[A case of progressive multifocal leukoencephalopathy with methionine uptake demonstrated by PET]

We report here a 55-year-old man with progressive multifocal leukoencephalopathy (PML) associated with chronic adult T cell leukemia (ATL). Neurological examination revealed mild dementia, right homonymous hemianopsia and visual agnosia. Serologically anti-HTLV-I antibody was positive. Peripheral blood analysis showed ATL cells up to 23% in white blood cells. Because he did not have symptoms or signs directly related to ATL, it was considered that he had chronic ATL. T2-weighted cranial MRI demonstrated multiple hyperintensity lesions confined to the white matter from the bilateral occipital to parietal lobes, without enhancement after gadolinium administration or mass effect. We performed stereotactic biopsy of the left occipitoparietal white matter. Histological examination of the biopsied specimens showed demyelinated lesions, containing foamy macrophages and bizarre astrocytes. Oligodendrocytes contained nuclear inclusions which reacted with an antibody against the JC virus (JCV) antigen. These findings were consistent with those of PML. The genomic analysis of JCV from the biopsied brain revealed deletions in the regulatory region. We investigated cerebral blood flow, glucose and amino acid metabolism in this patient using positron emission tomography, and obtained the following three characteristic findings in the lesions: 1) luxury perfusion state, 2) decreased fluorodeoxyglucose (FDG) uptake, and 3) increased methionine (Met) uptake. These findings resembled those of low grade tumors.

Strength of the glenoid labrum and adjacent shoulder capsule

This study evaluates the role of the glenoid labrum and capsule in the prevention of shoulder dislocation. Fifteen shoulder joints from nine fresh cadavers were used. The labrum and capsule were cut into sections 5 mm wide, and the strength of each slice to rupture was measured. The rupture site was observed microscopically. The anterior-inferior portion was the weakest, with a mean force necessary to cause rupture of 3.84 +/- 1.00 kg/5 mm. The rupture site was the portion of the labrum close to the cartilage of the glenoid. Histologic structure and degenerative changes of the labrum did not differ in the anterior to posterior portions. These results show that the anterior-inferior portion of the labrum is relatively weak. This finding may explain the lesion commonly identified in anterior shoulder dislocation.

Entactin modulates the attachment of rabbit corneal epithelial cells

PURPOSE

To understand the biological activity of entactin, a component of the basement membrane of the corneal epithelium, we investigated the ability of rabbit corneal epithelial cells to attach to an entactin matrix and the effect of entactin on the cells' attachment to other corneal basement proteins.

METHODS

Multiwell plastic plates were coated with bovine serum albumin (BSA), alone or with BSA and entactin, laminin, fibronectin or collagen type IV. Cultured rabbit corneal epithelial cells were seeded on the plates. After incubation (usually 90 min), the cells were fixed and stained with 1% crystal violet. The number of attached cells was counted under a light microscope.

RESULTS

The numbers of attached cells increased in proportion to both the incubation period and the concentration of entactin coated. Furthermore, the number of cells attached to the entactin-coated plate was greater than the number attached to the BSA-coated plate for each incubation period (30 to 120 min). Likewise, when laminin-coated plates were treated with entactin, the number of the attached cells increased in proportion to the concentration of entactin. However, entactin did not affect the cellular attachment of fibronectin or type IV collagen. Cellular attachment to entactin was partially inhibited by the cells' preincubation with the synthetic peptide (GRGDSP).

CONCLUSIONS

The present results showed that cultured corneal epithelial cells adhere to entactin and that entactin stimulated the attachment of these cells to the laminin matrix. These findings suggest that entactin plays a specific role in maintaining the normal integrity of the corneal epithelium.

Histological grade in invasive ductal carcinoma of breast correlates with the proliferative activity evaluated by BrdU: an immunohistochemical study including correlations with p53, c-erbB-2 and estrogen receptor status

Thirty cases of invasive ductal carcinoma of the breast were classified to histological subtype according to the General Rules for Clinical and Pathological Recording of Breast Cancer of the Japanese Breast Cancer Society and histologically graded using the Nottingham method and the correlation of histology with proliferative activity was investigated using bromodeoxyuridine (BrdU). In addition, the overexpression of p53 protein, c-erbB-2 oncoprotein and estrogen receptor (ER) were immunohistochemically examined in order to discuss the relationship with histological subtype and histological grade. Histological grade correlated positively to the BrdU labeling index (LI) and overexpression of p53. High grade carcinoma demonstrated c-erbB-2 more frequently and exhibited a low incidence of ER. However, no significant relationship was found between BrdU LI, overexpression of p53 and c-erbB-2 and histological subtype. These results suggest that the histological grade does represent the proliferative activity of tumor cells and that adding the histological grade to the pathological diagnosis in invasive ductal breast carcinoma may be useful from the clinicopathological aspect concerning tumor behavior.

