Metastatic mode of gastric carcinoma by flow cytometric and clinicopathologic parameters

We used flow cytometric and conventional clinicopathologic parameters to analyse the metastatic mode of cancer in 113 stomach cancer patients. Liver metastasis was frequent in cases with intestinal-type cancer, cancer located in the distal stomach, positive venous invasion and aneuploid cancer. Lung and pleural metastasis (excluding nodular lung metastasis), however, were frequent in cases with serosal invasion and diploid cancer. Peritoneal metastasis was frequently seen with tumors located in the proximal or whole stomach, diffuse-type cancer and cancer with serosal invasion. All cases developing bone metastasis were positive for lymph node metastasis. DNA ploidy was partially related to the metastatic mode of stomach cancer, but this was not the sole parameter for predicting metastasis. However, prediction may be possible if based on both DNA ploidy and clinicopathologic parameters, suggesting the possibility of the prophylaxis of recurrence by appropriate postoperative adjuvant therapy.

[Clinico-immunological study of the patients infected with Mycobacterium avium complex (MAC)]

Lymphocyte functions of the peripheral blood in the patients infected with MAC (MAC-pts) were evaluated comparatively with age-matched normal controls by using flow cytometry. The results obtained were as follows: 1) In normal controls, the number of total lymphocytes and the proportion and number of T lymphocyte subsets significantly decreased with age. The proportion of natural killer lymphocytes significantly increased in elder controls. 2) In MAC-pts, the number of total lymphocytes and T lymphocyte subsets were significantly lower and the proportion of natural killer lymphocytes were higher respectively than normal controls. 3) The lymphocyte proliferation induced by PPD-S stimulation in vitro in MAC-pts was significantly lower than the normal controls in both age groups of 50-69 and 70-89 years old. 4) The lymphocyte proliferation induced by PPD-S stimulation in MAC-pts was increased slightly by adding recombinant IL-2 and significantly higher by depletion of monocytes. By combination of both treatments, it recovered to the level of normal controls. From these results, we suggested that the decline of lymphocyte proliferation induced by PPD-S stimulation in MAC-pts was due to the decrease of IL-2 production by antigen committed lymphocytes and suppression by monocytes. 5) Lymphocyte proliferation induced by PHA stimulation in vitro was also significantly depressed in MAC-pts as compared with normal controls.

Effect of colchicine on ganglioside composition of rat primary culture neurons

Developmental changes in gangliosides in the course of neurite outgrowth were examined in dissociated fetal rat cerebral neurons in culture. About a 2-fold increase in ganglioside levels was seen with the progression of neurite formation for up to 24 h in predominantly neuronal cultures. Ganglioside patterns appeared to be unchanged during the first 24 h, subsequently consisted of higher amounts of GD3 and b-series gangliosides (such as GD1b, GT1b, and GQ1b), and lower amounts of a-series gangliosides (GM1 and GD1a). Although the addition of colchicine to the cell growth medium inhibited neurite outgrowth in developing neurons, little if any differences in ganglioside patterns were found between control and colchicine-treated cells. Ganglioside levels decreased slightly in colchicine-treated cells in agreement with the decrease in cell attachment to culture dishes. Although colchicine treatment 8 h after plating caused complete retraction of formed neurites, the ganglioside level of the cells continued to increase during the following 16-hour incubation. Thus, the data suggest that ganglioside synthesis in differentiating neurons does not primarily accompany the expansion in cell surfaces due to neurite formation, and raises the possibility that a large proportion of gangliosides is retained in intracellular compartments.

[Diffuse subendocardial ischemia in a patient with aortic valve stenosis without coronary artery disease by exercise 201Tl SPECT]

A case of aortic valve stenosis without coronary artery disease was confirmed to have diffuse subendocardial ischemia by exercise Thallium-201 myocardial single photon emission computed tomography. A 72-year-old woman, who had been diagnosed as aortic valve stenosis, was admitted because of chest pain during exercise. In cardiac catheterization findings, the patient angiographically had normal coronary arteries and no asynergy of left ventricular wall motion. The peak flow velocity in continuous wave Doppler echocardiography was about 5.0 m/sec at aortic valve level, providing a pressure drop of 100 mmHg across a stenotic valve with calculating on a modified Bernoulli equation (PG = 4V2). Thallium-201 myocardial SPECT images during exercise showed a transient "dilation and a widespread wall thinning" of left ventricle with apical perfusion defect. Simultaneous electrocardiogram showed further ST depression and the patient had chest pain. In 6 months after aortic valve replacement the patient no longer demonstrated both apical perfusion defect and "wall thinning" in postoperative thallium-201 myocardial SPECT images and also had neither ST depression nor chest pain. Thus; a transient "dilation and wall thinning" of left ventricle in this patient is suspected to be a sign of diffuse subendocardial ischemia.

