[A case of tuberculous aneurysm of the descending thoracic aorta]

A case of a 55-year-old female with tuberculous false aneurysm of the descending aorta is reported. She was admitted to our hospital on February, 1989 with hemoptysis and lumbago. Active pulmonary tuberculosis, caries of the 1st and 2nd abdominal vertebrae, and abnormal left lower mediastinal tumor shadow were confirmed by roentgenogram. Aortography and computer tomography revealed a false aneurysm of the descending aorta. After anti-tuberculous chemotherapy, fist sized false aneurysm was resected and the punch out hole of the descending aorta, 8 mm in diameter was closed successfully using partial extracorporeal circulation. Histologic examination of the aneurysmal wall revealed granulomatous formation containing numerous giant cells. She is doing well, 7 months after surgery.

Cerebellar hypoplasia associated with Arnold-Chiari malformation in a Japanese shorthorn calf

A case of Arnold-Chiari malformation associated with severe cerebellar hypoplasia in a Japanese Shorthorn calf is reported. Histological examination revealed severe and extensive lesions in the cerebellar vermis. Hypoplasia of the cerebellum in Arnold-Chiari malformation appeared to indicate the abnormal embryonic development of the neural tissue, but the exact cause is not known.

Effect of prolactin in serum and follicular fluid on fertilization and cleavage of human oocyte

To assess the effect of PRL on fertilization and cleavage of oocytes, PRL levels in serum and follicular fluid of normoprolactinemic women who had undergone in vitro fertilization and embryo transfer (IVF-ET) were determined, and the relationship between PRL levels and fertilization and cleavage rates was studied. A transient increase in serum PRL at the ovulatory phase was found in about half of the IVF-ET patients during clomiphene stimulation, and increased levels of PRL in serum and follicular fluid at the ovulatory phase may suppress the fertilization and cleavage of oocytes.

[Internal rotation angle measurement of the elbow with 3D reformatted CT image]

The examination of internal rotation angle at the elbow is difficult on conventional radiographs. The angle of internal rotation has been measured with three dimensional reformatted CT image of GE CT/T9800. The angle of internal rotation with the cubitus varus deformity was measured both preoperatively and postoperatively. Postoperatively the angle of internal rotation became equal on both sides. Three dimensional CT reconstruction is useful in determining the internal rotation angle of elbow.

Effect of 2-buten-4-olide, an endogenous suppressant of feeding, on reproductive function in rats

The effects of 2-buten-4-olide, an endogenous feeding suppressant, on the estrous cycle and LH secretion were studied to determine the influence of this compound on reproductive function. Estrous cycling female Wistar rats were treated ip with 2-buten-4-olide (0, 30 or 100 mg.kg-1.day-1) for 2 weeks. Treatment with 100 mg.kg-1.day-1 delayed the estrous cycle. 2-Buten-4-olide increased the pituitary content of LH (1651.3 +/- 164.4 vs 927.7 +/- 65.1 ng/pituitary; p less than 0.01), and decreased the serum LH level compared with the control level in diestrus (0.16 +/- 0.01 vs 0.26 +/- 0.03 microgram/l; p less than 0.05). However, it did not affect the GnRH content of the mediobasal hypothalamus. The direct effects of 2-buten-4-olide on the pituitary response to GnRH was examined by perifusing the pituitary. Medium containing 2-buten-4-olide (10(-4) mol/l) suppressed the pituitary response to GnRH (2 micrograms/l) (percent increase at 50 min after start of GnRH stimulation: 180 +/- 47 vs 406 +/- 66%; p less than 0.05). These findings suggest that 2-buten-4-olide is involved in the regulation of pituitary gonadotropin secretion directly by suppressing the pituitary responsiveness to GnRH, and that 2-buten-4-olide may play an important role in starvation-induced anestrus.