Spatial and temporal expression of P-glycoprotein in the congenitally hydrocephalic HTX rat brain

The purpose of the present study is to examine spatial and temporal expression of P-glycoprotein in the brain of congenitally hydrocephalic HTX rats. P-glycoprotein has been reported not only as a drug efflux pump but also one of the factors that restricts brain edema. We examined the rat brain from postnatal day 1 to 60 using light and electron microscopy, immunohistochemistry, Western immunoblot and reverse transcriptase-polymerase chain reaction (RT-PCR) methods with monoclonal antibody specific for P-glycoprotein. Immunohistochemically, the positive anti-P-glycoprotein reactivity was found in capillaries of the normal control rat cerebrum. In the hydrocephalic HTX rat brains, it was also found in the capillaries, but only very weak to no reactivity was found in the capillaries of the spongy changes and cystic wall in the subcortical and lateral periventricular white matter. Immunoelectron microscopically, the reaction product was found exclusively on the luminal surface of the capillary endothelium in control rats. A tracer study with intracardiac perfusion of lanthanum chloride showed that lanthanum penetrated the tight junctions and passed through the intercellular space. In the Western immunoblot analysis, P-glycoprotein of 170 kDa was detected clearly in most normal control rat brains but it was not found in the hydrocephalic HTX rat brains. Moreover, mdr1 P-glycoprotein gene expression in the subcortical white matter was examined by RT-PCR. It was detected in all normal control rat brains, but not found in the hydrocephalic HTX rat brains. The results suggested that the absence of P-glycoprotein expression in the capillaries of deep subcortical and lateral periventricular white matter of hydrocephalic HTX rats led to a deficiency of the blood-brain barrier and might be related to vasogenic edema and to the formation of the spongy changes and cystic cavities.

Cloning and expression of a rat brain basic helix-loop-helix factor

We cloned two rat cDNAs of brain basic helix-loop-helix factor 1 (BHF1). These have an identical coding region, contain 357 amino acids and exhibit 94.6% identity to MATH-2/NEX1 in the basic helix-loop-helix region. BHF1mRNAs are dominantly expressed in the brain particularly in the cerebellum, in the adult bovine, rat and mouse. Two shorter BHF1mRNAs (1.6 kb and 1.8 kb) were also detected in the mouse embryo, and these decreased in the developmental process. These results suggest that BHF1 may play important roles in cerebellum-specific functions and development of neurons.

Oxidized ethyl linoleate induces mucosal hypertrophy of the large intestine and affects cecal fermentation of dietary fiber in rats

Oxidized ethyl linoleate (OEL) was prepared by aeration at low temperature. Peroxide value (POV, mEq/kg lipid) of OEL was 1400; the major oxidized compounds were 9-hydroperoxy-cis, trans- and 13-hydroperoxy-trans, cis-octadecadienoate. Rats fed fiber-free or sugar-beet fiber (SBF, 100g/kg diet) diets were divided into three groups for each diet, and administered OEL (high OEL group), OEL diluted with ethyl linoleate (low OEL group, POV 700) and nonoxidized ethyl linoleate (EL group) through gastric tubes each day at 1400-1600 h (2.5 g/kg body wt) for 16 d. The relative wet weight, and DNA and protein contents of the cecal mucosa were higher in the high OEL groups than in the low OEL and EL groups in rats fed the fiber-free diet and in rats fed the SBF diet except for mucosal protein content. Spermidine concentration in cecal mucosa of rats fed the fiber-free diet was greater in the high OEL group than in the EL group. These results suggest that metabolism related to mucosal proliferation of the cecum was affected by the high dose of OEL. The total short-chain fatty acid (SCFA) concentration in the cecal contents of SBF-fed rats was 100% higher than the concentration in rats fed the fiber-free diet in the EL group, but the administration of low dose and high dose OEL lowered the SCFA concentration in fiber-fed rats to that of rats fed the fiber-free diet. Butyric acid concentration was markedly lowered by ingestion of OEL in a dose-dependent manner in rats fed the SBF diet. In contrast, the isobutyric acid concentration was higher in the OEL-treated groups than in the EL groups. We conclude that a low dose of OEL depresses cecal fermentation of dietary fiber with changes in SCFA composition, and that a high dose of OEL induces mucosal hypertrophy in the cecum. These data show that dietary oxidized lipids affect cecal metabolism and may be associated with colon cancer.

