Atomic-resolved depth profile of strain and cation intermixing around LaAlO3/SrTiO3 interfaces.

Novel behavior has been observed at the interface of LaAlO3/SrTiO3 heterostructures such as two dimensional metallic conductivity, magnetic scattering and superconductivity. However, both the origins and quantification of such behavior have been complicated due to an interplay of mechanical, chemical and electronic factors. Here chemical and strain profiles near the interface of LaAlO3/SrTiO3 heterostructures are correlated. Conductive and insulating samples have been processed, with thicknesses respectively above and below the commonly admitted conductivity threshold. The intermixing and structural distortions within the crystal lattice have been quantitatively measured near the interface with a depth resolution of unit cell size. A strong link between intermixing and structural distortions at such interfaces is highlighted: intermixing was more pronounced in the hetero-couple with conductive interface, whereas in-plane compressive strains extended deeper within the substrate of the hetero-couple with the insulating interface. This allows a better understanding of the interface local mechanisms leading to the conductivity.

Fetal and adult liver stem cells for liver regeneration and tissue engineering.

For the development of innovative cell-based liver directed therapies, e.g. liver tissue engineering, the use of stem cells might be very attractive to overcome the limitation of donor liver tissue. Liver specific differentiation of embryonic, fetal or adult stem cells is currently under investigation. Different types of fetal liver (stem) cells during development were identified, and their advantageous growth potential and bipotential differentiation capacity were shown. However, ethical and legal issues have to be addressed before using fetal cells. Use of adult stem cells is clinically established, e.g. transplantation of hematopoietic stem cells. Other bone marrow derived liver stem cells might be mesenchymal stem cells (MSC). However, the transdifferentiation potential is still in question due to the observation of cellular fusion in several in vivo experiments. In vitro experiments revealed a crucial role of the environment (e.g. growth factors and extracellular matrix) for specific differentiation of stem cells. Co-cultured liver cells also seemed to be important for hepatic gene expression of MSC. For successful liver cell transplantation, a novel approach of tissue engineering by orthotopic transplantation of gel-immobilized cells could be promising, providing optimal environment for the injected cells. Moreover, an orthotopic tissue engineering approach using bipotential stem cells could lead to a repopulation of the recipients liver with healthy liver and biliary cells, thus providing both hepatic functions and biliary excretion. Future studies have to investigate, which stem cell and environmental conditions would be most suitable for the use of stem cells for liver regeneration or tissue engineering approaches.

Heterotopic pancreas--clinical presentation and pathology with review of the literature.

BACKGROUND/AIMS: Heterotopic pancreas is usually a silent gastrointestinal malformation, but it may become clinically evident when complicated by chronic inflammation or by growth. METHODOLOGY: We report on eleven cases of heterotopic pancreatic tissue. The cases were selected from the records of our Surgical Department and Institute of Pathology. The literature about heterotopic pancreas is reviewed. RESULTS: Nausea and vomiting (27%), epigastric pain (27%), ulceration (27%) and weight loss (18%) were the three most frequent symptoms and signs. The lesions were diagnosed as gastrointestinal tumor or ulcer by gastroduodenoscopy (36%). The other patients were diagnosed during surgery (64%). Definitive diagnosis was only achievable by pathology. Heterotopic pancreas was the reason for surgery in 36% of the cases, in another 45% diagnosis was incidental during surgery and in 18% the diagnosis was established endoscopically and surgery was not necessary. CONCLUSIONS: The diagnosis of heterotopic pancreas is rarely established, most cases remain clinically silent. In symptomatic patients diagnosis should to be secured histologically to exclude malignant disease.

Activity of some lysosomal enzymes in serum and in tumors of patients with squamous cell lung carcinoma.

The aim of the study was an assessment of some lysosomal enzymes activity in serum and in tumors of patients with lung cancer histopathologically confirmed as squamous cell lung carcinoma. The first group constisted of 10 patients with stage II of the disease and the second group consisted of 11 patients with stage III of the disease. Lysosomal enzymes activities were assayed in serum before surgery and on the 10th day after surgery in serum and in tumors. Arylsuphatase, cathepsin D and acid phosphatase activities were higher in the patients serum than in that of the control group. The decrease of arylsulphatase and cathepsin D activities after surgery was statistically significant in both groups of patients, but the cathepsin D activity was still 3 times higher in patients than in those from the control group. The decrease of acid phosphatase activity after surgery was about 50% in both groups of patients and this decrease was statistically significant. The arylsulphatase and acid phosphatase activity in tumors was nearly 3 times higher in stage III patients than it was in stage II patients, but the cathepsin D activity was nearly the same in both patient groups. Higher lysosomal enzyme activity may be a useful factor in diagnosing and monitoring of lung cancer. However, further investigations are needed.

