrier function and cellular porlarity. Claudin, occluding, and ZO-1 are known as trans-membrane proteins which compose tight junction. Roles of these tight junction-associated proteins of gastric cancer is not yet determined. In this study, we investigated expression levels of these proteins in gastric cancer immunohistochemically and compared the results with clinicopathological features of the tumors and patient prognosis. Methods: One hundred and twenty-four gastric cancer patients underwent gastrectomy between 2000 and 2004 were included in this study. Formalin fixed and parafine embedded tissues were sliced into 4-μm sections and immunohistchemistry was performed using anti-claudin-4, anti-occluding and anti-ZO-1 antibodies. Stained slides were investigated and the incidence of positive cells was graded as: 0, negative; 1, < 20 %; 2, 20–80 %; 3, >80 %. Results: The expression of claudin-4, occludin, and ZO-1 was observed at the membrane, and the positivity rates in cancer tissues were 87.1%, 95.2% and 100%, respectively. In concerning with correlation between protein expression and clinicopathologic features, claudin-4 expression was significantly decreased in tumors with undifferentiated type adenocarcinoma (p No significant financial relationships to disclose.

13034 Background: We have previously reported that tumors with high orotate phosphoribosil transferase (OPRT) and low dihydropyrimidine dehydrogenase (DPD) mRNA expression levels showed remarkable sensitivity to 5-fluorouracil (5-FU) by real-time RT-PCR using fresh frozen (FF) tumor samples. However, the use of fresh frozen samples has some limitations. The use of formalin fixed parafine embedded (FFPE) samples has great advantage to apply these technologies for clinical settings. In order to investigate the feasibility of real-time RT-PCR from FFPE samples to predict sensitivitiy to 5-fluorouracil (5-FU), we investigated the gene expression levels of 5-FU metabolism-relating enzymes by real-time RT-PCR from FFPE samples and compared the results from FF samples in gastric and colorectal cancer. Methods: FFPE samples and FF samples were obtained from 46 patients with gastric cancer and 29 patients with colorectal cancer. Gene expression levels of tymidylate synthase (TS), OPRT, thymidine phosphorylase (TP) and DPD were determined by quantitative real-time RT-PCR. In FFPE samples tumor tissue was obtained using laser captured microdissection (LCM). Tumor sensitivity to 5-FU was evaluated by in vitro ATP assay. Results: Gene expression levels of TS, TP, DPD determined from FFPE samples significantly correlated with those from FF samples. Although respective gene expression levels alone failed to show signifcianct correlation with the in vitro 5-FU sensitivity, statistically significant correlation was noted either from the samples of FF or FFPE in both gastric (FF: r = 0.660, FFPE: r = 0.780) and colorectal cancer (FF: r = 0.780, FFPE: r = 0.660), when OPRT/DPD mRNA ratio was applied for comparison with the results of 5-FU sensitivity. Thus, high OPRT/DPD ratio determined from FFPE samples resulted in high sensitivity to 5-FU. Conclusions: From these results, it is suggested that sensitivity to 5-FU is predictable by quantitative RT-PCR using FFPE samples. Measurement of 5-FU metabolism-relating enzyme gene expression level from FFPE samples appeared to be feasible for predicting 5-FU sensitivity and to have great advantage to apply the molecular predicting assay in clinical settings. [Table: see text]

4143 Background: Five-fluorouracil (5-FU) is still one of the key-drug for chemotherapy in gastric and colorectal cancer. Therefore, prediction of 5-FU sensitivity is of great importance for chemot...

4200 Background: We had previously reported that peritoneal micrometastasis determined by CEA mRNA level in peritoneal washings using real-time quantitative RT-PCR (RQ-PCR) is a good predictor for ...

The proposita was a healthy 51-year-old female donor who was brought to our attention when her serum reacted with all the cells tested except two Ko samples by saline, bromelin, albumin and anti-globulin methods.The proposita's cells failed to react with anti-K, anti-k, anti-Kpa, anti-Kpb, anti-Kpc, anti-Jsa, anti-Jsb and anti-Ku as expected. These negative reactions were reconfirmed by absorption-elution tests with appropriate sera. These findings indicated that the proposita was Ko with anti-Ku in her serum. Furthermore, she was found to be SS besides Ko, which is exceedingly rare in Japanese.A family study disclosed that the Ko phenotype occurred in two successive generations.Our experiments showed that the three samples of anti-Ku including the proposita's were absorbed by cells from the platelets layer, but the other antibodies of the Kell system such as anti-k, anti-Kpb, anti-Kpc and anti-Jsb were not.