Transesophageal Doppler echocardiographic assessment of pulmonary venous flow pattern in subjects without cardiovascular disease

This study was designed to assess pulmonary venous flow dynamics using transesophageal Doppler echocardiography. Under general anesthesia, we studied 54 surgical patients with no history or physical evidence of cardiac disorders. In all patients pulmonary venous flow was easily identified by transesophageal color flow mapping. Pulmonary venous flow pattern, which was obtained clearly in 85% (4654) of patients by transesophageal pulsed Doppler echocardiography, was tri- or quadriphasic. The first wave, which was often biphasic in elderly patients, occurred during ventricular systole (S wave). The second wave occurred in diastole during the early ventricular filling phase of mitral flow (D wave). The third wave was reverse flow toward the pulmonary vein during atrial contraction (A wave). The following variables were measured: the peak flow velocities of each wave (PFVs, PFVd, PFVa), and the ratio of PFVs to PFVd (PFV(S/D)). The PFVd correlated with age (r = -0.56, P < 0.001), indicating age-related decrease. The PFV(S/D) correlated with age (r = 0.61, p < 0.001), indicating age-related increase. These results would indicate that the contribution of pulmonary venous flow during diastole to total pulmonary venous flow decreases with age. Our data suggest that age-related diastolic dysfunction of the left ventricle would affect pulmonary venous flow dynamics and that left atrial storage volume during ventricular systole would increase with age.

Absorption of recombinant human granulocyte colony-stimulating factor (rhG-CSF) from rat nasal mucosa

Nasal absorption of recombinant human granulocyte colony-stimulating factor (rhG-CSF) was examined in the rat. The relative bioavailability of rhG-CSF for subcutaneous administration was approximately 2%, as evaluated from the immunologically active rhG-CSF concentration in rat plasma and the area under the curve (AUC) of the plasma rhG-CSF concentration versus time for 8 hr. Pharmacological availability relative to subcutaneous administration was determined from the increase in total blood leukocyte numbers. The pharmacological availability was 5-10%, determined from the AUC for the increased ratio of total leukocyte numbers versus time for 48 hr; it was slightly dependent on the pH and the osmotic pressure of the dosing solution. Accordingly, the plasma concentration of rhG-CSF did not always reflect its pharmacological effects. Relative bioavailability and pharmacological availability were increased about 23 times and 3 times, respectively, by polyoxyethylene 9-lauryl ether (Laureth-9), but no increase in availability occurred with sodium glycocholate. The increase in total leukocyte numbers was maintained during multiple rhG-CSF dosing, and the addition of Laureth-9 further increased the pharmacological effects of this agent. This study indicates that nasal administration of rhG-CSF is an effective parenteral administration route.

[An infection model which was induced in a carboxymethyl cellulose (CMC) pouch on the back of the rat]

The air-pouch model of inflammation in rats is excellent in that it allows quantitative evaluation of inflammation, and it is used for analysis of inflammatory mediators and as an evaluation system for anti-inflammatory drugs. We investigated the possibility of using this system as an experimental infection system. As a result, inflammation was found to be caused by injection of a constant amount of Staphylococcus aureus solution (10(4)-10(8)). The amount of infiltration and the number of infiltrating cells varied with quantity of bacteria. The infiltrating cells consisted mainly of neutrophils. In this experimental model of infectious disease, the severity of inflammation could be quantitatively evaluated as a function of time in terms of bacterial proliferation and the body's response to bacterial proliferation based on the amount of fluid in the air pouch and the number of infiltrating cells, suggesting that the model is useful. In this experimental system, there were no differences between the number of live bacteria, the number of infiltrating cells or the amount of infiltration when S. aureus Smith strain and clinically-isolated methicillin-resistant S. aureus (MRSA) were used, suggesting that there is no difference between the inflammation-induced activity of MRSA and MSSA.

