Two adult cases of IgM-associated mesangial proliferative glomerulonephritis

Two adult patients with mesangial proliferative glomerulonephritis with diffuse IgM deposition in the glomeruli are reported. Case 1 was a 25-year-old female with nephrotic syndrome who showed complete remission after treatment with prednisolone (PSL). Case 2 was a 46-year-old male with asymptomatic proteinuria who showed incomplete remission (0.5-1.0 g/24 hr) of urinary protein without any medication. In light microscopy, these patients revealed minimal or slight proliferation of glomerular mesangial cells without glomerular sclerosis and crescent formation. Deposition of IgM and C3 was observed in the glomerular mesangial areas and capillary walls by immunofluorescence. Electron-dense deposits were observed in the glomerular mesangial areas in these patients. Mesangial proliferative glomerulonephritis associated with diffuse IgM deposition in the glomeruli appears to have a benign clinical course. It has also been suggested that this disease has variant clinical courses since we recently experienced two other patients with mesangial proliferative glomerulonephritis with focal IgM deposits who showed renal tubular dysfunction or chronic renal failure.

[Pulmonary blastoma--long-term survival of a patient with metastases]

We report a rare case of pulmonary blastoma. This 59-year-old woman has been apparently well with recurrent and metastatic tumors in her left lung for 9 years after the initial operation. On May 28, 1984, she underwent a thoracotomy of left upper lobectomy and lymph nodes dissection. The histologic diagnosis of resected specimen was pulmonary blastoma. In August 1986 (27 months after the initial surgery), chest X-ray revealed some nodules in the lungs. Then, the patient had two thoracotomies for the excision of 4 tumors and one chest wall resection of the tumor. In addition, she received systemic chemotherapy 28 times, directly intrapulmonary drug injection 3 times and radiation therapy once for recurrent and metastatic disease. Following some cycles of our combination chemotherapy consisting of cis-platinum and vindesine, some lesions had decreased in size and others previously seen on chest X-ray were no longer evident. She achieved an objective response with receiving two-drug chemotherapy. Our observation suggest that this intensive combination chemotherapy is effective in recurrent and metastatic disease of pulmonary blastoma as a surgical adjuvant.

New modification of the Damus-Kaye-Stansel operation

We report a successful modification of the Damus-Kaye-Stansel operation for transposition of the great arteries when the coronary arteries are unsuitable for transfer. The procedure includes creation of a neoaorta with end-to-end anastomosis of the proximal pulmonary artery to the distal ascending aorta and creation of an aortopulmonary window between the proximal great arteries. A valved conduit is interposed between the right ventricle and the distal pulmonary artery.

[A case report of giant esophageal leiomyoma associated with an epiphrenic esophageal diverticulum]

A well-nourished 33-year-old male, who was entirely asymptomatic and in apparently good health, was referred to our hospital because of abnormal findings on a routine chest X-ray film. A chest X-ray taken upon admission revealed an oval mass suggesting a mediastinal tumor in the posterior mediastinum. An esophagogram demonstrated severe distortion of the esophageal lumen and an epiphrenic diverticulum on the right side. Endoscopy disclosed a submucosal bulge covered by normal mucosa. The mass, which was located on the right diaphragm between the heart and right ribs, appeared to be of homogenous density on CT scan and MRI films. Infiltration of contiguous structures and enlargement of mediastinal lymph nodes appeared to be absent. The preoperative diagnosis was an esophageal leiomyoma. A right posterior thoracotomy was performed in the prone position under general anesthesia. The tumor (12 x 8 x 4.5 cm, 170 g) associated with an epiphrenic esophageal diverticulum was removed by a partial esophageal resection. The pathologic specimen showed a leiomyoma with normal esophageal mucosa and a true diverticulum containing all the layers of the esophageal wall. We suggest that the diverticulum resulted from retraction of the esophageal wall related to the extraluminal growth of the leiomyoma.