Impaired pancreatic acinar sensitivity to cholecystokinin but not to carbachol in rats with chronic bile pancreatic juice diversion

Changes in the sensitivity and responsiveness to CCK and cholinergic stimuli were examined in isolated pancreatic acini prepared from 7-day BPJ-diverted rats. The sensitivity to CCK was lower in BPJ-diverted rats than in the control rats, but the sensitivity to the cholinergic agonist, carbachol, was not changed. These results suggest that the contribution of the cholinergic pathway to pancreatic enhancement by feeding dietary protein can be increased after chronic BPJ diversion.

Laser-diode end-pumped Tm(3+):YAG eye-safe laser

The lasing characteristics of a laser-diode end-pumped Tm:YAG laser were investigated. We obtained a laser output power of 124 mW, a slope efficiency of 36%, and a threshold power of 77 mW with a 3% Tm-doped YAG crystal at room temperature. This lasing performance was improved when the crystal was cooled. The dependencies of both slope efficiency and threshold power on temperature were measured.

Characterization of single chain urokinase-type plasminogen activator with a novel amino-acid substitution in the kringle structure

ECV304 is a cell line established by a spontaneous transformation of endothelial cells of a human umbilical vein. It was shown that ECV304 secretes single chain urokinase-type plasminogen activator (scu-PA). A subclone, ECV304 clone 15, was obtained by acclimatization of parental clone to serum-free medium followed by limiting dilution. The clone was found to produce approximately five times as much scu-PA (approximately 20 IU/10(6) cells per day) as the parental clone after a 40 days' culture. Though the biochemical characteristics of the purified scu-PA were indistinguishable from those of the native scu-PA, it had a lower affinity for fibrin clots under the employed conditions. Molecular cloning of a cDNA encoding the scu-PA has identified a novel substitution from C to T in the nucleotide sequence encoding the kringle structure. The substitution resulted in an alteration from Pro (CCG) to Leu (CTG) at amino-acid position 121, which may be directly or indirectly involved in the decrease in the apparent affinity.

[Two cases of von Recklinghausen's disease with diffuse pulmonary changes]

Two patients with von Recklinghausen's disease had diffuse pulmonary diseases. The pulmonary diseases were interstitial fibrosis and emphysematous bullae. In case 2, examination of a specimen obtained by transbronchial lung biopsy revealed fibrotic interstitial thickening and adenomatous hyperplasia. Diffuse pulmonary abnormalities in von Recklinghausen's disease have been said to be fibrotic changes and emphysematous changes, as shown in roentgenograms in these two cases. The biopsy specimen obtained in case 2, however, revealed fibrotic changes only, which could not be distinguished from findings in cases of idiopathic interstitial pneumonia. In case 2, bronchoalveolar lavage fluid was also examined but it did not reveal any unique features of von Recklinghausen's disease. Since 1978, von Recklinghausen's disease has been diagnosed 10 times in our hospital, but diffuse pulmonary diseases was seen in only two of those 10 cases.

