[Evaluation of right ventricular function in severe left ventricular failure: comparison of old myocardial infarction with dilated cardiomyopathy]

To evaluate right ventricular (RV) function in severe left ventricular (LV) failure, we measured RV and LV ejection fractions (EF) in 18 patients with old myocardial infarction (OMI) and in 18 with dilated cardiomyopathy (DCM) using cardiac blood pool scintigraphy. In patients with OMI, RVEF was significantly greater in stage II LV failure than in stage III (functional class of the New York Heart Association, 47 +/- 8% and 28 +/- 12%, respectively: p less than 0.01), and this correlated well with exercise tolerance by bicycle ergometer and mean pulmonary artery pressure (r = 0.83 and r = -0.71, respectively). In patients with DCM, however, there was no correlation between RVEF and these indexes. After the oral administration of denopamine (beta 1 effector), both RVEF and LVEF increased in patients with OMI (35 +/- 13% to 45 +/- 12%, and 27 +/- 9% to 30 +/- 10%: p less than 0.01), but they did not change significantly in patients with DCM. These results indicate that RVEF in patients with OMI correlates well with subjective symptoms, exercise tolerance and RV afterload, but these correlations were not apparent in patients with DCM. We concluded that RV function in cases of severe LV failure has a different meaning between OMI and DCM.

[An autopsy case of Paget's disease of the scrotum with general metastasis]

An autopsy case of genital Paget's disease with a widespread metastases is reported. A 69-year-old man with redness, itching and swelling of the scrotum obtained dermatological consultation and underwent tumor resection for Paget's disease. At 8 months after discharge, he suffered from a costal fracture because of carcinomatosis of the bone marrow. In laboratory data the serum level of alkaline phosphatase and carcinoembryonic antigen was shown to be high. Four months later, he died of severe congestive edema of the lung with diffuse micrometastases. An autopsy revealed a widespread metastases in various organs and lymph nodes. The Paget cells were positive in carcinoembryonic antigen.

[Analysis of drug sensitivity by successive colony-forming assay]

It is difficult to predict the adequate doses of effective drugs which must be administered in cancer chemotherapy. We have developed a successive colony-forming assay in order to analyze changes of drug sensitivity in human cancer cell lines, and it is used as a model of cancer chemotherapy. Presently, widely used methods include the clonog ceni assay as in vitro sensitivity test established by Salmon and Hamberger et al., for revealing effective drugs. However, formation of a second colony using initial colony-forming cells has not yet been performed. We therefore analyzed the changes occurring in drug sensitivity in 2nd and 3rd colony-forming assays. Using a human lung adenocarcinoma cell line PC-9 (established by Hayata at the Surgical Department in Tokyo Medical School), we measured the changes in sensitivity to CDDP and its derivatives. After picking up the colony-forming cells by micropipette and culturing them in culture medium, we tried to incubate them for 1 hour with the anticancer drug, and then replate them in soft agar. This technique is called "2nd colony-forming assay". We were able to carry this out three times. The results obtained showed that the anti-tumor effect of 254S was the same as that of CDDP, whereas that of CBDCA was less than either of them. Although these tendencies were noticeable even in the 2nd colony-forming assay, the sensitivities to CDDP and its derivatives were diminished in the 3rd colony-forming assay.

Clinical features of 53 cases with pustulotic arthro-osteitis

We have described clinical features of 53 cases with pustulotic arthro-osteitis. Anterior chest wall symptoms such as intersterno-costoclavicular or manubriosternal lesions were observed in all of 53 cases. Spondylitis or spondylodiscitis was found in 18 cases. Sacroiliitis resembling ankylosing spondylitis was seen in 7 cases. Peripheral inflammatory arthritis was seen in 14 cases, which were of nonerosive, of oligoarthritis type, and cured within 1 to 2 months, leaving no residue. HLA B27 was never found, and RAW factor was negative. Histological examinations revealed nonspecific chronic inflammation of bone and soft tissue. Pustulotic arthro-osteitis is apparently distinct from known rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and Reiter's disease. We have proposed that this condition should be classified as a member of the "seronegative spondylo-arthritis' group as designated by Wright and Moll.

