Clinical Analysis of Intraperitoneal Lymphangioma.

BACKGROUND: Intraperitoneal lymphangioma (IL) used to be thought of as a benign lymphatic malformation with a low rate of preoperative diagnosis. This retrospective study aimed to explore the connection between the cysts and clinical manifestation and imaging characteristics, and to study diagnostic confusion, therapeutic principles and potential recurrent reasons, to further enhance the comprehension of this rare disease. METHODS: Here, we retrospectively reviewed 21 patients diagnosed with IL. Age, sex, complaints, physical findings, and imaging features of each patient were documented. The therapies, postoperative complications and treatments were discussed. RESULTS: Symptomatology included eight patients (38%) with intermittent dull pain in the abdomen, and three patients (14%) complained of abdominal persistent pain. The physical examination revealed an abdominal mass in 16 patients (76%), and eight (38%) were reported no discomfort. IL was correctly established preoperatively in 19 patients (90%). Patients were treated using laparotomy, except one who was treated with laparoscopy. Two recurrences were noted during follow-up. CONCLUSIONS: IL should be suspected in any patient with a mobile abdominal mass and surgery is required immediately after discovery of the tumor.

Systematic review and meta-analysis of prophylactic abdominal drainage after pancreatic resection.

AIM: To investigate whether prophylactic abdominal drainage is necessary after pancreatic resection. METHODS: PubMed, Web of Science, and the Cochrane Library were systematically searched to obtain relevant articles published before January 2014. Publications were retrieved if they met the selection criteria. The outcomes of interest included: mortality, morbidity, postoperative pancreatic fistula (POPF), clinically relevant pancreatic fistula (CR-PF), abdominal abscess, reoperation rate, the rate of interventional radiology drainage, and the length of hospital stay. Subgroup analyses were also performed for pancreaticoduodenectomy (PD) and for distal pancreatectomy. Begg's funnel plot and the Egger regression test were employed to assess potential publication bias. RESULTS: Nine eligible studies involving a total of 2794 patients were identified and included in this meta-analysis. Of the included patients, 1373 received prophylactic abdominal drainage. A fixed-effects model meta-analysis showed that placement of prophylactic drainage did not have beneficial effects on clinical outcomes, including morbidity, POPF, CR-PF, reoperation, interventional radiology drainage, and length of hospital stay (Ps > 0.05). In addition, prophylactic drainage did not significantly increase the risk of abdominal abscess. Overall analysis showed that omitting prophylactic abdominal drainage resulted in higher mortality after pancreatectomy (OR = 1.56; 95%CI: 0.93-2.92). Subgroup analysis of PD showed similar results to those in the overall analysis. Elimination of prophylactic abdominal drainage after PD led to a significant increase in mortality (OR = 2.39; 95%CI: 1.22-4.69; P = 0.01). CONCLUSION: Prophylactic abdominal drainage after pancreatic resection is still necessary, though more evidence from randomized controlled trials assessing prophylactic drainage after PD and distal pancreatectomy are needed.

MACC1 expression correlates with PFKFB2 and survival in hepatocellular carcinoma.

OBJECTIVE: To validate the relationship between MACC1 and 6-phosphofructo-2-kinase/fructose 2, 6 bisphosphatase (PFKFB2) expression as well as its clinicopathological features and prognostic significance in hepatocellular carcinoma. METHODS: By using immunohistochemistry, we investigated the MACC1 and PFKFB2 protein expression in 60 pairs of hepatocellular carcinoma and corresponding non-tumor tissues. Using the Mann-Whitney U test, the Chi-square test, Kaplan-Meier survival analysis, Cox proportional hazard regression analysis and Spearman analysis, we studied the relationship between MACC1 and PFKFB2 protein expression and postoperative overall survival (OS) of the HCC patients. RESULTS: MACC1 and PFKFB2 positive staining rates were significantly higher in hepatocellular carcinoma than in the corresponding nontumor tissues (P=0.012 and 0.04, respectively). The clinicopathological features evaluation revealed that positive expression of MACC1 was associated with a high Edmondson classification (P=0.007) and advanced TNM stage (P=0.027). Similar findings were evident for PFKFB2 expression (P=0.002 and P=0.027). MACC1 and PFKFB2 positive expression was associated with a lower OS rate (P=0.004 and 0.03, respectively). Kaplan-Meier survival and Cox proportional hazard regression analyses revealed MACC1 positive expression to be a prognostic factor for postoperative OS, but PFKFB was not. CONCLUSION: Highly expressed MACC1 and PFKFB2 protein were associated with TNM stage, Edmondson -Steier classification and overall survival. MACC1 may affect tumor metabolism partly through expression and phophorylation of PFKFB2.