Effect of prenatal glucocorticoids and postnatal nitric oxide inhalation on survival of newborn rats with nitrofen-induced congenital diaphragmatic hernia.

BACKGROUND/PURPOSE: Pulmonary hypertension and pulmonary hypoplasia account for the high mortality rate associated with congenital diaphragmatic hernia (CDH). In animal models of CDH, postnatal nitric oxide (NO) inhalation resulted in significantly better survival rates and antenatal glucocorticoid administration in improved lung compliance. The objective of this study was to evaluate the combined effect of prenatal glucocorticoid administration and postnatal NO inhalation on the survival rate of newborn rats with nitrofen-induced CDH. METHODS: Right-sided CDH was induced by maternal administration of a single oral dose (100 mg, intraperitoneally) of nitrofen on day 11.5 of pregnancy. Dexamethasone (DEX, 0.25 mg/kg) was given in groups III and IV by maternal intraperitoneal injection on day 18.5 and 19.5 of pregnancy. Control animals (groups I and II) received vehicle alone. After spontaneous delivery, the newborn animals were exposed to either NO (80 ppm; groups II and IV) or room air (groups I and III). Vitality (Rat-Score), sO(2) and survival were monitored continuously for 12 hours until animals were killed. Hernia size was estimated as percentage of total thoracic content. RESULTS: Right-sided CDH was observed in 392 of 491 newborn rats (81%). Animals with large hernias (>50%) died within 4 hours after birth, irrespective of treatment. Hernias with less than 50% of the thoracic volume were considered clinically relevant hernias. In this category, 12.5% of animals without treatment (group I) survived compared with 63.6% after NO treatment alone (group II; P <.01). Survival rate after DEX treatment alone (group III) was 69.4% (group III v I; P <.01). In group IV (DEX and NO) 95.2% of the animals survived (group IV v I; P <.001). In contrast to DEX alone, NO administration resulted in significantly better sO(2)(group II and IV) compared with group I (P <.05). CONCLUSION: Combination of prenatal maternal glucocorticoids and postnatal NO inhalation significantly improved survival rate of newborn rats with nitrofen-induced CDH.

[Levels of soluble thrombomodulin in blood of patients with lung cancer]. / Poziom rozpuszczalnej trombomoduliny we krwi chorych na plaskonablonkowego raka pluca.

Thrombomodulin /TM/ is a surface glycoprotein involved in the regulation of blood coagulation and fibrinolysis. TM has been reported to be expressed in variety of tumors. The purpose of this study was to evaluate the concentration of soluble TM in patients with planoepithelial lung cancer. Study group consisted of 33 patients aged 51 years in IB /15/ and IIIB /18/ stage of cancer and 20 adults as control. Concentration of TM in plasma with ELISA method was performed. Mean level of TM in lung cancer patients was 4.98 +/- 0.94 ng/ml and was similar to control--4.60 +/- 0.88 ng/ml. No significant differences were found between patients with IB and IIIB stage of cancer.

[The role of thoracoscopy in traumatic diaphragmatic rupture]. / Wartosc torakoskopii w diagnostyce urazowego uszkodzenia przepony.

The aim of this study was assess the role of thoracoscopy in the diagnosis of diaphragmatic rupture. Eight patients: six male and two female with blunt thoracic trauma underwent thoracoscopy. The chest X-ray and CT findings, pleural ultrasound indicated a diaphragmatic rupture only in three cases. Five of eight diaphragmatic injuries were confirmed by thoracoscopy. Authors suggests that thoracoscopy is a safe, accurate method for the diagnosis of diaphragmatic rupture.

[Urokinase plasminogen activator /U-PA/in blood of patients with lung cancer]. / Urokinazowy aktywator plazminogenu/u-PA/we krwi chorych na raka pluca.

