Cementless or hybrid total elbow arthroplasty with titanium-alloy implants. A study of interim clinical results and specific complications

Twenty-six patients (32 elbows) with rheumatoid arthritis had a total elbow arthroplasty with insertion of a cementless prosthesis. The humeral component was made of titanium alloy and it was fixed without cement in all elbows. The patients were followed for an average of 3 years 1 month (range, 2 years 2 months to 4 years 4 months). A good result was seen in 25 elbows, a fair result in 2, and a poor result in 5. The reason for the poor results was a breakage of the humeral component at the junctional portion of its stem. In all five of these elbows a marked resorption of bone mass within the condylar portion of the humeral component was observed on the lateral radiograph. The five elbows with a poor result had a revision operation, and in each of these black staining of the soft tissues within the joint was seen. This tissue metallosis due to wear debris of the titanium alloy was responsible for the osteolysis within the condylar portion. It became clear from this study that even in a non-weight-bearing joint, such as the elbow, titanium alloy may wear and result in tissue metallosis when used as a bearing surface of the implant. However, it was also found that in the majority of the elbows an establishment of the biologic fixation of the porous-coated stem could be achieved by use of this alloy.

Isozyme analysis of anaerobic rumen fungi and their relationship to aerobic chytrids

Isozymes of 23 cultures of the anaerobic rumen fungi and seven cultures of aerobic chytridiomycete fungi were analysed by PAGE. A total of 14 isozyme loci were successfully typed by PAGE. They were peptidase A & C-1, peptidase A & C-2, peptidase D-1, peptidase D-2, malate dehydrogenase-1, malate dehydrogenase-2, esterase-1, esterase-2, malic enzyme-1, malic enzyme-2, isocitrate dehydrogenase, shikimate dehydrogenase, phosphoglucomutase and 6-phosphogluconate dehydrogenase. Isozyme analysis can be used for studying the genetic relationships among the different anaerobic rumen fungi and the aerobic chytridiomycete fungi and the isozyme characteristics can serve as additional taxonomic criteria in the classification of the anaerobic rumen fungi. A dendrogram based on the isozyme data demonstrated that the anaerobic rumen fungi formed a cluster, indicating a monophyletic group, distinctly separated from the aerobic chytridiomycete fungi. Piromyces communis and P. minutus showed a close relationship but P. spiralis showed a more distant relationship to both P. communis and P. minutus. Piromyces as a whole was more related to Caecomyces than to Neocallimastix. Orpinomyces was also found to be more related to Piromyces and Caecomyces than to Neocallimastix. Orpinomyces intercalaris C 70 from cattle showed large genetic variation from O. joyonii, indicating that it is a different species.

Regulation of pyrimidine nucleotide synthesis in rat hematopoiesis

In an attempt to define a regulation of pyrimidine nucleotide synthesis in hematopoietic cells, we investigated the activities of thymidylate synthetase and thymidine kinase, and the cell cycle by flow cytometric DNA analysis and bromodeoxyuridine-immunohistochemistry during the recovery phase of hematopoietic cells in bone marrow after the hypoplastic period induced by cyclophosphamide treatment in rats. The hematopoietic cells first entered into cell cycle via the de novo pathway in pyrimidine nucleotide synthesis, and were secondly proliferated and differentiated via the salvage pathway. S-phase cells associated with a myeloid hematopoiesis increased earlier than those associated with an erythroid hematopoiesis in the recovery phase of in rat bone marrow.

Glycogen storage disease associated with Niemann-Pick disease: histochemical, enzymatic, and lipid analyses

A case of glycogen storage disease associated with multiple hepatic adenomas and Niemann-Pick disease is reported. Type IA glycogen disease was diagnosed soon after birth in a female patient, and she was treated at our clinic. At the age of 12 yr, the patient was found to have a hepatic tumor, which was surgically extirpated. Histological examination showed that the tumor was a hepatocellular adenoma. Increasing hepatomegaly and jaundice were noted when the patient was 18 yr of age. She died of pneumonia and cardiac tamponade at the age of 19. The liver weighed 3310 g, and showed severe jaundice and many nodules measuring up to 8 cm in diameter. These nodules were composed of mature hepatocytes without atypia and were diagnosed as hepatocellular adenomas. In addition, many adenomatous lesions were found at the microscopical level. The spleen weighed 1310 g, and showed two small infarctions at the upper part. A histological examination showed a diffuse infiltration of large foamy cells in the splenic red pulp. These cells were 20 to 100 microns in diameter and weakly positive for periodic acid-Schiff (PAS) staining, positive for lipid staining with Sudan black B, and positive for Pearce's phospholipid staining. Electron microscopy showed many lamellar bodies in the cytoplasm that were characteristic of Niemann-Pick disease. These foamy cells were also found in liver, bone marrow, lymph nodes, kidneys, and lungs.(ABSTRACT TRUNCATED AT 250 WORDS)