[Neonatal hyperthyroidism: a case report and literature review].

OBJECTIVE: We report a case of neonatal thyrotoxicosis with concurrent respiratory failure in an infant born to a mother with Graves' disease and review the published literature describing neonatal hyperthyroidism. The male infant who was born by spontaneous delivery at 35 weeks of gestational age presented with fever, tachycardia and tachypnea at rest on day 11 after birth, and developed severe apnea on day 14. Thyroid function studies revealed hyperthyroidism in the infant, and his mother was confirmed to have Grave's disease during pregnancy. Literature review showed that among the 33 infants with similar conditions, tachycardia, tachypnea and poor weight gain were the most distinct clinical features of congenital hyperthyroidism. Accurate diagnosis of Graves' disease in the mother during pregnancy and awareness of the clinical presentations of neonatal hyperthyroidism are key to reducing missed diagnosis or misdiagnosis of neonatal hyperthyroidism.

[Expression of Fbxw7 and its correlation with cell proliferation in human hepatocellular carcinoma].

AIM: To observe the expression of Fbxw7 and explore its correlation with cell proliferation of hepatocellular carcinoma (HCC). METHODS: The expression of Fbxw7 in paired tumor and tumor-adjacent normal tissues from 40 patients with HCC were assessed using RT-PCR and immunohistochemistry. The expression level of Fbxw7 mRNA in normal liver cell line (LO2) and HCC cell lines (Hep3B and SMMC-7721) were detected by real-time RT-PCR. Colony formation assay and tumor xenograft assay were performed in different cell lines with different Fbxw7 expression respectively to investigate the ability of cell proliferation in vitro and in vivo. RESULTS: The expression of Fbxw7 at both mRNA and protein levels in HCC tissues were significantly down-regulated compared to tumor-adjacent normal tissues (P<0.05). Down-regulation of Fbxw7 was found apparently associated with high Edmonson-Steiner classification and advanced TNM stage (P<0.05). The expression of Fbxw7 mRNA in LO2 was significantly higher than that in Hep3B or SMMC-7721 (P<0.05). Cell lines with less Fbxw7 expression had not only more colonies in colony formation assay (P<0.05), but also bigger xenografts in vitro (P<0.05). CONCLUSION: The low expression of Fbxw7 correlates with the poor clinicopathological characteristics and cell proliferation of HCC.

[Downregulation of HSP70 gene expression and apoptosis in human hepatocellular carcinoma SMMC-7721 cells induced by nimesulide in vitro].

AIM: To investigate the effect of nimesulide on cell apoptosis and possible mechanism in human hepatocellular carcinoma SMMC-7721 cells. METHODS: SMMC-7721 cells were treated with nimesulide at different concentrations. Cell viability was assessed by MTT assay. Cell apoptosis rate was determined with flow cytometry. The cleavage activity of PARP and caspase-9 and the expression of HSP70 were evaluated using RT-PCR and Western blotting. The influence of HSP70 on cell apoptosis was observed using RNA interference silencing HSP70 expression. RESULTS: Nimesulide significantly inhibited cell growth in SMMC-7721 cells in a time- and concentration-dependent manner, and induced cell apoptosis in a concentration-dependent manner. Moreover, nimesulide promoted the cleavage of caspase-9 and PARP and inhibited the mRNA and protein expression of HSP70. Through the specific inhibition on HSP70 gene with siRNA, cell apoptosis increased, and the apoptosis was enhanced by the cleavage activity of caspase-9 and PARP. CONCLUSION: Nimesulide could inhibit cell growth and induce apoptosis in human hepatocellular carcinoma SMMC-7721 cells via the downregulation of HSP70.

