Appearance of tenascin in healing skin of the mouse: possible involvement in seaming of wounded tissues

Distribution of the extracellular matrix glycoprotein tenascin during wound healing in mouse skin was studied immunohistochemically. Within 24 hours after wounding, and preceding the formation of granulation tissue, tenascin appeared in the basement membranes beneath epidermis and hair follicles adjacent to the wound edges and in the wounded edges of cutaneous muscle layer. Granulation tissue began to form in the wound space at about 1-2 days and was immediately covered by epidermis. Tenascin first appeared in the periphery of the granulation tissue beneath healing epidermis and around the wounded edges of cutaneous muscle layer. Then the tenascin-positive area extended into the inner region of granulation tissue. At about 5-7 days, all of the granulation tissue was intensely stained with anti-tenascin serum. Tenascin immunoreactivity decreased as granulation tissue was replaced with reconstructed dermal tissue at 7-14 days. In most cases, tenascin staining persisted longest in the dermis beneath the healing epidermis and at the juncture of healing edges of cutaneous muscle layer. It disappeared at about 10-14 days after wounding. These findings suggest that tenascin may play an important role in the seaming of wounded tissues.

Cases of XY female, single-birth freemartin and trisomy (61, XX, +20) observed in cytogenetical studies on 18 sterile heifers

A total of 18 sterile heifers, their mother cows, their half-sib cows and a bull which may or may not be a full-sib were cytogenetically investigated. Three cases out of the 18 sterile heifers showed different types of chromosomal abnormalities respectively; 60, XY; 60, XX/60, XY; 61, XX, +20. The remainder showed normal karyotype.

The effect of hyperoxia on the lungs of rats deficient in essential fatty acids

Morphological alterations in the lungs of rats deficient in either or both of vitamin E and essential fatty acids were investigated after exposure to hyperoxia for 48 h. In rats deficient in both vitamin E and essential fatty acids, there was damage to type-2 alveolar cells observed as swollen mitochondria and bleb formation in the cytoplasm. None of these changes was found in rats deficient in only one of these substances. Hyperoxia in rats deficient in both substance also caused destruction of the capillary endothelial cells and edema in the interstitium. The lungs of rats deficient in only one of the substances showed some edema in the capillary endothelial cells, but not destruction, and less interstitial edema. These findings suggest that simultaneous deficiency in vitamin E and essential fatty acids facilitates lung damage in rats exposed to hyperoxia.

[Respiratory failure after thymectomy in myasthenia gravis: evaluation of preoperative influencing factors and preventive managements against postoperative respiratory dysfunction]

Postoperative respiratory function was evaluated in 94 patients with myasthenia gravis after thymectomy. Preoperative clinical and pulmonary function data were submitted to statistical analyses. The duration of respiratory support and intratracheal intubation time were significantly correlated to % vital capacity, the clinical stage of myasthenia gravis, and the clinical stage of thymoma. Statistical analyses proved that anticholinesterase drugs taken in immediate postoperative period contributed to the improvement of postoperative respiratory function, and non-depolarizing muscle relaxants, i.e. d-tubocurarine which had been considered to be contraindicated in myasthenia gravis was found to be beneficial immediately after the operation in patients with severely deteriorated respiratory function preoperatively.

Improvement of right ventricular systolic performance by long-term domiciliary oxygen therapy in patients with chronic respiratory failure

Eight patients with clinically stable chronic respiratory failure, hypoxemia (PaO2 less than or equal to 60 mmHg) and pulmonary hypertension (mean pulmonary arterial pressure greater than or equal to 20 mmHg) were allocated to long-term domiciliary oxygen therapy, and were followed for three months. Oxygen was supplied for from 15 to 18 hours daily from an oxygen concentrator at a flow rate sufficient to raise the PaO2 to 60 to 80 mmHg. We examined the effects of this therapy on right ventricular performance both at rest and during exercise in these patients. Hemodynamic data were obtained by right heart catheterization. Right ventricular ejection fractions (RVEF) were ascertained using first-pass quantitative radionuclide 81mKr angiocardiography. Thirty minutes of oxygen inhalation at rest had no significant effect on cardiac function, both before therapy (T0) and after 3 months of therapy (T1). The mean pulmonary arterial pressure and the pulmonary vascular resistance during exercise were not significantly different between T0 and T1. On the other hand, at T0, the RVEF tended to decrease from 51.6 +/- 4.9% (during oxygen inhalation at rest) to 48.7 +/- 7.9% (during exercise), whereas at T1 it significantly (p less than 0.05) increased from 48.8 +/- 6.8% (during oxygen inhalation at rest) to 54.2 +/- 8.2% (during exercise). Thus, while 3 months of long-term domiciliary oxygen therapy did not reduce the right ventricular afterload either at rest or during exercise, it was found to improve the right ventricular systolic performance during exercise. This suggested that long-term oxygen therapy could be useful in improving the quality of daily life of patients with chronic respiratory failure.

