[Coronary artery bypass surgery in dialysis patient]

In patients with chronic renal failure undergoing hemodialysis for a long period, arteriosclerosis progresses rapidly, and the incidence of ischemic heart diseases is high. We performed coronary artery revascularization in a patient with chronic renal failure complicated by angina pectoris in whom discontinuation of dialysis was sometimes needed for hypotension during dialysis. Her postoperative course was uneventful. Problems in intra and postoperative management of dialysis patients are reported.

[A case of neoplastic angioendotheliosis--possible mechanism of JC virus infection for the selective growth of tumor cells in the blood vessel]

A case of 55-year-old man pathologically proven as neoplastic angioendotheliosis was reported. He initially developed sensory disturbance and motor weakness in the lower extremities. After admission, he showed progressive deterioration of higher brain functions with moderate fever. Routine laboratory examinations revealed elevated serum LDH level and erythrocyte sedimentation rate without leukocytosis or increased serum globulin level. Immunological tests were normal, except positive RA. Immunocytochemical investigation of tumor cells in the blood vessel gave the results that these cells appeared to be derived from B cells. Southern blot analyses of the brain samples revealed clear positive bands corresponding to JC virus DNA in the blot. JC virus has been known to infect the endothelial cells of the blood vessel as well as urethral epithelial cells. We discussed the possible mechanism of the selective growth of tumor cells in the blood vessel in terms of possible JC virus infection to the endothelial cells of the blood vessel and abnormal recognition between tumor cells and endothelial cells.

A large outbreak of gastroenteritis associated with a small round structured virus among schoolchildren and teachers in Japan

In March 1989 a large outbreak of acute gastroenteritis occurred simultaneously among schoolchildren and teachers at nine elementary schools in Toyota City, Japan. Illness was observed in 3236 (41.5%) of 7801 schoolchildren and 117 (39.4%) of 297 teachers. The main clinical symptoms were diarrhoea, vomiting, nausea and abdominal pain. Gastroenteritis was significantly associated with the consumption of school lunch served by one particular lunch preparation centre. One food handler at the centre suffered from gastroenteritis during the outbreak. Small round structured virus (SRSV) was detected in 4 of 8 stool specimens from sick persons. The school lunch contaminated by the infected food handler is the most probable source of this outbreak due to SRSV.

Effect of insulin-like growth factor I on gonadotropin release from the hypothalamus-pituitary axis in vitro

The effects of insulin-like growth factor-I on gonadotropin release were studied using primary culture of rat anterior pituitary cells incubated with IGF-I (20-5000 micrograms/l) and a hypothalamus-pituitary perifusion system, in which either the mediobasal hypothalamus-pituitary unit or the pituitary were perifused with IGF-I (20-2000 micrograms/l). In primary cultures of rat anterior pituitary cells, IGF-I (2000 micrograms/l) caused a significant increase in the release of both LH (46% increase) and FSH (27% increase). It also caused a significant decrease in the cellular content of LH (9%) and FSH (19%). Its effects in stimulating gonadotropin release were suppressed by administration of anti IGF-I receptor antibody (1 mg/l). In the perifusion system, IGF-I (2000 micrograms/l) did not affect the LH release from the hypothalamus-pituitary or pituitary alone. However, it caused a significant increase in the GnRH (10(-9) mol/l) stimulated LH release from perifused pituitary. These data suggest that IGF-I enhances pituitary gonadotropin release via the IGF-I receptor, but its effect on the hypothalamus was not confirmed.

Autoprocessing of Drosophila copia gag precursor to generate a unique laminate structure in Escherichia coli

Drosophila copia protease is likely to be encoded in the gag gene. We have expressed copia gag polyprotein precursor in E. coli. The gag precursor was correctly processed to generate a unique laminate structure in E. coli. The processing was almost completely blocked by a mutation at the putative active site of copia protease, and resulted in accumulation of the precursor. Furthermore, the laminate structure was not found in E. coli expressing the mutant precursor. These results indicate that the protease is involved in cleaving the gag precursor itself. Also, the assembly of copia gag protein should correlate to the autoprocessing of copia gag polyprotein precursor.