Usefulness of sodium chloride as a nondiffusible indicator in the measurement of extravascular lung thermal volume in dogs

The authors examined the usefulness of sodium chloride as a nondiffusible indicator during the first passage through dogs' lungs, before and after increased-permeability pulmonary oedema produced by an intravenous injection of alloxan. With an injection of a mixture of ice-cold 3 per cent sodium chloride and indocyanine green dye (a nondiffusible reference indicator), the authors simultaneously recorded three dilution curves from the aortic root: dye dilution, thermal and blood electrical conductivity dilution curves in six dogs. The mean transit time of sodium chloride in the conductivity dilution curve was significantly different from, but fairly equal to, that of indocyanine green dye (6.2 +/- 1.4 s (mean +/- SD) against 6.5 +/- 1.4 s (p < 0.01) in the baseline period, and 7.6 +/- 1.9 s against 8.4 +/- 2.1 s (p < 0.01) in the oedema period, respectively). The calculated extravascular lung thermal volume with the thermal and conductivity dilution method (Y, ml kg-1) correlated well with the gravimetrically determined extravascular lung mass in a total of 12 dogs, including six other dogs without intervention (x, g kg-1) (y = 0.72 x +3.03, r = 0.96). The authors conclude that sodium chloride is useful as a nondiffusible indicator in the first passage through the lungs, and that the thermal and conductivity dilution method is also useful for measuring extravascular lung water mass.

Comparative free radical scavenging action of angiotensin-converting enzyme inhibitors with and without the sulfhydryl radical

The free radical scavenging effects of an angiotensin-converting enzyme (ACE) inhibitor containing sulfhydryl (SH; captopril) were compared with those of ACE inhibitors not containing SH (enalapril, enalaprilat, delapril and its de-esterified products). Electron spin resonance (ESR) using 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) as the spin trap showed that enalapril and delapril (0.6-4.8 mmol/l) inhibited hydroxyl radicals concentration-dependently. Captopril (2.4-10 mmol/l), enalaprilat and the de-esterified product of delapril (1.2-4.8 mmol/l) also inhibited hydroxyl radicals in a concentration-dependent manner. The effects of captopril and enalapril (2.4-4.8 mmol/l) on the scavenging of superoxide anion radical were also concentration-dependent. Delapril, its de-esterified product, and enalaprilat weakly inhibited superoxide anion radical. These results indicate that both SH- and non-SH-containing ACE inhibitors scavenge hydroxyl radical more strongly than the superoxide anion radical and that the free radical scavenging action of ACE inhibitors is probably not related only to the presence of the SH radical.

Right atrial contractile performance in patients with myocardial infarction

To evaluate right atrial (RA) contractile performance in patients with myocardial infarction, we validated a cineangiographic method of RA volume measurement, and investigated RA volume change in 'normal' individuals and patients with a previous myocardial infarction. Sixteen silicone rubber RA casts made from human cadavers were filmed in the postero-anterior and left lateral projections. The cast volumes calculated following Simpson's rule were in good agreement with those measured by water replacement (r = 0.992, P < 0.01). At cardiac catheterization, biplane RA cineangiography was performed in 19 'normal' individuals (N group), in 14 patients with a previous antero-septal infarction (AMI group) and in seven patients with a previous inferior infarction (IMI group). The RA volume-time curve was constructed at 20-40 ms intervals for one cardiac cycle. RA volume at the beginning of the atrial contraction (RAVd), which was defined as the 'preload' of the RA, tended to be larger in both the AMI and IMI groups compared with 'normal' individuals. The RA ejection volume was significantly larger in both the AMI (18.4 +/- 2.1 ml.m-2, P < 0.01) and IMI groups (19.4 +/- 2.8, P < 0.01) than in the N group (14.5 +/- 1.9), even for a comparable level of RAVd (range from 26 to 36 ml.m-2) (18.6 +/- 2.1, P < 0.01, 18.2 +/- 2.0, P < 0.01, 14.7 +/- 1.9, respectively). These results suggest that RA contraction increases in patients with myocardial infarction by increasing both the 'preload' and 'contractility' of the RA.