[Gli1 expression and its relationship with the expression of Shh, Vimentin and E-cadherin in human hepatocellular carcinoma].

AIM: To investigate the expression and clinical features of glima-associated oncogene 1(Gli1) and its correlation with the expression of sonic hedgehog(Shh), one of the ligands of hedgehog (Hh) signaling, and two epithelial-mesenchymal transition (EMT) markers, Vimentin and E-cadherin in human hepatocellular carcinoma(HCC). METHODS: Paired HCC and normal tumor-adjacent tissues were collected from 63 HCC patients. Gli1 expression at both the protein and mRNA level were examined by immunohistochemistry and RT-PCR. The protein expression of Shh, Vimentin and E-cadherin were evaluated by immunohistochemistry to identify correlations with Gli1. RESULTS: The protein and mRNA expression of Gli1 were significantly up-regulated in the HCC tumor tissues compared to the normal tumor-adjacent tissues. Gli1 protein expression in HCC was closely correlated with intrahepatic metastases (x(2);=6.205, P<0.05), portal vein invasion (x(2);=4.014, P<0.05), high Edmonson-Steiner classification (x(2);=19.668, P<0.05) and advanced TNM stage (x(2);=7.091, P<0.05). Gli1 protein expression was positively correlated with Shh (r=0.574, P<0.05) and Vimentin(r=0.467, P<0.05), and negatively correlated with E-cadherin (r=-0.439, P<0.05). CONCLUSION: Gli1 is up-regulated in HCC tissues and closely correlated with clinicopathological characteristics, the increased expression of Gli1 in HCC tissues may be attributed to Shh, and Gli1 may play an important role in HCC progression and metastasis by inducing EMT.

[UbcH10 expression in hepatocellular carcinoma and its clinicopathological significance].

OBJECTIVE: To investigate UbcH10 expression in hepatocellular carcinoma and explore its clinicopathological implications. METHODS: We detected UbcH10 mRNA expression using RT-PCR in normal liver cell line, cancer cell lines, surgically removed hepatocellular carcinoma tissue and corresponding adjacent non-tumor tissue and evaluated the clinicopathological significance of UbcH10. Immunohistochemistry was performed to investigate UbcH10 protein expression in hepatocellular carcinoma tissue, the adjacent tissue, and normal liver tissue specimens. RESULTS: Normal liver cell line L02 showed significantly lower UbcH10 mRNA expression levels than the cancer cell lines BEL-7402, Hep3B, HepG2 and SMMC-7721 (P<0.05). UbcH10 mRNA expression was also was significantly higher in hepatocellular carcinoma tissues than in the corresponding non-tumor tissues (P<0.05). Clinicopathological evaluation suggested that UbcH10 expression was associated with tumor invasion of the portal vein, tumor size, TNM staging, and tumor differentiation (P<0.05). Immunohistochemistry identified stronger UbcH10 expression in hepatocellular carcinoma tissues than in the adjacent tissues and normal liver tissues (68.6%, 28.6%, and 26.7%, respectively). CONCLUSION: UbcH10 is over-expressed in hepatocellular carcinoma and may serve as a novel biomarker as well as a therapeutic target of hepatocellular carcinoma.

[Alveolar capillary dysplasia: a case report and review of literature].