Intracellular-free magnesium in the smooth muscle of guinea pig taenia caeci: a concomitant analysis for magnesium and pH upon sodium removal

This study is concerned with the regulation of intracellular-free Mg2+ concentration ([Mg2+]i) in the smooth muscle of guinea pig taenia caeci. To assess an interaction of Ca2+ on the Na(+)-dependent Mg(2+)-extrusion mechanism (Na(+)-Mg2+ exchange), effects of Na+ removal (N-methyl-D-glucamine substitution) were examined in Ca(2+)-containing solutions. As changes in pHi in Na(+)-free solutions perturb estimation of [Mg2+]i using the single chemical shift only of the beta-ATP peak in 31P NMR (nuclear magnetic resonance) spectra, [Mg2+]i and pHi were concomitantly estimated from the chemical shifts of the gamma- and beta-peaks. When extracellular Na+ was substituted with N-methyl-D-glucamine, [Mg2+]i was reversibly increased. This increase in [Mg2+]i was eliminated in Mg(2+)-free solutions and enhanced in excess Mg2+ solutions. ATP content fluctuated little during removal and readmission of Na+, indicating that [Mg2+]i changes were not induced by Mg2+ release from ATP, and that Mg(2+)-extruding system would not be inhibited by fuel restriction. A slow acidification in Na(+)-free solutions and transient alkalosis by a readmission of Na+ were observed regardless of the extracellular Mg2+ concentration. When the extracellular Ca2+ concentration was increased from normal (2.4 mM) to 12 mM, only a marginal increase in [Mg2+]i was caused by Na+ removal, whereas a similar slow acidosis was observed, indicating that extracellular Ca2+ inhibits Mg2+ entry, and that the increase in [Mg2+]i is negligible through competition between Mg2+ and Ca2+ in intracellular sites. These results imply that Na(+)-Mg2+ exchange is the main mechanism to maintain low [Mg2+]i even under physiological conditions.

Primary structure of chicken cardiac myosin S-1 heavy chain

The sequence of the NH2-terminal 830 amino acid residues of chicken cardiac ventricular muscle myosin subfragment-1 (S-1) was determined. S-1 was obtained by limited chymotryptic digestion, and cleaved into three characteristics fragments (23, 41, and 22 kDa fragments) by limited tryptic digestion. These fragments were isolated by gel filtration on a Sephadex G-100 column, followed by cation-exchange chromatography on a CM-52 column and reverse-phase HPLC. The isolated fragments were sequenced completely. Peptides overlapping the 23 and 41 kDa fragments and also overlapping the 41 and 22 kDa fragments were obtained by cleaving S-1 with cyanogen bromide, and sequenced completely. We also obtained a minor fragment, the 20 kDa fragment, in addition to the three characteristic fragments. Amino acid compositions of the cyanogen bromide peptides of the 20 kDa fragment indicated that a portion of S-1 heavy chains had lost their COOH-terminal 21 residues during limited tryptic digestion. Methylated amino acid residues were found at four positions: epsilon-N-monomethyllysine at position 32, epsilon-N-trimethyllysine residues at 127 and 549, and 3-N-methylhistidine at 754.

[Results of surgical treatment of aortic dissections]

From January 1989 to September 1993, 59 consecutive patients (35 males and 24 females, mean age 59.6 years old) underwent surgical repair of aortic dissection on the cardiovascular surgical unit at Takeda Hospital. The type of aortic dissection were classified according to Stanford University criteria. Twenty-two patients had acute type A (Ac-A), 10 had chronic type A (Ch-A), 4 had acute type B (Ac-B), and 23 had chronic type B (Ch-B) dissection. Seventeen dissections (29%) in the entire group of 59 cases had ruptured (including cardiac tamponade, pleural effusion and hemoptysis etc.). Ischemia of lower extremity occurred in 7 patients and ischemia of visceral organs in 3 patients. Type A dissection were approached via a median sternotomy and cardiopulmonary bypass with systemic hypothermia. Type B dissections were approached through a left postrolateral thoracotomy. Left heart bypass (left atrial-femoral in 8 cases) and partial cardiopulmonary bypass (femoral-femoral in 12 cases) generally were utilized. Resection of intimal tear and replacement of aorta with vascular grafts (including aortic arch in 19 cases) were performed in most patients and primary closure of the intimal tear was performed in 9 cases using GRF. The over-all operative mortality rate was 36% (8/22) for Ac-A, 20% (2/10) for Ch-A, 25% (1/4) for Ac-B, 22% (5/23) for Ch-B. Main causes of operative death was perioperative brain damage. It is necessary to improve the operative mortality for Ac-A dissections (especially in replacement of aortic arch and arch vessels). Further researches are needed regarding optimal methods of the cerebral protection during reconstruction of aortic arch.