Lower lumbar branching of caudal medullary expiratory neurons of the cat

Extracellular spike activities of medullary expiratory (E) neurons in the caudal ventral respiratory group were recorded in cats anesthetized with sodium pentobarbital. The majority of E neurons extended their axons in the lower lumbar or the sacral segments and distributed collaterals in L5-L7. These results suggest that E neurons are involved not only in respiratory activities but also in the respiratory modulated motor activities of the lower lumbar segments.

[Replacement of the ascending aorta and aortic valve with a composite graft using a reversed St. Jude medical mitral valve prosthesis]

Between 1981 and 1989, ten patients underwent replacement of the ascending aorta and aortic valve by a composite graft for an aneurysm of the ascending aorta with aortic regurgitation. The first two cases using an SJM aortic valve prosthesis and Teflon felt-pledgeted mattress sutures for the proximal anastomoses required a coronary bypass graft from the tube graft to the anterior descending coronary artery because of difficulty in completing the graft-left coronary ostial anastomoses. In the subsequent seven cases, an SJM mitral valve prosthesis with a large, soft cuff for a valved conduit was sewn in reverse and a thin wall Teflon roll was used for the Teflon felt of the pledgeted mattress suture in the proximal anastomoses. As a result, anastomoses between the tube graft and coronary ostia were performed easily and successfully in eight patients. One case with Marfan syndrome required reoperation nine years after the first operation for recurrence of the aneurysm of the aortic arch. Thus, the need for careful and continued follow-up is important in the Marfan syndrome.

[Successful emergency operation of a right atrial rupture due to a traffic accident]

A case of right atrial rupture with cardiac tamponade due to a traffic accident is reported. By thoracic CT, we diagnosed this condition and successfully repaired the ruptured site five hours after injury. Early diagnosis of cardiac rupture is always very difficult, but at any time in nonpenetrating injury, we must treat patient under suspicion of this disease.

Lipid peroxidation and concentration of glutathione in erythrocytes from workers exposed to lead

Lipoperoxide concentration in erythrocytes from workers occupationally exposed to lead (mean blood lead concentration 57.1 (SD 17.6) micrograms/dl) was significantly higher than that in controls. It was not different in plasma from the two groups. The activity of superoxide dismutase (SOD) and catalase in erythrocytes from workers exposed to lead was significantly lower than that of control subjects. The effect of lead was also seen in the glutathione concentration of erythrocytes from lead exposed workers, which was reduced to 69% of that found in erythrocytes from control workers. The increase in methaemoglobin content of erythrocytes from workers exposed to lead was less than expected and not significantly different from that of controls. A positive correlation between lipoperoxide concentration in erythrocytes and lead concentration in blood and a negative correlation between glutathione concentration in erythrocytes and blood lead concentration were found. Incubation of erythrocytes for 24 hours at 37 degrees C in the presence of lead (100 micrograms/dl) produced no changes in glutathione and lipoperoxide concentrations, although there was inhibition of activity of SOD (14.3%), catalase (10.1%), and glutathione peroxidase (35.1%). A similar experiment with heparinised whole blood showed increased haemolysis with no changes in membrane lipid peroxidation of erythrocytes. It is postulated that the lowered concentration of glutathione and decreased activity of SOD, catalase, and glutathione peroxidase in erythrocytes from workers exposed to lead may play a part in the increased membrane lipid peroxidation. Furthermore, the results suggest the possibility that leucocytes, or platelets, or both, may induce haemolysis in the presence of lead.

Promoter sequence analysis in Bacillus and Escherichia: construction of strong promoters in E. coli

Many derivatives of the nprM promoter of Bacillus stearothermophilus and the strong early promoter, A3, of coliphage T3 were designed and chemically synthesized. These promoters consisted of some or all of the AT box, consensus sequence, tac promoter sequence, spacer, and lac operator. The promoter activities were assessed by their ability to express the cat gene in Escherichia coli. One of the derivatives of the A3 promoter, which contained the lac operator, was much stronger (about 3.5 times) than the tac promoter. The promoter activities in E. coli were considerably modified by the substitutions in the -43 (AT box) and -35 regions.