Plasma apolipoprotein and lipid profiles in infants in the first year of life

Five different apolipoproteins (apo) and lipid profiles were studied in breast-fed mature (BM), brest-fed premature (BP), formula-fed mature (FM) and formula-fed premature (FP) infants in the first year of life. The plasma apo A-1, B, C-II and C-III levels in all groups of infants increased rapidly after birth until 4 weeks of age, and then became stable. On the other hand, apo A-II levels did not change markedly in any of the groups of infants during the neonatal period, but there was a gradual increase in mature infants thereafter. At 12 months of age, apo A-I, A-II and B remained significantly lower than in adults. There were no significant differences in any of the apolipoprotein levels between BM and FM infants or between BP and FP infants except for apo A-I and C-III of premature infants at 3 weeks of age. When premature and mature infants were compared, premature infants showed lower apolipoprotein levels except for apo A-II, and the differences were especially prominent in the neonatal period. Plasma triglyceride levels rapidly increased in the neonatal period and were stable thereafter. Whereas plasma total cholesterol levels increased gradually until one year of age. There were no differences between breast-fed and formula-fed infants. Both triglyceride and total cholesterol levels in premature infants were lower than those in mature infants during the neonatal period. Thus, the proportional change in plasma lipids and apolipoprotein levels during this study period may indicate that lipoprotein composition is not markedly deteriorated even in different nutritional condition in the first year of life.

[Evaluation of mid-ventricular obstruction of hypertrophic cardiomyopathy by real-time two-dimensional Doppler flow imaging: a case report]

Mid-ventricular obstruction was evaluated in a case of hypertrophic cardiomyopathy using a real-time two-dimensional Doppler flow imaging system. A 60-year-old woman was referred to our hospital because of oppressive precordial sensation., I-mode echocardiography showed asymmetric septal hypertrophy: thickness of the end-diastolic left ventricular posterior wall was 9 mm, and that of the interventricular septum was 19 mm. However, there was no systolic anterior motion of the mitral apparatus. Doppler color flow imaging showed a mid-left ventricular narrowing in late-systole and a mosaic pattern was depicted from the mid-ventricle to the outflow tract. Continuous wave Doppler echocardiography disclosed a peak velocity of 2.0 m/sec (pressure gradient (PG) = 16 mmHg). In the right ventricular outflow tract, a mosaic pattern was also seen and a peak velocity of 1.5 m/sec was detected (PG = 9 mmHg). These results were nearly identical with the data measured by cardiac catheterization. Thus, it was concluded that intraventricular obstruction of hypertrophic cardiomyopathy is diagnosed by observing the flow image and flow velocities in the ventricle using a real-time two-dimensional Doppler flow imaging system.

Transient carnitine-responsive medium-chain dicarboxylic aciduria in an infant with cholestasis, hypoglycemia and cardiac failure

In a cholestatic infant showing hypoglycemia and cardiac failure, non-ketotic medium-chain dicarboxylic aciduria was disclosed by urinary organic acid analysis. As urinary excretion of long-chain fatty acids was also increased, a defect in beta-oxidation of long-chain fatty acids appeared likely. To try to improve this abnormality, carnitine supplements were given, which led to the complete resolution of clinical and laboratory abnormalities. This is the first reported case of a cholestatic infant who responded to carnitine supplementation. Deficiency of carnitine palmitoyl transferase was suspected as the underlying cause.

A long-term follow-up study of patients with gastric cancer detected by mass screening

This report is based on 1,139 patients with gastric cancer (GC) detected by mass screening conducted by the Center for Adult Diseases, Osaka during 1961-1985. Early GC totalled 527 patients and advanced GC totalled 612 patients. In 859 patients curative resection was performed. Their vital status was traced yearly and six patients were lost to follow-up. Relative survival rates of screening-detected GC patients were 69-70% and almost constant after 5 years from operation/diagnosis. The survival curve in which only death from GC was counted as a death was almost equal to the relative survival curve in its shape and value. The hazard rates of screening detected GC patients decreased rapidly within 7 years and remained low after 7 years. It was confirmed by this long-term follow-up study that about two thirds of GC patients detected by screening were successfully cured of their disease.