Immunoglobulin deposits in diabetic microangiopathy. Observations in autopsy materials

Non-enzymatic glycosylation of vascular wall collagen is considered to be most important in the pathogenesis of diabetic microangiopathy, and glycosylated collagens are reported to bind immunoglobulins in vivo. We investigated the occurrence of IgG or IgM deposits in the microvasculature of certain organs of diabetics using routine autopsy materials. Glomerular capillary basement membrane/endothelium was often positive for IgM in diabetics. Endothelial cells of glomerular capillaries were positive for HLA-DR in 6 of 16 diabetics and in 2 of 11 controls. This was associated with IgM or IgG deposits in 5 cases. In the esophagus and/or tongue of diabetics, IgG was frequently deposited in the microvasculature. In total, IgG deposits were found in 13 of 16 diabetics, either in the esophagus or the tongue, but in only 3 of 16 controls. The difference was significant at p less than 0.005. These observations suggest that deposition of immunoglobulins is a component of diabetic microangiopathy. Differences in expression of HLA-DR in glomeruli between diabetics and non-diabetics remain to be explored.

Pulmonary lymphangiomyomatosis

Two cases of pulmonary lymphangiomyomatosis are reported and findings of high resolution computed tomography (CT) are described. CT reveals that most lesions appearing reticular or emphysematous on radiographs are actually cysts, and accurately displays the extent and distribution of cystic change of the lung. On high resolution CT, individual cystic walls are much better displayed than on routine 10 mm section CT. Further, it is possible to detect even trivial pleural effusion and mediastinal lymph node swelling by CT.

The mechanism of the effect of combination treatment with clomiphene and bromocriptine in patients with normoprolactinemic anovulation

The combination treatment with bromocriptine and clomiphene citrate was applied to 11 normoprolactinemic anovulatory patients who did not respond to clomiphene citrate alone. This combination treatment restored ovulation in 8 of these patients (72.7%). Conception was observed in 2 patients (18.1%) out of 11. The patients who responded to combination treatment showed a significant increase in the serum level of estradiol in the preovulatory phase, of progesterone in the mid-luteal phase, and a significant decrease of serum prolactin. They also showed significant increase in the frequency of luteinizing hormone (LH) pulsatility on day 12 of the cycle from 1.38 +/- 0.86 to 3.75 +/- 0.83 pulses/4h. The 3 patients who did not respond to combination treatment showed no increase in the serum level of estradiol or progesterone, but showed increase in the frequency of LH pulsatility in spite of continuous anovulation. These results indicate that the combination treatment with bromocriptine and clomiphene citrate is effective for treatment of patients with normoprolactinemic anovulation who do not respond to clomiphene alone, and suggest that the mechanism of the effect of combination treatment is related to an increase in the frequency of LH pulsatility caused by bromocriptine, which in turn stimulates follicular maturation.

[Two cases of pulmonary leiomyosarcoma]

Pulmonary sarcoma is a rare tumor of the lung. There are 81 cases in the literature for review, including our two cases. Our first case who was a thirty-seven year old male who was admitted to our hospital with complaints of left back pain. His chest X-ray showed an 11 X 14 cm tumor shadow in the lower left lung area. A left upper lobectomy was performed, and the histological diagnosis was leiomyosarcoma of the pulmonary vein. He died due to mediastinal recurrence 29 months later. Our other case was a fifty-six year old female. Her chest X-ray showed an abnormal shadow that was a tumor shadow in the right central lung area of 4 cm in diameter. As the diagnosis of the transcutaneous lung biopsy was benign tumor, partial resection of lung was performed. The histological diagnosis was leiomyosarcoma of the bronchus, and she is alive and well at 29 months after the operation. As the rate of diagnosis in leiomyosarcoma detected by transcutaneous lung biopsy is low, the most acceptable method of diagnosis is a total examination, including cytology of sputum, bronchoscopic findings, and roentgenoscopy. Probe thoracotomy would also be necessary if malignancy could not ruled out. The treatment of lobectomy should include lymph node resection.