Incidence of arthro-osteitis in patients with pustulosis palmaris et plantaris

Arthro-osteitis at the anterior chest wall was found in 12 (9.4%) out of 128 consecutive patients with pustulosis palmaris et plantaris. This finding indicates that the concomitance of arthro-osteitis with PPP is not incidental but is based on some common aetiological factor. We propose a term ;pustulotic arthro-osteitis' for this condition.

Clinical features of 22 cases with "inter-sterno-costo-clavicular ossification". A new rheumatic syndrome

We present 22 cases with inter-sterno-costoclavicular ossification. Clinical and pathological findings show that abnormal ossification observed in this situation is due to non-suppurative chronic inflammation of the soft tissues around the sterno-costo-clavicular region such as the costo-clavicular ligament. We have classified X-ray findings into three stages according to the extent of the ossification; localized, generalized, and hyperostotic, and show that the disease progressed in this sequence. A considerable number of the patients showed abnormal X-ray findings in the spine or the sacro-iliac joint. Frequent association of pustulosis palmaris et plantaris was noted in this disease. Most of the cases were treated effectively with anti-inflammatory drugs, but a few cases required surgical resection of the ossified mass with the clavicle or the first rib in order to relieve the severe pain.

In vitro microbiological evaluation of TEI-1194 and TEI-2012, novel antipseudomonal semisynthetic penicillins

TEI-1194, sodium 6-[D-(-)-alpha-(coumarin-3-carboxamide)-phenylacetamide] penicillanate and TEI-2012, sodium 6[D-(-)alpha-(8-hydroxy-coumarin-3-carboxamide)-phenylacetamide] penicillanate are new semisynthetic penicillin derivatives both possessing a broad spectrum of in vitro antibacterial activities. Minimal inhibitory concentrations of both agents were compared with carbenicillin. TEI-1194 and TEI-2012 were clearly found to have more potent activities especially against Pseudomonas aeruginosa than carbenicillin. At a concentration at 6.25 micrograms/ml, 85 approximately 90% of a total of 50 strains of clinically isolated P. aeruginosa were inhibited by TEI-1194 and TEI-2012, whereas carbenicillin had no effect. Evaluation of the antibacterial activity against a series of mutants producing different levels of beta-lactamases and test of the susceptibilities to some beta-lactamases demonstrated that TEI-1194 and TEI-2012 had low susceptibility to various cephalosporinases. However, both compounds were susceptible to penicillinase from Klebsiella pneumoniae H-2 at a rate of about 15% of penicillin-G taking its absolute rate as 100.

Prostaglandin I2 as a potentiator of acute inflammation in rats

Prostaglandin I2 potentiated the paw swelling induced by carrageenin in rats. Prostaglandin I2 (0.1 microgram) showed similar activity to PGE1 (0.01 microgram). This potentiating property disappeared in 60 minutes and was completely abolished by diphenhydramine (25 mg kg-1, i.p.). In vascular permeability tests, PGI2 itself (2.5 X 10(-10) mol, 88 ng) caused no dye leakage reaction, but PGE1 (2.5 X 10(-10) mol, 88.5 ng) caused a significant dye leakage. This effect of PGE1 was statistically significant compared with vehicle- or PGI2-treated groups (p less than 0.05). Prostaglandin I2 potentiated the increased vascular permeability induced by 5-hydroxytriptamine (2.5 X 10(-10) mol), bradykinin (5 X 10(-10) mol) and histamine (2 X 10(-10) to 2 X 10(-8) mol). The potentiation was the most evident in the case of histamine.

Factors involved in beta-lactam antibiotic resistance in Pseudomonas aeruginosa

A temperature-sensitive mutant, strain SS, which is assumed to be devoid of beta-lactamase activity and deficient in a permeability barrier to antibiotics, was isolated from a beta-lactamase-less mutant, strain L-2, derived from Pseudomonas aeruginosa IFO 3080. By comparing the beta-lactam antibiotic susceptibility between strains IFO 3080, L-2, and SS, the involvement of both beta-lactamase and a permeability barrier in determining the beta-lactam antibiotic resistance was estimated.