Surgical Strategy for Low Imperforate Anus in Girls -Cutback Anoplasty , Anal Transplantation or Limited Posterior Sagittal Anorectoplasty?-

From 1991 to 2001, we performed 5 re-operations with limited posterior sagittal anorectoplasty (PSARP) for low imperforate anus in girls who had anteriorly located anus after primary surgery. Four girls were diagnosed with anocutaneous fistula and one girl with anovestivular fistula. Primary operations were one cutback anoplasty and four anal transplantation. None of them underwent colostomies before re-operation with the limited PSARP. The sphincter muscle was cut through a median perineal skin incision and then the rectum was placed at the center of the complex muscles. This limited PSARP could give good anal function and satisfactory cosmetic appearanc

Serum Level of Hyaluronic Acid Does not Correlate with Changes of Hepatic Volume after Portal Vein Embolization

The serum hyaluronic acid (HA) levels are associated with liver regeneration after hepatectomy. In the present study, the HA concentrations were examined to evaluate the relationship with changes of hepatic volume after right portal vein embolization (PVE). The HA level of serum samples from 10 patients who underwent PVE before hepatectomy of the right lobe was measured, and the results were compared to the changed volume of embolized right lobe and unembolized left lobe of the liver. The mean serum HA level in patients with chronic viral liver disease (CVLD) (202+/-118 ng/ml) was significantly greater than in those without CVLD (70+/-24 ng/ml) (p<0.05). The volume of embolized liver decreased 72+/-96 CM3 (-8.9+/-5.5 %), while the volume of unembolized liver increased 106+/-67 CM3 (+8.9+/-5.5 %) 2 weeks after PVE. HA concentrations after 2 weeks of PVE (296+/-216 ng/ml) tended to be greater than that before PVE (134+/-108 ng/ml) but not statistically significant (p=0.105). There were no correlations between serum HA levels before PVE and the changes of hepatic volume in embolized and unembolized lobe after PVE. Our results indicate that the measurement of HA level is not useful for predicting the effect of PVE

Interferon regulatory factor-4 activates IL-2 and IL-4 promoters in cooperation with c-Rel.

Interferon regulatory factor (IRF)-4 is a member of the IRF transcription factor family, whose expression is primarily restricted to lymphoid and myeloid cells. In T-cells, IRF-4 expression is induced by T-cell receptor (TCR) cross-linking or treatment with phorbol-12-myristate-13-acetate (PMA)/Ionomycin, and IRF-4 is thought to be a critical factor for various functions of T-cells. To elucidate the IRF-4 functions in human adult T-cell leukemia virus type 1 (HTLV-1)-infected T-cells, which constitutively express IRF-4, we isolated IRF-4-binding proteins from T-cells, using a tandem affinity purification (TAP)-mass spectrometry strategy. Fourteen proteins were identified in the IRF-4-binding complex, including endogenous IRF-4 and the nuclear factor-kappaB (NF-κB) family member, c-Rel. The specific association of IRF-4 with c-Rel was confirmed by immunoprecipitation experiments, and IRF-4 was shown to enhance the c-Rel-dependent binding and activation of the interleukin-4 (IL-4) promoter region. We also demonstrated that IL-2 production was also enhanced by exogenously-expressed IRF-4 and c-Rel in the presence of P/I, in T-cells, and that the optimal IL-2 and IL-4 productions in vivo was IRF-4-dependent using IRF-4-/- mice. These data provide molecular evidence to support the clinical observation that elevated expression of c-Rel and IRF-4 is associated with the prognosis in adult T-cell leukemia/lymphoma (ATLL) patients, and present possible targets for future gene therapy

Surgical Strategy for Low Imperforate Anus in Girls -Cutback Anoplasty , Anal Transplantation or Limited Posterior Sagittal Anorectoplasty?-

From 1991 to 2001, we performed 5 re-operations with limited posterior sagittal anorectoplasty (PSARP) for low imperforate anus in girls who had anteriorly located anus after primary surgery. Four girls were diagnosed with anocutaneous fistula and one girl with anovestivular fistula. Primary operations were one cutback anoplasty and four anal transplantation. None of them underwent colostomies before re-operation with the limited PSARP. The sphincter muscle was cut through a median perineal skin incision and then the rectum was placed at the center of the complex muscles. This limited PSARP could give good anal function and satisfactory cosmetic appearanc