HTLV-I associated myelopathy (HAM) after blood transfusion in a patient with CD2+ hairy cell leukemia

Hairy cell leukemia complicating hemolytic anemia developed in a 46-year-old woman. Morphologically and cytochemically typical hairy cells were found to express both CD20 and CD2 antigens. Expression of surface IgG of kappa-chain type and the rearrangement of Ig but not T-cell receptor beta genes confirmed a B-cell origin of the leukemia. Blood transfusion was followed by disappearance of the hemolysis and a marked improvement of the leukemia. However, the patient developed progressive spastic spinal paraplegia about seven months after transfusion and was diagnosed as having HTLV-I associated myelopathy (HAM) by the demonstration of HTLV-I antibodies in serum and cerebrospinal fluid. HTLV-I infection via the transfusion may have been involved in the hematologic improvement seen in this patient. Autopsy showed demyelination, vacuolar degeneration, gliosis, and perivascular cuffing in the white matter of spinal cord without evidence of leukemic infiltration.

An autopsy case of malignant fibrous histiocytoma of the mediastinum, presenting multiple metastases to the small intestine and to the brain--a rare case report with a review of the literature

An autopsy case of malignant fibrous histiocytoma (MFH) of the mediastinum in a 25-year-old Japanese man is described. He initially complained of general fatigue and intermittent tarry stool, and was radiographically revealed to have a huge mass within the mediastinum as well as multiple nodules within the abdominal cavity, respectively. The mediastinal tumor could not be resected because of direct tumor invasion into surrounding tissues. Within the abdominal cavity, three distinct tumor nodules were discovered in the jejunum, which could be resected surgically. Histopathologically, the components of both lesions were very similar, and the present case was interpreted as multiple metastases of mediastinal MFH to the intestinal wall. In spite of various kinds of treatment, the mediastinal tumor rapidly enlarged, causing SVC syndrome. Brain CT findings suggested multiple metastases which were considered to be the cause of death. Autopsy confirmed that the main tumor nodule was located within the mediastinum, with brain metastases. The present case of mediastinal MFH is considered to be the youngest case as well as the first case presenting intestinal metastases.

Nuclear-magnetic-resonance studies of human epidermal growth factor

The 1H-NMR spectra of native human epidermal growth factor (EGF) and a derivative lacking the final five residues have been assigned by two-dimensional methods, enabling their structures to be compared. The same structural features are observed for each protein, although the final five residues of native human EGF interact with residues earlier in the sequence. Comparison of the resonance shifts of human, rat and mouse EGF and human transforming growth factor alpha (TGF alpha) enables shifts characteristic of the EGF conformation to be identified, providing standards by which the structures of related proteins may be assessed.

An autopsy case of triple cancers including signet-ring cell carcinoma of the breast--report of a rare case with reference to a review of the literature

A 67 year old Japanese woman who had been suffering from general fatigue was diagnosed as having metastasis of signet-ring cell carcinoma of the bone marrow from a biopsied specimen. A clinical effortive search to the systemic organs revealed a tumor of 4 x 3 cm in size in the lower part of her left breast, which was subsequently diagnosed as the primary site histopathologically. The patient was immediately treated surgically, however, her general condition generally deteriorated and she expired 5 months after the operation. Autopsy revealed dissemination of tumor cells in the bone marrow, bilateral pleura, and soft tissue around the operated site. The autopsy additionally revealed squamous cell carcinoma of keratinizing type in the uterine cervix and well differentiated tubular adenocarcinoma in the gallbladder. A review of the literature revealed this case to be the first reported case of triple cancers including signet ring-cell carcinoma of the breast, proven by autopsy in Japan.