OBJECTIVE: To report a newborn infant who died of alveolar capillary dysplasia (ACD). The literature on about 20 cases of ACD was reviewed. METHODS: A retrospective review of records of infants from Medline with a diagnosis of ACD was carried out. RESULTS: The case was a newborn female infant who developed respiratory distress 5 hours after an uncomplicated delivery. She died at the fourth day after birth despite full ventilatory support. The lung autopsy provided a diagnosis of ACD. In the 21 infants, 7 were male and 14 were female; 19 infants were born full-term and 2 were born pre-term. The birth weight of 19 infants and Apgar score of 15 infants were normal; 16 infants developed progressing tachypnea and cyanosis within 24 hours of age, 5 developed cyanosis at 1 day to 19 days. Echocardiography demonstrated a right to left shunt in the hearts of all the 21 infants, and pulmonary hypertension in 20 infants. Twenty infants were treated with conventional mechanical ventilation, 7 infants with high-frequency oscillatory ventilation and 12 infants with extracorporeal membrane oxygenation (ECMO). Fourteen infants were also treated with inhaled nitric oxide therapy and 4 with exogenous surfactant. Diagnostic open lung biopsy was performed in 6 infants. The chest radiography showed normal findings in 3 infants, pneumothoraces in 9 infants, reticular markings, granular, patchy or diffuse opacity in lungs of 7 infants, and decreased pulmonary vascular markings in two infants. All the 21 infants died; 8 of them died within 10 days of age, 7 within 30 days of age, and one died at the age of 4 months who was the longest survivor. Fourteen infants were associated with congenital malformations, such as cardiovascular, gastrointestinal, and genitourinary systems, including one infant associated with chromosomal abnormalities, two infants of familial genetic predisposition. CONCLUSIONS: At present, ACD is still a disease with poor prognosis, significant medical expenses and no specific treatment. When respiratory failure or persistent pulmonary hypertension (PPHN) is persistent after routine treatment in an infant, ACD should be highly suspected and conventional open-lung biopsy should be preformed to confirm the diagnosis.

Relation among p130Cas, E-cadherin and beta-catenin expression, clinicopathologic significance and prognosis in human hepatocellular carcinoma.

BACKGROUND: p130Cas (p130Crk-associated substance) is a junction protein that is important to the adhesion between cytoskeleton and extracellular matrix. Also, the adhesion molecules E-cadherin and beta-catenin play important roles in the invasiveness of carcinoma. This study was undertaken to investigate the effects of p130Cas, E-cadherin and beta-catenin on the invasion, metastasis and prognosis of hepatocellular carcinoma (HCC). METHODS: Immunohistochemistry was used to evaluate the expression of p130Cas, E-cadherin, and beta-catenin in 40 patients with HCC. All patients were followed up postoperatively, and the relationship between expression and clinicopathological prognostic parameters was analyzed. RESULTS: The positive expression rates of p130Cas and E-cadherin in HCC tissue (n=40) were 62.50% and 55.00%, but in normal liver tissue 10%, and 100%, respectively (P<0.05). The abnormal expression rate of beta-catenin in HCC tissue was 70%, while in normal liver tissue it was 13.33% (P<0.05). The positive rate of p130Cas was correlated with lymph node invasion, pathological stage, TNM stage, and a worse prognosis, but not with gender, age, HBV infection, hepatic cirrhosis, alpha-fetoprotein (AFP) level before operation, and tumor diameter. Similarly, the expression of E-cadherin and beta-catenin was correlated with lymph node invasion, pathological stage, TNM stage, and worse prognosis, but not with gender, age, HBV infection, hepatic cirrhosis, AFP level before operation, and tumor size. Correlations were found between p130Cas and abnormal E-cadherin/beta-catenin expression (P<0.001 and <0.05, respectively). CONCLUSIONS: In HCC, there is a negative correlation between the positive expression of p130Cas and the normal expression of the adhesion molecules E-cadherin/beta-catenin, and p130Cas plays important roles in the invasion, metastasis and prognosis of HCC. p130Cas may be involved in alterating the structure and function of E-cadherin/beta-catenin, by regulating tyrosine phosphorylation via the p130Cas-Src signal pathway.

[Application of a tumor cell vaccine transfected with GM-CSF/IL-2 fusion gene for specific immunotherapy of hepatocellular carcinoma].