Effects of nefiracetam on drug-induced impairment of latent learning in mice in a water finding task

We investigated the effects of nefiracetam (DM-9384), a pyrrolidone derivative, on chlordiazepoxide-, apomorphine-, and methamphetamine-induced impairment of latent learning in a water finding test in mice. Pretreatment with nefiracetam reversed the inhibitory effects of chlordiazepoxide and apomorphine, but not those of methamphetamine, on latent learning. The ameliorative effects of nefiracetam on apomorphine-induced, but not chlordiazepoxide-induced impairment of latent learning were antagonized by scopolamine. These results provide further evidence that nefiracetam has anti-amnesic effects. Further, it is suggested that the cholinergic neuronal system may be involved in the ameliorative effects exerted by nefiracetam on apomorphine-induced impairment of latent learning.

The state of recurrence and the role of hepatectomy in hepatocellular carcinoma

The subjects involved in the present study were 113 patients with hepatocellular carcinomas who had undergone hepatectomy in our hospital during the past 10 years. During the surveillance, 79 of the 113 patients (69.9%) had recurrence in the residual liver. The cumulative non-recurrence rate at 2 and 5 years was 48.4% and 18.1%, respectively and the cumulative survival rate at 2 and 5 years was 83.8% and 47.5%, respectively. The recurrence in the residual liver tended to occur in the group with the larger tumor size, in the single nodular surrounding proliferative types and in the aneuploid types. There were no differences in the recurrence rate and state relating to the operative procedure. To improve the prognosis of hepatocellular carcinoma, it is necessary to consider the hepatic functional reserve after hepatectomy, and to make plans for multidisciplinary therapy, including such further treatment as transcatheter arterial embolization, infusion chemotherapy and preoperative percutaneous ethanol injection.

Effect of single amino acid substitution at residue 167 of HLA-B51 on binding of antibodies and recognition of T cells

We recently showed that a single amino acid substitution of tryptophane into glycine at residue 167 facing the "A pocket" forms a novel HLA-B51 subtype, B*5103, which is serologically discriminated as HLA-BTA. CDC assay of human alloantisera specific for the HLA-B5 CREG against B*5103- or B*5101-transfected human B-cell line, Hmy2C1R (C1R), supported the belief that human alloantisera can discriminate B*5103 from B*5101 Ag. Moreover, we found that 4D12 anti-B5, B35 CREG mAb cannot bind to B*5103 Ag on C1R cells or L cells although it binds to B*5101 Ag on both cells. These results indicate that alloantibodies can detect a single amino acid substitution at residue 167. Furthermore, it was suggested that 4D12 mAb recognizes the structure formed by the HLA-peptide complex since this mAb did not bind to empty HLA-B5, B35 CREG Ag on RMA-S transfectants. Six of eight anti-HLA-B*5101 CTL clones are not able to kill C1R cells expressing B*5103, indicating that conformational change of the A pocket by substitution at residue 167 has a crucial influence on recognition of alloreactive T cells. Therefore, discrimination of B*5103 from B*5101 would seem to be important in bone marrow transplantation.

