[Problems and prevention in using arterial grafts for coronary artery bypass grafting]

The arterial graft has proved to be superior to the saphenous vein graft for coronary bypass grafting (CABG), because of its excellent long-term patency. However, there mains controversial on the choice of the arterial grafts. Six hundreds and twenty seven patients who had CABG using both arterial grafts and saphenous vein grafts, operated upon over 11-years period between 1980 and 1991, have been analysed. Some disadvantages and complications associated with the use of arterial grafts were demonstrated in our series. We discussed, the flow capacity, myocardial protection and postoperative complications in using arterial grafts for CABG.

Usefulness of ultrasonography and Doppler color flow imaging in the diagnosis of internal jugular phlebectasia

A 20-year-old woman presented to our hospital for investigation of a left neck mass. Ultrasonographic examination of the jugular mass demonstrated an echo-free space, the caliber of which markedly increased when the patient shifted from the sitting to the recumbent position or performed a Valsalva maneuver. On color Doppler flow imaging, a slow flow signal flowing in the direction opposite to that of the common carotid artery was found within this space. Ultrasonography and color Doppler flow imaging thus proved to be useful for correctly diagnosing internal jugular phlebectasia.

[A case of renal cell carcinoma in a horseshoe kidney]

We report a 68-year-old man with renal cell carcinoma in a horseshoe kidney. Abdominal computed tomography revealed a left renal tumor in a horseshoe kidney, and we carried out left radical nephrectomy. Histopathological diagnosis was renal cell carcinoma. Only 19 cases of renal cell carcinoma in a horseshoe kidney have been reported in Japan, and our case was the 20th.

The effects of branched-chain amino acid-enriched elemental diet in patients with biliary atresia

Supplemental administrations of ED-H, branched-chain amino acid (BCAA)-enriched elemental diet for hepatic disorder, were performed in 10 postoperative biliary atresia (BA) patients. These patients were exhibiting, more or less, cirrhotic changes. The duration of ED-H administration ranged from 7 months to 3 years. initially, these patients showed lowered molar ratios, Val+Leu+Ile/Phe+Tyr, in plasma aminograms with decreased levels of plasma rapid-turnover proteins. ED-H administration induced a significant increase in molar ratio as well as increases in plasma prealbumin and retinol-binding protein levels. With an improved general status, such as activity level and play performance, there were significant increases both in weight for age and weight for height. No particular deleterious effects were observed throughout the period of ED-H administration. In conclusion, supplemental ED-H administration can be performed safely with an efficacy in postoperative BA patients who need metabolic/nutritional supports due to abnormal liver functions.

Differences in development of bovine oocytes recovered by aspiration or by mincing

This experiment was performed to clarify relationships between conditions of bovine ovaries and developmental capacity of the follicular oocytes recovered from them and to compare two methods of oocyte collection, aspiration and mincing. Follicular oocytes with surrounding intact, unexpanded cumulus recovered by follicular aspiration or by mincing of tissue from 24 pairs of ovaries were matured and fertilized in vitro. The number of follicular oocytes recovered from pairs of ovaries averaged 32.1 +/- 3.2, but the number recovered varied greatly among the 24 pairs of ovaries (range, 7 to 71). The overall rate of development to the blastocyst stage was 18% (137/771), and the average number of blastocysts produced from a pair of ovaries was 5.7 +/- 1.1 (range, 0 to 17). No relationships were found between the presence of corpora lutea or large follicles and the proportion of oocytes capable of reaching the blastocyst stage in vitro. However, a positive correlation was observed between the number of oocytes obtained from each pair of ovaries and subsequent in vitro development; the correlation was especially high for oocytes obtained by aspiration. These data suggest that the developmental capacity of bovine follicular oocytes after in vitro maturation and fertilization is correlated to the number of antral follicles aspirated from the pair of ovaries.

Multiple- and single-shot autocorrelator based on two-photon conductivity in semiconductors

Two-photon-induced conductivity has been observed in Si and GaAsP photodiodes and in a CdS photo-conductive cell at room temperature and applied to the ultrashort optical pulse measurement with a simplified Michelson-type arrangement. The efficiency of the two-photon conductivity is found to be 3 x 10(-14)I A/W, where I is the intensity of the incident pulse in watts per squared centimeter. A single-shot pulse-width measurement has also been performed by using a two-dimensional silicon CCD array. Use of these inexpensive photodetectors with nonlinear characteristics has proved to be convenient for intensity correlators because of their instantaneous response to temporal coincidence of optical pulses and ease of optical arrangement.