Gastrospirillum hominis-associated gastritis: the first reported case in Japan

Tightly coiled spiral micro-organisms (Gastrospirillum hominis), distinct from Helicobacter pylori, were found in the gastric mucosa of a 66-year-old man with a 4-month history of intermittent epigastric pain. The organisms were distributed in the antral mucosa, which showed erosive gastritis; histologically, the affected mucosa presented moderate to severe chronic gastritis with focal neutrophil infiltration. After a 2-week administration of cimetidine, his symptoms resolved and the active inflammation was reduced, both endoscopically and histologically, but the organisms still remained. Biopsy specimens taken 4 weeks after treatment with minocycline and cimetidine showed normal gastric mucosa without the spiral organisms. The above clinical course suggests the possible role of Gastrospirillum hominis in the pathogenesis of gastritis.

Ultrastructural demonstration of salmon-type gonadotropin-releasing hormone (sGnRH) in the olfactory system of masu salmon (Oncorhynchus masou)

Immunocytochemical and immunoelectron microscopic localization of salmon-type gonadotropin-releasing hormone (sGnRH) were observed in the olfactory system (olfactory epithelium, olfactory nerve and olfactory bulb) of masu salmon (Oncorhynchus masou) to investigate its possible involvement in the olfactory functions. sGnRH-immunoreactive (ir) bipolar neuron, which might be related to the terminal nerve, was located in dorsal portion of the olfactory nerve. sGnRH-ir gold particles were concentrated on electron-dense granule-like structures of 50 nm in diameter in fibers of the olfactory nerve close both to the olfactory epithelium and to the olfactory bulb. These findings suggest that sGnRH might participate in neurotransmission and/or neuromodulation in the olfactory system of masu salmon. sGnRH would become a useful molecular marker for studying the olfactory imprinting and homing mechanisms in salmonids.

Derivation and implementation of a cone-beam reconstruction algorithm for nonplanar orbits

B.D. Smith (ibid., vol.MI-4, p.15-25, 1985; Opt. Eng., vol.29, p.524-34, 1990) and P. Grangeat (These de doctorat, 1987; Lecture Notes in Mathematics 1497, p.66-97, 1991) derived a cone-beam inversion formula that can be applied when a nonplanar orbit satisfying the completeness condition is used. Although Grangeat's inversion formula is mathematically different from Smith's one, they have similar overall structures to each other. The contribution of the present paper is two-fold. First, based on the derivation of Smith, the authors point out that Grangeat's inversion formula and Smith's one can be conveniently described using a single formula (the Smith-Grangeat inversion formula) that is in the form of space-variant filtering followed by cone-beam back projection. Furthermore, the resulting formula is reformulated for data acquisition systems with a planar detector to obtain a new reconstruction algorithm. Second, the authors make two significant modifications to the new algorithm to reduce artifacts and numerical errors encountered in direct implementation of the new algorithm. As for exactness of the new algorithm, the following fact can be stated. The algorithm based on Grangeat's intermediate function is exact for any complete orbit, whereas that based on Smith's intermediate function should be considered as an approximate inverse excepting the special case where almost every plane in 3D space meets the orbit. The validity of the new algorithm is demonstrated by simulation studies.

Suppression by kampo medicine, sho-saiko-to, on papillomas induced by 7,12-dimethylbenz(a)anthracene in mice

Sho-saiko-to (SST) is a Japanese modified, traditional Chinese herbal medicine (Kampo medicine) consisting of seven medical plants. We examined the effects of SST on formation and growth of squamous cell papillomas induced by 7,12-dimethylbenz(a)anthracene application in mouse skin. Chronic oral administration of SST reduced the incidence and growth of papillomas with the reduction of activities of succinate-dehydrogenase and thymidylate synthetase, which were evaluated as the cell viability and DNA synthesis via the de novo pathway, respectively.