Long-term complications of dialysis: pathogenic factors with special reference to amyloidosis

Amyloidosis, caused by amyloid containing beta 2-microglobulin (beta 2m), is a frequent complication of long-term hemodialysis. The precise mechanism of its pathogenesis is not known. While beta 2m is an amyloid protein, other factors likely are involved in the pathogenesis of such amyloidosis. In treating patients with dialysis-related amyloidosis, it is essential to remove as much beta 2m from the blood as possible. In this respect, progress has been made in developing a column to adsorb beta 2m from the blood. Using a combination of a high-flux dialyzer and an adsorption column, it becomes possible to efficiently eliminate beta 2m. We have treated four patients with this column in combination with a high-flux dialyzer three times a week for periods of one month or one year. The absorbent column eliminates beta 2m from the blood, and may thus halt or slow the progression of beta 2m-related amyloidosis. However, such treatment is still in a preliminary phase; long-term studies are required to determine clinical efficacy.

Time-course of recovery of atrial contraction after cardioversion of chronic atrial fibrillation

We aimed to study the time-course of recovery of atrial contraction after cardioversion of chronic atrial fibrillation (duration of more than 3 months) to sinus rhythm. Using M-mode, two-dimensional and pulsed Doppler echocardiography, we determined left atrial (LA) and ventricular (LV) dimensions, peak velocities, and velocity-time integrals of early and atrial filling velocity-time profiles in both LV and right ventricular (RV) inflows (peak E and peak A, Ea and Aa). Results of the LA and LV functions in seven elderly patients (an initial study group) were as follows. The extent of the LA dimensional reduction resulting from atrial contraction was significantly increased up to 5-8 weeks compared with values 0-1 day after cardioversion [from 1.3 +/- 0.8 (mean +/- SD) mm to 3.9 +/- 1.1, P < 0.01]. In conjunction with the progressive increase in peak A, the ratio of peak E to peak A (peak E/A) was significantly decreased and reached a plateau at 5-8 weeks (from 1.93 +/- 0.59 to 0.67 +/- 0.11, P < 0.01). LV fractional shortening was increased significantly 5-8 weeks after cardioversion (from 0.20 +/- 0.06 to 0.29 +/- 0.05, P < 0.01). Since a large part of the improvement in LA contraction was expected to occur in an early stage after cardioversion, we studied eight additional patients more frequently in the early stage (an additional study group). Furthermore, we studied the time course of LA and right atrial (RA) contractions.(ABSTRACT TRUNCATED AT 250 WORDS)

Decreased type VI collagen gene expression in cultured Werner's syndrome fibroblasts

Gene expression of collagens VI, I, and III in Werner's syndrome was studied by measuring messenger RNA (mRNA) and protein production levels in four fibroblast strains from patients with Werner's syndrome and comparing them with age-matched healthy subjects. Levels of type VI collagen mRNA were decreased in all Werner's syndrome fibroblast strains and the decreases were in parallel in all three chains (alpha 1, alpha 2, and alpha 3) of type VI collagen. A coordinate increase of the alpha 1(I) and alpha 1(III) collagen mRNA levels was observed in three of the four Werner's syndrome fibroblast strains. However, no qualitative abnormality of these mRNA transcripts in Werner's syndrome fibroblasts were found by Northern blot analysis. Changes in type VI and type I collagen mRNA correlated well with production levels of corresponding proteins, as determined by immunologic assays. These data suggest that there are changes in expression of multiple connective tissue constituents in Werner's syndrome fibroblasts.

[Two cases of mediastinitis as a complication of odontogenic infection and tonsillitis]

We experienced two cases of descending necrotizing mediastinitis with different etiology. Case 1: A 59-year-old woman presented with chief complaints of dyspnea and swallowing disturbance. She had been diagnosed as having tonsillitis one week before. She was very pyrexic, and laboratory examination indicated acute inflammation. Chest X-ray and CT-scan showed enlargement of the mediastinum and pleural effusion. We diagnosed the mediastinitis to be a complication of tonsillitis. Case 2: A 54-year-old man had a tooth extracted 3 weeks prior to admission. His chief complaints were craniomandibular disturbance and neck swelling. Laboratory examination disclosed multiple organ failure and DIC. Chest X-ray and CT-scan showed enlargement of the mediastinum and pleural effusion. We diagnosed the mediastinitis in this case to be a consequence of an odontogenic infection following tooth extraction. Both patients received continuous drainage and irrigation of the abscesses and recovered in about 2 months. Case 1 showed an impaired glucose tolerance after recovery from mediastinitis. Although the main causes of mediastinitis are cardiac surgery and esophageal perforation, our cases demonstrate that mediastinitis may occur as a complication of deep neck infection.