Clinical and experimental studies suggest that urokinase plasminogen activator/u-PA/ is associated with cancer invasion and metastasis. The aim of study was to evaluate the concentration and activity of u-PA in the plasma of patients with planoepithelial lung carcinoma. The examined group consisted of 40 patients/33 men, 7 women/aged 58 years with lung cancer in II, IIIa and IIIb stage of disease and 30 healthy adults as control. In citrate plasma concentration and activity of u-PA with ELISA method were performed. Concentration of u-PA was significantly lower in cancer patients then in controls. No associations between sex, age and plasma levels of u-PA were observed. Concentration and activity of u-PA in patients with IIIb stage of cancer were significantly decreased in comparison to patients with IIIa stage.

Feminizing Sertoli cell tumors associated with Peutz-Jeghers syndrome: an increasingly recognized cause of prepubertal gynecomastia.

Testicular sex cord tumors with annular tubules are an increasingly recognized cause of prepubertal gynecomastia typically accompanied by accelerated linear growth and advanced bone maturation. Serum estrogen levels may be elevated. Testicular ultrasound and biopsy are diagnostic, and mastectomy is indicated. Although these tumors can occur independently, causing gynecomastia in 10 percent of cases, they usually occur in patients with Peutz-Jeghers syndrome. In any Peutz-Jeghers syndrome patient developing gynecomastia, a testicular tumor should be sought. Conversely, because a significant proportion of all reported prepubertal gynecomastia patients have Peutz-Jeghers syndrome with testicular tumors, this syndrome must be considered for all young boys in whom the cause of gynecomastia is not otherwise apparent. When Peutz-Jeghers syndrome is suspected, gastroscopy, colonoscopy, and testicular biopsies can be performed under one anesthetic at the time of mastectomy.

Hereditary multiple atresias of the gastrointestinal tract: report of a case and review of the literature.

Hereditary multiple atresia of the gastrointestinal tract is an extremely rare subgroup of intestinal atresia. The aim of this study was to report a new case, to review the literature, and to describe the unique features of this malformation. A computer-generated list of articles on this subject was obtained, and all articles relative to this malformation were reviewed. Thirty-five other well-documented cases were found in the literature. Hereditary multiple atresias have several unique features: (1) the abdominal x-ray shows signs of gastric or duodenal atresia combined with typical large rounded or oval homogeneous calcifications in the abdominal cavity, (2) intraoperatively widespread atresias (exclusively type I and II) extending mostly from stomach to rectum are found, (3) cystic dilatation of the bile ducts can be present in cases with both complete pyloric and duodenal or proximal jejunal atresia, (4) the pathogenesis is still speculative; a combined immunodeficiency should be excluded, and (5) a fatal outcome is the rule.

[Long-term results of surgical treatment in patients with lung neoplasms depending on the time of diagnosis]. / Odlegle wyniki leczenia operacyjnego chorych na raka pluca w zaleznosci od czasu rozpoznania.

In this work we did an analysis of the correlation between duration of lung cancer symptoms before operation and the stage of disease and long-term results of treatment. 181 pts were examined and 5-year survival was evaluated after surgical treatment. We found that it took from 2 weeks to 2 years and average 4,6 months, from the first clinical symptoms of lung cancer and occasional detection in X-ray examination till the moment of surgical treatment. We also noticed that long term results depended on the stage of disease of the surgically treated pts.

Current concepts in the embryology of anorectal malformations.

Today, the normal and abnormal development of the hindgut is still a matter of speculation. However, owing to recent studies in appropriate animal models, most embryological events that finally lead to abnormal hindgut development are better known than in the past: (1) The process of maldevelopment starts early in the embryo. (2) The cloacal membrane always is too short in its dorsal part. Thus the dorsal cloaca is missing too. (3) As a result, the hindgut remains attached to the sinus urogenitalis, thus forming the recto-urethral fistula. In the past, an impaired process of septation was believed to be the main cause of abnormal hindgut development. In contrast to this, our results indicate that the development of the septum is more passive than active. Further results of our studies in normal and abnormal development indicate that (1) the embryonic cloaca never passes through a stage that is similar to any form of anorectal malformation in neonates, including the so-called "cloacas" in females, and (2) to explain abnormal development, studies in abnormal embryos are mandatory.

