Mediastinal lymph node metastasis in patients with clinical stage I peripheral non-small-cell lung cancer

Our aim in this study was to determine the mediastinal areas where lymphadenectomy should be done at the time of surgical resection of clinical stage I lung cancer. Between 1984 and 1994, 575 patients with clinical stage I non-small-cell lung cancer underwent lobectomy and systematic mediastinal lymphadenectomy. Mediastinal lymph nodes were pathologically positive for disease in 79 patients (14%), and positive nodes appeared normal intraoperatively in 54 patients (68%). Thirty-three percent of those patients with positive N2 (mediastinal) nodes had negative lobar (N1) nodes. In cancer of the right upper lobe, all N2 cases had the lymph node metastases in the superior mediastinal compartment. In cancer of the right middle lobe, all N2 cases but one had the metastases in subcarinal or anterior mediastinal nodes. In cancer of the right lower lobe, all N2 cases but one the metastases in subcarinal nodes. In cancer of the left upper lobe, all N2 cases had the lymph node metastases in the subaortic compartment. In cancer of the left lower lobe, all N2 cases but one had the lymph node metastases in the subcarinal area or subaortic compartment. In conclusion, systematic staging of mediastinal lymph nodes is necessary for all patients with resectable clinical stage I lung cancer. The location of the primary tumor determines the mediastinal areas where lymphadenectomy should be done to examine all lymph nodes.

New fracture-labelling method: alkaline phosphatase in unstimulated human neutrophils

We show a new freeze-fracture enzyme cytochemistry technique, i.e. fracture-labelling by enzyme cytochemistry. Freeze-fracture replication is carried out first and subsequently enzyme molecules in the split-membrane halves of cellular membranes are labelled with enzyme cytochemical markers. A replica-digestion treatment before the cytochemical reactions is a key step in this method. Triton X-100, saponin, and ultrasonication provided adequate cleaning of the replicas with good preservation of enzyme activity. Enzyme cytochemical fracture-labelling was applied to the study of alkaline phosphatase (ALPase)-positive granules in unstimulated human neutrophils. ALPase activity was found primarily on the exoplasmic membrane halves of intracellular small granules. Using X-ray microanalysis, we confirmed that the electron-dense deposit on replicas was the reaction product demonstrating ALPase activity. The results obtained by this method should provide unique information for the understanding of structure and function of biological membranes.

The alginate reduce the postprandial glycaemic response by forming a gel with dietary calcium in the stomach of the rat

Soluble dietary fibers include an alginate which reduces the postprandial glycaemic response. We speculated that the cause of the reduction of alginate on the glycaemic response is the gel formation of alginate with dietary calcium in the stomach. The aim of the present study was to confirm our hypothesis and to examine the effect of the sugar composition of alginates on the glycaemic response and the effect of continuous feeding of alginate-containing diet to rats. Diabetic rats were made by injecting streptozotocin (STZ) intravenously. These rats were fed 5 g of the experimental diet with or without sodium alginate and with or without calcium after overnight fasting. In the rats fed the diet containing both alginate and calcium, the postprandial glycaemic response was lower than in the rats fed other diets and gastric contents were retained as gel form. Three beta-d-mannuronic acid (M) to alpha-l-guluronic acid (G) (ratios (M/G 0.5, 1.3, 2.1) of alginates were not associated with the acute glycaemic response in STZ rats. Then, we fed normal rats with an alginate-free or one of three respective alginate-containing diets for 4 weeks. During the first 2 weeks of the feeding period, the total amount of food intake of rats fed the G-rich alginate diet was smaller than that of rats in the other dietary groups. Moreover, the weight of the dorsal abdominal adipose tissue of rats given the G-rich alginate diet was the lowest among the dietary groups. We conclude that the reductive effect of alginate feeding on the postprandial glycaemic response was not caused only by their inherent viscosity, but also by gel formation with dietary calcium in the stomach. Moreover, it is necessary to pay attention to the M/G ratio of alginates for estimating their physiological effect.