Acute effects of conventional oral dose of disopyramide on left atrial and ventricular functions

Disopyramide, an antiarrhythmic drug, is known to impair cardiac function, but acute cardiac effects of conventional oral dose of disopyramide are not well known. To examine the extent of acute cardiac effects of daily oral dose of disopyramide, we gave 150 mg of disopyramide to thirteen patients with normal or impaired cardiac function, and observed cardiac function on an hourly basis for 3 hours after baseline period. The serum level of disopyramide reached a therapeutic level (2.0-5.0 micrograms/ml) mostly 1 hour after administration. Doppler-echocardiographically determined left ventricular ejection fraction, and the ratio of the peak early filling velocity to the peak atrial filling velocity in left ventricular inflow velocity remained unchanged throughout the experimental period. Other hemodynamic variables, such as blood pressure and heart rate remained unchanged. We conclude that daily oral dose of disopyramide appears to have no significant effects on cardiac function after administration. Disopyramide seems to be safe and may not be necessarily withheld from patients who need it, when hemodynamic variables are to be measured.

Chemical synthesis and properties of an oligodeoxyribonucleotide containing a 2-deoxyribosylformamide residue

To elucidate the conformational properties of DNA with a 2-deoxyribosylformamide residue (dF), an oligodeoxyribonucleotide containing this abasic residue in a specific position of the nucleotide sequence was synthesized by the standard solid-phase phosphotriester method. Deprotection of the synthesized oligonucleotide was performed under routine alkaline and acidic conditions. The presence of a dF residue in the oligomer was confirmed by ion-spray mass spectrometry. A dF residue was found to affect considerably the stability of the DNA duplex, as determined from the melting behavior of the dF-containing duplex.

Survival of Pseudomonas pseudomallei strains at 5 degrees C

The ability of 15 Pseudomonas pseudomallei strains of different origin to survive at 5 degrees C was tested, in comparison with the type strains of Pseudomonas aeruginosa and Pseudomonas cepacia. Viable cells of each strain were suspended in tryptic soy broth (diluted 1:10) at a concentration of about 10(6) CFU/ml. The suspensions were kept at 5 degrees C, and the number of viable cells was determined by counting colonies every 10 days. Four strains of P. pseudomallei, including the type strain for the species, died within 90-100 days at 5 degrees C. Ten other P. pseudomallei strains together with the type strain of P. cepacia survived 160 days or more, although viable counts of these strains decreased to 10(1-2) CFU/ml. The Oklahoma strain of P. pseudomallei and the type strain of P. aeruginosa maintained 10(5) CFU/ml after 170-190 days. It was concluded that resistance of P. pseudomallei to low temperature differs from strain to strain. From the results of our experiments and those reported in the literature of nation-wide soil contamination by P. pseudomallei in France, prejudice regarding the organism as a tropical inhabitant must be corrected.

Membrane damage and interleukin-1 production in murine macrophages exposed to listeriolysin O

To obtain some insight into the interaction between listeriolysin O (LLO) and the macrophage membrane, we examined the effect of purified Listeria monocytogenes hemolysin on the viability and functions of mouse peritoneal exudate macrophages. The study showed that purified LLO impaired a variety of functions of the macrophages. First, it suppressed the luminol-dependent chemiluminescence response of macrophages. Second, it suppressed the phagocytic ingestion of opsonized sheep erythrocytes and latex beads. Third, exposure of macrophages to LLO resulted in an increase in dead cells, as determined by the trypan blue dye exclusion method. An interesting observation of this study is that the LLO-induced production of interleukin-1 from macrophages could not be blocked by preincubation with cholesterol, while the membrane-damaging ability could be blocked by cholesterol. The dissociation of the blocking effects of cholesterol suggests that the interleukin-1-inducing ability of LLO may be distinct from its membrane-damaging ability.

