Examination of the early wound healing process under different wound dressing conditions.

OBJECTIVE: Various types of wound-healing dressings have been used to assist in the healing of surgical wounds. We analyzed the wound-healing process in an animal model using different existing wound dressings. STUDY DESIGN: Full-thickness defects were created using a biopsy punch on the backs of 7-week-old rats. The wounded areas were covered with NEOVEIL (polyglycolic acid [PGA]) or TERUDERMIS (collagen sponge [CS]) affixed using a rat jacket. The wound area, neo-epithelium length, and α-smooth muscle actin (α-SMA) expression were evaluated and compared among the control, PGA, and CS groups. RESULTS: The wound areas in the control group on days 4 and 7 were significantly smaller than those in the PGA and CS groups. The expression of α-SMA in granulation tissue peaked on day 4 for all groups. The expression of α-SMA in the control group on days 4 and 7 after injury was greater than in the PGA and CS groups. However, there was no significant difference in the expression of α-SMA between the PGA and CS groups. CONCLUSIONS: In this study, PGA and CS suppressed wound contracture and reduced expression of α-SMA in wound areas. However, PGA and CS did not affect the neo-epithelium length at the wound site.

Prognostic value of preoperative immunosuppressive acidic protein levels in patients with gastric carcinoma.

BACKGROUND/AIMS: Immunosuppressive acidic protein has been found to suppress both phytohemagglutinin-induced lymphocyte blast formation and mixed lymphocyte reaction in vitro. The level of immunosuppressive acidic protein has revealed clear increases with the progression of cancer, and has been reported to be a useful diagnostic and follow-up marker for ovarian and renal cancer. We examined immunosuppressive acidic protein levels in patients with gastric cancer to examine the influence of clinical parameters. METHODOLOGY: The present study was based on a retrospective analyses of data on 107 patients with gastric cancer, all of whom had been surgically treated in the Department of Surgery II, Kyushu University Hospital from 1988 to 1992. All patients were examined for immunosuppressive acidic protein level, based on a peripheral blood sampling done preoperatively. RESULTS: Significant associations among immunosuppressive acidic protein level and clinicopathological parameters, including lymphatic involvement, vascular involvement, and lymph node metastases were evident. The 5-year survival rates were 75.9% and 92.1% for those with immunosuppressive acidic protein level > or = 355 and < 355, respectively, the value being statistically significant (P < 0.05). CONCLUSIONS: These data show that immunosuppressive acidic protein levels may be related to lymph node metastases. Measurement of preoperative immunosuppressive acidic protein levels may be pertinent for the prognosis of patients with gastric cancer and for follow-up clinical management.

[A case of locally extended rectal cancer responding to intra-arterial infusion therapy via the internal iliac artery].

Chemotherapy with combined administration of 5-FU and l-Leucovorin has been reported to be effective for advanced rectal cancer. A 61-year-old woman with a huge, locally extended advanced rectal cancer was treated with intra-arterial infusion therapy via internal iliac artery. Catheters were inserted from the bilateral femoral arteries to the opposite internal iliac arteries and the bilateral upper and lower gluteal arteries and lateral sacral artery were embolized with a metallic coil. The port was positioned under the skin of her lower abdominal wall. The chemotherapy regimen was 5-FU (500 mg/body) and l-Leucovorin (250 mg/m2), administered over 5 hours once weekly to bilateral reservoirs through an infuser pump. After 5 sessions of the chemotherapy, the perineal pain decreased and the patient no longer needed morphine. Following 34 administrations (at 10 months) of this regimen, reductions of tumor size on pelvic CT and CEA level were confirmed. Side effects of the intra-arterial infusion chemotherapy were pygal dermatitis, leg desensitization, infection of circumferential reservoir and obstruction of the catheter due to flection were observed. Local intra-arterial infusion chemotherapy via the internal iliac artery appears to be effective for local advanced rectal cancer.

Prediction of recurrence after curative resection of gastric carcinoma invading the muscularis propria: a multivariate analysis.

BACKGROUND: In Japan, the incidence of gastric cancer invading the muscularis propria is about 10% of all patients with gastric cancer undergoing surgical resection. Although many prognostic factors for early gastric cancer and advanced gastric cancer have been identified, there are few reports concerning prognostic factors for gastric cancer invading the muscularis propria, and the characteristics of recurrence are not well understood.METHODS: We retrospectively analyzed data on 167 patients with gastric cancer that had invaded the muscularis propria. All patients had undergone curative resection.RESULTS: Recurrences were evident in 37 patients (22.2%). Based on our univariate analysis, the recurrence was associated with lymph node metastases. Multivariate analysis showed that independent risk factors for recurrence were lymph node metastases and location of tumor in the upper or lower one-third of the stomach. With respect to the pattern of recurrence, 17 (46.0%) were secondary to hematogenous recurrence, 8 (21.6%) to peritoneal dissemination, and 6 (16.2%) to a local recurrence in the remnant stomach and in regional lymph nodes. Most deaths occurred during the second year after surgery, and approximately two-thirds of all patients (64.8%) died within 3 years after surgery.CONCLUSION: In patients with the risk factors of lymph node metastases and tumor in the upper or lower one-third of the stomach, lymph node dissection and postoperative adjuvant therapy are vital to try to prevent recurrences, especially during the first 2 years after surgery.

Ultrastructure of the tubular accessory gland in Haemaphysalis longicornis (Acari: Ixodidae).

The paired tubular accessory glands in Haemaphysalis longicornis open at the junction of the cervical and the vestibular parts of vagina via short and narrow ducts. The pseudostratified columnar glandular epithelium covered by the muscle layer consists of both secretory and supporting cells. As feeding proceeds, the secretory cells increase in volume. In ovipositing females, well-developed rough endoplasmic reticulum, the Golgi complex, and membranebound granules that are undergoing exocytosis suggest that the secretory cells are involved in protein synthesis. However, in virgin females that fed 10 days, only small dense granules and no secretion activity were observed. The secretions from the tubular accessory gland may be released into the genital tract during the egg passage through the vagina. However, the supporting cells located between the secretory cells become slender during feeding, cohere to each other at the luminal side, and have a very narrow attachment at the basement membrane. Supporting cells probably help maintain secretory cell shape especially during granular discharge into the lumen. © 1994 Wiley-Liss, Inc.