[Establishment of a congenic strain with complement regulatory protein of factor H allotype derived from Mus. musculus molossinus]

Factor H is a plasma glycoprotein with M. W of 160 KDa which serves as one of the regulatory proteins for C 3 convertases. We have previously reported three serologically defined mouse factor H allotypes by surveying many laboratory and wild mice. In the present work, we established a congenic strain with factor H allotype, H. 2. on BALB/c (H. 1 allotype) background and named this strain BALB-H.2. Alloantiserum against each allotype has been easily prepared using two congenic strains by immunization with a small amount of whole mouse serum. BALB-H.2 is valuable for the genetic studies on the genes in the vicinity of factor H gene (cfh) derived from Mus. m. molossinus.

A case report of intraoperative ultrasonic exploration for an inferior vena cava thrombectomy of the right Wilms' tumor

The intraoperative ultrasonic explorations for a case of right Wilms' tumor with inferior vena cava thrombosis are reported. This method of assessment is most appropriate for cases of inferior vena cava thrombectomy of malignant tumors either with or without an inferior vena cava resection.

Metastatic mode and DNA ploidy in gastric carcinoma

We studied the amounts of nuclear DNA in gastric cancer metastases histologically and cytochemically by flow cytometry, which was performed retrospectively on paraffin-embedded specimens from 95 patients. At surgery, all cases of aneuploid cancer were positive for lymph node metastases. Liver metastases were frequently seen in aneuploid cancer (63%, P < 0.01), while lung metastases were the most common in diploid cancer (50%, P < 0.05). The incidence of peritoneal metastasis was high in undifferentiated diploid cancer (72%, P < 0.01). Local lymph node recurrence after surgery was more common in aneuploid than in diploid cancer (P < 0.01). The incidence of bone and distant lymph node metastasis was found to be strongly dependent on tissue differentiation. The DNA ploidy pattern is thus considered to be closely linked to lymph node, liver, and lung metastases in gastric cancer.

Ultrasonic exploration of contralateral side in pediatric patients with inguinal hernia

The width of low echoic region at the internal ring (WLIR) of an inguinal canal demonstrated by ultrasonography was applied in the preoperative diagnosis of the contralateral side in pediatric patients with inguinal hernia. The ultrasonic diagnosis of 39 pediatric patients with inguinal hernia and 38 children without inguinal hernia under 15 years of age were conducted at Hamamatsu University Hospital from April 1988 to January 1989. The WLIR of children without inguinal hernia were within 6 mm in boys under 15 years of age and within 3 mm in girls under 5 years of age. There were no statistically significant differences between the WLIR of the right side and that of the left side, and the WLIR of the following three age groups also demonstrated no statistical significance: under 1 year of age, 1 to 5 years of age, 5 to 15 years of age. On the other hand, the WLIR of the hernia side of pediatric patients with inguinal hernia were significantly wider than that of the contralateral side in boys and girls under 5 years of age (P less than 0.01), as well as in boys 5 to 15 years of age (P less than 0.05). Therefore, we recommend a contralateral exploration for pediatric patients with inguinal hernia when the WLIR is 7 mm or more in boys under 15 years of age and 4 mm or more in girls under 5 years of age.

[Experience of predeposit autologous blood transfusion and medication of recombinant human erythropoietin in pediatric open heart surgery]

To avoid using the homologous blood, 11 children between the age of 5 and 15 years donated autologous blood of 10 ml/kg of body weight (upper limit 400 ml) once a week for two weeks prior to elective open heart surgery. Five of 11 children received erythropoietin (100 U/kg of body weight) intravenously three times a week for two weeks. Only one patient experienced a mild donor reaction but no adverse effects occurred in erythropoietin therapy. In all the patients cardiac operations were able to be completed without homologous blood transfusion. Patients treated with erythropoietin were not anemic despite of preoperative donation although without erythropoietin therapy patients were mildly anemic. Our experience documents safety and effectiveness of predeposit autologous blood transfusion and erythropoietin therapy in pediatrics.