A new therapeutic approach to dialysis amyloidosis: intensive removal of beta 2-microglobulin with adsorbent column

Amyloidosis, in which amyloid protein consists of beta 2-microglobulin (beta 2-M), is both a common and a serious complication of long-term hemodialysis. The mechanism of its development is not completely understood. Since beta 2-M is an amyloid protein, it is essential to try to remove as much of it as possible. A specific adsorbent of beta 2-M has been developed for use in direct hemoperfusion. The adsorbent is a porous cellulose bead to which hydrophobic organic compound is bound covalently. A combination of a high-flux membrane dialyzer and an adsorption column (BM-01) would make it possible to efficiently eliminate beta 2-M. Dialysis with a combination of direct hemoperfusion (DHP) and an adsorption column led to the elimination of more than 200-300 mg of beta 2-M. We observed 5 patients who received treatment with this column (BM-01) in combination with high-flux dialysis 3 times a week for periods of 1 week (3 patients), 6 months (1 patient), or 14 months (1 patient). It is demonstrated that the adsorbent column (BM-01) provides an intensive method to eliminate beta 2-M from the blood with no serious adverse effect. It thus has the potential to suppress the progression of dialysis amyloidosis. The use of this adsorbent column (BM-01) in combination with a high-flux dialyzer may present an improved approach to removing beta 2-M from the body.

[A study of the clinical factors which have the greatest effect on bronchial hyperresponsiveness in atopic asthma by multiple regression analysis]

We studied the clinical factors which have the greatest effect on bronchial hyperresponsiveness, with 37 atopic asthma patients (23 males and 14 females). They were from 13 to 59 years old. We measured the control value of the respiratory conductance (Grs.cont), the minimum dose of methacholine (bronchial sensitivity, Dmin), the linear slope of the Grs (= 1/Rrs) decreased (bronchial reactivity, SGrs) and SGrs/Grs.cont by the "Astograph" method (Chest 80, 600, 1981). Statistical analysis was performed by multiple regression analysis. Grs.cont, log Dmin, SGrs and SGrs/Grs.cont were regarded as objective variables. Age, onset age of asthma, period of disease, smoking history, family history of atopy, serum IgE, blood eosinophil counts, positive skin test counts, FEV1.0% and type of asthma attack (perennial or seasonal) were regarded as explanatory variables. The results were as follows: 1) The explanatory variable which showed the highest partial correlation coefficients, was the type of asthma attack in multiple regression analysis of Grs.cont and log Dmin (p < 0.05, p < 0.05). 2) Grs.cont of perennial asthma attack (0.247 +/- 0.064) was significantly lower than that of seasonal attack (0.318 +/- 0.097) (p < 0.02). Log Dmin of perennial asthma attack (-0.837 +/- 0.457) was significantly lower than that of seasonal attack (-0.254 +/- 0.429) (p < 0.005). Therefore in mild atopic asthma, the clinical factor which has the greatest effect on bronchial hyperresponsiveness is the type of asthma attack. We conclude that the existence of perennial asthma attacks is mostly related to increased bronchial hypersensitivity.

Localization of apolipoprotein(a) and B-100 in various renal diseases

Recently it has become clear that abnormalities of lipid metabolism play a large role in the progression of renal diseases. To investigate the relationship between lipids and kidney tissue, we employed an immunofluorescent technique to determine the localization pattern of apolipoprotein(a) [apo(a)], apoB-100, and low-density lipoprotein receptor in the glomeruli, and analyzed the relationship between their presence and the clinical and histological findings of a total 92 patients with glomerular diseases. Immunostaining showed co-localization of apo(a) and apoB-100 in glomeruli. The patients were divided into three groups, as follows: both apo(a) and apoB-100 positive (Group 1; 38 cases), apo(a) positive only (Group 2; 19 cases) and apo(a) negative (Group 3; 35 cases). Group 1 had more severe proteinuria, higher levels of lipoprotein(a) [Lp(a)], and lower total protein levels than Group 3. Group 1 had a higher prevalence of glomerulosclerosis and interstitial changes than Group 3. Group 2 had more severe proteinuria and a higher prevalence of glomerulosclerosis than Group 3. Although apo(a) and apoB-100 are almost absent in normal controls, these apoproteins [and presumably lipoproteins Lp(a)] are present in the glomeruli of patients with glomerular diseases. The data support the view that these apoproteins play a significant role in progressive renal diseases.