[The role of epidemiologic research of the natural history of cancer for evaluating cancer screening programs--a prospective study of colorectal polyps on the occurrence of colorectal cancer]

In order to elucidate the natural history of colorectal polyps and to examine the effectiveness of endoscopic polypectomy in reducing the incidence of colorectal cancer, we conducted a retrospective cohort study of all patients who had undergone endoscopic examination at the Center for Adult Diseases, Osaka in 1970-82. The study subjects consist of 653 non-polyp cases and 431 colorectal polyp cases including 222 cases treated by endoscopic polypectomy. These were followed up until the end of 1985 by the method of a record linkage with the Osaka Cancer Registry's file. The colorectal polyp group and the endoscopic polypectomy group experienced 4.4 and 2.9 times, respectively, as much incidence of colorectal cancer as the non-polyp group. The magnitude of the prevented fraction by the use of endoscopic polypectomy was estimated at 31.3%. A large-scale and long-term study is necessary to elucidate the original study purpose.

Second primary cancers following female breast cancer in Osaka, Japan--a population-based cohort study

Using the data accumulated in the Osaka Cancer Registry, a cohort study was conducted on the occurrence of second primary cancers following the first breast cancer in females. Of the 9,503 breast cancer patients newly diagnosed in the period 1965-1982 who were followed up until the end of 1983 (average follow-up period, 5.7 years), 344 developed second cancers, whereas the expected number had been 211 (relative risk (RR) = 1.6; 95% confidence interval (CI) = 1.5-1.8). The increased risk was observed throughout the observation period, and was higher in patients of less than 45 years of age at diagnosis than in older women. Significant excess risks were found for second cancers of the opposite breast (RR = 4.2; 95% CI = 3.4-5.2), buccal cavity (RR = 3.6; 95% CI = 1.6-7.2), stomach (RR = 1.4; 95% CI = 1.2-1.8), colon (RR = 1.8; 95% CI = 1.1-2.1) and thyroid gland (RR = 3.2; 95% CI = 1.5-6.1). The effects of chemo- and radiotherapy administered for initial breast cancer on the increased risk of the above mentioned second cancers were also examined. These therapeutic measures were found not likely to be related to the excess risks for cancers of the buccal cavity, stomach and colon. For second cancer of the opposite breast, however, both chemotherapy and radiotherapy remained as possible risk factors. The effect of radiation was proposed as being a likely explanation for the excess risk of second thyroid cancer.

A histological study of the development of the penis of wild-type and androgen-insensitive mice

Development of the penis of wild-type and androgen-insensitive (Tfm) mice was compared histologically to demonstrate possible androgen-dependent histogenesis in this organ. The os penis of the normal males consists of a hyaline cartilage and a membrane bone in the proximal segment and a fibrocartilage in the distal segment. Only the membrane bone of the proximal segment developed in the Tfm mice. The corpus cavernosum penis, corpus cavernosum glandis, and corpus cavernosum urethrae developed only to a small degree in the penis of the Tfm mice. It is also suggested that the morphogenesis of the urethra and formation of spines on the skin of the glans penis are dependent on androgens.

Autoradiographic studies of the localisation of androgen-binding cells in the genital tubercles of fetal rats

Distribution of androgen-binding cells in the genital tubercles of male and female fetuses of rats was examined by steroid autoradiography. Binding of [3H]testosterone appeared in the preputial mesenchymal cells, mesenchymal cells around the urethra and in the urethral epithelial cells at 15.5 days of gestation, and in the precursor cells of the proximal and distal segments of the os penis and corpus cavernosum penis at 16.5-17.5 days of gestation in both the male and female fetuses. Mesenchymal cells were suggested to be target cells for androgens which cause the morphogenetic and histogenetic changes in the penis of rats.