OBJECTIVE: To prepare a transgenic tumor cell vaccine transfected the fusion gene of murine granulocyte-monocyte colony stimulating factor (mGM-CSF) and human interleukin-2 (hIL-2) using H22 cells, and explore its specific antitumor immunity against hepatocellular carcinoma. METHODS: The eukaryotic vector expressing the fusion gene mGM-CSF/hIL-2 was transfected into H22 cells followed by radiation exposure to construct the tumor cell vaccine, which was used to immunize Balb/c mice by subcutaneous inoculation. The mice inoculated subcutaneously with H22 cells, cells transfected with the empty vector pcDNA(+), or with PBS served as the controls. A week later, H22 cells were injected peritoneally into Balb/c mice for establishing the tumor-bearing model, and their serum levels of interleukin-10 (IL-10) and interferon-gamma (IFN-gamma) were detected using enzyme-linked immunosorbent assay (ELISA) with the survival of the mice recorded. The spleen cells were obtained from the mice immunized with the tumor cell vaccine, the tumor-bearing mice and the normal control mice to assess their cytotoxicity against the parental H22 cells in vitro using (51)C(r)-release assay. RESULTS: The transgenic H22 cell vaccine transfected with mGM-CSF/hIL-2 fusion gene was successfully constructed. The killing rate of H22 cells by the spleen cells from the mice immunized with the transgenic cell vaccine was significantly higher than those by the spleen cells from the tumor-bearing mice or normal control mice (38.3% vs 13.6% and 7.5%, P<0.05). Serum IFN-gamma in the tumor-bearing mice immunized with the transgenic cell vaccine was significantly higher, and serum IL-10 significantly lower than those of the control groups (P<0.01). The survival time of the tumor-bearing mice injected with the transgenic cell vaccine was also significantly prolonged. CONCLUSION: Syngeneic tumor cell vaccine genetically modified by mGM-CSF/hIL-2 fusion gene transfection can elicit specific cellular immune response and enhance the host antitumor immune response to extend the survival time of tumor-bearing mice.

[Factors triggering extraintestinal infection of rotavirus].

OBJECTIVE: To investigate the role of immunodeficiency and intestinal mixed infection on inducing extraintestinal dissemination of rotavirus (RV). METHODS: Immunodeficiency was induced in healthy Kunming mice by introperitoneal injection of cyclophosphamide, and RV was administered either orally or via intraperitoneal injection. In another group, toxigenic E. coli and human RV were given sequentially by intragastric administration to induce mixed infection. Three days later the organs of the mice were taken for pathological examination, and RV was detected by in situ PCR and hybridization. In children with or without viremia of rotavirus, blood tests for levels of tumor necrosis factor alpha (TNF-alpha), interleukin-2 (IL-2) and 7 trace elements (zinc, iron, copper, lead, calcium, manganese, and magnesium) were performed. RESULTS: In immunodeficient mice, pathological changes were found in the small intestinal villus, gastric lamina propria and the cardiac cells of mice taking RV orally, and the mice with intraperitoneal RV injection showed additional liver and kidney pathologies. In mice with mixed infections, pathological changes occurred in the intestines, livers and kidneys. In situ hybridization detected RV in the intestinal villus of immunodeficient mice with oral RV administration, and in the intestinal villus and kidneys of the mice with mixed infections. In situ PCR revealed the presence of RV in the intestinal villus, intestinal gland cells, epithelial cells of the proximal convoluted tubules and collecting tubes in the kidneys of immunodeficient mice taking RV orally, in the intestinal villus, kidneys, livers, hearts and pancreases of those with RV injection, and in the intestines, kidneys, and livers of the mice with mixed infection. Children with rotavirus viremia had TNF-alpha level in comparison with those free of rotavirus viremia, and the majority of the former children showed disorder in trace elements. CONCLUSION: Immunodeficiency, mixed infection and malnutrition can be important factors contributing to or exacerbating RV infection and extraintestinal RV dissemination.

[Clinical analysis of 9 cases of solid-cystic pseudopapillary tumor of the pancreas with literature review].

BACKGROUND & OBJECTIVE: Solid-cystic pseudopapillary tumor of the pancreas (SCPT) is a rare type of pancreatic tumor with low grade of malignancy. Its diagnosis and treatment remain controversial. This study was to discuss the diagnosis criteria and treatment strategy of SCPT. METHODS: Clinical data, including general history, medical history, treatment history and treatment outcome, of 9 SCPT patients, treated in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi'an Jiaotong University from Jan. 1997 to Feb. 2005, were analyzed retrospectively, and the related literature was reviewed to summarize the clinical characteristics, diagnosis, and treatment of SCPT. RESULTS: Among the 9 patients, 7 (77.8%) were women under 44 years old. The laboratory tests of liver function, serum amylase, and CEA, CA199 were normal. The accurate diagnosis rate of ultrasound was 22.2%, while that of CT was 77.8%. Most patients received local resection of the tumor. All patients were followed-up till Oct. 2005 and no metastasis was detected. CONCLUSIONS: SCPT is a rare disease with good prognosis. It occurs mainly in young women. In spite of unspecific laboratory tests, CT and fine needle aspiration method are useful to diagnose the disease. Based on literatures, operation could achieve satisfactory efficacy for SCPT patients.