Chronic melioidosis: a report of the first case in Japan

A 41-year-old Japanese male with uncontrolled diabetes mellitus and alcoholic liver dysfunction developed melioidosis after his business trip to Indonesia and Singapore in 1988. His disease started with spiked fever on the following day after extraction of a tooth, and a liver abscess developed, followed by abscesses in the spleen and in the subphrenic space. In spite of splenectomy and intensive antimicrobial treatments for three months, he developed parotitis, prostatitis, and abscess of the right submandibular gland at 5 to 16-month interval. Pseudomonas pseudomallei was isolated from the blood and pus from each abscess. The lung was not involved. At present, he has returned to work, with continued intravenous instillation of imipenem/cilastatin.

Ultrastructural localization of protein kinase C beta-subspecies in the axon terminal of rat neuromuscular junction

Ultrastructural localization of protein kinase C (PKC) beta-subspecies in neuromuscular junctions of the rat lumbrical muscle was investigated by the immunoperoxidase and immunofluorescence methods. By light microscopy, PKC beta-like immunoreactivity (PKC beta-LIR) was found in the axon terminal expansions as well as in the preterminal axons. By confocal laser scanning microscopy, the staining for PKC beta-like immunoreactivity was more intense in the presynaptic regions just in contact with the acetylcholine receptor stained by FITC-alpha-bungarotoxin. By electron microscopy, PKC beta-like immunoreactivity was distributed non-uniformly in the terminal expansions. In the terminal expansions, PKC beta-like immunoreactivity was accumulated in the presynaptic regions in contact with the post-synaptic folds. This accumulation was approximately 0.1-0.2 microns in diameter, which comprised a part of the presynaptic plasma membrane and a group of synaptic vesicles adjacent to it. Weak immunoreactivity was also found diffusely in the axoplasmic matrix. The discrete presynaptic accumulation of PKC beta-subspecies may represent the strategical localization specialized for the effective regulation of neurotransmitter release.

Glomerulonephritis with various crystalline deposits

A 60-year-old Japanese male was admitted with nephrotic syndrome complaining of facial and pedal edema. Renal biopsy revealed mesangial and endocapillary proliferation with massive mesangial and subendothelial deposits. Deposits of IgA, IgG, IgM, C3 and fibrinogen were identified by immunofluorescence technique in both mesangial and subendothelial areas. Deposits of kappa and lambda light chains were also recognized in similar patterns. Electron microscopy revealed crystalline structures of various appearance in these deposits. A large deposit consisted of various small triangular, quadrilateral and polygonal shapes of deposits with crystalline structures. These crystalline structures exhibited lattice or parallel lamellar lines with different periodic distances. Although a disease producing paraproteinemia was suspected, no immunoglobulin disorder or light chain abnormality could be detected on clinical and laboratory examinations. On the second biopsy, a faint reaction for cryoglobulin was recognized. However, the crystalline deposits observed in this case were absolutely different from the tubular structures seen in cryoglobulinemic nephropathy. This was a very rare and unclassified case.

Effects of tumor necrosis factor-alpha on connective tissue metabolism in normal and scleroderma fibroblast cultures

Recent studies have demonstrated that tumor necrosis factor-alpha (TNF-alpha) selectively decreases production of collagens I and III, the major types of collagen in the dermis, and increases production of collagenase in cultured dermal fibroblasts. The effects of TNF-alpha on collagens I, III and VI, fibronectin and collagenase gene expression by fibroblasts derived from normal individuals and patients with systemic sclerosis (SSc) were studied. SSc is characterized by excessive accumulation of collagen in the skin and in certain organs. TNF-alpha inhibited collagen production and mRNA levels of collagens I and III and of fibronectin, and stimulated collagenase activity and collagenase mRNA levels in SSs fibroblasts. Levels of mRNA for alpha 1 (VI) and alpha 3 (VI) collagen and for beta-actin were unaltered in SSc fibroblasts incubated with TNF-alpha. Similar results were observed for mRNA levels in normal fibroblasts incubated with TNF-alpha. These results suggest that TNF-alpha could be expected to be beneficial in the treatment of SSc. In addition, our results indicated that collagen-VI expression is regulated independently from expression of collagens I and III, and expression of fibronectin and collagens I and III are regulated in parallel in fibroblasts treated with TNF-alpha.