Reciprocal/dichotomic expression of vimentin and B cell differentiation antigens in Reed-Sternberg's cells

An immunohistochemical study of 63 cases of Hodgkin's disease was undertaken using formalin-fixed paraffin embedded tissue sections. The antibodies used were against L26, LN-1, LN-2, EMA (epithelial membrane antigen), Leu-M1, Vimentin, UCHL-1, S-100, and lysozyme. Hodgkin's disease could be divided into three groups: the first group was LN-1+/L26+/vimentin-, the second LN-1-/L26+/vimentin+, and the third LN-1-/L26-/vimentin+). Sixteen cases of follicular lymphomas were also examined and were all positive for LN-1 and L26 and negative for vimentin. Thus the vimentin negativity of the first group, including 7 nodular lymphocyte-predominant cases, gives further evidence of their germinal center B-cell origin. Since vimentin is expressed mainly in the immature stage of B-lymphocytes, the second group of Hodgkin's disease may represent immature B-cell Hodgkin's disease. In the third group, vimentin was present in Reed-Sternberg's (RS) and Hodgkin's (H) cells in 45 of the 48 cases (92.5%). In none of 48 cases were these cells positive for S-100 or lysozyme, but strong vimentin-positivity still suggested monocytic or histiocytic origin. The results of our study suggest, at least, divergent origin of RS's and H's cells.

IgD multiple myeloma with renal involvement: case report

IgD multiple myeloma is a unique type of multiple myeloma which is characterized by increased serum IgD and IgD type M-component in immunoelectrophoresis. It frequently shows renal involvement but it is a rare form of myeloma. The distinctive features of IgD myeloma are the dominance in males, high frequency in younger persons, and the uncertain appearance of M-component in serum electrophoresis. We experienced 3 cases of IgD multiple myeloma with renal failure which required hemodialysis before IgD myeloma was diagnosed. It is important to consider IgD myeloma when treating the patients with renal involvement of unknown origin.

Perocormus associated with segmental aplasia of the cervical spinal cord in a Japanese shorthorn calf

A rare case of perocormus associated with segmental aplasia of the cervical spinal cord in a Japanese Shorthorn calf is reported. The severe reduction of body length with normal extremities combined to produce so the called "elk calf" appearance. Other associated malformations included hypoplasia of the lung, anorectal agenesis and a lobulated spleen.

[A case of pulmonary arteriovenous fistula with mitral stenosis]

The patient was a 61-year-old female, complaining of cyanosis, dyspnea and shortness of breath on exertion. She was diagnosed as having a pulmonary arteriovenous fistula (PAVF) in combination with mitral stenosis. The fistula was located in the left lower lobe and a right-left shunt of 28.7% was detected. Cardiac catheterization showed a pulmonary artery pressure of 44/22 mmHg (mean pressure, 31 mmHg). By occluding the PAVF using a balloon catheter, PaO2 increased from 47 mmHg to 88 mmHg. The mitral stenosis of this patient was though to be a mild form, and PAVF seemed to be responsible for symptoms. Since left lobectomy together with mitral valve replacement was considered to have a high risk, left lower lobectomy was performed initially. Thereafter mitral valve replacement was done successfully. Separate operations for PAVF and mitral stenosis are likely to be beneficial in patients with mitral stenosis associated with moderate pulmonary hypertension.

[Anemia in patients on continuous ambulatory peritoneal dialysis (CAPD)]