[Multilocular cystic renal cell carcinoma: report of a case]

We report a 76-year-old man with a multilocular cystic renal cell carcinoma resembling a multilocular renal cyst by radiological diagnosis. His creatinine clearance was 43 ml per minute and we carried out simple enucleation, to avoid renal failure after radical nephrectomy and because of low percentage of local recurrence after renal conservative surgery of low stage renal cell carcinoma. We have been following up the patient carefully.

Expression and transport into mitochondria of bovine cytochrome P-450(SCC) in insect cells using the baculovirus expression system

Bovine cytochrome P-450(SCC) introduced with the baculovirus host vector system was found to be expressed in Spodoptera frugiperda cells. Cell fractionation analysis indicated that the P-450(SCC) expressed as the precursor form was transported into mitochondria and converted to a mature form. However, this form did not exhibit definite activity for cholesterol side chain cleavage. These findings suggest that most of the P-450(SCC) expressed by this system is an inactive protein within mitochondria that is not folded to the conformation of the active enzyme and/or does not incorporate heme appropriately.

Effects of growth hormones on bone formation and resorption in rainbow trout (Oncorhynchus mykiss), as examined by histomorphometry of the pharyngeal bone

Effects of salmon and eel growth hormones (GHs) on bone metabolism in rainbow trout (Oncorhynchus mykiss) were studied using histomorphometry of their pharyngeal bones. When salmon GH (sGH) was injected intraperitoneally at a dose of 0.01 or 0.1 microgram/g/week for 10 times into fed trout, body growth in both length and weight was accelerated. Formation and resorption of bone were enhanced only by the higher dose of sGH. When a cholesterol pellet containing recombinant eel GH (reGH-pellet) was implanted subcutaneously into starved trout for 1 week (37 micrograms reGH/18 g fish), formation and resorption of bone increased, although activity of bone formation was low. The results indicate that the GHs increased both formation and resorption of bone, regardless of the nutritional status of the fish.

Pathogenesis of cyclosporine-induced hypomagnesemia

We studied the pathogenesis of cyclosporine-induced hypomagnesemia in five patients with nephrosis. Serum magnesium concentrations and urinary excretion of magnesium were reduced by the therapy. In contrast, the magnesium concentrations in mononuclear blood cells were increased. We conclude that short-term use of cyclosporine induces an intracellular shift of magnesium and causes hypomagnesemia.

Partial purification and characterization of a factor for the enhancement of colony formation in vitro by myeloid progenitor cells

We have purified a factor, hematopoietic promoting factor (HPF), from porcine kidney extract (PKE), which exhibits a promoting activity on granulocyte/macrophage (GM) colony and burst-forming-unit-erythroid (BFU-E)-derived colony formation by progenitors from murine bone marrow cells in vitro. The addition of HPF resulted in an enhancement of the GM colonies as well as BFU-E-derived colonies, but did not enhance the colony-forming-unit-erythroid (CFU-E)-derived colony formation. HPF was added to the BFU-E cultures together with cytokines, such as recombinant murine interleukin-3 (IL-3), recombinant murine GM colony-stimulating-factor (GM-CSF) and recombinant human G-CSF, which have all been shown to enhance BFU-E growth. The combination of HPF plus these cytokines resulted in an enhancement of benzidine negative colony formation in comparison to the case of each cytokine alone; however, no increase was found on BFU-E colony formation. HPF is able to enhance the granulopoiesis and erythropoiesis in vitro. And the synergistic activity of HPF is significantly affected by the presence of cytokines in the cultures.

