[原著］A Histochemical Comparative Study on Four Different Types of Lectins and Carcinoembryonic Antigen (CEA) on Human Colorectal Tissues

To evaluate the specificity and efficacy of lectin histochemical staining characteristics on human colorectal neoplastic and adjacent non-neoplastic tissue, a thorough comparative study has been performed to that of a recognized colorectal tumor marker,carcinoembryonic antigen (CEA). Neoplastic tissue and adjacent non-neoplastic mucosa of 26 surgically extirpated specimens were examined lectin histochemically by four differentlectins (Ulex europaeus-I. Arachis hypogaea, Triticum vulgare and Canavaha ensiformis) and immunohistochemically by anti CEA antibody. According to their degree of staining all the four lectins(UEA-I moderate 57.69%, extensive 39.42%; PNA moderate 60.57% extensive 5.76%; WGA moderate 76.92% extensive 1.92% and Con-A moderate 48.07%. extensive 51.29%) and CEA (moderate 66.34%,extensive 22.11%)showed very high percentages of positive staining for neoplastic tissues but almost reciprocal results were observed by UEA-I (moderate 7.69%, extensive O%) and partially by PNA lectin (moderate 15.38%,extensive O%) for non-neoplastic mucosa (P0.05). Further study regarding their staining pattern revealed that for neoplastic tissues UEA-I mainly stained the cytoplasmic (without polarity) (60.58%) or the stromal (28.85%) types but in case of non-neoplastic mucosa the cytoplasmic (with polarity) (57.15%) or the apical (35.71%) types predominated. No such distinct staining patterens were observed for CEA and the other lectins. From our study it is strongly suggestive that UEA-I lectinis by far morespecific and localized for the malignant transformation of colorectal tissues with compared to that of carcinoembryonic antigen, CEA.論文http://purl.org/coar/resource_type/c_650

[原著］Protective effects of lidocaine in hepatic ischemia : reperfusion injury in-vivo and ex-vivo

We investigated the effect of lidocaine on hepatic ischemia/reperfusion (I/R) injury in the rat both in vivo (ExperimentA, groups 1 to 3) and ex vivo (Experiment B, groups 4 to 7). In Experiment A, hepatic ischemia were performed for 60 min at room temperature. In groups 1 and 2, physiological saline (group 1, n=5) or 10 mg/kg of lidocaine (group 2, n=5) was injected through the peripheral vein, before the hepatic ischemia. In group 3 (n=5), 10 mg/kg of lidocaine was injected twice at reperfusion and before hepatic ischemia. The hepatic tissue blood flowingroup 1 was lower than in group 2 or 3 at 5 min to 90 min after reperfusion. Serum transaminase level was significantly lower in group 3 compared to that in group 1 at 2 hours after reperfusion. In Experiment B, livers were removed from the rat and preserved in saline at room temperature for 60 min, followed by 120 min of reperfusion with oxygenated perfusate at 37℃. The livers were perfused with Krebs-Henseleit solution (group 4, n=5). The perfusate was supplemented with lidocaine in group 5 (n=5), 3.5×10^6 of neutrophil in group 6 (n=5), and both lidocaine and neutrophils in group 7 (n=5). The levels of GOT, GPT and LDH were all significantly lower in group 7 than in group 6. These data thus suggest that lidocaine plays a protective role in hepatic I/R injury by stabilizing both the hepatocytes and the neutrophil membrane.論文http://purl.org/coar/resource_type/c_650

[原著］Effect of Bcl-2 expression on morphological alteration of hepatic mitochondria in liver regeneration after a partial hepatectomy : An immunohistochemical and ultrastructural study

We investigated the effects of Bcl-2 0verexpression on the morphological changes of the mitochondria (MC) in the regenerating rat liver after a 70% partial hepatectomy (PH). Bcl-2 or control marker (LacZ) gene transfection to the regenerating liver was performed immediately after PH by a systemical injection of 1X10^9 pfu/body of recombinant adenovirus, which encodes either human Bcl-2 protein (ACalbBcl2pLpA) in group 1 (n=39) or E.Coli $\beta$-galactosidase (AxCALacZ) in group 2 (n=39). Ingroup3 (n=13), 1ml of normal saline was injected instead of the recombinant adenovirus. The rats were allowed to survive until the scheduled sacrifice at 0.5h, 2h, 4h, 12h, 24h, 2d, 3d, 5d, 7d, 9d, 11d, 14d, and 21d after PH (3 rats each). In the immunohistochemical analysis, the Bcl-2 protein expression showed a peak intensity at 12 to 72 hrs after PH in group 1, whereas it was delayed until 5 days after PH in groups 2 and 3 vMth a rather mild intensity, followed by a gradual decrease in all three groups. At its peak intensity, the Bel-2 protein expression was recognized over a wide range of the parenchymal area as well as in the penportal area. The $\beta$-galactosidase activities in X-gal staining, showed apeak intensity at 48 hrs after PH followed by a gradual decrease until 21 days after PH in group 2. In the hepatocyte ultrastructure, MC shape was well preserved in group 1 until 7 days after PH with number of regular shaped mitochondria, well preserved cristae and dense matrix (RM) being $58 \pm 22$% at 12hrs and $60 \pm 21$% at 24 hrs, compared to groups 2 ($36 \pm 23$% at 12hrs and $40 \pm 15$% at 24hrs, p≦0.015 and ≦0.004 respectively) and 3 ($29 \pm 11$% at 12hrs and $35 \pm 12$% at 24 hrs, p≦0.0004 and ≦0.0015 respectively). In conclusion, Bcl-2 0verexpression in the regenerating liver was important in preserving mitochondrial shape in the early stage of liver regeneration, thus contributing to an accelerated liver regeneration.論文http://purl.org/coar/resource_type/c_650