Method for the time-resolved measurement of the size and position of a moving particle using an image sensor

A new method for the continuous measurement of both the size and position of a moving particle using a two-dimensional metal-oxide-semiconductor-type image sensor is described. With this method the particle position is determined precisely by the number of the scanning line and the pixel number within one frame image in place of the frame number used in ordinary video camera methods. This simple and novel sizing method, associated with the image storage property of the image sensor over one field interval, was first described and applied by König et al. [J. Aerosol. Sci. 17, 157 (1986)]. The numerical analysis and the experiment to verify the sizing method are performed. Details of the system and its application for a freely falling small glass sphere are presented.

[Clinical study of urinary fungal infection: survey of patient background and fungal strains from the urine]

Clinical features of urinary fungal infections were analyzed in 152 patients in whom fungi were cultured from urine and mycologically identified between February, 1989 and June, 1990. The average age was 66 years old, and approximately 70% of the patients were 60 years old or older. Systemic and urinary tract underlying diseases were observed in 145 patients (95.4%) and 70 patients (46.1%) had urinary indwelling catheters. Previous use of antimicrobial agents before isolation of urinary fungi was recorded in 103 patients (67.8%), the 2nd and 3rd generation cephems and new quinolones being most frequent. A mixture of fungi and bacteria was observed in 68 patients (44.7%). Gram-positive cocci were isolated from 50% of them. Of 173 strains of fungi, C. glabrata was the most frequent (31.2%), followed by C. albicans (27.8%), C. tropicalis (17.3%) and T. beigelii (15.0%). All strains of C. glabrata, C. albicans, C. tropicalis and T. beigelii were highly sensitive to flucytosine (5-FC), miconazole (MCZ) and amphotericin B (AMPH), except for 3 strains which were resistant to 5-FC. The consecutiveness was confirmed by repeated culture in 59.4% of the patients. Fungi in the urine, however, spontaneously disappeared in the other patients.

[Successful mitral valve replacement in osteogenesis imperfecta--a case report]

A 34-year-old man with osteogenesis imperfecta who underwent successful mitral valve replacement due to mitral regurgitation was reported. Cardiac disease associated with osteogenesis imperfecta is very rare and only fifteen patients were operated under the extracorporeal circulation previously. While excessive hemorrhage due to tissue fragility was observed in 7 of 15 patients, perioperative course of the case reported here was completely uneventful. The difference of hemorrhagic tendency as well as etiology of osteogenesis imperfecta will be defined according to the advance of technology in collagen genetics and biochemistry in future.

[Effect of age on visualization of right atrium by thallium-201 myocardial scintigraphy]

With Thallium-201 (Tl) myocardial scintigraphy, right atrial (RA) myocardium has been visible in the disease involving the right side of the heart. We have found RA visualization in the elderly patients without the evidence of right heart disease. Therefore, we studied the relation of age to the RA visualization with Tl myocardial scintigraphy performed at rest. Planar images of 291 patients without valvular or congenital heart disease were read by two observers and classified into the three by the degree of RA visualization; RA 0 = not visualized, RA 1+ = moderately visualized, RA 2+ = intensely visualized. The results were as follows: 93.1% of under 50 y.o., 77.8% of fifties, 86.7% of sixties, 50.5% of seventies and 36.7% of over 80 y.o. showed RA 0. 6.9% of under 50 y.o., 22.2% of fifties, 8.3% of sixties, 46.5% of seventies and 36.7% of over 80 y.o. showed RA 1+. None of under 60 y.o., 5.0% of sixties, 3.0% of seventies, and 26.6% of over 80 y.o. showed RA 2+. In conclusion, RA visualization in Tl myocardial scintigraphy, suggesting right heart overload, may increase with aging.

