Isolated congenital left ventricular diverticulum in an adult. A case report

A sixty-three-year-old man presented himself with atrial flutter and congestive heart failure. Cardiac catheterization revealed that left ventricular diverticulum was located on the anterobasal wall with narrow connection to the left ventricular cavity. Coronary angiography revealed normal coronary arteries. The patient had been asymptomatic until adult life with no other thoracoabdominal or cardiac anomalies. This is an extremely rare finding in the adult population.

Inhibitory effect of interleukin-2 on histamine release from rat mast cells

Interleukin-2 (IL-2) inhibited histamine release from rat mast cells induced by compound 48/80 in a concentration-dependent manner. The inhibitory effect of IL-2 on histamine release was also dependent on the length of the incubation period; the maximum inhibition was achieved at 8 h after IL-2 addition. Furthermore, IL-2 inhibited not only IP3 production but also 45Ca uptake in mast cells stimulated by compound 48/80. Since IL-2 enhanced [3H]-leucine uptake into mast cells, this suggests that protein synthesis may be related in some way with the inhibition of histamine release. IL-2 treatment augmented the synthesis of a protein having a molecular weight of approximately 35 kDa. From Western blotting analysis, it became clear that the production of lipocortin-I was augmented in rat mast cells by IL-2 treatment. The present study shows that IL-2 induces the synthesis of lipocortin-I in mast cells and that lipocortin-I may play some role in inhibiting histamine release from mast cells.

Novel antibiotics, amythiamicins. I. Taxonomy, fermentation, isolation, physico-chemical properties, and antimicrobial activity

Novel antibacterial antibiotics, amythiamicins A, B, C and D, have been isolated from the fermentation broth of Amycolatopsis sp. MI481-42F4. In this paper, the taxonomy of the producing strain, fermentation, isolation, physico-chemical properties and biological activities of amythiamicins are reported. Amythiamicins inhibit the growth of Gram-positive bacteria including multi-drug resistant strains.

[Clinical usefulness of serum assay of EIA-CYFRA 21-1 in lung cancer]

Enzyme immunoassay CYFRA 21-1, a novel lung tumor marker presented in serum (upper limit of normal values: 3.5 ng/ml) was measured in 84 patients with lung cancer and 141 patients with benign respiratory diseases. The positive rate for CYFRA 21-1 in primary lung cancer was 70.3% and the false positive rate in respiratory diseases was 24.1%. In respect to the histological types of lung cancer, CYFRA 21-1 was elevated in 85.0% of squamous cell carcinoma and in 64.8% of other cell types of primary lung cancer. Elevated CYFRA 21-1 levels were found in 40% of Stage I-II, in 80.0% of Stage IIIA-B, and in 73.5% of Stage IV. The overall diagnostic efficiency was 53.4% for CYFRA 21-1 and 44.5% for CEA, respectively. Receiver operating characteristic (ROC) curve analysis suggested that CYFRA 21-1 test has an advantage over CEA. From the results of this study, CYFRA 21-1 was more efficient than CEA as primary diagnostic marker in lung cancer.

Cytostatin, a novel inhibitor of cell adhesion to components of extracellular matrix produced by Streptomyces sp. MJ654-NF4. I. Taxonomy, fermentation, isolation and biological activities

Cytostatin has been identified as a novel inhibitor of cell adhesion to components of extracellular matrix (ECM) in cultured broth of Streptomyces sp. MJ654-NF4. Though cytostatin did not inhibit EL-4 cell adhesion to ECM components such as laminin and fibronectin; it inhibited the adhesion of B16 melanoma cells to laminin and collagen type IV but not to fibronectin. It exhibited antimetastatic activity on B16 melanoma cells in mice. The cytotoxicity of cytostatin are also reported.

Labeling of v-Src and BCR-ABL tyrosine kinases with [14C]herbimycin A and its use in the elucidation of the kinase inactivation mechanism

The ansamycin antibiotic, herbimycin A, selectively inactivates cytoplasmic tyrosine kinases, most likely by binding irreversibly to the reactive SH group(s) of kinases. To further investigate the mechanism of herbimycin A action, we attempted to label tyrosine kinases with [14C]herbimycin A. p60v-src and p210BCR-ABL in immune complexes were labeled with [14C]herbimycin A, demonstrating that the antibiotic binds directly to tyrosine kinases. Digestion of [14C]herbimycin A-labeled p60v-src with Staphylococcus aureus V8 protease revealed that the herbimycin A binding site is within the C-terminal 26-kDa fragment of p60v-src, which contains the tyrosine kinase domain. Herbimycin A treatment inhibited labeling of p60v-src by [14C]fluorosulfonylbenzoyl adenosine, an affinity labeling reagent of nucleotide binding sites, indicating that herbimycin A-modified p60v-src cannot interact with ATP. The results suggest that herbimycin A inactivates tyrosine kinases by binding directly to the kinase domain, thereby inhibiting access to ATP.