Effects of Chinese herbal medicines on DNA-synthesizing enzyme activities in mammary tumors of mice

Sho-saiko-to (SST) and Juzen-taiho-to (JTT), Japanese modified Chinese herbal prescriptions, suppressed the activities of thymidylate synthetase and thymidine kinase involved in de novo and salvage pathways for pyrimidine nucleotide synthesis, respectively, in mammary tumors of SHN mice with the reduction of serum prolactin level. These results indicate that SST and JTT may have the antitumor effects on mammary tumors.

Effects of recombinant human erythropoietin on DNA synthesis in rat hematopoietic organs

In an attempt to define the effects of recombinant human erythropoietin (rEPO) on DNA synthesis in hematopoietic organs, we investigated DNA-synthesizing enzyme activities, i.e., thymidylate synthetase and thymidine kinase activities, and bromodeoxyuridine-immunohistochemistry during the recovery phase of hematopoietic cells in bone marrow and spleen after the hypoplastic period induced by cyclophosphamide (Cy) treatment in rats. Treatment with rEPO increased enzyme activities and cell number of erythroid series in bone marrow cells; it also increased organ weight and S-phase cells in the spleen, followed by an augmentation of the number of erythrocytes and a rise in the hemoglobin and hematocrit levels in peripheral blood with or without Cy treatment.

Nucleotide sequence of rice dwarf phytoreovirus genome segment 2: completion of sequence analyses of rice dwarf virus

The complete nucleotide sequence of rice dwarf phytoreovirus genome segment 2 (S2) was determined to be 3,512 nucleotides long with one open reading frame initiating at nucleotide 15 and terminating at nucleotide 3363. The encoded polypeptide was predicted to have 1,116 residues with a relative molecular weight of 123 kD. Comparison of S2 of two isolates showed they had identical lengths and 97 and 98.3% nucleotide and amino acid sequence identities, respectively. A search of the Swiss-Prot data base (R 22.0) failed to find any proteins with significant homology to the S2-encoded protein. Determination of the nucleotide sequence of the S2 has completed the sequence determination of the genome of rice dwarf virus. Homology searches made for proteins encoded by each of the genomic segments showed that the polypeptide encoded by S11 has similarity to histone H1 protein and VP6 of blue tongue virus, indicating it might possess nucleic acid binding properties.

Hepatocellular carcinoma with unusual metastasis to the small intestine

An autopsy case of a hepatocellular carcinoma (HCC) with unusual metastasis to the mucosa of the small intestine is reported. The patient was a 73 year old female. At autopsy, the liver weighed 970 g, and an ovoid and necrotic 6 x 5 cm sized tumor was found in the right posterior lobe with many daughter tumors within the cirrhotic liver. The tumor embolus in the portal vein was not found. Extrahepatically the tumor metastasized to the lungs, sacral bone and hepatohillar and para-aortic lymph nodes. Additionally, many sessile and pedunculated polyps up to 2 cm in diameter were found sporadically in the small intestine. These seemed to be primary adenomatous polyps but histologically they were HCC metastasis. To the best of the authors' knowledge, many polypoid involvements of the small intestine by a hepatocellular carcinoma have not been reported until now.

[Essential thrombocythemia in pregnancy]

A 30-year-old woman was admitted to our hospital because of thrombocythemia during pregnancy. Her leukocyte count was 10,000/microliters, Hb was 11.7 g/dl, and platelet count 181.9 x 10(4)/microliter. Bone marrow aspirate showed an increase in megakaryocytes (255/microliters). Both Ph1 chromosome and bcr rearrangement were negative. She was diagnosed as having essential thrombocythemia (ET) with pregnancy, and was treated with aspirin (150 mg/day). Her pregnancy was uneventful, but she was readmitted because of overterm pregnancy. A caesarean section was performed, and a healthy male infant weighing 3,672 g was delivered, with a platelet count of 25.5 x 10(4)/microliter. However, the uterine was atonic, and atonic hemorrhage occurred. Supravaginal hysterectomy was performed. Subsequently, intrabdominal gross hemorrhage occurred, but the bleeding was halved by platelet transfusion. Microscopic examination showed uterine infarction. We suggest that platelet count should be reduced by means of plateletpheresis or interferon-alpha throughout pregnancy with ET.