The effect of percutaneous ethanol injection therapy on small solitary hepatocellular carcinoma is comparable to that of hepatectomy

OBJECTIVES

Forty patients with solitary hepatocellular carcinoma (HCC) smaller than 20 mm in diameter were admitted to our hospitals from March 1986 to December 1989. Of that 40 patients, 17 were treated with hepatectomy, 12 with percutaneous ethanol injection therapy, and 11 with the combination of percutaneous ethanol injection therapy and transcatheter arterial embolization.

METHOD

Following up the patients after their first treatment for 2 months to 6 yr, as of April 30, 1993, we evaluated the effects of hepatectomy, percutaneous ethanol injection therapy, and the combination of percutaneous ethanol injection therapy and transcatheter arterial embolization.

RESULTS

Of the 23 patients who did not undergo surgery, eight died from recurrence of HCC and one died from ruptured varices. Of the 14 surviving patients, 10 experienced recurrences during the follow-up period. Of the 17 patients who underwent surgery, one died in hospital and four died from recurrence of carcinoma. Of the remaining 12 patients, nine experienced recurrences. The cumulative survival and recurrence rates were similar in operated and nonoperated patients. There was no significant difference in these rates in patients treated with versus without transcatheter arterial embolization.

CONCLUSION

Our results showed that the efficacy of hepatectomy and the efficacy percutaneous ethanol injection therapy for small solitary HCC were similar. However, percutaneous ethanol injection therapy was safer and less expensive than hepatectomy.

[Changes of lipids and lipoproteins in cholesterol free-high fructose diet-fed rats and the effects of clinofibrate]

The present study was performed to determine the serum lipid and lipoprotein changes in cholesterol free-high fructose diet (HFD)-fed rats and to examine the effects of clinofibrate (CF) on these changes. HFD feeding for 2 weeks increased the high density lipoprotein (HDL1) subfraction and decreased the low density lipoprotein subfraction. The contents of total cholesterol (TC), triglyceride (TG) and phospholipid (PL) in the serum increased by HFD feeding. CF inhibited the increase in HDL1 and lipid content. The continuance of HFD-induced hyperlipidemia was investigated in rats fed a normal diet after HFD feeding for 4 weeks. The HFD-induced increases of TC, PL and HDL1 contained for 5 days. TG was also increased by HFD feeding, but the elevated level was not maintained after feeding of the normal diet was initiated. The administration of CF for 3 or 5 days to the rats that had been switched to the normal diet inhibited the increases in lipids and HDL1. The increase of cholesterol synthetic activity continued for 3 days after the rats were switched to the normal diet but CF increased to a higher level than that of the HFD group. The main mechanism of the hypolipidemic effect of CF on HFD-induced hyperlipidemia is considered to be the increase of lipid excretion and HDL1 metabolism.

Molecular abnormality of a unique Japanese glucose-6-phosphate dehydrogenase variant (G6PD Kobe) with a greatly increased affinity for galactose-6-phosphate

Systematic molecular analysis of a Japanese class 1 glucose-6-phosphate dehydrogenase (G6PD) variant (G6PD Kobe) cDNA revealed a unique nucleotide substitution (1318 C to T) in exon 11, which predicts a substitution of leucine for phenylalanine at residue 440. This substitution is located in a region surrounding the putative structural NADP-binding domain. The markedly abnormal kinetics of glucose-6-phosphate (G6P) of G6PD Kobe suggest the interaction between both NADP and G6P binding sites.

Marked thrombocytosis with chromosomal abnormalities in a patient with rheumatoid arthritis

An 80 year-old Japanese woman with rheumatoid arthritis (RA), complicated with thrombocytosis is described. Mild to moderate thrombocytosis is commonly observed in patients with RA, but she had marked thrombocytosis of over 1000 x 10(3)/mm3 and monosomy 22 with marker chromosome. This case suggests that thrombocytosis unusual with disease activity of RA might occur, and that careful evaluation of the thrombocytosis is required.