Evaluation of aortic distensibility in patients with essential hypertension by using cine magnetic resonance imaging

In order to evaluate the exact distensibility in various parts of aorta in hypertensive patients, the authors performed cine magnetic resonance (MR) in 30 normal control (NC) subjects and 30 hypertensive (HT) patients whose age and sex were matched. Cine MR was carried out at transverse sections in the ascending, descending, and abdominal aorta. Aortic diameter and area were measured in the frames of the maximum and the minimum aortic area. Aortic distensibility was calculated from the following formula: (Max area-Min area)/(Min area x delta P), where delta P is pulse pressure. Cardiac parameters were measured with echocardiography in all subjects. Aortic distensibility was significantly lower in HT patients than in NC subjects at each transverse section (P < 0.01). Minimum diameter index (Min diameter/body surface area) and cardiac function parameter showed no significant differences between NC and HT groups. From these findings, it is suspected that hypertension is a strongly contributing factor that promotes aortic sclerosis.

Contractile dysfunction in the diabetic-rat heart is an intrinsic abnormality of the cardiac myocyte

1. In order to clarify whether the myocardial dysfunction observed in diabetic-rat hearts is an intrinsic property of the myocytes or not, we investigated cardiac function and myocyte contractile function in diabetic rats 5 weeks after the injection of streptozotocin. 2. Maximal and minimal dP/dt and time constant of isovolumic pressure fall were measured using a micromanometer in diabetic and age-matched control rats. 3. Isolated myocytes were enzymically obtained from each rat heart and were stimulated at 1 Hz (37 degrees C) in a buffer containing 1.5 mmol/l Ca2+. The images of myocyte contractions were recorded by a video system. Normalized maximal velocity of shortening (maximal velocity of cell shortening/resting cell length; s-1), normalized maximal velocity of relengthening (maximal velocity of cell relengthening/resting cell length; s-1) and extent of shortening [(twitch amplitude/resting cell length) x 100; %] were analysed by a digitalized computer as contractile functions of the myocyte. 4. The maximal and minimal dP/dt in diabetic rats (7876, 5341 mmHg/s) were significantly lower than those in control rats (9349, 7876 mmHg/s). The time constant of isovolumic pressure fall in diabetic rats (12.7 ms) was significantly greater than that in control rats (8.6 ms). Moreover, the normalized maximal velocity of shortening, normalized maximal velocity of relengthening and extent of shortening in myocytes from diabetic rats (1.40 s-1, 1.38 s-1, 9.5%) were significantly lower than those in myocytes from control rats (1.64 s-1, 1.60 s-1, 11.8%). 5. These results suggest that contractile impairment in this diabetic-rat heart model is mainly due to an intrinsic abnormality of the cardiac myocytes.

Accurate diagnosis of metastatic cardiac leiomyosarcoma with infundibular stenosis and cardiac tamponade by transesophageal echocardiography and Gd-DTPA magnetic resonance imaging--report of a case

We present a patient with metastatic cardiac leiomyosarcoma that was diagnosed antemortem by transesophageal echocardiography (TEE) and ECG-gated magnetic resonance imaging with gadolinium diethylene triaminepentaacetic acid (Gd-DTPA MRI). TEE and Gd-DTPA MRI clearly revealed the morphological characteristics of infundibular stenosis and cardiac tamponade. Our patient has survived about 30 months after cardiac surgery. Since sarcoma is usually associated with a very poor prognosis, surgical treatment should be performed as soon as possible. TEE with color Doppler imaging and Gd-DTPA MRI are very useful diagnostic methods for determining the precise anatomical characterization of cardiac tumor, and these procedures are prerequisite to precise therapy.

[Intra-ventricular pressure gradient and systolic anterior movement of the mitral valve associated with administration of dopamine in a 91-year-old patient]

A 91-year-old woman had decreased systemic blood pressure accompanied by dyspnea and general fatigue after resection of a face tumor (Merkel cell carcinoma). Dopamine was administered to elevate systemic blood pressure, but it did not sufficiently restore the hemodynamic status. Left ventricular apical aneurysm was observed on echocardiogram. Furthermore, SAM (systolic anterior movement of the mitral valve) was observed on M-mode echocardiogram and a pressure gradient of 34.6 mmHg in the midventricular position was confirmed by continuous wave Doppler using the Bernoulli equation. After volume overload and discontinuation of dopamine, SAM completely disappeared and midventricular pressure gradient markedly decreased. Her general condition improved. Because of the narrowed outflow tract, hypercontractile state induced by beta adrenergic stimulation seemed to be one of the important factors for the genesis of SAM and pressure gradient.