Effect of ethylene thiourea on cultured rat embryos in the presence of hepatic microsomal fraction

To investigate whether teratogenicity of ethylene thiourea (ETU) is due to ETU per se or to its metabolites, rat embryos cultured in vitro were exposed to 10 and 30 micrograms/ml of ETU in the presence or absence of rat liver microsomal fraction (S9mix). In the absence of S9mix, the incidence of morphological abnormalities increased dose-dependently. In the presence of S9mix, abnormal morphogenesis was almost absent in all embryos. These findings suggest that teratogenicity of ETU is due to ETU per se.

alpha 1-Adrenoceptor stimulation partially inhibits ATP-sensitive K+ current in guinea pig ventricular cells: attenuation of the action potential shortening induced by hypoxia and K+ channel openers

Effects of alpha 1-adrenoceptor stimulation on the action potential shortening produced by K+ channel openers (KCOs) or hypoxia and on the ATP-sensitive K+ current (IK.ATP) activated by KCOs were examined in guinea-pig ventricular cells by using conventional microelectrode and patch-clamp techniques. In papillary muscles, nicorandil (1 mM) or cromakalim (30 microM) markedly shortened the action potential duration (APD) (to 51 +/- 2% and 40 +/- 5% of each control value). Addition of 100 microM methoxamine, an alpha 1-adrenoceptor agonist, partially but significantly reversed the KCOs-induced APD shortening (to 69 +/- 3% and 50 +/- 4% of each control value). The APD-prolonging effect of methoxamine was antagonized by 1 microM prazosin (alpha 1-antagonist) and 100 nM WB4101 (alpha 1A-antagonist) but not by 10 microM chloroethylclonidine (alpha 1B-antagonist). In papillary muscles exposed to a hypoxic, glucose-free solution, APD declined gradually. In the presence of 100 microM methoxamine or 10 microM glibenclamide, the hypoxia-induced action potential shortening was significantly inhibited. In single ventricular myocytes, the KCOs increased a steady-state outward current that was abolished by glibenclamide (1 microM), thereby suggesting that these KCOs activate IK.ATP. Methoxamine (100 microM) significantly inhibited the nicorandil-induced IK.ATP by 18 +/- 5% and the cromakalim-induced IK.ATP by 16 +/- 2%. 4 beta-Phorbol 12-myristate 13-acetate (100 nM), a protein kinase C activator, failed to mimic the alpha 1-adrenoceptor-mediated inhibition of the nicorandil-induced outward current. Staurosporine (30 nM), a protein kinase C inhibitor, also failed to affect the partial inhibition of IK.ATP by methoxamine. Neither intracellular loading of heparin (100 micrograms/ml), an inositol 1,4,5-trisphosphate (IP3)-dependent Ca2+ release inhibitor, nor IP3 (20 microM) plus inositol 1,3,4,5-tetrakisphosphate (IP4 5 microM) could affect the inhibitory action of methoxamine. In conclusion, alpha 1A-adrenergic stimulation partially inhibits IK.ATP in cardiac cells. Neither protein kinase C activation nor IP3 formation appears to be involved in the partial inhibition of IK.ATP. The alpha 1A-adrenoceptor-mediated inhibition of IK.ATP may be deleterious for ischemic myocardium and partly offset the cardioprotective effect of KCOs because attenuation of action potential shortening may potentially increase Ca2+ influx in ischemic cells.

Time course of ethylene thiourea in maternal plasma, amniotic fluid and embryos in rats following single oral dosing

Ethylene thiourea (ETU) was administered once orally to pregnant rats on gestation day 12 at a dose of 200 mg/kg, and its concentration-time courses in the maternal plasma, amniotic fluid and embryos were investigated. The ETU concentrations in the maternal plasma and amniotic fluid reached the peak level about 2 hr after dosing, then declined gradually and had disappeared by 48 hr. In embryos, the concentration of ETU peaked at 30 min after dosing and disappeared at 48 hr. The prolonged exposure of the embryos to the high concentration of ETU in the amniotic fluid could be partially responsible for the teratogenic effect of ETU.

Possible involvement of double-stranded RNA-activated protein kinase in cell death by influenza virus infection

We reported previously that influenza virus infection induces the apoptotic death of HeLa cells associated with activation of the Fas gene. In this report, we show that transfection with a PKR having a point mutation in the catalytic domain of K at 296 to R suppressed both the augmented expression of Fas and cell death by influenza virus infection. These results suggested the involvement of PKR in influenza virus-induced cell death.