[Ultrastructural changes of the extraintestinal organs of newborn mice with human rotavirus infection].

OBJECTIVE: To investigate the ultrastructural changes of the extraintestinal organs of newborn mice with human retrovirus (RV) infection to probe into the mechanism and clinical diagnose and therapy of extraintestinal RV infection. METHODS: Human RV was inoculated into the abdominal cavity of the newborn mice, and the ultrastructural changes of the heart, lung, livers, and kidneys of the infected and control mice were observed by transmission electron microscope. RESULTS: The mice with intraabdominal RV injection showed pathological changes of the cells in the small intestinal villus, liver, and kidneys. Shortened small intestinal villus, nuclear membrane disorganization, massive vacuolization, mitochondrial swelling and rough endoplasmic reticulum dilation were observed in the cells of the small intestinal. In the liver of the mice, marked mitochondrial swelling and agglutination, cell nucleus pyknosis or collapse, presence of numerous lipid droplets and vacuoles were seen in the liver cells, with lymphocyte and plasmacyte infiltration. Obvious dilatation and shedding of the microvillus were seen in cholangioles. The mitochondria of the proximal convoluted renal tubule showed mild swelling, but the cells in the heart and lung did not display obvious changes. CONCLUSION: The small intestinal villi were highly susceptible to RV infection, and systemic spread of human RV may cause damage of various extraintestinal organs especially the liver, which can also be susceptible to RV.

[Molecular epidemiology of diarrhea among children with Norwalk-like virus in a hospital of Guangzhou in autumn and winter].

OBJECTIVE: To explore the epidemiological characteristics of Norwalk-like virus (NLVs) infection in children with diarrhea and to study the genotype and predominant cluster at a hospital in Guangzhou city. METHODS: Fecal specimens from 358 children with acute gastroenteritis from October 2003 to January 2004 and information about the cases were collected. NLVs was detected from the specimens by reverse transcription-polymerase chain reaction (RT-PCR) and the PCR products were purified and sequenced. RESULTS: Forty-two positive specimens were detected from the 358 fecal specimen with a positive rate of 11.73% (42/358). Of these, 40 specimens were obtained from infants younger than 3 years of age. The youngest infant infected with NLVs in this study was only 25 days. The positive rate in November (17.27%) was the highest. Eleven positive PCR products were selected and sequenced. Nucleotide sequence analysis revealed that 11 strains all belong to genogroup II (G II), and of these, 5 strains belonged to G II-3 cluster, with another 5 strains belonged to G II-4 cluster. However, one strain with its cluster could not be determined. CONCLUSION: NLVs served as one of the important pathogens causing sporadic acute gastroenteritis among children at a hospital in Guangzhou. The predominant strains were identified as G II-3 and G II-4 cluster.

Mechanism of benign biliary stricture: a morphological and immunohistochemical study.

AIM: To explore the mechanism of benign biliary stricture. METHODS: A model of trauma of bile duct was established in 28 dogs. The anastomosed tissues were resected and examined by light and electron microscopes on day 3, in wk 1, 3 and mo 3, 6 after operation. CD68, TGF-beta1 and alpha-SMA were examined by immunohistochemical staining, respectively. RESULTS: The mucosal epithelium of the bile duct was slowly recovered, chronic inflammation lasted for a long time, fibroblasts proliferated actively, extracellular matrix was over-deposited. Myofibroblasts functioned actively and lasted through the whole process. The expression of macrophages in lamina propria under mucosa, TGF-beta1 in granulation tissue, fibroblasts and endothelial cells of blood vessels, alpha-SMA in myofibroblasts were rather strong from the 1st wk to the 6th mo after operation. CONCLUSION: The type of healing occurring in bile duct belongs to overhealing. Myofibroblasts are the main cause for scar contracture and stricture of bile duct. High expressions of CD68, TGF-beta1 and alpha-SMA are closely related to the active proliferation of fibroblasts, extracellular matrix over-deposition and scar contracture of bile duct.