Inactivation of the voltage-dependent Ca2+ channel current in smooth muscle cells isolated from the guinea-pig detrusor

1. Whole-cell voltage clamp techniques were applied to single smooth muscle cells enzymatically dissociated from guinea-pig urinary bladder. The inactivation and recovery of voltage-dependent Ca2+ channel currents were examined by manipulating the membrane potential over a wide range and by changing the extracellular divalent cation concentrations. 2. After exposing the cells to conditioning potentials (-100 to +80 mV in 20 mV increments), the degree of inactivation was estimated by stepping to a 0 mV test potential. In the presence of 2.5 mM Ca2+, the inactivation of the current was U-shaped with respect to the conditioning potential, with maximum inactivation at 0 mV. The maximal inactivation was 60 and 90% after conditioning durations of 0.8 and 5 s, respectively. The U-shaped curve is characteristic of Ca(2+)-dependent inactivation. When conditioning potentials of +80 mV with either duration were applied, the inward current at the test potential and the subsequent tail current on returning to the holding potential were larger than in control conditions (when the conditioning potential = the holding potential, -60 mV). 3. A U-shaped inactivation curve was also observed in the presence of 2.5 mM Ba2+. The inactivation was maximal with a conditioning potential of about -20 mV, and the inactivation was smaller than seen with Ca2+ entry. 4. Paired-pulse protocols were applied to examine the voltage dependence of recovery of the Ca2+ inward current. After the inward current had been inactivated during a 100 ms depolarization at 0 mV, it took 700 ms at -60 mV for nearly complete recovery of the current. Recovery was also observed at +80 mV. When the potential of the paired pulses was increased to +20 mV, less recovery was seen when the interpulse potential was at +80 mV. When a longer (3 s) depolarization was applied, the peak amplitude of the inward current took much longer to recover, and had not completely recovered after 4 s at either of the interpulse potentials, although recovery was greater with an interpulse potential of -60 mV than with one of +80 mV. Similar recoveries were observed in the presence of Ba2+. 5. During a long depolarization (8 s, 0 mV), the effects of rapid changes in the extracellular solution were examined. Partial recovery of the inward current occurred after a period in which Ca2+ was replaced with Mg2+. This recovery was not observed in the presence of Ba2+.(ABSTRACT TRUNCATED AT 400 WORDS)

Evidence for multiple open states of the Ca2+ channels in smooth muscle cells isolated from the guinea-pig detrusor

1. Whole-cell voltage clamp techniques were used to examine the properties of voltage-dependent Ca2+ channel currents in single smooth muscle cells enzymatically dissociated from guinea-pig urinary bladder. Potassium currents were blocked with intracellular Cs+. A holding potential of -60 mV was normally applied. 2. When the membrane potential was returned to the holding potential after a depolarizing step, tail currents were seen after depolarizations to positive potentials, and the size of the tail current increased with increasing positivity of the preceding depolarization. 3. After depolarization to +80 mV (a potential at which little inward current flowed through the Ca2+ channels) tail currents on returning to the holding potential increased in size as the duration of the depolarization was increased. 4. Investigation of the mechanism mediating the tail currents showed that they were not flowing through non-selective cation channels, and had no contribution from Ca(2+)-activated Cl- channels or Na(+)-Ca2+ exchange. 5. The tail currents and the inward currents evoked by a simple depolarizing test potential were equally decreased by nifedipine in a dose-dependent manner. This suggests that L-type Ca2+ channels are responsible for both of the two types of inward currents. The inward currents were also inhibited in a similar manner when caffeine was applied. 6. Although the tail currents evoked on stepping from +80 mV to a holding potential of -60 mV increased in size with the duration of the conditioning potential, the total membrane Ca2+ conductance did not increase, since the inward currents evoked on stepping to +20 mV (a potential at which the Ca2+ channels are still fully activated) did not change with time. 7. The amplitude of the inward current evoked by a simple depolarizing test potential was similar to that evoked on stepping to the same test potential after preconditioning at +80 mV, if the test potential was higher than +20 mV. However, following repolarization to the holding potential, the amplitude of the subsequent tail current was larger and the deactivation time constant longer, after the conditioning depolarization. These results suggest that the voltage-dependent Ca2+ channels have at least two open states with different time constants, the tail current being the result of a long open channel state induced by large depolarizations. 8. When variable repolarizing potentials were applied after n +80 mV depolarization (5 s), the current-voltage relationship of the tail current was nearly linear between -60 and +30 mV. The deactivation was faster when a larger repolarization step was applied.(ABSTRACT TRUNCATED AT 400 WORDS)