Inhibitory effect of indomethacin on neonatal lung catabolism of prostaglandin E2: possible mechanism of the re-opening of the ductus arteriosus after indomethacin therapy

Indomethacin has been used to treat patent ductus arteriosus (PDA). Re-opening of the ductus arteriosus (DA) after indomethacin therapy, however, is common, although the reason is unclear. Patency of the ductus arteriosus is thought to be maintained primarily by the vasodilatory effect of PGE2 in fetuses and neonates. The enzyme, 15-hydroxy prostaglandin dehydrogenase (15-PGDH) catalyzes the initial reactions converting the biologically active PGE2 to its inactive metabolite 15-keto-PGE2, and the lungs are a major site of this inactivation. In the present study, the effect of prenatal indomethacin treatment on the activity of neonatal rat lung 15-PGDH, and the effect of prenatal indomethacin on the re-opening of the DA induced by PGE2 were examined in rats. Indomethacin treatment at 3 mg/kg/day from day 18 to day 20 of gestation significantly decreased the activity of 15-PGDH in neonatal lungs. In a subsequent experiment, subcutaneous injection of PGE2 (4 micrograms) was given to newborn rats 3 hr after Cesarean delivery from pregnant females administered indomethacin (1, 3 mg/kg/day) as in the above experiment. The ratio of the DA to pulmonary artery was determined at intervals after injection. Maternal indomethacin treatment significantly increased the re-opening of the DA and prolonged the duration of re-opening induced by PGE2. These results suggest that the decrease in the catabolism of PGE2 in the lung is partly responsible for the failure of indomethacin therapy for PDA.

Antibody mediated lung targeting of long-circulating emulsions

Monoclonal antibody 34A, which specifically binds to a surface glycoprotein (thrombomodulin) of the pulmonary endothelial cell surface in mice, has been conjugated to the surface of long-circulating emulsions composed of Castor oil, phosphatidylcholine and polyethylene glycol coupled to distearoylphosphatidyl-ethanolamine. These antibody-containing emulsions were found capable of binding to the lung when injected into mice through the tail vein. The level of lung accumulation of these emulsions depends on the amount of antibodies conjugated to the surface of the emulsions. With an input antibody to lipid ratio of 2:1 (w/w), 30% injected emulsions were found in the lung 30 minutes after administration. Such high level accumulation can be blocked by co-administration of free 34A antibody, indicating that the binding is specific and 34A antibody mediated. Kinetic studies showed that emulsion targeting to the lung was very rapid. Five minutes after tail vein injection, the total amount of emulsion found in the lung was the highest among the time points examined, indicating the completion of lung binding. However, about 50% of the initially bound emulsions remained bound for more than 4 hours. These results indicate that the targeted drug delivery using oil-in-water emulsions could be very useful to enhance the therapeutic efficacy of lipophilic drugs.

Effect of maternal adrenalectomy and corticosterone therapy on the early development of B-cells in the fetal pancreatic islet in the rat

Pregnant Wistar rats were divided into 3 groups, non-operated control, adrenalectomized, and adrenalectomized and corticosterone-treated. Maternal adrenalectomy was performed on day 6 of gestation. Corticosterone therapy was made from the day at operation to the day at observation. The growth pattern of insulin-producing B-cells was observed immunohistochemically and histometrically from days 12 to 16. The results obtained were as follows: From day 12 to day 15, maternal adrenalectomy resulted in a significant retardation of the growth of insulin-positive B-cells in terms of the collective volume of the cells. Maternal corticosterone therapy prevented this retardation. On day 16, however, the growth of B-cells in collective volume overcame the suppressive effect of maternal adrenalectomy. These results suggest that the lack of adrenocortical hormones causes a retardation of B-cell growth in early development, and that, when once developed well, B-cells can grow independently of the hormones.

Identification and expression of six family genes in mouse retina

We identified five cDNA clones of the Six gene family which are expressed in retina. They are Six2, Six3 alpha and Six3 beta (which are derived from alternative splicing forms), Six5, and AREC3/Six4. All of these Six family genes possess extensive sequence similarity among each other in the so-homologous region (Six domain and homeodomain) but differ greatly in structure in some other regions. The amino acid sequence similarity of the so-homologous region to the previously identified AREC3/Six4 is 70.1% for Six2, 57.3% for Six3 alpha and Six3 beta, and 70.3% for Six5. The expression of these genes was observed in inner and outer nuclear layer, ganglion cell layer, and pigment epithelium of mouse retina by in situ hybridization. The so-homologous region of each Six family protein has specific DNA binding activity. Six5 and Six2 bind to the same sequence as does AREC3/Six4, while Six3 does not. These observations suggest that some of the Six family genes can regulate the same target genes.