[Right ventricular function in patients with chronic obstructive pulmonary disease measured by krypton-81m]

Right ventricular function was assessed at rest and during exercise in patients with chronic obstructive pulmonary disease (COPD). Right ventricular ejection fraction (RVEF) was measured by first-pass radionuclide angiography using ultrashort-lived radionuclide krypton-81m. The half-life of this nuclide is only 13 sec, and it is completely expired from the lungs. These properties allow measurement of RVEF without correcting for background activity. In 30 patients with cardiac or pulmonary disease, RVEF was first measured by krypton-81 m scintigraphy (Kr-RVEF), then by technetium-99m (Tc-RVEF), without changing the patients' positions. In eight of the 30 cases, right ventricular cineangiography (RVG) was performed within 72 hrs after the radionuclide study, and RVEF was measured according to the Chapman's rule (RVG-RVEF). Kr-RVEF correlated significantly with Tc-RVEF (r = 0.87), and also with RVG-RVEF (r = 0.80). In 10 patients with stable COPD, who had severe hypoxemia (PaO2 less than or equal to 60 mmHg) and pulmonary hypertension [mean pulmonary arterial pressure (mean PAP) greater than or equal to 20 mmHg], and in seven normal control subjects, radionuclide angiographic and hemodynamic monitoring were performed at rest and during supine ergometer exercise. Kr-RVEF at rest was 47.6 +/- 5.4% (mean +/- SD) in patients with COPD and was 54.1 +/- 4.8% in normal subjects. Kr-RVEF during exercise was 51.8 +/- 7.3% in the patients, and 62.3 +/- 3.2% in the normal subjects. Hemodynamically, mean PAP and pulmonary vascular resistance (PVR) increased significantly during exercise, but the RV end-diastolic volume index (RVEDVI) did not change. There was inverse correlation between Kr-RVEF and mean PAP (r = -0.51) or PVR (r = -0.47) as an index of RV afterload. However, there was no correlation between Kr-RVEF and RVEDVI as an expression of RV preload. These findings suggest that a poor response by RVEF during exercise in patients with COPD is associated with elevation of afterload. Thus, right ventricular imaging techniques using the ultrashort-lived nuclide krypton-81 m allow noninvasive, serial and accurate assessments of right ventricular function in patients with COPD.

Development of the os penis in genital tubercles cultured beneath the renal capsule of adult rats

Genital tubercles of male and female rats were cultured beneath the renal capsule of castrated and intact adult male rats treated with androgens, oestrogen, or anti-androgen, and the development of the os penis in the transplants was studied. When the genital tubercles were cultured in normal male hosts, a membrane bone and a hyaline cartilage of the proximal segment of the os penis were formed 8-11 days after transplantation, and a fibrocartilage of the distal segment of the os penis at 11-14 days. In genital tubercles cultured in castrated males, the rudiments of both the proximal and distal segments remained as undifferentiated mesenchymal cell masses. However, similarly cultured genital tubercles were found to develop cartilages and bone when the hosts were treated with high doses of androgens. The potency of androgen-dependent chondrogenesis and osteogenesis was equivalent in the male and female genital tubercles. Chondrogenesis and osteogenesis of the os penis were caused by androgens, while the rudiments of the os penis were formed independently of androgens. The overt differentiation of the corpus cavernosum penis was also caused by androgens.

Proximal-distal sequence of development of the skeletal tissues in the penis of rat and the inductive effect of epithelium

The penis of adult rats comprises the corpus cavernosum penis and the proximal and distal segments of os penis which are situated proximal-distally in this order. Androgens are necessary for the phenotypic differentiation of these tissues. In the present study, genital tubercular mesenchyme of foetal rats was recombined with or without homologous or heterologous epithelia and transplanted beneath the kidney capsule of syngeneic adult male rats, and the development of the corpus cavernosum penis and the os penis in the transplants was examined. Only in the presence of epithelia can the genital tubercular mesenchyme acquire the capacity for differentiation into the corpus cavernosum penis, the proximal segment of os penis, and the distal segment of os penis in this chronological order. The inductive effect of epithelium is a permissive step in the differentiation of the os penis of rat. The epithelium seems to be necessary for the process of rudiment formation of the os penis and the corpus cavernosum penis.

Association of second primary leukemias with the method of treatment of the first primary cancer

A case-control study of the association between chemotherapy and/or radiotherapy for the first primary cancer and the second primary leukemia was made. All leukemia cases were collected from the cancer patients' file of the Osaka Cancer Registry which listed more than 220,000 cases during the 1965-82 period. Among the 2,765 leukemia patients, 46 had other (first) cancers. Two controls were selected from the cancer patients' file for each of the first primary cancers of 46 cases, with which they were matched in age, sex, cancer site, date of diagnosis, size of the treating hospital and survival period. Comparing the method of treatment of the first primary cancer in the cases and the controls, the proportion of patients treated by chemotherapy and/or radiotherapy was significantly higher among the cases than among the controls when the interval of the two primary cancers was 5 years or more.