Inhibitors of erythropoiesis found in the blood of uremic patients have been implicated as some of the causes of anemia in chronic renal failure. As a treatment to remove the inhibitors, continuous ambulatory peritoneal dialysis (CAPD) is thought to be more effective than hemodialysis. Some researchers have reported that CAPD has improved anemic state in hemodialysis patients. However, there have been some cases of severe anemia seen in CAPD patients. To access the effect of the CAPD, we have performed serial examination on hemoglobin (Hb) and hematocrit (Ht) in 5 uremic patients under CAPD treatment. Hb levels in 4 and Ht in 3 of 5 patients have been known to be increased. One patient was shown to have no increment on the levels of Hb and Ht. On the other hand, further investigation has been down to access the effect of the recombinant human erythropoietin (r-HuEPO: Chugai pharmaceutical) on anemic patients, in whom no effect was noticed by treatment of CAPD. One severe anemic patient, who had been undergoing the treatment of CAPD for two years, was given r-HuEPO intravenously. The patient showed the increment on the levels of Hb and Ht, and the decreases on the levels of serum iron and ferritin. However, the patient has developed hypertension. In conclusion, CAPD was known to be not always effective for the increment of Hb and Ht, while r-HuEPO was very effective for the improvement of severe anemia in CAPD patients which enabls them to lead better social life for them.

[Investigation on antibodies to human T cell leukemia virus type I in patients with primary glomerulonephritis]

We investigated on antibodies to human T cell leukemia virus type I (anti HTLV-I) in 101 patients with primary glomerulonephritis in Kagoshima prefecture, an endemic area of HTLV-I in Japan. The positive rate in patients with primary glomerulonephritis was 17.8%, which was not significantly higher than in healthy residents 4741 persons of 11.9% in the same area. Classified by renal biopsy findings, the positive rate in patients with membranous nephropathy was 21.4% (9/42), minimal change nephrotic syndrome 14.3% (2/14), IgA nephropathy 15.4% (2/26), and others 15.8% (3/19) respectively, which were not significantly differed from that in healthy residents. Positivity of aged patients (60 years or over) in membranous nephropathy on the contrary was significantly higher than that in healthy residents (p less than 0.01). Further study is required to clarify the relationship between HTLV-I infection and glomerulonephritis.

[A case of bilateral multiple lung cancer resected by synchronous bilateral thoracotomy]

A 59-year-old female with multiple lung cancer, located in left upper lobe and in right upper lobe received synchronous bilateral thoracotomy. The patient underwent left upper division segmentectomy and right S3 segmentectomy. Histological examination showed large cell carcinoma in the left side and small cell carcinoma in the right side. The patient died 5 years and 3 months after operation. If general condition and pulmonary function permit, bilateral thoracotomy for multiple lung cancer is recommended.

Tyrosine protein kinases in membrane fractions from rat cerebral cortex

Specific activities of tyrosine tubulin kinase in the particulate fractions from rat cerebellum, medulla oblongata, hypothalamus, striatum, midbrain, and cerebral cortex ranged within 30% of each other and more than 3 times higher than those in the soluble fractions. In the cerebral cortex, tyrosine protein kinase activity toward tubulin and tyrosine-glutamate (1:4) copolymers was mainly distributed in the plasma membrane and the microsome fractions. The kinase activity in cerebral cortex particulate fractions was quantitatively solubilized and separated into two peaks, kinase I and kinase II, by Sephacryl S-300 gel filtration in the presence of 0.2% Nonidet P-40 and 0.2 M NaCl. Kinases I and II were each resolved into 5 active peaks (I-1----5 and II-1----5) by casein-Sepharose column chromatography. The molecular weights of these kinases were estimated from the s20,w values to be 59,000-65,000. The Km values of II-1----5 for tubulin were nearly 10 times higher than those of I-1----5. However, the Km values of the two groups of kinases for tyrosine-glutamate copolymers were not so significantly different. About 60% of the copolymers kinase activity in I-3, I-4, II-3, and II-4 was immunoprecipitable with a saturating amount of monoclonal antibody against pp60c-src. Incubation of the immunoprecipitates with ATP resulted in the autophosphorylation of a 60 kDa protein in I-3 and I-4, and a 52 kDa protein in II-3 and II-4. Immunoblotting also indicated I-3 and I-4 as 60 kDa bands and II-3 and II-4 as 52 kDa bands on SDS-polyacrylamide gels.(ABSTRACT TRUNCATED AT 250 WORDS)