[Selection of staple for closure of the lobar bronchus]

From January 1984 to October 1995, Stapling of lobar bronchus excluding middle lobe was investigated in 335 patients with lung cancer. We used routinely the 3.5 mm staple in the previous term and the 4.8 mm staple in the latter term. The stapling with 3.5 mm staple was performed in 220 patients. The stapling failed in the pressure proof test intraoperatively in 8 patients and bronchopleural fistula occurred postoperatively in 4 patients. The bronchus was cut or destroyed by the staple in most of them. The stapling with 4.8 mm staple was performed in 115 patients. The stapling failed in the pressure proof test intraoperatively in one patient because of loose closure of the bronchus. Bronchopleural fistula did not occur postoperatively. In conclusion, the 4.8 mm staple is a better choice for closure of the lobar bronchus except for a small woman or middle lobe.

Effects of the new calcium antagonist efonidipine hydrochloride on resting and exercise hemodynamics in patients with stable effort angina

The action of efonidipine hydrochloride ((+/-)-2-[benzyl(phenyl)-amino]ethyl 1,4-dihydro-2,6-dimethyl-5-(5,5-dimethyl-2-oxo-1, 3,2-dioxaphosphorinan-2-yl)-4-(3-nitrophenyl)-3-pyridinecarboxy late hydrochloride ethanol, CAS 1110011-76-8, NZ-105) a new dihydropyridine calcium antagonist, on cardiac hemodynamics at rest and during exercise as well as plasma concentration and pharmacokinetic parameters were studied in 9 patients with angina pectoris. NZ-105 was administered 40 mg once daily for a week and cardiac hemodynamics parameters were measured at rest and during exercise using a bicycle ergometer before and after treatment. All patients showed anginal symptoms during exercise before treatment, while only 4 showed anginal symptoms during exercise after treatment. Improvement on electrocardiograms (ECG) (> 0.1 treatment mV) was detected in 4 out of 9, and NZ-105 was recognized to have an anti-anginal action. The mean plasma concentration of NZ-105 at the time was 14.5 ng/ml. At rest, reduction in blood pressure and decrease in total peripheral vascular resistance were observed, however, NZ-105 showed no effect on heart rate, cardiac index, pulmonary arterial pressure and central venous pressure. During maximum exercise, a decrease in total peripheral vascular resistance, reduction in pulmonary arterial pressure and central venous pressure, increasing tendency of left ventricular ejection fraction, and increase in cardiac index were observed. However, NZ-105 showed no effect on heart rate and blood pressure. Based on the results mentioned above, cardiac hemodynamics of NZ-105 during exercise, featured primarily, reduction of afterload and improvement of cardiac functional deterioration due to exercise. In conclusion, NZ-105 is useful in patients with ischemic cardiac diseases by improving hemodynamics and ECG findings during exercise in patients with effort angina.

Staging of primary lung cancer by computed tomography-guided percutaneous needle cytology of mediastinal lymph nodes

BACKGROUND

The necessity of an easy and noninvasive technique to evaluate mediastinal node status cytopathologically is considered.

METHODS

Eighteen cases of clinical N2 primary lung cancer were examined. Under local anesthesia, the lymph node was punctured with a 19-gauge needle using intermittent computed tomographic monitoring, and samples were studied cytologically. Subcarinal (no. 7) nodes and lower paratracheal (no. 4) nodes were sampled using the paraspinal posterior approach. Anterior mediastinal (no. 6) nodes were sampled using the parasternal anterior approach. Node status was diagnosed pathologically at operation.

RESULTS

Number 7 nodes were examined in 11 cases, no. 4 nodes in 5 cases, and no. 6 nodes in 2 cases. Malignant cells were detected in 14 cases. Fourteen cases were diagnosed as true positive, 2 cases as true negative, and 2 cases as false negative. The sensitivity, specificity, and accuracy of this method were 88%, 100%, and 89%, respectively. Pneumothorax developed in 4 cases (22%).

CONCLUSIONS

Computed tomography-guided percutaneous needle cytology of mediastinal lymph nodes is useful for staging primary lung cancer. Because this is a small series, additional studies are necessary.

Fibrillary inclusions in neoplastic and fetal acinar cells of the pancreas

We report a case of pancreatic acinar cell carcinoma which contained a large number of pleomorphic inclusions with fibrillary internal structures and mature zymogen granules. To clarify the significance of fibrillary inclusions in the differentiation of acinar cells of the pancreas, we further investigated fetal pancreases (gestational weeks 16, 17, 19, 20 and 28). We found two types of inclusions: type A, corresponding to fibrillary inclusion of neoplastic acinar cells, was observed only in a 19-week fetus; type B showed a homogeneous density similar to that of zymogen granules. Type B was observed in all the fetuses after the 17th gestational week. Although the type A inclusion might be generated through a different mechanism than the type B inclusion, the appearance of a large number of fibrillary inclusions in neoplastic acinar cells may represent a transient form of zymogen granule.