Mutagenicity of airborne particulates in Sagamihara City

Airborne particulates in Sagamihara city were collected on quartz fibre filters using a high-volume air sampler for 14 days in each month from July 1984 to June 1985. Organic components in airborne particulates were extracted by the ultrasonic extraction method using benzene-ethanol (3:1 v/v) as an extracting solvent. The mutagenecities of airborne particulates extract were measured by the pre-incubation method using Salmonella typhimurium strains TA100 and TA98 with and without S-9mix. The concentration of airborne particulates was nearly the same level throughout the survey period, but the content of extract in particulates of winter was higher than those of other seasons. All the airborne particulates extracts showed positive mutagenic response to both strains with and without S-9mix. The average of mutagenic activities (revertants/m3 air) in winter was significantly higher than those in summer and spring. Furthermore, mutagenic activities fluctuated sharply in one month from several to ten times compared with the normal level, depending upon sampling days, and tended to be lower on Sundays and holidays in summer and new year holidays. In many days mutagenic activities without S-9mix were comparatively higher than those with S-9mix. The existence of nitroarene was surveyed using TA98NR strain. Nitroarene was found to be higher concentration in summer than in winter.

Development of early bovine embryos to the blastocyst stage in serum-free conditioned medium from bovine granulosa cells

Bovine granulosa cell-conditioned medium (BGC-CM) was prepared in a serum-free medium consisting of TCM 199, 5 micrograms/ml insulin, and 0.5 micrograms/ml aprotinin (TCM 199 IAP). Granulosa cells surrounded with embryos were denuded 24 to 30 h after in vitro fertilization. The proportion of denuded granulosa cell-free embryos that developed to the blastocyst stage in BGC-CM (43/219; 20%) as well as in the co-culture system (43/178; 24%) was significantly greater (P less than 0.001) than in fresh TCM 199 IAP medium (FM: 10/191; 5%), whereas the proportion of embryos that developed to the eight-cell stage was similar (P greater than 0.05) in all three culture systems (95/178; 53% in co-culture, 111/219; 51% in BGC-CM, and 86/191; 45% in FM, respectively). Higher rates of hatching and hatched blastocysts 8.5 days after in vitro fertilization were observed in co-culture (13/44; 29.5%) and in conditioned medium (8/39; 20.5%). On the other hand, no hatching or hatched blastocysts were obtained in the fresh medium (0/7; 0%). Cell numbers per blastocyst in BGC-CM (178.3 cells/blastocyst) were approximately two-fold higher than those in FM (97.1 cells/blastocyst). However, higher cell numbers (249.3 cells/blastocyst) were observed in co-culture with BGC than in BGC-CM. The embryotrophic activity in BGC-CM was stable upon freezing and thawing, lyophilization, and heating at 56 degrees C whereas activity was reduced by dilution in fresh medium, dialysis, pronase digestion, and heating at 80 degrees C. These results suggest that BGC cultured in a serum-free medium can synthesize and secrete an embryotrophic factor(s) that supports blastocyst formation in vitro beyond the 8- to 16-cell stage.

Biochemical and molecular genetic analyses on placental aromatase (P-450AROM) deficiency

Biochemical and molecular genetic studies were made on a case of placental aromatase (P-450AROM) deficiency. Of the enzymes participating in the electron transport system of placental microsomes, only aromatase activity was decreased specifically in the patient, being less than 0.3% of the normal activity. Northern and Western blotting analyses showed that the transcription of the aromatase gene and the translation of its mRNA proceeded normally in the placenta of this patient. However, aromatase cDNA isolated from a placental cDNA library of the patient was found to have an insert of 87 base pairs, encoding 29 amino acids in frame with no termination codon. The insert was located at the splicing point between exon 6 and intron 6 of the normal aromatase gene, and the extra DNA fragment was the first part of intron 6, except that its initial GT was altered to GC. These findings indicated that in this patient with aromatase deficiency, splicing between exon 6 and intron 6 did not occur at the normal position because of a point mutation in its consensus sequence and was forwarded to GT in the next cryptic consensus sequence 87 base pairs downstream according to the canonical GT/AG rule, resulting in translation of an abnormal protein molecule with 29 extra amino acids. During the transient expression in COS-7 cells, the aromatase cDNA of the patient was found to produce a protein with a trace of activity. This is the first report of a genetic defect for aromatase deficiency.

