Rathke's cleft cyst

Two cases of Rathke's cleft cyst which produced symptoms of compression of the optic chiasm are described. The first case has been followed for five years since the operation. No evidence of recurrence has been noticed. The prognosis after a partial removal of the cyst wall seems to be good with this lesion. In the second case, there was clinical and laboratory evidence of hypopituitarism and the CT scan revealed suggestive findings to differentiate the cyst from a pituitary adenoma.     

Long-term results of preoperative hyperthermo-chemo-radiotherapy (HCR) for patients with esophageal carcinoma invading neighboring structures (T4)

PATIENTS: A total of 180 patients with esophageal carcinoma invading the neighboring structures (T4) were surgically treated by esophagectomy and reconstruction in the Department of Surgery II, Kyushu University from January 1965 to April 1997. Any of these cases with distant node metastasis and demonstrating organ metastasis or a combined resection of adjacent structures were excluded from this study. As a result, twenty-six patients treated with preoperative hyperthermo-chemo-radiotherapy (HCR Group), 39 treated either with preoperative radiotherapy or preoperative chemo-radiotherapy (R or CR Group) and 23 non-treated patients (Non-tx Group) were thus entered in this study. RESULTS: The 3-year survival rates after esophagectomy in HCR Group, R or CR Group and Non-tx Group were 26.5%, 0% and 9%, respectively, while the 5-year survival rate of the HCR group was 15.9%. The group with preoperative HCR thus showed a significantly more favorable outcome than R or CR Group and Non-tx Group. (p < 0.05). DISCUSSION: The significant difference observed in the prognosis was thought to be due to the reinforced effect of local regulation due to hyperthermia. Our data thus suggest that preoperative HCR contributes to the prolonged post-operative survival for carcinoma of the esophagus invading the neighboring structures.     

Clinical outcome of surgical treatment for invasive early colorectal cancer in Japan

BACKGROUND/AIMS: Despite the high frequency of early colorectal cancer, little is known about the clinicopathologic features of invasive early colorectal cancer for which endoscopic polypectomy is not indicated. We wanted to determine the clinicopathologic features of these early colorectal cancers. MATERIALS AND METHODS: From 1973 to 1994, a total of 728 patients with colorectal cancer were reviewed retrospectively from hospital records. The clinicopathologic features of the 90 invasive early colorectal cancer patients who underwent major surgeries were compared with those of 626 patients with advanced colorectal cancer. RESULTS: The frequency of early colorectal cancer increased significantly from the periods 1973-1979 to 1990-1994: 0% in the former period and 18.3% in the later period. Minimally invasive surgery was chosen more frequently for the treatment of early colorectal cancers than for the treatment of advanced cancers (p < 0.005). Lymph node metastasis, lymph vessel invasion, and vascular invasion were more prevalent in advanced cancer cases than in early cancer cases (p < 0.005). Lymph node metastasis was found in 7 patients with early colorectal cancer (7.8%). There was no difference in histologic type between the early and advanced colorectal cancers. The 5-year survival rates of early colorectal cancer patients were higher than those of advanced cancer patients: 97.5% in early colon cancer patients; 93.5% in early rectal cancer patients; 59.8% in advanced colon cancer patients; 55.4% in advanced rectal cancer patients. Three early colorectal cancer patients died of recurrence. CONCLUSION: Minimally invasive surgery such as laparoscopic colectomy should be performed on patients with invasive early colorectal cancer when it is impossible for the cancer to be removed by endoscopic polypectomy.     

Oxidant stress incites spreading of macrophages via extracellular signal-regulated kinases and p38 mitogen-activated protein kinase

Cultured macrophages exhibit spreading in response to external stimuli. It is relevant to in vivo morphologic changes of macrophages during extravasation, migration, and differentiation. The present study was performed to elucidate molecular mechanisms that regulate spreading of macrophages. Redox is a crucial factor that modulates a wide range of cell function. We found that macrophages undergo spreading in response to oxidant stress caused by hydrogen peroxide or an oxidant generating agent menadione. To identify signaling pathways involved, a role of mitogen-activated protein (MAP) kinases was investigated. Western blot analysis showed that treatment of macrophages with menadione rapidly induced phosphorylation of extracellular signal-regulated kinases (ERK1, ERK2) and p38 MAP kinase, but not c-Jun N-terminal kinase (JNK). Pharmacologic inhibition of either ERK or p38 activation blunted the macrophage spreading. Similarly, transfection with dominant-negative mutants of ERKs or a mutant p38 significantly suppressed the oxidant-triggered spreading. ERKs and p38 are known to activate serum response element (SRE) via phosphorylation of the ternary complex factor Elk-1. To further identify downstream events, we focused on a role of SRE. Stimulation of macrophages with menadione induced activation of SRE. Intervention in the SRE activation by a dominant-negative mutant of Elk-1 inhibited the menadione-induced spreading. These results suggest that oxygen radical metabolites, the well-known mediators for tissue injury, incite spreading of macrophages via the MAP kinase-SRE signaling pathways.     

Different secretion patterns of adrenomedullin, brain natriuretic peptide, and atrial natriuretic peptide during exercise in hypertensive and normotensive subjects

The purpose of this study was to investigate the effect of exercise on plasma concentrations of adrenomedullin, brain natriuretic peptide (BNP), and atrial natriuretic peptide (ANP) in patients with essential hypertension (n = 15) and in normotensive controls (n = 10). Exercise consisted of two fixed workloads, 40 and 80 watts of work load using a supine bicycle ergometer. Plasma levels of all three peptides at rest were significantly higher in hypertensives than in controls. Plasma concentrations of ANP increased with exercise in both groups and had greater increments in hypertensive patients than in normotensives. Plasma concentrations of BNP increased only in patients with hypertension and the levels of increase correlated with basal plasma BNP levels (r = 0.94, p < 0.001) and with left ventricular mass (r = 0.62, p < 0.01) determined by echocardiography. In contrast, plasma adrenomedullin did not change with exercise in either group. These results suggest that secretion patterns of these peptides are regulated by different mechanisms and that the amount and kind of peptides mobilized by exercise may depend on the underlying diseases or pathophysiologic condition.     

High-power single-longitudinal-mode operation of 1.3 ?m DFB-DC-PBH LD

CW light output power as high as 38 mW at room temperature and with a CW operable temperature as high as 80°C, both under single-longitudinal-mode operation, has been achieved for the first time in newly developed 1.3 ?m distributed-feedback (DFB) laser diodes with a double-channel planar buried heterostructure (DC-PBH).