[症例報告]Radiation-induced malignant lymphoma of the ileum : a case report

A case of intestinal malignant lymphoma which developed as a result of radiotherapy for uterine cervical cancer is herein reported. A 67-year-old female who underwent radiotherapy at a total dose of 74 Gy for uterine cervical cancer in 1988 was referred to our Obstetncs and Gynecology Department on October 6, 1995 with a chief complaint of lower abdominal distention. An abdominal CT scan showed pyometra and a large heterogeneous dense mass at the ileocecal region. After draining the pyometra, she developed an intestinal obstruction and was referred to our Department on the 4th hospital day. Despite conservative treatment, her general condition continued to deteriorate and an exploratory laparotomy was performed 2 weeks after admission. A laparotomy revealed a large inflammatory mass consisting of a folded lleum with radiation damage, and this mass was resected with the affected ileum. In the resected specimen, the tumor appeared as an inflammatory conglomerated mass forming a whitish, hard mass expanding to the mesentery and infiltrating into the adjacent ileum. Microscopically, the tumor was diagnosed as malignant lymphoma (diffuse, medium-sized cell and B-cell type) and the adjacent ileum showed a radiation enteritis. Since this neoplasm developed within the irradiated field 7 years after radiotherapy, and had a different histologic type, while the organ of origin was also differed from the initial cancer, the patient was thus diagnosed as having radiation-induced malignant lymphoma.論文http://purl.org/coar/resource_type/c_650

[症例報告]Small Cell Carcinoma of the Gallbladder Associated with an Ordinary Adenocarcinoma : A Mixed Type Tumor

A small cell carcinoma associated with an ordinary adenocarcinoma (mixed type tumor) of the gallbladder in a 49-year-old man is presented herein. Macroscopically, the gallbladder showed an annular, diffuse thickening of the body and fundus. The commonbile duct distal to the cystic duct was also segmentally constricted by infiltration of carcinoma. Microscopically, the tumor of the gallbladder was composed of two neoplastc components; an ordinary adenocarcinoma and a small cell carcinoma. The ordinary adenocarcinoma replaced the mucosa with invasion to the muscularis, while the small cell carcinoma revealed extensive spread with vascular invasion into the commonbile duct. Both tumors were partially intermingled with occasional transitional zones. Following pancreaticoduodenectomy, the patient had been placed on adjuvant chemotherapy, however expired with clinical manifestations of recurrence of carcinoma five months after surgery.論文http://purl.org/coar/resource_type/c_650

[原著］Graft-directed gene transfection in a rat model of liver transplantation

In this model of liver transplantation, liver grafts were transfected with the El-deleted, replication-defective adenovirus vectors encoding the LacZ gene driven by the human CMV promoter, or the replication-defective retrovirus vectors encoding the human IL-7 and neomycin phosphotransferase genes. Liver grafts were perfused ex-vivo with either of these two vectors during cold preservation time. In adenovirus-mediated gene transfer, positive staining of the hepatocyte was recognized predominantly around the portal triads at post-operative day 2. Positive staining was observed until 14 days after transfection. In a retrovirus-mediated gene transfection, gene transfection was tested both in a whole-size and a reduced-size graft implantation of the liver because the retrovirus vector requires a replication of the target cells for gene transfection. In conclusion, adenovirus-mediated gene transfection to the liver graft during cold preservation time resulted in an effective expression of the transfected sequence. On the other hand, retrovirus vector required the reduction of the liver graft for a successful gene transfection.論文http://purl.org/coar/resource_type/c_650

[症例報告]Carcinosarcoma (sarcomatoid carcinoma) of the Gallbladder Presenting with a Cholecystocolic Fistula and a Marked Leukocytosis : A Case Report