[The diastolic pressure-volume relationship of the left ventricle--evaluation of canine isovolumetric contracting left ventricle]

Isovolumetrically contracting left ventricle of the anesthetized dog was used to evaluate the end-diastolic pressure-volume relationship [LVEDP (P)-LVEDV (V) relationship (curve)] following changes in heart rate, ischemia and administration of beta-adrenergic blocking drug. At the same time, relaxation indices were also obtained. Initial left ventricular volume was set at the end-diastolic pressure of 2.0 mmHg. Comparison of each parameters after intervention was done when each initial left ventricular volume was increased by 10 ml. With increase in heart rate, LVEDP increased significantly from 5.1 +/- 2.1 to 14.0 +/- 2.2 mmHg (at 160 bpm, p less than 0.02, vs 100 bpm) and to 24.0 +/- 1.0 mmHg (at 180 bpm, vs p less than 0.001, vs 100 bpm). Regional ischemia also increased LVEDP significantly from 6.4 +/- 1.4 mmHg to 12.8 +/- 4.1 mmHg (after 30 min, p less than 0.01, vs control) and to 14.1 +/- 4.7 mmHg (after 45 min, p less than 0.01, vs control). However, global ischemia produced by decreasing coronary perfusion pressure to 50 mmHg, or administration of propranolol (1.0 mg/kg) brought about no significant changes in LVEDP. Among the relaxation indices, peak negative dp/dt decreased significantly following global ischemia, regional ischemia and administration of propranolol (from 1101 +/- 131 to 733 +/- 49 mmHg/sec, p less than 0.01, from 888 +/- 425 to 268 +/- 94 mmHg/sec after 45 min, p less than 0.01 and from 562 +/- 160 to 291 +/- 100 mmHg/sec, p less than 0.01, respectively). On the other hand, time constant (T) of the left ventricular pressure fall was prolonged significantly following regional ischemia from 44.7 +/- 5.2 to 72.0 +/- 8.6 msec (after 30 min, p less than 0.001) and 95.4 +/- 26.0 msec (after 30 min, p less than 0.001) and 95.4 +/- 26.0 msec (after 45 min, p less than 0.001). Therefore, it is concluded that LV diastolic compliance decreases by tachycardia (160 and 180 bpm) and regional ischemia, while the changes of the relaxation indices were not necessarily parallel to those of the LV compliance.

Relationship between lipids and angiographically defined coronary artery disease in Japanese patients

The relationship between the severity and extent of coronary artery disease (CAD) and the lipid profiles was evaluated in 120 Japanese male patients, who underwent coronary angiography. Analysis of the lipid quartile distribution showed that the percentage of patients with significant CAD increased as the total cholesterol (TC) increased and high-density lipoprotein cholesterol (HDL-C) decreased. In addition, as the number of vessels with marked coronary artery stenosis increased, TC and TC/HDL-C increased while HDL-C decreased. However, within this population, triglyceride level, high blood pressure, and smoking were not significantly associated with coronary angiographic findings.

Acute and chronic hemodynamic effects of the basic therapeutic regimen for congestive heart failure. Diuretics, low salt diet and bed rest

The acute and chronic hemodynamic effects of the "basic regimen" for congestive heart failure (CHF), consisting of diuretics (furosemide) low salt diet and bed rest, was studied in 10 patients with CHF (all in NYHA class IV initially). In the acute stage, furosemide 80 mg i.v. effected rapid clinical improvement with reduction in ventricular filling pressures (VFP); however, no increase in cardiac-(CI) or stroke volume index (SVI) was observed. Subsequently, furosemide 80 mg/day, p.o. was administered for a mean of 30 days with the patients hospitalized on a low salt diet. During this period, their clinical condition was stable. The second hemodynamic study revealed that SVI increased (p less than 0.05) with reduction in VFP maintained. Next, low molecular weight dextran was infused to construct the Frank-Starling ventricular function curve (VFC) and this was compared with the VFC at the acute stage (during diuresis). As a whole, CI and SVI at the chronic stage were significantly increased (p less than 0.05) at equal pulmonary wedge pressures (PWP: mean 20 mmHg). Mean arterial pressure and systemic vascular resistance were decreased during the chronic stage. These findings suggest that the "basic CHF regimen" is effective on a chronic basis in improving left ventricular pump function through afterload and preload reduction, in addition to acute symptomatic relief due to a decrease in PWP.