Multilineage response in aplastic anemia patients following long-term administration of filgrastim (recombinant human granulocyte colony stimulating factor)

The present multicenter study was undertaken to confirm whether filgrastim/recombinant human granulocyte colony stimulating factor (rhG-CSF) could mobilize residual multipotential stem cells by its G0-shortening effect in patients with aplastic anemia (AA) and induce a multilineage response. Twenty-seven patients with acquired severe or moderate AA received long-term administration (2 to 12+ months) of rhG-CSF in doses from 100 to 400 micrograms/body/day by s.c. injection or 250 to 1,500 micrograms/body/day by i.v. infusion. Twenty-six out of the 27 evaluable patients showed a substantial increase in neutrophils associated with a recovery of myeloid precursors in bone marrow within one month of therapy. Interestingly, 10 out of the 27 patients showed a dramatic improvement in severe anemia after two to ten months of therapy. Moreover, severe thrombocytopenia improved after two to four months of therapy in three out of these ten patients accompanied by a significant increase in megakaryocytes in bone marrow. Clonal cultures of bone marrow cells revealed a recovery in myeloid as well as erythroid precursors in most of these ten patients. In two patients who showed a trilineage response, mixed and megakaryocyte colony formations also recovered. These results suggest that long-term administration of rhG-CSF mobilizes myeloid, erythroid, megakaryocyte and multipotential progenitor cells and induces a multilineage response in some patients with AA.

Pharmacokinetics of indocyanine green in rats with experimentally induced hepatic diseases

The pharmacokinetics of indocyanine green (ICG) following intravenous administration was compared between normal rats and rats with experimentally induced acute hepatic diseases; namely D-galactosamine-intoxicated (GAL) rats, CDl4-intoxicated (CCl4) rats and rats with obstructive jaundice (OJ). The total body clearance of ICG was decreased in all rats with these hepatic diseases, especially in the rats with OJ. Hepatic plasma flow was also decreased in all rats with the three hepatic diseases. The profile of biliary excretion of ICG was characteristic of rats with each hepatic disease. The cumulative biliary excretion of ICG was markedly low in GAL rats, almost unchanged in CCl4 rats and the appearance of ICG was markedly delayed in rats with OJ. The pharmacokinetic analysis of these data showed that the decreased total plasma clearance of ICG in GAL and CCl4 rats results from both lowered influx across the sinusoidal plasma membrane of hepatocytes and the decreased hepatic plasma flow. In rats with OJ, the decreased total plasma clearance results only from a markedly lowered influx across the sinusoidal plasma membrane of hepatocytes without any relation to the decreased hepatic plasma flow. The decreased biliary recovery in GAL rats might relate to the decreased bile flow. The time lag of the appearance of ICG into the bile of rats with OJ was due to its slow efflux across the bile canalicular membrane, in addition to its slow influx across the sinusoidal membrane of the hepatocyte and its remarkably long period of stay in the hepatocyte.

Effects of excitatory neurotransmitters on Ca2+ channel current in smooth muscle cells isolated from guinea-pig urinary bladder