Expression of human liver arginase in Escherichia coli. Purification and properties of the product

Arginase is an enzyme that catalyses the hydrolysis of arginine to urea and ornithine. It is abundantly present in the liver of ureotelic animals (i.e. those whose excretion is characterized by the excretion of uric acid as the chief end-product of nitrogen metabolism), but its purification has hitherto not been simple, and the yield not high. Starting with a partially truncated cDNA for human liver arginase recently made available, we constructed an expression plasmid that had tandemly linked tac promotors placed upstream of a full-length cDNA. By selecting Escherichia coli strain KY1436 as the host micro-organism, we established an efficient system for the production of human liver arginase protein. Chromatographies on CM-Sephadex G-150, DEAE-cellulose and Sephadex G-150, followed by preparative agar-gel electrophoresis, yielded 10 mg of apparently homogeneous enzyme protein from 1 g (wet wt.) of E. coli cells. E. coli-expressed human liver arginase had chemical, immunological and most catalytic properties indistinguishable from those of purified human erythrocyte arginase. However, E. coli-expressed arginase was a monomer of Mr 35,000, whereas the purified erythrocyte arginase was trimer of Mr 105,000. They differed also in pH- and temperature-stabilities. Gel-filtration experiments with these two purified arginases under various conditions, as well as with unfractionated human liver and erythrocyte cytosol preparations, indicated that the native form of human arginase should be of Mr 35,000, and that the trimeric appearance of human erythrocyte arginase after purification was an artifact of the purification procedures. It was thus concluded that, in Nature, the liver and erythrocyte arginases are identical proteins.

[Hemodynamic changes with sufentanil-oxygen anesthesia for open heart surgery--a comparison of patients with beta-blocking medication or without it]

We investigated hemodynamic changes in patients undergoing coronary artery bypass grafting (CABG) and valve replacement. The former had been medicated with beta-blocking agent until the morning of operative day. On the other hand, the latter received no medication. We measured systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate, and rate pressure product (RPP) at the following five points; before induction of anesthesia, immediately before intubation, immediately after intubation, one minute after skin incision and one minute after sternotomy. In both groups, SAP and DAP decreased significantly after induction; heart rate did not change during our study; and RPP decreased significantly after skin incision. There were no significant differences between the group with beta-blocking agent and the group without it. These results suggest that beta-blocking agents exert no influence in our study, and sufentanil-oxygen anesthesia produce hemodynamic stability for open heart surgery.

Impaired development of mammary glands in scorbutic rats unable to synthesize ascorbic acid

The effects of ascorbic acid (AsA)-deficiency on the development of mammary glands were investigated using mutant rats (osteogenic disorder syndrome rats; ODS rats) with hereditary inability to synthesize AsA. Female ODS rats of 21 days old were castrated and divided into two groups. One group was given AsA in their drinking water, and the other was not. All the rats received a daily injection of oestradiol-17 beta and progesterone (EP) from day 28 to day 49 of age. After EP treatment, the concentrations of AsA in the mammary glands of rats not given AsA were less than one tenth of those of rats given AsA and the contents of hydroxyproline in the mammary glands of the former rats were about half of those in the latter. Furthermore, the concentration of serum prolactin in rats not given AsA was reduced to about one third of that in rats given AsA. After EP treatment, whole mounts of mammary glands showed that in rats not given AsA the development of ducts was impaired and there was extensive accumulation of endbuds. Consistent with this finding, EP injections did not increase the area of parenchyma in the mammary glands of rats not given AsA, whereas they increased it about 2-fold in rats given AsA. Moreover, after EP treatment the amount of alpha-lactalbumin was significantly less in the mammary parenchyma of rats not given AsA than in that of rats given AsA. On the other hand, AsA deficiency did not impair the response of the mammary cells to insulin or prolactin in terms of DNA synthesis and alpha-lactalbumin production. These findings indicate that AsA deficiency impaired the development of mammary glands. This effect may be partly attributable to a defect in collagen synthesis in the mammary glands and a decrease in the concentration of serum prolactin.

[Comparison of sufentanil and fentanyl anesthesia for coronary artery bypass grafting--changes in stress hormones]

We compared the changes in hemodynamics and stress hormones in 30 patients who received for CABG operation either sufentanil-oxygen or fentanyl-oxygen anesthesia. The mean doses of fentanyl and sufentanil for intubation were 1.66 +/- 0.69 mg and 0.35 +/- 0.14 mg respectively and mean total doses were 6.91 +/- 1.14 mg and 1.68 +/- 0.38 mg, or 21.4 micrograms.kg-1.hr-1 and 4.5 micrograms.kg-1.hr-1 respectively. SAP decreased significantly immediately before intubation in both groups. Immediately after intubation, a significant intergroup difference (P less than 0.05) was noted. The changes in DAP and MAP were almost similar to those of SAP. This study demonstrates that sufentanil-oxygen anesthesia gave more stable hemodynamic parameters before and after intubation. Especially no significant changes in heart rate occurred immediately after intubation and with CABG operation, thus preventing the increase in rate pressure product during procedure. Sufentanil anesthesia did attenuate more effectively the stress hormones release than high dose fentanyl anesthesia, but neither sufentanil nor fentanyl anesthesia could prevent the increases in these hormones postoperatively.