Target-dependent hormonal control of neuron size in the rat spinal nucleus of the bulbocavernosus

The spinal nucleus of the bulbocavernosus (SNB) in the rat is a cluster of sexually dimorphic motoneurons that innervate perineal muscles. In adult male rats, the size of SNB neurons is reduced following castration, and this effect is reversed by treatment with testosterone. However, androgen receptors are present in the perineal muscles as well as in SNB neurons. Therefore, it is not clear whether the neuronal size is regulated by direct action of the hormone on SNB neurons or by a target-derived factor that may be controlled via hormonal action on the innervated muscle. To address this question, the peripheral (pudendal) nerve of SNB neurons on one side was cut and united to the grafted soleus muscle, which lacks androgen sensitivity. On the control side, the pudendal nerve was similarly cut but was allowed to reinnervate the perineal muscles. The size of SNB neurons was measured on both sides after a postoperative period of 10 weeks, during which the animal had been castrated or treated with testosterone after castration. The size of SNB neurons that had reinnervated perineal muscles was reduced following castration and enlarged by testosterone treatment. In contrast, the size of SNB neurons that had innervated the soleus muscle remained unaltered in response to testosterone manipulation. It is concluded that hormonal regulation of the size of SNB neurons in adult rats is mediated by their target muscles.

The mouse factor H allotypes with multiple amino acid replacement, H.1 and H.2 show indistinguishable co-factor activity for factor I

The authors report the functional analysis of the purified mouse factor H allotypes H.1 and H.2, which were clearly distinguished from each other by an immunodiffusion test. Both allotypes acted as a co-factor for factor I in cleaving mouse C3b and we found no significant difference between their activities. The results strongly suggest that the function of mouse factor H for the co-factor activity has been well conserved between two allotypes.

Total synthesis of a gene for octopus rhodopsin and its preliminary expression

To carry out systematic structure-function studies of octopus rhodopsin, photoreceptor protein of octopus visual cells, by means of specific amino-acid replacements, we have totally synthesized a DNA duplex of 1,365 base pairs that encodes the entire octopus rhodopsin of 455 amino acids [Ovchinnikov et al. (1988) FEBS Lett. 232, 69-72] by introducing codons preferred in Escherichia coli. Total synthesis simplifies site-specific mutagenesis in all parts of the gene by replacement of short restriction fragments by their newly synthesized counterparts containing the required nucleotide alterations. Thirty unique restriction sites were introduced in the octopus rhodopsin gene, which was assembled on a plasmid in two steps. Five cartridge genes of 344, 296, 320, 212, and 317 base pairs capable of being expressed independently were first constructed by using 48 synthetic oligonucleotides ranging in size from 54 to 73 nucleotides. The entire gene was constructed by consecutive linkage of cartridge genes. These cartridge genes were designed to correspond to the transmembrane helical unit of octopus rhodopsin, resulting in easy construction of various chimeric rhodopsins. The nucleotide sequences were confirmed by sequencing the cartridges as well as the entire gene. These synthetic genes were cloned into an expression vector carrying the trp promoter of E. coli, and were preliminarily expressed in vitro and in vivo.

Enhancement of endogenous prostaglandin I2 (prostacyclin) generation in vivo by a phenolic anti-inflammatory agent in the rabbit

Angiotensin II (i.v.) increased the plasma level of 6-keto-PGF1 alpha from 241 +/- 60 pg/ml (n = 8) to 612 +/- 108 pg/ml (n = 8) in anesthetized rabbits, which was further significantly increased by pretreatment with a phenolic anti-inflammatory agent, MK-447, to 1007 +/- 218 pg/ml (n = 8). MK-447 alone did not affect the level. The level of thromboxane B2 was not affected by these treatments. These results suggest that MK-447 may selectively enhance the PGI2 level by acting as a tryptophan-like cofactor of PG endoperoxide synthase.

Transantral ligation of the maxillary artery for refractory epistaxis. A case report

A case of severe arterial epistaxis treated by transantral ligation of the maxillary artery is reported. A 66-year-old woman had recurrent left sided epistaxis from the posterior nasal cavity which was difficult to control by conventional nasal packing methods. Selective angiography was performed to identify the arterial flow patterns and site of bleeding which was confirmed to be the descending palatine artery. Following radiographical examination, ligation and clipping of the maxillary artery and its branches was performed with transantral approach under general anesthesia. No further epistaxis occurred after the ligation. This surgical procedure seems to be relatively simple and highly effective in the management of refractory epistaxis.