1. A whole-cell voltage clamp technique was used to examine the effects of purinoceptor and muscarinic receptor agonists on voltage-sensitive Ca2+ channels in guinea-pig isolated urinary bladder cells. 2. When the cell membrane was clamped at the holding potential, rapid application of ATP elicited a large inward current in normal solution containing 2.5 mM Ca2+, and reduced the subsequent Ca2+ channel current evoked by a depolarizing pulse (0 mV). Carbachol (CCh) elicited little membrane current, but similarly reduced the Ca2+ current. 3. When purinoceptor agonists were rapidly applied during conditioning depolarizations at +80 mV, an outward current was elicited, and the Ca2+ channel current evoked by the subsequent test potential of 0 mV was not affected. Application of CCh at +80 mV also elicited an outward current, but it reduced the subsequently evoked Ca2+ current. 4. The inhibitory effect of muscarinic agonists on the Ca2+ channel current was attenuated by caffeine (10 mM). 5. In Ca(2+)-free, low-Mg2+ solution, a Na+ current flowing through voltage-dependent Ca2+ channels was evoked by depolarization. This current was not reduced by bath application of purinoceptor agonists (ATP and alpha,beta-methylene ATP). 6. These results suggest that the main effect of purinoceptor stimulation is opening of non-selective cation channels, and that muscarinic stimulation triggers Ca2+ release from intracellular stores. Voltage-sensitive Ca2+ channels are inactivated through an increase in intracellular Ca2+ induced by either activation of purinoceptor or muscarinic receptors.

[Quantitative assessment of fibroblast viability in cryopreserved aortic valve allografts]

The purpose of this study is to clarify whether serum (fetal bovine serum or human serum) is necessary or not for cryopreservation of aortic valve allografts. The protective effects of fetal bovine serum compared with human serum were evaluated by means of quantitative assessment of fibroblast viability. Porcine aortic valves were excised and rinsed immediately after death, followed by treatment with low concentration antibiotics. Valves were gradually frozen at a control-rate of -1 degree C/min and then stored in liquid nitrogen vapor-phase. The samples were classified into three groups by nutrient medium as follows. Group A (n = 5); Dulbecco's Modified Eagle Medium (DMEM), Group B (n = 5); DMEM containing 10% fetal bovine serum, Group C (n = 5); DMEM containing 20% human serum. At 1 week, 1 month, and 3 months after initiation of storage, the valves were thawed rapidly and examined for fibroblast viability, which was assessed quantitatively by means of autoradiography with tritiated proline. After 1 week storage, the fibroblast viability rate reduced from 98% to 80.7% in group A, 79.4% in group B and 79.2% in group C respectively, but there were no significant differences among three groups. The viability rate decreased with the passage of time, and remained around 72% in all groups after 3 months storage. The histological examination did not show any changes in the structure of the valves in all samples up to 3 months of storage. The results demonstrate that the fibroblasts are still viable after 3 months storage by cryopreservation. The addition of fetal bovine serum or human serum does not improve fibroblast viability.(ABSTRACT TRUNCATED AT 250 WORDS)

Removal of trypsin complexed alpha-2 macroglobulin by plasma fractionation

The aim of this study is to assess in vitro the efficacy of a plasma fractionator to remove trypsin complexed alpha 2MG (alpha-2 macroglobulin) from human plasma in a manner analogous to the reticuloendothelial system (RES). Eval filter type "4A" (Kuraray Co., Osaka, Japan) was chosen as a plasma fractionator. Two and one half liters of bovine trypsin spiked human plasma was perfused in vitro through the fractionator in a single pass mode (n = 5). The concentrations of complexed alpha 2MG, total alpha 2MG, albumin, and IgM were measured before and after fractionation, and the concentration of free alpha 2MG and the sieving coefficients of each solute were calculated. The concentration of the trypsin complexed alpha 2MG measured by ELISA was significantly decreased by fractionation with Eval "4A" from 103.7 +/- 16.7 to 13.8 +/- 8.2 mg/L (reduction of 86.7%). Mean sieving coefficients of each solute were 0.133 +/- 0.079 in complexed alpha 2MG, 0.203 +/- 0.065 in free alpha 2MG, 0.203 +/- 0.065 in total alpha 2MG, 0.770 +/- 0.130 in albumin, and 0.070 +/- 0.010 in IgM. Although in vivo study will be required in patients with acute pancreatitis, in vitro study shows the feasibility of membrane plasma fractionation in eliminating trypsin complexed alpha 2MG.