Hemorrhagic fevers represent a wide spectrum of viral infectious diseases, out-breaking mostly as epidemics, some of them being highly lethal. They range from those caused by bunyaviridae, associated with renal or pulmonary syndromes and those recently emerging and caused by the filoviridae family of thread-like viruses. Among the latter, Ebola hemorrhagic fever (EHF) bears the highest mortality and morbidity rates. One form of the disease has been documented only in monkeys. The human form, has occurred mainly in areas surrounding rain forests in central Africa. Patients present with signs of hemorrhagic diathesis, fever, diarrhea and neurological disorders, leading sometimes to confusion with local endemic diseases. Fatal victims of the disease die of dehydration. Poor hygienic conditions facilitate the spread of the virus. Biologically, the virus seems to target both the host blood coagulative and immune defense systems. Intensive epidemiologic search have failed to establish the definitive natural host of the virus. Twice, with a 19-year interval, major outbreaks have taken place in the Democratic Republic of the Congo. The second major outbreak in the northwestern city of Kikwit in April 1995 will serve here to elucidate the mechanism of the viral infection.

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The present study aimed to measure sensory nerve conduction velocity (SNCV) and muscle sympathetic nerve activity (MSA) in both normal subjects and patients with lumbar spinal canal stenosis (LSCS), and to determine what sensory and sympathetic nerve systems relate to the development of abnormal sensation in the lower limbs of the patients. The study population was 12 patients and 10 age-matched healthy control subjects.
A statistical difference in the mean MSA intervals was found between the LSCS patients and the normal subjects. There was a fairly large difference between them in the values of the standard deviations as one of the parameters to determine the degree of fluctuation of MSA. These results suggest the LSCS patients have shorter MSA intervals and narrower fluctuations of MSA than normal subjects.
As for the range of fluctuation of the MSA intervals and SNCV, the faster the SNCV, the wider the range of fluctuation of MSA intervals in the normal subjects. Many patients with LSCS seem to maintain a correlation between SNCV and MSA intervals. This suggests that even in cases of LSCS, human homeostasis works to keep the relationship between sympathetic nerve function and somato sensory nerve function to some extent. A few LSCS patients showed no correlation between MSA and SNCV. These patients were rather old, suffered spinal stenosis in the relatively higher levels of the spinal canal, and had suffered from the disease for longer than the mean period of all the patients. When the peripheral nerves or cauda epuina are chronically compressed, the nerve systems can not maintain the relationship between them, which finally results in failure. It is suggested that the disrupted coordination between sympathetic nerve function and somato sensory nerve function is one of the reasons why abnormal sensations occur in the lower extremities of LSCS patients.

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Solitary fibrous tumors (SFTs) represent a distinct neoplasm that should be included in the differential diagnosis of spindle-cell neoplasms of the soft tissue. Basic fibroblast growth factor (bFGF or FGF-2) is a mitogenic and angiogenic polypeptide produced by diverse cell types, including the cells derived from normal tissue and neoplastic lesions. In this study, the expression of bFGF, vimentin, CD 34, c-kit (or CD 117), desmin, S-100 protein, and α-smooth muscle actin (α-SMA) in SFTs, hemangiopericytomas (HPC), gastrointestinal stromal tumors (GIST), and dermatofibrosarcoma protuberans (DFSP) were evaluated to assess their usefulness in the differential diagnosis of these lesions. The expression of bFGF mRNA was also examined in SFTs by in situ hybridization (ISH) using a digoxigenin-labeled bFGF oligonucleotide probe. All the SFTs, GISTs and DFSPs exhibited strong and diffuse immunoreactivity for CD34 and vimentin, and were completely negative for desmin, S-100 protein and α-SMA. The HPCs were positive for vimentin, but negative for CD34. In all the SFTs, strong and diffuse nuclear immunostaining was observed with bFGF antibody, contrasting with the negative staining observed in the majority of the HPCs, GISTs, and DFSPs. The bFGF mRNA was also expressed in the SFT cells. The constitutive expression of the bFGF in the SFT widens the spectrum of available markers for these tumors, providing a useful addition to their differential diagnosis in difficult cases, and contributing to the understanding of their histogenesis and molecular pathogenesis.

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Sentinel lymph nodes are the first draining nodes that contain tumor cells. Identification of sentinel nodes may help to determine the suitable extent of lymphadenectoy. To assess the location of sentinel lymph nodes, a series of 41 patients with single and two metastatic lymph nodes who underwent esophagectomy and 3-field lymphadenectomy between 1991 and 1999 were investigated retrospectively. Only 29 (47.5%) of 61 metastatic nodes showed correspondence between the tumor site and the regional metastatic lymph nodes by routine histologic examination. In the patients with tumors in the upper and middle thoracic esophagus, metastatic lymph nodes were distributed in the cervix, mediastinum and abdomen. Although sentinel nodes were limited to the regional and adjusting compartments in 82%, nodes were found beyond the adjusting compartments in 18%. The sentinel nodes were broadly distributed depending on the location of the tumor in esophageal cancer.