Applied embryology in pediatric surgery.

The surgical correction of birth defects in the newborn is still a major challenge for pediatric surgeons. Approximately 3% of human newborns present with congenital malformations. In 1%, these malformations are so severe that immediate surgical intervention is necessary to save the affected newborns life. Morbidity remains high in some of these children with the necessity of repeated operations and hospitalizations despite a successful primary operation. As a consequence, in the United States today congenital malformations are the main cause of death in the neonatal period. This mortality shift indicates that gradually knowledge about congenital malformations lags behind the general progress clinical research has made in the surrounding fields. This is highlighted by the fact that detailed knowledge of the embryological background, the natural history and the teratology of many congenital defects is still unclear or controversial. In the past, progress in this field of research was hampered by small numbers of suitable normal human embryos of the various stages. Three-dimensional (3-D) reconstructions which are an essential component to investigate the development of structures like the foregut, the hindgut or the diaphragm, were technically difficult and time consuming to perform. Studies on abnormal development were not possible due to a paucity of appropriate embryos and young fetuses with congenital defects. However, recently some animal models have been developed applicable to embryological studies. We used these to elucidate the abnormal development of the hindgut and the diaphragm. An animal model for the study of abnormal foregut development will be available soon.

Inhaled nitric oxide increases survival rates in newborn rats with congenital diaphragmatic hernia.

The high mortality of newborn infants with congenital diaphragmatic hernia (CDH) can be partly attributed to pulmonary hypertension causing extrapulmonary right-to-left shunting with subsequent severe hypoxemia. Inhaled nitric oxide (NO) may reduce elevated pulmonary artery pressure and has been successfully improve arterial oxygenation in some newborns with CDH. However, it is not clear whether inhaled NO will actually improve survival of newborns with CDH. We therefore investigated the effect of inhaled NO on the survival rate of newborn rats with CDH following intrauterine exposure to nitrofen. A total of 151 newborn rats (9 litters) were exposed to nitrofen on day 11 of pregnancy, After spontaneous delivery, 63 newborn rats (4 litters) were allowed to spontaneously breathe air containing NO (80 parts per million), while 88 newborn rats (5 litters) were given air without NO. Survival was checked 15 min after birth and then hourly until the animals were sacrificed at 24 h of age to verify the absence or presence of CDH. The 2 groups of newborn rats breathing air with or without NO did not differ significantly with respect to the presence or size of CDH. Twenty-four of 63 (38%) newborn rats breathing air with NO survived for 24 h, compared to 12 of 88 (14%) rats breathing air alone (p < 0.01). Of newborn rats that were actually found to have CDH (n = 113), 8 of 42 (19%) animals breathing air with NO survived for 24 h, compared to 2 of 71 (2.8%) animals breathing air alone (p < 0.01). In animals with CDH confirmed by autopsy, the median survival time was significantly longer with NO (p < 0.001) ( 2 h, interquartile range 2h-15h), than those breathing or without NO (median/interquartile range 15 min). We conclude that in the nitrofen rat CDH model, significantly improved survival rates occur with inhaled NO as a sole intervention. The combined impact of inhaled NO and mechanical ventilation remains to be determined.

Decreased selenium concentration and glutathione peroxidase activity in blood and increase of these parameters in malignant tissue of lung cancer patients.

We studied the selenium (Se) concentration in whole blood and plasma, glutathione peroxidase (GSH-Px) activity in red blood cells and plasma, as well as both of these parameters in cancerous and tumor-free lung tissue of lung cancer patients. Blood samples were taken from 84 cancer patients and 61 healthy controls. Normal and neoplastic lung tissues were obtained from 57 patients at the time of surgery. Se concentrations in whole blood and plasma were lower by 23% (p < 0.001) in patients compared with controls. GSH-Px activity in red cells was lower by 20.2% (p < 0.004) and in plasma by 11.7% (p < 0.05) in patients than in the control group. On the other hand, the tumor Se level was higher by 66.6% (p < 0.0001) and GSH Px activity by 49.5% (p < 0.0001) than in adjacent tumor-free tissue. No differences in Se concentrations and GSH-Px activities were found between squamous cell carcinoma and adenocarcinoma nor among the clinical stages of the disease. In the whole blood and plasma of cancer patients significantly lower Se concentrations were found in smokers than in nonsmokers. Significantly lower Se concentrations were also found among cancer patients who were smokers compared with controls. These findings show that in the blood of cancer the antioxidant ability, as measured by Se and GSH-Px, is reduced significantly. The cause of increased Se and GSH-Px in the malignant part of the lung is not understood and requires further studies.