Effects of danazol on endometrial DNA synthesis in rats

The suppressive effects of Danazol, an isoxazol derivative of the synthetic steroid 17 alpha-ethinyltestosterone, on endometrial DNA synthesis were investigated in rats by immunohistochemistry with bromodeoxyuridine (BrdU) and DNA-synthesizing enzyme assays. Rats treated with Danazol for 14 days at 17-19 weeks of age showed a decrease of plasma gonadotropins associated with ovarian hypofunction, persistent diestrus, and a smaller number of corpora lutea in ovary, resulting in no BrdU-immunoreactive (S-phase) cells in endometrial epithelium and lower activity of thymidine kinase in the uterus compared with control.

Suppression by kampo medicines in preneoplastic mammary hyperplastic alveolar nodules of SHN virgin mice

Sho-saiko-to (SST), Keishi-bukuryo-gan (KBG), and Shakuyaku-kanzo-to (SKT) are Japanese modified traditional Chinese herbal medicines (Kampo medicines) consisting of 7, 5, and 2 medical plants, respectively. It is known that the hyperplastic alveolar nodule (HAN) is a representative preneoplastic state in the mammary glands of mice. We examined the effects of SST, KBG, and SKT on the formation and growth of HAN in a high-mammary-tumor strain of SHN virgin mice. Oral administration of SST for 60 days beginning at 90 days of age reduced the number and area of HAN and mammary thymidylate synthetase activity with a reduction of serum prolactin level. There was little difference between the other experimental groups and the control in the formation and growth of HAN and the enzyme activities. These results indicate that SST may have a preventive effect on malignant mammary transformations.

Syrinx-fourth ventricle and lateral ventricle-peritoneal shunts for congenital hydrocephalus with syringobulbia and syringomyelia: case report

A case of congenital hydrocephalus with syringobulbia and syringomyelia was reported. Although his neurological condition had deteriorated because of shunt malfunction, progressing syringobulbia, and syringomyelia, he recovered because of the direct communication from the syrinx in the medulla to the fourth ventricle, the shunt from the syrinx in the cervical spinal cord to the fourth ventricle, and the lateral ventriculoperitoneal shunt.

[The role of the clinical microbiology laboratory in the past]

Over the past 150 years, since Koch first isolated the tubercle bacillus, clinical microbiologists have used culturing techniques to demonstrate of the presence of pathogenic microorganisms associated with infectious diseases in clinical specimens. The development of medicine and chemotherapy and the improvement of sanitary conditions resulted in a marked decrease in infectious diseases. In stead of infections due to virulent pathogens, opportunistic infections in the compromised hosts by non-virulent or weakly virulent bacteria have been on the rise. As a result, determining the pathogenicity of an isolated bacteria becomes important. The past two decades have seen extensive efforts to exploit the potential of automation in clinical microbiology and to develop increasingly rapid procedures. New technology, such as molecular genetics, has also been introduced into clinical microbiology. For more correct and precise diagnoses of infectious diseases, the clinical microbiology laboratory should be enlarged as an "Infectious Disease Laboratory" to include an extended work on not only the detection of pathogens from the specimens of infectious disease, but also serodiagnostic tests and immunological tests of hosts. The "Infectious Disease Laboratory" would also play a key role in the control of nosocomial infection working with the infection control committee and infectious disease clinicians.

[Turning point in quality control in Japan--current status & problems and future issues]

Some authorities suggest that quality control in Japan is now at a turning point. During the 30 years since its introduction in the 1960s, quality control has improved dramatically, and a number of new quality control techniques have been designed and applied to routine examination. In actual practice, however, people tend to become insensitive to abnormalities or to ignore them, causing an increase in the number of abnormal results. This article will review a survey of quality control and describe the current status, problems and future issues in quality assurance.

Synergistic effect of oral UFT in combination with cisplatin on DNA synthesis in rat hepatocarcinomas

We investigated the synergistic efficacy of CDDP and UFT, an oral anticancer derivative of 5-fluorouracil, on DNA synthesis of 3'-MeDAB-induced hepatocarcinomas in rats. Chronic treatment with CDDP slightly reduced tissue activities of thymidylate synthetase and thymidine kinase in the hepatocarcinomas, and, moreover, simultaneous administration of a low dose of UFT with CDDP markedly suppressed both enzyme activities, i.e., UFT and CDDP showed a potent synergism on DNA synthesis in hepatocarcinomas.