[Mechanism of the induction of apoptosis by influenza virus infection]

Influenza virus frequently causes acute respiratory inflammation. We and others have observed that influenza virus infection induces apoptosis both in vitro and in vivo. We found that the virus infection induces augmented Fas expression. We proposed that double-stranded RNA (dsRNA) activated protein kinase (PKR) is involved in Fas expression since a synthetic dsRNA activated Fas gene and exposure of the cells to anti-interferon-beta antibody, which decreased the PKR activity, suppressed the cell death, as well as an increase in Fas mRNA. Furthermore, transfecting the mutant PKR suppressed the augmented Fas expression and rendered the cells resistant to death upon virus infection. These results suggest that Fas gene activation in virus-infected cells is regulated by the PKR/interferon system.

Freeze-fracture enzyme cytochemistry: application of enzyme cytochemistry to freeze-fracture cytochemistry

We present a novel freeze-fracture cytochemistry method based upon enzyme cytochemistry. By this method, freeze-fractured membranes are labeled with cerium as an enzyme cytochemical marker on replicas. The cerium capture method was suitable for freeze-fracture enzyme cytochemistry because the cerium phosphate reaction product is stable after replica-cleaning. As a model system, acid phosphatase, which is a well-known lysosomal marker, was detected on freeze-fractured membranes of lysosomes in the proximal tubular epithelium of the rat kidney. This technique should be a useful addition for analyzing the ultrastructure of biological membranes.

Thermotropic phase behavior and stability of monosialoganglioside micelles in aqueous solution

The thermotropic phase behavior of monosialoganglioside in a dilute aqueous dispersion at pH 6.8 was measured by using synchrotron radiation small-angle x-ray scattering and was analyzed by a shell-modeling method. Previous calorimetric studies on ganglioside systems have shown quite different thermotropic behaviors from other biological lipid systems, however, the details have still been ambiguous. Because of high statistical data and a shell-modeling analysis, we could elucidate the internal structural change of monosialoganglioside micelle induced by the elevation of temperature from 6 to 60 degrees C, that is, the shrinkage of the hydrophilic region and the slight expansion of the hydrophobic region occurring simultaneously, accompanying the elongation of the axial ratios of the ellipsoidal micelles. The model structures obtained explain the changes in the experimental scattering curves, the distance distribution functions, and the gyration radii. In addition we have also found an evident thermal hysteresis in the scattering curves and in the structural parameters. The present result suggests that the thickness of the hydrophilic region, namely, the conformation of oligosaccharide chains, is sensitive to a change of temperature.

AT1 receptor antagonist, TCV 116, does not prevent cardiac hypertrophy in salt-loaded Dahl salt-sensitive rats

1. We investigated the effects of direct blockade of angiotensin II (AngII) by a potent, non-peptide angiotensin II toff 1 (AT1) receptor antagonist, TCV 116, on the development of cardiac hypertrophy in salt-loaded Dahl salt-sensitive rats. 2. Six week old male Dahl salt-sensitive rats (n = 44) were fed a 4% salt diet and were simultaneously given various doses of TCV 116 orally for 7 weeks. Each control group received vehicle alone. 3. Dietary high salt intake elevated blood pressure continuously and caused left ventricular hypertrophy in rats treated with vehicle. TCV 116 had a minor effect on the rise in blood pressure. Left ventricular mass (left ventricular weight/body-weight) decreased slightly but not significantly, in rats treated with 3 mg/kg per day of TCV 116 (n = 8). Higher doses of TCV 116 (6 and 10 mg/kg per day; n = 8 each) did not show a decrease in left ventricular mass compared with the vehicle control. 4. These results suggest that AngII blockade has only minor effects on hypertension and on cardiac hypertrophy in salt-loaded Dahl salt-sensitive rats and that the renin-angiotensin system may not contribute to the development of cardiac hypertrophy in Dahl salt-sensitive rats on a moderately high-salt diet.