Evaluation of acute myocarditis and pericarditis by Gd-DTPA enhanced magnetic resonance imaging

Gd-DTPA enhanced magnetic resonance imaging was performed in two adult patients with acute myocarditis and pericarditis. Gd-DTPA enhancement seemed to identify the exact cardiac region with the higher degree of inflammation.

Systolic anterior motion of the mitral valve associated with acute myocardial infarction in a 62-year-old patient

A 62-year-old patient was admitted to our hospital for treatment of early gastric cancer. After total gastrectomy, he suffered from anteroseptal myocardial infarction. Systolic anterior motion of the mitral valve which was not observed before surgery was observed during the acute phase of myocardial infarction and completely disappeared 3 weeks after the onset of myocardial infarction. Systolic anterior motion of the mitral valve in this patient may have been caused by changes in left ventricular wall motion during the acute phase of myocardial infarction.

Myocardial scintigraphic characteristics in patients with primary aldosteronism

To evaluate the difference in myocardial damage between primary aldosteronism and untreated essential hypertension, we performed thallium-201 myocardial single-photon emission computed tomography in 10 patients with primary aldosteronism and 10 patients with essential hypertension who were matched for age, sex, blood pressure, and the severity of left ventricular hypertrophy for primary aldosteronism. From the analysis of thallium-201 myocardial scintigraphy, extent score was calculated. Extent score was significantly higher in primary aldosteronism than in essential hypertension (45.8 +/- 23.5% versus 9.5 +/- 7.3%, P < .01). After operation, blood pressure significantly decreased, and the precordial voltages (SV1 + RV5) and left ventricular mass indexes were significantly reduced in patients with primary aldosteronism. Extent score was also significantly improved. These results suggest that despite the same severity of myocardial hypertrophy between primary aldosteronism and essential hypertension, the myocardial damage estimated by thallium-201 myocardial scintigraphy is more severe in primary aldosteronism than in essential hypertension. Extent score was useful for evaluation of the severity of myocardial damage in hypertensive patients.

Expression of multidrug resistance gene product (P-glycoprotein) in transitional cell carcinomas of the upper urinary tract

We assessed the expression of P-glycoprotein, the product of the multidrug resistance gene, in 107 specimens from patients with transitional cell carcinoma of the upper urinary tract, using an immunohistochemical method with a polyclonal antibody. P-glycoprotein was expressed in 28 of 107 (26%) specimens. While P-glycoprotein expression was not related to the grade or stage of these tumors, the incidence of P-glycoprotein in specimens with tumors which coexisted in renal pelvic and ureter is significantly higher than those with either renal pelvic or ureter tumor alone. In the patients with advanced upper urinary tract tumor who had adjuvant chemotherapy including at least one P-glycoprotein-transported drug (mdr regimen), overall survival of patients with P-glycoprotein-positive tumor was significantly shorter than that of patients with negative tumor. This pilot study demonstrates that P-glycoprotein can be expressed in one fourth of transitional cell carcinomas of the upper urinary tract and that P-glycoprotein expression serves as a prognostic indicator in patients with these tumors who are treated with mdr regimens.

Effects of glyceryl trinitrate on blood pressure and arterial compliance

Glyceryl trinitrate (GTN) mainly reduces systolic blood pressure (SBP) rather than diastolic blood pressure (DBP) in acute conditions. To examine the efficacy of GTN as an antihypertensive agent in patients with isolated systolic hypertension (ISH), the authors examined the effects of GTN on BP and arterial compliance (AC) in patients who underwent cardiac catheterization. Seventy patients (with old myocardial infarction, 36; angina pectoris, 25; chest pain syndrome, 9) who underwent cardiac catheterization because of chest pain were included in this study. They were aged between thirty-seven and seventy-four (mean sixty-one) years. According to the levels of BP at cardiac catheterization, the authors selected two subgroups: the normotensive group (NT group, n = 18) and the isolated systolic hypertensive group (ISH group, n = 20) from all subjects. The authors measured BP before and after (three minutes) sublingual administration of GTN (0.3 mg) at the cardiac catheterization. AC was assessed by means of diastolic pressure decay. The change of BP was estimated by the differences between values before and at three minutes after GTN. After administration of GTN, SBP was decreased significantly from 157 +/- 25 to 142 +/- 23 mmHg (P < 0.01), while DBP did not change (83 +/- 13 vs 84 +/- 15 mmHg). The change in SBP was positively correlated with the pretreatment SBP and negatively correlated with AC (r = 0.51, P < 0.001; r = 0.39, P < 0.001, respectively). AC was significantly lower in the ISH group than in the NT group (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

[Antigen-induced dynamic alterations of endothelin receptors--guinea pig lung tissues]