[From the aspects of complicated diseases]

Pulmonary tuberculosis is one of the most prevalent infectious diseases in Japan. Host defense mechanisms may play an important role in every aspect of the disease, for example in acquiring the disease and/or in progression of the clinical course. Host defense mechanisms are constituted from mechanical protection such as cough or sneeze, chemical resistance such as complements or lactoferrin, nonspecific cellular defense such as macrophages or neutrophiles and specific immunological defense mechanisms such as immunoglobulins or immunocompetent cells. If there were any complicated disease other than pulmonary tuberculosis, the disease outcome might become different. We examined 44 patients whose sputa culture was continuously positive for one year or more, despite of administration of anti-tuberculous regimens. And we also analyzed clinical outcome of 556 patients with pulmonary tuberculosis (control group) who were discharged after bacteriological negative conversion. Diabetes mellitus is one of the most common complications in patients with pulmonary tuberculosis, 11/44 in continuously positive patients and 101/580 in control group. There was no statistical significance between these two. Next, the control group was divided into four subgroups, those were 1. no complication, 2. complicated with diabetes mellitus, 3. complicated with liver dysfunction, 4. complicated with the other diseases. Bacteriological negative conversion rate was analyzed in these four subgroups. At the first and the second month, there were significant difference in negative conversion rate between subgroup 1 and 2. But these differences disappeared as the time goes by.

A comparison of the prevalence and risk factors of high blood pressure among Japanese living in Japan, Hawaii, and Los Angeles

THE AUTHORS STUDIED THE PREVALENCE AND RISK FACTORS of hypertension in samples of 2053 Japanese ages 40 to 70 in Hiroshima, Hawaii, and Los Angeles. The prevalence of hypertension (systolic blood pressure greater than or equal to 140 mmHg, diastolic blood pressure greater than or equal to 90 mmHg, or receiving antihypertensive drug treatment) was higher in Hawaii and Los Angeles for both sexes and almost all ages than in Hiroshima. The age- and sex-adjusted prevalence of hypertension in Hawaii, Los Angeles, and Hiroshima was 42.6%, 37.2%, and 29.7%. Hypertension was associated with a significant elevation in serum glucose, insulin, triglyceride, and total cholesterol levels in the combined participant population of Hawaii, Los Angeles, and Hiroshima. Age- and sex-adjusted mean values of serum total cholesterol, triglyceride, and insulin were highest in Hawaii and lowest in Hiroshima. The mean body mass index and 2-hour serum glucose levels were greatest in Hawaii and equal in the two other cohorts. These results suggest that hyperinsulinemia and hyperlipidemia may explain the prevalence of hypertension in the research participants.

Inhibitory effect of antineoplaston A10 and AS2-1 on human hepatocellular carcinoma

Antineoplastons, first described by Burzynski, are naturally occurring peptides and amino acid derivatives which control neoplastic growth. Antineoplaston A10 (3-pehnylacetylamino-2,6-piperidinedion) is the first chemically identified antineoplastons and when it is administered orally it is hydrolysed in pancreatic juice to phenylactylglutamine and phenylacetylisoglutamine in the ration of 4 to 1. These metabolites are water soluble and have antitumor effect, they are further degraded to pehnylacetic acid. The mixture of phenylacetylglutamine and phenylacetylisoglutamine in the ratio of 4 to 1 was formulated as Antineoplaston A10 injectable formulation. The mixture of phenylacetylglutamine and phenylacetic acid in the ratio of 1 to 4 was also shown to have antitumor effect in tissue culture study, then formulated as Antineoplaston AS2-1. The reported cytostatic inhibitory effect of A10 on human hepatocellular carcinoma cells and differentiation inducing effect of AS2-1 on various tumor cells suggest potential benefit for the treatment of human hepatocellular carcinoma since this tumor recurs frequently despite initial successful treatment. We report here the effects of Antineoplaston A10 and AS2-1 on cell proliferation, cell morphology, cell cycle, and DNA in human hepatocellular carcinoma cell lines. Both agents inhibited cell proliferation and increased the number of cells in G0 and G1 phases and Antineoplaston AS2-1 induced apoptosis, we also describe our clinical experience of a hepatocellula carcinoma (HCC) patient whose tumor, after incomplete trancathere arterial embolization (TAE) for a 7cm 7cm HCC, has been stable for more than 15 months during which time he has been taking Antineoplaston AS2-1 continuously without any serious adverse effects.