Synthesis of 7-O-[2,6-dideoxy-2-fluoro-4-O-(3-fluorotetrahydropyran-2-yl)- alpha-L-talopyranosyl]daunomycinone

7-O-[2,6-Dideoxy-2-fluoro-4-O-(3-fluorotetrahydropyran-2-yl)-alpha -L- talopyranosyl]daunomycinones (7a-7c) have been prepared by condensation of 3'-O-benzoyl derivative of 7-O-(2,6-dideoxy-2-fluoro-alpha-L-talopyranosyl)daunomycinone with 2,3-difluorotetrahydropyran as the key reaction. Antitumor activities of these compounds are described.

Experimental study of hub contamination: effect of a new connection device: the I system

Experimental studies of hub contamination of intravenous catheters were done comparing the standard connection method (Luer-Lock connector) with a newly invented connection method (I system). Immersion of the connection sites into a bacteria-containing solution showed no bacterial contamination of the medium in any tubing. The second experiment investigated whether bacterial contamination would occur during a tubing change procedure. A high incidence of bacterial contamination was seen with the Luer-Lock connector, but no bacterial contamination occurred with the I system. These experiments suggest that the use of Luer-Lock connectors is associated with a high risk of bacterial contamination during tubing change, but the I system can prevent contamination during tubing change, which cannot be avoided with Luer-Lock connector.

[A case of subaortic stenosis due to parashute accessory mitral valve tissue]

An 11-year-old boy with subaortic stenosis due to parashute accessory mitral valve tissue was treated successfully with surgery. He had a mild left ventricular-aortic pressure gradient associated with mild aortic regurgitation. The abnormal subaortic tissue was attached to the anterior leaflet of the mitral valve and was complicated with discrete subaortic stenosis. This tissue had five chordae connecting to the anterior papillary muscle and the anterior leaflet of the mitral valve. By resection of this accessory tissue and the part of the septal discrete stenotic tissue, stenosis of the left ventricular outflow tract was relieved completely.

[Primary localized amiloidosis with recurrent relapse: a case report]

This is a case report of primary localized amyloidosis of the urinary bladder. The patient was a 73-year-old woman who had relapse of this disease three times. Primary localized amyloidosis of the urinary bladder is an especially rare disease and the prognosis is excellent in most cases. We performed transurethral resection of the bladder tumor (TUR-Bt) each time and we are following up this patient carefully. After the last TUR-Bt, she has had no recurrence for 7 months. Considering multifocal recurrence and excellent prognosis, we stress the importance of TUR-Bt for diagnosis and careful follow up.

Beneficial effects of dietary intervention on serum lipid and apolipoprotein levels in obese children

Effects of weight reduction on serum levels of lipids and apolipoproteins were measured in 13 obese children (seven girls, six boys). Mean weight loss of 8.4% of the initial body weight was achieved after 4 weeks of energy intake restriction and exercise. Serum total cholesterol (5.46 +/- 1.01 mmol/L) and triglyceride (2.08 +/- 0.52 mmol/L) levels were significantly high compared with control values before treatment and were significantly reduced to 4.32 +/- 0.75 and 1.31 +/- 0.42 mmol/L, respectively, after treatment. Serum high-density lipoprotein cholesterol level (1.03 +/- 0.23 mmol/L) was significantly low and unchanged after treatment (0.94 +/- 0.25 mmol/L). Serum apolipoprotein A-I level (0.039 +/- 0.009 mmol/L or 111 +/- 0.26 g/L) was normal before treatment and significantly reduced, to 0.032 +/- 0.007 mmol/L or 0.92 +/- 0.19 g/L, after weight reduction. Serum apolipoprotein B level (0.00019 +/- 0.00007 mmol/L or 1.07 +/- 0.21 g/L) was significantly high before treatment and decreased to the normal range after treatment (0.00014 +/- 0.0009 mmol/L or 0.76 +/- 0.24 g/L). The ratio of apolipoprotein B to apolipoprotein A-I (1.09 +/- 0.29) was significantly high on admission and decreased significantly to 0.64 +/- 0.12 after treatment. Serum apolipoprotein E level (0.0014 +/- 0.0006 mmol/L or 0.05 +/- 0.02 g/L) was normal and decreased to 0.0008 +/- 0.0002 mmol/L or 0.03 +/- 0.01 g/L after treatment. In conclusion, weight reduction achieved by energy intake restriction and exercise had beneficial effects on serum lipid and apolipoprotein concentrations for the prevention of future atherosclerosis.