Acceleration of proliferative activity of esophageal squamous cell carcinoma with invasion beyond the mucosa: immunohistochemical analysis of Ki-67 and p53 antigen in relation to histopathologic findings

BACKGROUND

The authors observed patients with superficial esophageal squamous cell carcinoma (s-ESC). Those with cancer invasion beyond the muscularis mucosae (SM-carcinoma) had an extremely poor prognosis, compared with those with intramucosal carcinoma (M-carcinoma). Therefore, we surveyed cell proliferative activities in relation to pathologic findings of the s-ESC.

METHODS

p53 protein expression and Ki-67 labeling index (LI) were surveyed with detailed pathologic examinations of 75 s-ESC lesions from 70 patients who underwent esophagectomy. The results were compared by statistical analysis using the chi-square test and unpaired Student's t-test.

RESULTS

p53 protein expression was observed in 57.3% of the patients with s-ESC. The frequency and intensity of its accumulation correlated with the depth of cancer invasion and was markedly elevated in invasion beyond the muscularis mucosae. The LI of Ki-67 positive nuclei was also increased with cancer invasion. The values in the intraepithelial carcinoma and in carcinoma with invasion to the muscularis mucosae were 48.5 +/- 13.7% [mean +/- standard deviation (SD)] and 66.6 +/- 12.9%, respectively, and the difference is significant, P < 0.01. In the SM-carcinomas, the LIs of Ki-67, with or without lymph node metastasis, were 73.5 +/- 10.0% and 64.4 +/- 11.3%, respectively, and the former was higher than the latter with a significant difference, P < 0.05.

CONCLUSIONS

Cancer cell proliferative activities were markedly accelerated in s-ESC cases with cancer invasion beyond the muscularis mucosae and lymph nodal involvement, which was associated with a poorer prognosis of the SM-carcinoma compared with the M-carcinoma, and must be one of the important indices to decide the indication of local resection for s-ESC.

Endothelin-1 partially inhibits ATP-sensitive K+ current in guinea pig ventricular cells

To clarify the pathophysiological significance of endothelin (ET) in the ischemic myocardium, we examined the effect of endothelin-1 (ET-1) on the ATP-sensitive K+ current (IK.ATP) and compared it with that of ET-3 in guinea pig ventricular cells using conventional microelectrode and patch clamp techniques. In isolated guinea pig papillary muscles, ET-1 (30 nM) markedly increased developed tension (DT), with little influence on action potential duration (APD), whereas ET-3 at the same concentration failed to affect DT or APD. Both nicorandil (1 mM) and cromakalim (30 microM) markedly shortened APD and decreased DT in papillary muscles. ET-1, but not ET-3, partially reversed the nicorandil-induced decreases in APD and DT in a concentration-dependent manner. ET-1 also attenuated the cromakalim-induced decreases in APD and DT. In single ventricular myocytes, both nicorandil and cromakalim increased a steady-state outward current, which was sensitive to 1 microM glibenclamide, suggesting that these drugs activate IK.ATP. ET-1 (30 nM) significantly inhibited the IK.ATP, whereas ET-3 failed to affect it. The ET-1 induced inhibition of IK.ATP was abolished by BQ-485 (100 nM), an ETA receptor-selective antagonist. Neither the protein kinase C (PKC) inhibitor staurosporine (20 nM) nor the calmodulin antagonist W-7 (50 microM) affected the inhibitory action of ET-1 on the nicorandil-induced IK.ATP. In pertussis toxin (PTX)-treated cells, the inhibitory action of ET-1 on IK.ATP was augmented rather than attenuated. These results suggest that ET-1 partially inhibits the IK.ATP through the activation of ETA receptors, although the precise intracellular mechanism remains to be clarified. Because activation of the ATP-sensitive K+ channels is considered to protect the ischemic myocardium, the partial inhibition of IK.ATP by ET-1 may lead to the aggravation of myocardial injury, potentially due to an increase in transmembrane Ca2+ influx.

[Successful treatment of hemopneumothorax with intrapleural OK432 in pulmonary metastases of cutaneous angiosarcoma]

An 80-year-old woman with angiosarcoma of the scalp was treated with radiation and interleukin 2. The patient experienced dyspnea one month later because of pulmonary metastases, and underwent video-assisted thoracoscopic surgery for a right pneumothorax. Right hemopneumothorax recurred 3 weeks after the surgery and left hemopneumothorax occurred 4 months later. Both were successfully treated with intrapleural OK432 and drainage. As of March 1995 the patient had been alive and well for one year since the right pneumothorax developed.