Effects of kampo (Japanese herbal) medicine "sho-saiko-to" on DNA-synthesizing enzyme activity in 1,2-dimethylhydrazine-induced colonic carcinomas in rats

Sho-Saiko-To (SST) is a modified Japanese traditional Chinese herbal medicine containing seven medical plants: Bupleuri radix, Pinelliae tuber, Suxtallariae radix, Zizyphi fructus, Ginseng radix, Glycyrrhizae radix, and Zingiberis recens rhizoma. This preparation has been used in the treatment of some inflammatory diseases of the respiratory system and chronic hepatitis. In the present study, the effects of SST were investigated on the activities of DNA-synthesizing enzymes in 1,2-dimethylhydrazine (DMH)-induced colonic carcinomas in rats. Six-week administration of SST prevented nearly 100% of the body weight loss and the final number of the colonic carcinomas compared to those in the rats treated with DMH alone, and suppressed the enhanced activities of thymidylate synthetase (TS) and thymidine kinase (TK) which were involved in the de novo and salvage pathways of pyrimidine synthesis, respectively, in DMH-induced colonic carcinomas. These results indicate that SST may show directly and/or indirectly inhibitory effects on the development of colonic carcinomas.

[Serum inorganic fluoride concentrations and their urinary excretion during and after sevoflurane, isoflurane, or enflurane anesthesia in man]

Serum inorganic fluoride concentrations and their urinary excretion were examined during and after sevoflurane, isoflurane, or enflurane anesthesia in man. Duration of anesthesia was 3 hours in sevoflurane and enflurane groups (S3 group: n = 10, E3 group: n = 5), and 3 or 5 hours in isoflurane groups (I3 group: n = 5, I5 group: n = 5). Serum inorganic fluoride concentration of the S3 and E3 groups increased immediately following induction, and reached the maximum concentration of 21.8 +/- 9.3 (M +/- SD) mumol.l-1 (S3), 13.6 +/- 6.2 mumol.l-1 (E3) at 1 hour after anesthesia. Serum inorganic fluoride decreased after the peak concentrations, and returned to the pre-anesthesia level at 96 hours (S3) and 144 hours (E3) after anesthesia. On the other hand, serum inorganic fluoride of the I3 and I5 groups scarcely changed from the pre-anesthesia level, and maximum concentrations of these two groups were one tenth of the S3 group. Urinary excretion of inorganic fluoride of the S3 and E3 group began to increase from 2 hours after anesthesia, and showed plateau of 60-90 mmol.h-1 from 12 hours to 24 hours after anesthesia. The change of serum inorganic fluoride sharply contrasted with urinary excretion. Our results suggest that fluoride excretion is largely carried out by the kidney. Therefore sevoflurane or enflurane anesthesia should be avoided in patients with renal dysfunction.

Effects of danazol on DNA synthesis in rat prostate

Effects of danazol, an isoxazol derivative of the synthetic steroid 17 alpha-ethinyltestosterone, on activities of thymidylate synthetase and thymidine kinase, which are the DNA-synthesizing enzymes included in de novo and salvage pathways of pyrimidine metabolism, respectively, were investigated in rat prostate. Danazol markedly reduced plasma levels of luteinizing hormone and testosterone, and organ weight, both enzyme activities and bromodeoxyuridine-immunoreactive cells which were regarded as the S-phase cells in prostate. These results indicate that danazol shows a property as a potent antigonadotropin.

Effects of luteinizing hormone-releasing hormone analogue on DNA synthesis in rat prostate and uterus

Buserelin, a potent LH-RH agonist, has been used for the treatment of hormonal disorders such as precocious puberty, endometriosis, cystic mastitis and prostatic carcinoma. Prolonged treatment with buserelin has been known to induce a refractory phase of pituitary desensitization. In the present study, we found that two-week treatment with buserelin strongly suppressed the activities of thymidylate synthetase and thymidine kinase, and markedly reduced the appearance of BrdU-immunoreactive (S-phase) cells in both prostate glands and uteri in male and female adult rats, respectively.