[Percutaneous ethanol injection for unresectable pancreatic cancer-report of two cases].

Two cases of unresectable pancreatic cancer underwent percutaneous ethanol injection (PEI). The first was a 65-year-old man with a 43 x 39 mm mass in the head of the pancreas. He received PEI (total 38.5 ml of ethanol) 6 times. Serum CA19-9 decreased from 3,800 U/ml to 1,700 U/ml. The patient was dead 6 months after PEI. Autopsy revealed coagulative necrosis at the site of ethanol injection. The second case was a 66-year-old man with a 70 x 50 mm mass in the body of the pancreas. He was treated by PEI (total 10 ml). After PEI, his abdominal pain was relieved considerably. He died 4 months after PEI treatment. These findings suggest that PEI may be useful not only for pain control but also for tumor reduction of unresectable pancreatic cancer.

BMP signaling during bone pattern determination in the developing limb.

To examine the role of BMP signaling during limb pattern formation, we isolated chicken cDNAs encoding type I (BRK-1 and BRK-2) and type II (BRK-3) receptors for bone morphogenetic proteins. BRK-2 and BRK-3, which constitute dual-affinity signaling receptor complexes for BMPs, are co-expressed in condensing precartilaginous cells, while BRK-1 is weakly expressed in the limb mesenchyme. BRK-3 is also expressed in the apical ectodermal ridge and interdigital limb mesenchyme. BRK-2 is intensely expressed in the posterior-distal region of the limb bud. During digit duplication by implanting Sonic hedgehog-producing cells, BRK-2 expression is induced anteriorly in the new digit forming region as observed for BMP-2 and BMP-7 expression in the limb bud. Dominant-negative effects on BMP signaling were obtained by over-expressing kinase domain-deficient forms of the receptors. Chondrogenesis of limb mesenchymal cells is markedly inhibited by dominant-negative BRK-2 and BRK-3, but not by BRK-1. Although the bone pattern was not disturbed by expressing individual dominant-negative BRK independently, preferential distal and posterior limb truncations resulted from co-expressing the dominant-negative forms of BRK-2 and BRK-3 in the whole limb bud, thus providing evidence that BMPs are essential morphogenetic signals for limb bone patterning.

Epitheloid granuloma formation in type C chronic hepatitis: report of two cases.

Two cases of type C chronic hepatitis with the presence of epitheloid granulomas were reported. Case 1 was a 44-year-old man who presented with a moderate increase in serum ALT and positive anti-HCV. Histological examination of percutaneous liver biopsy specimens showed dense portal inflammation with piecemeal necrosis. Lobular inflammation was present mederately and a large well-organized epitheloid granuloma was found within a liver lobule. Case 2 was a 55-year-old woman, who was presented because of a slight increase in serum ALT and positive anti-HCV. Histologically, liver biopsy specimens showed lymphoid aggregates in the portal area and slight piecemeal necrosis. Moderate steatosis were noted and an epitheloid granuloma was present in the hepatic lobule. Acid-fast stains were negative for both cases and serum ACE and lysozyme were within normal range. These granulomas were composed of epitheloid cells surrounded by lymphocytes. They were not present within the portal tracts, but were found in the hepatic lobule. The incidence of the appearance of epitheloid granuloma in liver biopsy specimens of type C chronic hepatitis was 2 out of 273 cases (0.73%). The role of HCV infection in the genesis of epitheloid granulomatosis is of much interest and should be investigated.

[Painful muscle cramps in liver cirrhosis and effects of oral taurine administration].

We administered 3 g of taurine orally for four weeks to 35 patients suffering from liver cirrhosis with repeated muscle cramp (MC). Improvement of MC was noted in 22 cases (62.9%). We also determined the plasma taurine concentration in eight cases of liver cirrhosis with MC. The plasma taurine concentration before ingestion was 54.1 +/- 20.7 nmol/ml, whereas that of four weeks after ingestion was 125.1 +/- 59.1 nmol/ml, which was significantly elevated by 2.3 fold. As the concentration increased, the frequency of MC decreased, suggesting the good correlation between ingestion and the decrease in frequency of MC. In liver cirrhosis without MC the plasma taurine concentration was 81.0 +/- 16.7 nmol/ml, which was significantly higher than in liver cirrhosis with MC. In a few cases with taurine ingestion, serial plasma taurine concentrations were detected. Plasma taurine reached the peak value during the first week of ingestion and plasma taurine levels were maintained 2-5 fold higher during ingestion.