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Fibroblast growth factor (FGF) -10 (keratinocyte growth factor 2, KGF 2) is a new member of the FGF family that is mainly synthesized by mesenchymal cells and acts predominantly on epithelial cells in a paracrine manner. Its actions are dependent on its binding to the iiib isoform of the cell-surface FGF receptor 2 (FGFR2 iiib). FGF-10 is known to play an important role in fetal limb and lung development, skin wound healing and prostatic epithelial cell growth.
In the present study, the expression of FGF-10 and FGFR2 iiib in five cultured human colorectal adenocarcinoma cell lines (COLO 205, DLD-1, HCT-15, SW 480 and WiDr) and the localization of FGF-10 messenger RNA (mRNA) and its protein in human colorectal cancer tissues from 10 patients were determined. All five colorectal cancer cell lines expressed FGF-10 mRNA and its protein. FGFR2 iiib mRNAs were expressed in these cells and the recombinant FGF-10 (1ng/ml) increased the growth rate of COLO 205 cells. To determine the localization of FGF-10 protein and its mRNA in normal and cancerous human colorectal tissues, immunohistochemistry and in situ hybridization were performed. In normal colorectal tissues, FGF-10 and its mRNA were not detected. In contrast, moderate immunoreactivity was present in cancer cells in 5 of 10 colorectal cancer cases and mild immunoreactivity was recognized in adjacent fibroblasts. By using in situ hybridization, FGF-10 mRNA was observed in colorectal cancer cells and fibroblasts adjacent to cancer cells.
These findings indicate that FGF-10 and its receptor, FGFR2 iiib expression in colorectal adenocarcinoma cells and FGF-10 may contribute to the growth of cells of this type.

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The aim of the present study was to determine the prevalence of and the host factors for asymptomatic pyuria (ASP) in women with type 2 diabetes. The study included 179 type 2 diabetic women and consecutive 455 non-diabetic women attending as out-patients in 1996. Patients with symptoms of a urinary tract infection were excluded. ASP was defined as the presence of more than 10 leukocytes/high-power field in a random urine sample. Diabetic women more often had ASP than non-diabetic women (27.9 vs. 15.8%, P<0.001). The prevalence of ASP was significantly increased in patients with a duration of diabetes exceeding 15 years (0∼4 years; 20.3%, 5∼9 years; 24.3%, 10∼14 years; 23.8%, and≥15 years; 46.3%). No differences were evident in HbA_1C between diabetic patients without ASP and those with ASP. Diabetic women with ASP more often had diabetic retinopathy, neuropathy, nephropathy, cerebrovascular disease, ischemic heart disease, and hyperlipidemia than those witout ASP. However, no statistically significant differences were evident in the prevalence of hypertension, constipation, or dementia. As the degree of neuropathy increases, it is accompanied by an increasing prevalence of ASP (none, 21.4%; blunt tendon reflexes, 24.5%; symptomatic, 50.0%; and gangrene, 66.6%). The prevalence of ASP was significantly increased in the patients with proliferative diabetic retinopathy (none, 23.2%; background, 29.4%; preproliferative, 18.2%; and proliferative, 50.0%). As the degree of nephropathy increases, it is accompanied by an increasing prevalence of ASP (none, 20.0%; microalbuminuria, 31.9%; macroalbuminuria, 37.0%; and renal failure, 60.0%). Thus, the prevalence of ASP is increased in women with diabetes and increased with longer duration of diabetes but was not affected by glucose control. The incidence of ASP increases significantly as diabetic microangiopathy becomes severer.

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A case of gastrointestinal stromal tumor (GIST) of the stomach is reported. GIST has been applied to gastrointestinal submucosal tumors mainly composed of spindle shaped cells that represent neither typical features of myogenic nor neurogenic tumors, and immunohistochemical studies are necessary for the diagnosis of GIST.
The patient was a 39-year-old man and was successfully diagnosed to be GIST (uncommitted type) preoperatively by immunohistochemical studies of biopsy specimens from an ulcerative submucosal tumor with bridging folds in the fundus, approximately 3.0 cm in size. Local excision of the stomach was performed. This is the 3rd case of GIST with a preoperative diagnosis to appear in the literature in Japan.
For gastroenterological surgeons, it is critical to select the most suitable surgical procedure. In the present, because the number of papers reporting GIST of the stomach is small, it is impossible to review GIST clinicopathologically. We reviewed the surgical procedure for gastric leiomyosarcomas, because of including many cases with GIST in them. Therefore, we performed 54 cases of gastric GIST in the literature, compared with 92 cases of gastric leiomyosarcoma. As a result, it was thought that local excision for gastric GIST should be preferred.

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Infantile cortical hyperosteosis (ICH) is usually a self-limited disease of infancy with bony changes, soft tissue swelling, fever, irritability, decreased appetite, and decreased movement of the affected bones. Its description in isolated patients or in multiple members of families suggests the existence of two different forms, namely a sporadic form and a familial form with incomplete penetrance. In this article, we report a 2.5-month-old girl with ICH of sporadic form, due to unusual presentation.

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In a 63-year-old woman computed tomography (CT) incidentally detected a celiac artery aneurysm approximately 3 cm in diameter. While conventional angiography suggested that the splenic artery and common hepatic artery arose from the celiac artery aneurysm, three-dimensional CT angiography indicated that the aneurysm involved only the mid portion of the celiac artery. Considering the risk of eventual aneurysm rupture, surgery was performed. Aneurysmectomy and devascularization of hepatic, splenic, and celiac arteries were carried out following complete cross-clamping of the celiac artery. The distal segment of the celiac artery was directly anastomosed to the proximal segment in an end-to-end fashion. Histologically, the aneurysm wall showed atheromatous changes. Contrast-enhanced abdominal CT confirmed complete removal of the celiac artery aneurysm, and postoperative angiography confirmed good arterial flow. The patient recovered uneventfully after surgery, with normalization of transiently abnormal hepatic function parameters. In this case of celiac artery aneurysm, three-dimensional CT angiography was found to be valuable in determining the relationships of the aneurysms to important arterial branches.

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