[Impairment of left ventricular diastolic function during the asymptomatic period in vasospastic angina patients without significant coronary stenosis]

We examined whether recurrent transient ischemia may effect left ventricular systolic and diastolic function or not. Left ventricular systolic and diastolic function during the asymptomatic period was studied by gated radionuclide ventriculography (RNV) in 25 patients with vasospastic angina (VA) who had no significant coronary stenosis, in 25 patients with effort angina (EA), and in 20 controls (C). There was no significant difference among patients in all three groups in regards to systolic indices (Ejection Fraction, Peak Ejection Rate). But diastolic indices (Peak Filling Rate, Time to Peak Filling Rate, 1/3 Mean Filling Rate, 1/3 Filling Fraction) were impaired not only in patients with EA but also in patients with VA. The treatment with nitrates and/or Ca antagonist for 6-24 months did not bring about any changes in these data concerning systolic and diastolic function in patients with VA. Thus, it is suggested that the diastolic function is impaired in patients with VA even during the asymptomatic period, though systolic function remains normal. Recurrent transient ischemia may cause irreversible myocardial injury.

Three dimensional intracellular structure of the cochlea using the A-O-D-O method

We have observed the three-dimensional intracellular structure of the organ of Corti and the spiral ganglion of the chinchilla using the aldehyde osmium-DMSO-osmium (A-O-D-O) method, and compared our findings with previous studies in the guinea pig. In cells of the spiral ganglion and the organ of Corti, microtubules and other cytoplasmic filaments were digested by OsO4 during processing to provide a clear view of membranous structures such as mitochondria, endoplasmic reticulum and Golgi apparatus. The appropriate digestion time with 0.1% OsO4 solution was found to be 60-80 hrs for the organ of Corti and 70-90 hrs for the spiral ganglion. The A-O-D-O method has been especially useful to show the organization of the endoplasmic reticulum of the outer hair cells. We have made a further characterization of the apical cistern, a reticular network which appears to link the basal body of the (vestigial) kinocilium to both Hensen's body and the subsurface cisternae.

Kinetic behavior of the monodehydroascorbate radical studied by pulse radiolysis

The reactions of the monodehydroascorbate radical (As.-) with various biological molecules were investigated by pulse radiolysis. As.- reacted with both fully reduced and semiquinone forms of hepatic NADH-cytochrome b5 reductase with second-order rate constants of 4.3 x 10(6) and 3.7 x 10(5) M-1 s-1, respectively, at pH 7.0. In contrast, no reaction of As.- with ferrous cytochrome b5 could be detected by pulse radiolysis, whereas the oxidation of cytochrome b5 by As.- was observed by ascorbate-ascorbate oxidase method. This suggests that the rate constant of As.- with the ferrous cytochrome b5 must be several orders in magnitude smaller than that of the disproportionation of As.-. On the other hand, As.- reduced Fe3+EDTA with a second-order rate constant of 4.0 x 10(6) M-1 s-1 but did not reduce ferric hemoproteins such as metmyoglobin, methemoglobin, and cytochrome b5 by either the pulse radiolysis or the ascorbate-ascorbate oxidase method.

Cochlear fistula found in a naturally healed tympanic cavity

A cochlear fistula found in a naturally healed mastoid cavity is reported. The patient is a 53-year-old Japanese woman who was complaining of unsteadiness. She had a long history of otorrhoea in childhood. Her tympanic and mastoid cavities were widely open and were covered by thin epithelium. The posterior wall of the ear canal was missing. She had no hearing in the ear but responded to electrical promontory testing. Exploratory surgery was indicated at which fistulae of the basal turn of the cochlea and the horizontal semicircular canal were found. These fistulae were sealed by pieces of bone and muscle.

Peduncular hallucinosis associated with ruptured basilar-superior cerebellar artery aneurysm--case report

A 65-year-old female developed peduncular hallucinosis 3 days after rupture of a basilar-superior cerebellar artery aneurysm. There were no neurological deficits except slight anisocoria when she first complained of hallucinations. Vasospasm of the perforating arteries to the upper brainstem, rather than direct brainstem damage caused by the bleeding, was probably the cause. Peduncular hallucinosis is possibly the only localizing sign of ruptured upper posterior circulation aneurysm.