Ultrastructural substrates for increased lung water content in experimental pulmonary edema

We examined the relationship between the incidence of ultrastructural changes in the alveolar septum and the extravascular lung water content. Pulmonary edema was induced in 18 mongrel dogs by either dextran (n = 12) or alloxan (n = 6) administration. Six other dogs served as controls. Extravascular lung water content was measured by the thermal-dye double indicator dilution method. Specimens of lung tissue were examined with an electron microscope, and the incidence of 13 types of pathological changes in the alveolar septum was studied. For each type of pathological change, the incidence was correlated with the magnitude of lung water content. The following results were obtained. The incidence of edematous changes in the alveolar interstitium (widening of the interstitial space, and dispersion and disarray of collagen fibres in the interstitial space) was well correlated with lung water content (r = 0.78, p < 0.01, and r = 0.84, p < 0.01, respectively). The correlation was not significant in the remaining types of changes. We conclude that the incidence of the pathological changes in the alveolar septum is increased along with the increase in the content of lung water in both dextran- and alloxan-induced experimental pulmonary edema in dogs.

[The genetic application for Japanese patients with coronary artery diseases using restriction fragment length polymorphisms (RFLPs) of apolipoprotein gene]

We applied restriction fragment length polymorphisms (RFLPs) for apolipoprotein (apoAI, apoCIII, apoAIV, apoCI, and apoB) genes to analyze differences between Japanese and Caucasian in allele frequencies as well as those between normal Japanese subjects and patients with coronary artery disease confirmed with coronary arteriography. Although the allelic fragment sizes in the two racial groups showed complete correspondence, the allelic frequencies of these markers detected by the combination of probes and restriction enzymes showed 60% difference in Japanese and Caucasian. There was a significant (p < 0.01) difference between the normal subjects (with arteriographically-confirmed absence of stenosis in all coronary branches) and those with severe coronary artery disease (50 to 100% stenosis in at least one branch) in plasma levels of apoAI, apoB, total cholesterol, HDL-cholesterol, and LDL-cholesterol. RFLP analysis for 13 markers, however, revealed no significant difference between these groups when analyzed in subjects of all ages (range, 12 to 82 years; N = 306). However, when analysis was restricted to data for 12-to 50-year-olds, a significant (p < 0.02) difference between the normal control group and the severe coronary artery disease group in 3' apoB probe and EcoRI enzyme test results. An acquired and environmental factors were assumed to be involved in this disease because the correlation between allelic frequencies and coronary artery disease status showed dilution when the subject age distribution included older subjects.

Correction for apparent prolongation of mean transit time resulting from response time in a thermodilution system

We investigated a method of correcting an apparent prolongation in the measured mean transit time (MTT), resulting from the response time of the thermodilution system. We measured the mean response times (MRT) for five commercially available thermistor-tipped catheters by recording their step function response curves. MRT is the sum of the time from the point of step change to the point of the first detection of change in temperature (latency time) plus the time from the first detection to the point of 63.2% of full response (time constant). By using a flow loop model filled with saline through a mixing chamber, we recorded pairs of thermodilution curves simultaneously with pairs of catheters, and studied the influence of MRT on MTT over the constant flow rates of 1-6 L/min. The difference in MRT's (delta MRT, second) between a pair of thermodilution systems correlated with the difference in MTT's (delta MTT, second) between a corresponding pair of thermodilution curves, yielding an equation: delta MTT = 1.07 delta MRT = 0.04 (n = 72, r = 0.95), delta MTT/delta MRT = 1.02 +/- 0.18 (mean +/- SD). We conclude that an apparent prolongation of MTT due to response time is removable by subtracting MRT from measured MTT.