[Extraintestinal dissemination of rotavirus in immunodeficient mice].

OBJECTIVE: To investigate the extraintestinal dissemination of rotavirus (RV) in immunodeficient mice. METHODS: Immunodeficiency mouse model was established by injection of cyclophosphamide into the abdominal cavities of normal mice, then to which RV was administered either orally or intra-abdominally. The pathological changes in the organs were observed by light microscopy and RV was detected by in situ hybridization and PCR. RESULTS: Small intestinal villi, gastric lamina propria and cardiac myocytes exhibited pathological changes in the mice with oral RV administration. Besides these changes, the mice with intra-abdominal RV injection showed changes in the liver and kidneys. The intestinal villi of the mice with oral RV were RV positive by in situ hybridization. Positive results of RV in in situ PCR detection were found in the intestinal villi, intestinal gland cells, epithelial cells of the proximal convoluted tubules and collecting tubes in the kidney of the mice taken RV orally, and in the intestinal villi, kidneys, liver, heart and pancrease of mice with intra-abdominal RV injection. CONCLUSION: Immunodeficiency may be the important factor for inducing and aggravating the infection and extraintestinal dissemination of RV.

[Comparison of several silver staining methods for DNA polyacrylamide gel electrophoresis].

OBJECTIVE: To compare 4 silver staining methods for DNA detection in polyacrylamide gel electrophoresis. METHODS: After the electrophoresis was completed, the gels were stained separately by four different methods, namely using ammonia-silver-citric acid, low-concentration silver nitrate, 0.1% and 0.2% silver nitrate. RESULTS: DNA was detected only by staining with 0.1% and 0.2% silver nitrate. CONCLUSION: 0.2% silver nitrate used along with sodium hydroxide shows the highest sensitivity in DNA detection, while its use with sodium carbonate produces the best quality of the image.

Reoperation for benign biliary tract diseases in 149 cases: causes and prevention.

BACKGROUND: Failure to diagnose and treat benign biliary tract disease relatively common surgical disease may cause serious consequences. Since the introduction of B-mode ultrasonography, CT, or MRI early and accurate diagnosis of the disease has been possible. In clinical practice, however, these methods have not been adequately used. Inappropriate surgical procedures can also lead to bile duct injury or stenosis after injury, residual cholecystitis, stenosis after cholangiojejunostomy, or stenosis of the Oddi's sphincter. But improvement of the diagnosis and treatment of benign biliary tract disease remains a great challenge to clinicians. METHODS: A total of 149 patients with benign biliary tract disease who had received reoperation from June 1988 to June 2001 were analyzed retrospectively. Among them 95 patients (63.76%) received operation twice and 38 (25.5%) underwent 3 operations. Sixteen patients (10.74%) needed 4 or more operations. The procedures for the first operation included cholecystectomy (71 patients, 47.65%), cholecystectomy with exploration of the common bile duct (42, 28.19%), cholangiojejunostomy (21, 14.1%), and laparoscopic cholecystectomy (15, 10.06%). RESULTS: The causes for reoperation included residual and recurrent bile duct stones in 53 patients (35.57%), bile duct injury or stenosis after injury in 41 (27.52%), residual cholecystitis with or without stones in 28 (18.8%), stenosis after cholangiojejunostomy in 17 (11.41%), stenosis of the Oddi's sphincter in 5 (5.35%), and others in 5 (5.35%). Four patients (2.68%) died after operation. CONCLUSIONS: To prevent reoperation for benign biliary tract diseases, the following measures should be taken to increase preoperative diagnostic rate, to understand conditions of the biliary tract by using imaging techniques and cholangiography, to examine comprehensively and carefully with choledochoscopy, cholangiography and B-mode ultrasonography intraoperatively, to choose appropriate operative procedures to decrease the rate of residual stones, and to decide the time for the first repair according to injury type of the bile duct. Roux-en-Y hepaticojejunostomy with cholangioplasty is the best operation for the reconstruction of the biliary tract.