We herein report a case of carcinosarcoma (sarcomatoid carcinoma) of the gallbladder with a cholecystocolic fistula and evidence of marked leukocytosis in a 77-year-old Japanese man. The patient presented with episodes of right upper quadrant pain and fever in April 2000. The physical examination revealed a painful, palpable mass in the right upper quadrant. Routine laboratory findings showed leukocytosis (18.000/mm^3). Abdominal sonography showed an echogenic mass occupying the entire gallbladder lumen. Abdominal CT demonstrated a solid mass lesion measuring 8×7 cm in size with a clear, hypodense asterisk configuration, suggesting a communication between the gallbladder and the gastrointestinal tract. At exploratory laparotomy, a large solid gallbladder tumor showed direct invasion into the transverse colon and regional lymph node metastasis. The tumor was evaluated to be Stage IV. With the intention of performing cytoreductive surgery, a cholecystectomy together with a partial transverse colectomy was thus performed. The gallbladder tumor showed penetration into the transverse colon, forming a cholecystocolic fistula. On a cut section analysis, the tumor occupied the entire gallbladder lumen and measured 7×5 cm in size. No gallstones were observed. The tumor was composed of two different histologic features: an adenocarcinomatous feature that was composed of moderately differentiated adenocarcinoma and a sarcomatous feature that consisted primarily of pleomorphic, spindle cells. Immunohistochemically, the adenocarcinoma cells were positive for keratin, EMA and CEA whereas the sacomatous spindle cells were positive for vimentin and CEA. However, both the carcinoma cells and sarcomatous cells were negative for G-CSF. Postoperatively, the patient's WBC counts increased from 26.9×10^3/mm^3 to 103.0×10^3/mm^3. Finally, the patient died with clinical manifestations of peritonitis carcinomatosa one month after surgery.論文http://purl.org/coar/resource_type/c_650

Interactive cueing with walk-Mate for Hemiparetic Stroke Rehabilitation

Background: Many techniques that compensate for locomotion problems in daily life using externally controlled stimulation have recently been reported. These techniques are beneficial for effortlessly supporting patients' locomotive functions, but the users of such devices must necessarily remain dependent on them. It is possible that some individuals with gait impairment may be prevented recovering locomotive function. From a rehabilitation viewpoint, it may therefore be supposed that ideally, devices that can be used in daily life to improve the locomotive functions of the body itself should be proposed. Methods: We evaluate the effectiveness of Walk-Mate, which has been used mainly as a gait compensation device, as a gait rehabilitation training device by analyzing improvement in locomotion before, during and after rehabilitation in hemiparetic patients and comparing it with a previous gait training method. Walk-Mate generates a model walking rhythm in response to a user's locomotion in real time, and by indicating this rhythm using auditory stimuli, provides a technology that supports walking by reducing asymmetries and fluctuations in foot contact rhythm. If patients can use the system to learn a regulated walking rhythm, then it may also be expected to fulfil the functions of a gait rehabilitation training device for daily life. Results: With regard to asymmetry, significantly improvements were seen for compensatory movement during training using Walk-Mate, but improvements were not retained as rehabilitative results. Regarding fluctuations in the foot contact period, significant improvement was observed for compensatory movement during training and these significant improvements were retained as rehabilitative results. In addition, it became clear that such improvement could not be adequately obtained by the previously proposed training technique utilizing constant rhythmic auditory stimulation. Conclusions: Walk-Mate effectively compensated for locomotion problems of hemiparetic patients by improving gait rhythm both during and after training, suggesting that locomotive function can be effectively recovered in some patients. The interactive mechanism of Walk-Mate may be capable of simultaneously achieving the aims of gait compensation and gait rehabilitation training methods previously developed under individual frameworks. Walk-Mate is a promising technology for assisting the reintegration of disabled persons into society

[症例報告]Retroperitoneal Paraganghoma : A Case Report

A case of 47-year-old woman of a retroperitoneal paraganglioma arising from the organs of Zuckerkandl with metastatic tumors is presented herein. The tumor was apparent 7 years after pancreaticoduodenectomy for carcinoma of the duodenal papilla, and located in the retroperitoneum along the abdominal aorta just proximal to the inferior mesenteric artery. It was hypervascular, lobular with a cystic area and 4 × 3.5 × 2 cm. in size. Microscopically paraganglioma was characteristic. Although only conservative excision of the mass in the retroperitoneum was of surgical treatment, the patient has been free from any symptoms and doing well 8 months after surgery.論文http://purl.org/coar/resource_type/c_650

[症例報告]Huge Carcinoid Tumor of the Gallbladder : A Case Report

A case of a huge carcinoid tumor of the gallbladder in a 68-year-old Japanese woman is reported herein. The patient presented with a huge mass in the right upper quadrant of the abdomen without a carcinoid syndrome. Diagnostic modaliLies demonstrated a huge tumor suggesting some malignant tumors of the gallbladder. Right hepatectomy with cholecystectomy and regional nodal dissection was carried out. The tumor together with the right hepatic lobe weighed 3,018 gm and the tumor itself measured 23× 18× 16 cm in size. Upon bisection, it was solid and well circumscribed, containing gallstones without any spread to the liver and regional lymph nodes. Microscopically, the tumor was composed of solid or trabecular nests with atypical polygonal cells which were argyrophil positive, expressed by CEA and chromogranin A, but not by NSE. They possessed several dense core neurosecretory granules on electron microscopic examination. Based on these morphological data, this carcinoid tumor was thought to be categorized as an endocrine cell carcinoma of a poorly differentiated carcinoid. The patient expired eight months after surgery with massive hepatic metastases. This case might be the largest carcinoid tumor from this location reported in literature.論文http://purl.org/coar/resource_type/c_650