[Extralobar lung sequestration with fistula to the esophagus]. / Extralobäre Lungensequestration mit Fistel zum Oesophagus.

Pulmonary sequestrations have no communication with the bronchial tree. Therefore they are usually airless. However, in the presence of a fistula to the esophagus or the stomach, they might contain air or could even be emphysematic. Such a case in a newborn is presented. This very rare anomaly is frequently named "communicating bronchopulmonary foregut malformation". This malformation has to be included in the differential diagnosis of multicystic lung diseases. Diagnosis can be made preoperatively by esophagography and Doppler sonography.

An unusual case of segmental dilatation of the sigmoid colon.

An unusual case of segmental dilatation of the colon (SDC) with a broad membranous bridge in the distal part of the dilated bowel is presented. To our knowledge, this association has not been previously reported and might provide further insight into the underlying etiology of SDC.

[Evaluation of long-term results of surgical treatment of lung cancer]. / Ocena odleglych wyników leczenia operacyjnego chorych na raka pluca.

In term Jan. 1988 and Dec. 1989 222 patients from 31 to 77 years old were surgically treated for lung cancer at The Department of The Thoracic Surgery of Medical Academy in Bydgoszcz. 102 patients (45.9%) had the first stage of disease, 31(13.9%) second and 89(40.2%) third stage of disease. 179(80.8%) patients had a resected proceeder and 43(19.2%) explorative thoracotomy. The perioperative mortality was 13(5.8%) patients. 64(36.4%) patients survived 5-years. We found a significant influence of a stage and the range of a surgical resection on the long-term survival. We found that 5-years survivals did not depend on the age and sex and place of life of the patients and histological type of cancer.

Attenuation of serotonin-induced contractures in skeletal muscle from malignant hyperthermia-susceptible patients with dantrolene.

BACKGROUND: Porcine malignant hyperthermia (MH) can be triggered by administration of certain serotonin2 receptor agonists. Pretreatment with dantrolene completely abolished serotonin-induced MH. The purpose of this study was to investigate the effects of the serotonin2 receptor agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) in skeletal muscle specimens from MH-susceptible (MHS) and MH-nonsusceptible (MHN) patients following pretreatment with dantrolene. METHOD: We used muscle specimens surplus to diagnostic requirements from 12 MHS and 13 MHN patients in this study. In the first experiment, DOI 0.02 mM was added to the organ bath. In the second experiment, muscle specimens were preincubated with dantrolene 0.5 microM or 1.0 microM, respectively, for 10 min before DOI 0.02 mM was administered. RESULTS: Administration of DOI 0.02 mM induced contractures in muscle specimens from MHS and MHN patients. Contracture development started significantly earlier in MHS than in MHN specimens. In MHS muscle the maximum contracture was significantly greater than in MHN. Pretreatment with dantrolene significantly delayed the start of contracture development in MHS muscles, whereas in MHN muscles no contractures were observed after dantrolene. The contracture maximum was significantly reduced in MHS. CONCLUSION: The acceleration of DOI-induced contracture development in skeletal muscle specimens from MHS patients indicates that an altered serotonin system might be involved in human MH. Dantrolene effectively delayed serotonin-induced contractures. Further investigations are needed to determine whether serotonin2 receptors of skeletal muscle from MHS subjects are altered in function or structure, or whether this response is a secondary phenomenon.

Toward understanding the developmental anatomy of congenital diaphragmatic hernia.

The pathway of abnormal embryonic development leading to congenital diaphragmatic hernia (CDH) is incompletely understood. Using a nitrofen-induced model of left CDH in rats, sequential stages of development were analyzed by scanning electron microscopy. Abnormal development patterns were observed in the cells comprising the posthepatic mesenchymal plate and the adjacent liver. The septum transversum did not appear to be involved. In this article, the authors theorize that a disturbed "balance of cell growth" is responsible for the creation of the diaphragmatic defect.