Endothelins (ETs) are a family of peptides with potent constrictive activity in vascular and treacheal smooth muscle. The lung tissues are abundant in these peptides and their receptors; the peptides are produced by endothelial cells and airway epithelial cells, while its receptor is mainly located on smooth muscle. Therefore, it has been proposed that endothelins act in a paracrine fashion on nearby smooth muscle, thus regulating its tone. However, little is known about its physiological and pathological roles in pulmonary functions. We hypothesized that ET plays an important role in bronchoconstriction elicited by antigen challenge. In order to test this hypothesis, we investigated tracheal contractile activities and ET-receptors by employing an animal model in guinea pigs. Here, we report that guinea pigs who were sensitized followed by multiple challenges with the antigens had alterations of ET receptor(s) with respect to number and affinity.

Localization of Cu/Zn and Mn superoxide dismutase in various thyroid disorders

The intracellular localization of Cu/Zn- and Mn-superoxide dismutase (SOD), which catalyze the dismutation of superoxide radicals (O2-) to O2 and H2O2, was studied in the thyroid tissue of various thyroid disorders by an immunohistochemical technique. The concentrations of both SODs in those tissues were measured also by a sandwich enzyme immunoassay technique. Copper/zinc-SOD in thyroid tissues were identified by immunocytochemical staining in most cases of papillary carcinoma and in some cases of other thyroid disorders. In normal follicular cells this enzyme is localized in the perinuclear cytoplasm, whereas in thyroid tumor or hyperplastic follicular cells it exists homogeneously in cytoplasm. Manganese-SOD stained strongly in papillary carcinoma and papillary-growing cells in the thyroid tissue of adenoma and Graves' disease. The concentrations of Cu/Zn-and Mn-SOD in thyroid tumor tissues and hyperplastic follicular disorders were significantly higher than those in normal thyroid tissue when they were compared as a function of protein or deoxyribonucleic acid contents. The ratio of Mn-SOD to Cu/Zn-SOD was significantly higher only in papillary carcinoma, except for other thyroid disorders as compared with that in the normal thyroid. In conclusion, SOD seems to be related to cell proliferation and differentiation in the thyroid follicular cell because Cu/Zn-SOD changes its localization in tumor and hyperplastic follicular cells and because the Mn-SOD concentration is increased in papillary carcinoma or papillary-growing cells.

Precise assessment of myocardial damage associated with secondary cardiomyopathies by use of Gd-DTPA-enhanced magnetic resonance imaging

To evaluate the myocardial damage in patients with secondary cardiomyopathies, the authors examined gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) in 5 patients (2 with cardiac amyloidosis, 2 with acute myocarditis, 1 with cardiac thyrotoxicosis). MR images were performed at 1.5-T by using a spin echo pulse sequence before and after intravenous administration of Gd-DTPA (0.2 mmol/kg). All patients revealed distinct high-intensity areas on postcontrast images. Moreover, MRI with Gd-DTPA could determine the severity and precise regions of myocardial damage associated with secondary cardiomyopathies. It is suggested that gated cardiac MRI with Gd-DTPA enhancement is useful for detecting the myocardial damage in secondary cardiomyopathies.

A patient with cardiac amyloidosis presenting a rapid increase in technetium-99m-hydroxymethylene diphosphonate accumulation

We assessed the changes in cardiac condition in a patient with cardiac amyloidosis, by means of dual nuclei single photon emission computed tomographic (SPECT) images with technetium-99m-hydroxymethylene diphosphonate (99mTc-HMDP) and thallium-201 (201Tl). Dual SPECT showed a marked increase in myocardial 99mTc-HMDP accumulation along with deterioration of symptoms and signs, while 201Tl scintigraphy remained almost unchanged.

Atrial natriuretic peptide and left atrial systolic function in normal subjects

The purpose of this study is to elucidate factors determining the release of atrial natriuretic peptide (ANP) in normal volunteers at rest. Ten normal volunteers were included in this study. Ages ranged between twenty-seven and thirty-three years (mean twenty-seven). The authors measured plasma levels of ANP, and four cardiac chamber volumes, and their functions by cine magnetic resonance imaging using the rephased gradient-echo method. Plasma levels of ANP in 10 normal subjects were 15.0-37.1 pg/mL (mean 23.6 pg/mL). No significant relationship was seen between ANP level and heart rate or blood pressure. The level of ANP was positively correlated with left atrial (LA) emptying fraction and negatively correlated with LA minimal volume (r = 0.85, P < 0.01; r = 0.64, P < 0.05, respectively). No significant relationship was observed between plasma ANP level and left ventricular, right ventricular, or right atrial parameters. These results suggest that LA systolic function is one of the major determinants for ANP release in normal subjects at rest.