Transposition of the great arteries with posterior aorta: detection by two-dimensional echocardiography

Two-dimensional echocardiographic features in a case of transposition of the great arteries (TGA) with the posterior aorta are described. The unusual arrangement of the great arteries and the presence of bilateral conuses and aortic-mitral fibrous continuity were clearly demonstrated by angiocardiography and then confirmed at surgery.

Virus-like particle formation of Drosophila copia through autocatalytic processing

Northern blot and nucleotide sequence analyses of copia RNA from a transfectant made by introducing a genomic copia into copia-free cells showed that the 2 kb RNA, one of the major transcripts of copia, is generated through splicing. Using the polymerase chain reaction (PCR), we have also found that the position of the splice sites used in Drosophila larvae and cultured cells originally containing copia is the same as that used in the transfectant. To investigate the function of the 2 kb RNA, we constructed mutant copias which harboured a single point mutation at the splice site or approximately 3 kb deletion of the internal region corresponding to the spliced out sequence. Analyses of transfectants made by introducing these mutant copias into copia-free cells demonstrated that the spliced 2 kb RNA contains sufficient information to make copia virus-like particles (VLPs). Furthermore, when copia RNA corresponding to the spliced RNA was translated in vitro, the major VLP protein was found to be released autocatalytically from its own precursor. A single amino acid substitution at the putative protease active site in the precursor prevented the processing, and resulted in accumulation of the mutant precursor in vitro. From these results, we conclude that copia VLPs are produced through autocatalytic processing of the precursor polyprotein encoded by the spliced copia RNA.

[Effects of DEAE-dextran, centrifugation, cycloheximide and their combination on infection and growth of Chlamydia psittaci bird isolates]

In order to establish a stable and uniform cultural method in a cell line HaLa 229, we studied the effect of DEAE-dextran, centrifugation, cycloheximide and their combination on infectivity and progeny yields of Chlamydia psittaci isolated mainly from birds. Of 11 strains (10 avian and one human origin Ito strain), 9 showed maximal inclusion formation when host cells were treated with a combination of dextran and cycloheximide. Of the other two strains, one showed maximum inclusion formation with dextran alone and any treatments did not enhance the inclusion formation in another strain. Maximal yields of progeny at 48 hours after infection was observed in 5 (4 avian and Ito) strains when host cells were treated with a combination of dextran and cycloheximide. One avian strain showed maximal yields with a triple treatment; dextran and cycloheximide combined with centrifugation. At 72 hours after infection, three avian and Ito strains showed maximal yields with a double treatment (dextran and cycloheximide) and other two avian strains showed that with a triple treatment (double treatment added with centrifugation). The results suggest that in a cell culture HeLa 229, the treatment with dextran and cycloheximide may provide an efficient isolation and growth pattern for most strains originated from birds.

Immunohistochemical examination of Peyer's patches in senescence-accelerated mice

The distribution of T cells, B cells and murine senile amyloid protein in Peyer's Patches was examined in senescence accelerated (SAM-P/1) and control (SAM-R/1) mice ranging in age from two to ten months. An immunohistochemical detection of lymphocyte surface antigens of T cells and B cells. A murine senile amyloid protein in Peyer's patches was detected by immunohistochemical staining with the specific antiserum. Congo red staining and electron microscopy. The T cell population increased and B cell population decreased slightly with age in SAM-P/1 mice, but little change was observed with age in SAM-R/1 mice. Murine senile amyloid protein positive spots were seen surrounding the vessels of the thymus-dependent area at 6 months of age, and were observed throughout the Peyer's patches at 10 months of age, but were not observed by 10 months of age in SAM-R/1 mice.