Mucosal invasion by fusobacteria is a common feature of acute appendicitis in Germany, Russia, and China.

BACKGROUND/AIM: To investigate the geographic occurrence of mucosa-invading Fusobacteria in acute appendicitis. PATIENTS AND METHODS: Carnoy- and formalin-fixated appendices from Germany, Russia, and China were comparatively investigated. Bacteria were detected using fluorescent in situ hybridization. Cecal biopsies from patients with inflammatory bowel disease and other conditions were used as disease controls. RESULTS: Fusobacteria represented mainly by Fusobacterium nucleatum were the major invasive component in bacterial infiltrates in acute appendicitis but were completely absent in controls. The occurrence of invasive Fusobacteria in Germany, Russia, and China was the same. The detection rate in Carnoy-fixated material was 70-71% and in formalin-fixated material was 30-36%. CONCLUSIONS: Acute appendicitis is a polymicrobial infectious disease in which F. nucleatum and other Fusobacteria play a key role.

[Segmental resection of the liver by Glissonean pedicle transection for primary liver cancer].

OBJECTIVE: To study the clinical effect of segmental resection of the liver using Glissonean pedicle transection for primary liver cancer. METHODS: The clinical data of 55 primary liver cancer patients admitted from January 2006 to October 2008 were analyzed retrospectively. Twenty-five of the patients underwent segmental resection of the liver by Glissonean pedicle transection (group A), and 30 underwent routine hepatectomy (group B). The positivity rate of the resection margin, micrometastasis in the hepatic parenchyma surrounding the lesions and postoperative recurrence rates were investigated. RESULTS: The positivity rate of the resection margin was 4.0% in group A, significantly lower than that of group B. The number of histological micrometastasis was significantly higher in group A than in group B (16 vs 8). The median distance of histological micrometastasis was 6.8 mm (2.7-25.6 mm) in group A and 4.2 mm (2.4-9.0 mm) in group B. The one-year recurrence rate was significantly lower in group A than in group B (16% vs 26.7%). CONCLUSION: Glissonean pedicle transection for segmental liver resection is a simpler procedure than routine hepatectomy for primary liver cancer and can reduce the number of histological micrometastasis and recurrence rate.

Cluster of acute hemorrhagic appendicitis among high school students in Wuhan, China.

BACKGROUND: Features of a cluster of acute appendicitis that occurred among a high school student population in China were investigated. METHODS: Epidemiologic data, medical records, and histologic slides of resected appendices were examined. RESULTS: During a period between April 10, 1997, and June 11, 1997, 11 cases occurred in a high school, with 10 cases among 290 students enrolled at the time. From the end of the initial cluster until June, 2000, 20 additional cases were encountered. Female cases (6.5%) are more frequent than male cases (1.9%). There was a clustering pattern. Many patients had a history of mutual contact before the onset of symptoms. Pathologically, the resected appendices exhibited diffuse or focal hemorrhages in the lamina propria or within hyperplastic lymphoid follicles, and infiltration by eosinophils and by lymphocytes. Appendical tissues were examined using immunohistochemistry, but no etiologic agent was identified. CONCLUSIONS: This cluster of acute appendicitis represented a special kind of appendicitis, with features of an infectious disease in epidemiology.