Regulation of acetylcholine release in vivo from rat hippocampus by monoamines as revealed by novel column-switching HPLC with electrochemical detection

To clarify monoaminergic regulation of acetylcholine (ACh) release in the rat hippocampus, the effects of administration of monoamines through a dialysis probe on extracellular ACh levels were examined using in vivo brain microdialysis combined with a novel column-switching HPLC system. Infusion of dopamine or 5-hydroxytryptamine, but not noradrenaline, increased ACh levels. The ACh levels also increased following infusion of apomorphine and 5-methoxy-N,N-dimethyltryptamine. These results demonstrate that hippocampal ACh release is regulated by dopamine and 5-hydroxytryptamine.

[Is there any correlation between urea kinetics and the clinical outcomes in CAPD patients?]

Urea kinetic modeling was applied to 19 CAPD patients followed in our outpatient clinics. Serum beta 2-microglobulin was also measured as a marker of large molecular weight substances. Clinical conditions of patients were assessed by both doctors and patients. Patient's assessment were done by the questionnaire. Indices of urea kinetics (KT/V, PCR) and biochemical parameters were compared between well-treated and not well-treated patients judging from patient's and doctor's assessment scores. The rate of peritonitis was significantly higher in the latter group. None of the parameters were different between 2 groups except for serum albumin. There was a significant correlation between serum concentration of albumin and doctor's assessment score (gamma = 0.52). In conclusion, urea kinetic parameters is not a good indicator for adequacy of dialysis in our CAPD population. Serum albumin seems to be one of the indices for adequate dialysis. However, clinical symptoms and signs are more valuable than biochemical parameters for the assessment of adequacy of dialysis.

Effect of Yeast Extract and Vitamin B 12 on Ethanol Production from Cellulose by Clostridium thermocellum I-1-B

Addition to media of yeast extract, a vitamin mixture containing vitamin B 12 , biotin, pyridoxamine, and p -aminobenzoic acid, or vitamin B 12 alone enhanced formation of ethanol but decreased lactate production in the fermentation of cellulose by Clostridium thermocellum I-1-B. A similar effect was not observed with C. thermocellum ATCC 27405 and JW20.

Massive small bowel resection in neonates--is weaning from parenteral nutrition the final goal?

Eight surviving cases from an original 15 pediatric patients who underwent massive small bowel resection during their neonatal period were reviewed for a period of 2-19 years to assess long-term prognosis. the primary diseases were congenital intestinal atresia in 6 cases and midgut volvulus in 2. The length of the residual small intestine ranged from 27-75 cm and the ileocaecal valve had been resected in 3 cases. All cases were able to be weaned from parenteral nutrition and at present, 6 of the children can tolerate normal meals but 2 are still receiving enteral nutrition, in the form of a low residue diet at home. Near normal somatic growth was achieved in the most recent 5 cases who received intensive nutritional treatment in the immediate postoperative period, whereas 3 who did not receive nutritional management exhibited growth retardation. The D-Xylose absorption test revealed gradual improvement and finally normal absorption in all except one case with the shortest remaining intestine (27 cm). However, the fat absorption test revealed abnormal absorption in cases with a residual intestine of less than 45 cm. Late metabolic complications such as renal calculi, cholelithiasis and pathologic fractures were encountered in 3 cases.

Local control of prostate cancer by intraarterial infusion chemotherapy facilitated by the use of angiotensin II

Intraarterial infusion chemotherapy with angiotensin II was carried out in 8 prostate cancer patients whose ages ranged from 61 to 77 years. They had stage C or D tumor progression and complained of difficult urination, bone pain or lymphedema caused by intrapelvic tumor infiltration. Endocrine therapy had been done before the infusion therapy but the clinical status showed little change with a persistence of local symptoms. Cis-platinum and doxorubicin were infused with an indwelling catheter into both internal iliac arteries. After the completion of 1-5 courses, 6 of 8 patients responded remarkably in local symptoms. It is thought that intraarterial infusion chemotherapy can be used safely and effectively in elderly patients.