Presence of a hypervariable region within the hr2 domain of the host range determining sequences of the envelope protein gp85 (SU) of subgroup-A avian sarcoma-leukosis viruses

The nucleotide sequence of the gene for the envelope protein gp85 (SU) of the Schmidt-Ruppin subgroup A (NY) strain of Rous sarcoma virus [SRA(NY)] was determined, and the deduced amino acid sequence was compared with those of other avian sarcoma-leukosis viruses. Among the five host-range determinant sequences (vr1, vr2, hr1, hr2, and vr3), the host-range determinant sequence hr2 of SRA(NY) showed a significant deviation from the hr2 sequences of other subgroup A viruses namely, RAV-1 and SRA(SF). A phylogenetic analysis of the amino acid sequence of this region indicated that this intra-subgroup diversity was as great as or even greater than the inter-subgroup diversity found among other subgroups of ASLV. Within the hr2 region, we found a short hypervariable segment that differs in length and sequence from hr2 of other subgroup-A viruses. The difference in the hr2 amino acid sequence between SRA(NY) and SRA(SF) is reflected in the predicted protein secondary structure of this region.

[II. multidisciplinary analysis of chronic excretors of Mycobacterium tuberculosis bacilli]

For the most patients with pulmonary tuberculosis, treatment are successful and the chemotherapy can be finished within a year. Few patients, though receiving standard anti-tuberculous chemotherapy, expectorate tubercle bacilli continuously for more than a year. They are named "chronic excretors of mycobacterium tuberculosis bacilli" or "intractable tuberculosis patients". Being suspected that this phenomenon is produced by many factors, it is necessary to correspond suitably to these patients for eradication of tuberculosis. This symposium was organized to search for some factors on the bacterium and on the host, which caused patients to be the chronic excretors or intractable patients. We hope that our discussion may contribute to take the appropriate measures for such hard diseases. The main results are summarized as follows. 1) Dr. TSUCHIYA conducted a epidemiologic study by questionaire method to 33 Japanese national sanatoriums. The total number of tuberculosis patients admitted to these hospitals on a optimal day from September to October 1994 were 1,295. Numbers of patients who had expectorated bacilli continuously for more than 12 months were 85 (6.6%). The male/female ratio was about 3, their average age was 64. They had a tendency of thin-physique and most of them had past histories of tuberculosis, being the refractory cases. The average clinico-epidemiologic conditions of the patients came before our eyes. 2) Dr. OGATA analysed the results of drug sensitivity tests of mycobacterium tuberculosis bacilli from 2,630 pulmonary tuberculosis patients which contained 179 chronic excretors. The only 2.2% of bacilli from the chronic excretors were sensitive to RFP (50 gamma). The 99.4% of bacilli showed to be resistant to INH (0.1 gamma). The 39.1% of bacilli were sensitive to streptomycin (20 gamma). To EB (2.5 gamma) 34.1% of bacilli were sensitive. However, the ratio of chronic excretors in tuberculosis patients was not increased in these 17 years, and for many cases of these chronic excretors, they are all inexperienced in PZA, multi-sensitive-drug chemotherapy including PZA and OFLX were useful. Some of them underwent lobectomy combined for effective chemotherapy. The chronic excretors are likely to be affected multidrug-resistant bacilli, and it is important for such cases to treat intensively with several kinds of sensitive drugs. 3) Dr. FUJIWARA studied Interleukin-10 (IL-10) producing function of monocytes stimulated by Mycobacterium tuberculosis (M-TB). The IL-10 usually down-regulates a number of different macrophage functions, including microbicidal activity against intracellular bacteria such as Mycobacterium species. They found that the mean IL-10 production by peripheral blood mononuclear cells (PBMC) obtained from a healthy tuberculin-reactor stimulated with multidrug-resistant M-TB was greater than that with drug-sensitive M-TB. The IL-10 producing cells were monocytes, not T-lymphocytes. They moreover found that PBMC from intractable tuberculosis patients secreted greater amounts of IL-10 than those of healthy subjects. These data may give a hint for development of new immunotherapeutic methods for multi-drug-resistant tuberculosis patients. 4) Dr. HARA analysed clinical courses of 580 consecutive cases of bacilli positive pulmonary tuberculosis admitted in his hospital from a point of underlying diseases. All of dead 24 cases had some underlying diseases; diabetes mellitus 3, chronic liver diseases 4, others 17 (malignant neoplasms, central nerve vascular diseases, malnutritional condition, etc). (ABSTRACT TRUNCATED)

A protein less sensitive to trypsin, guanidinated casein, is a potent stimulator of exocrine pancreas in rats

Previously, we have shown that, in rats that have had bile-pancreatic juice (BPJ) diverted from the proximal small intestine for 7 days, the exocrine pancreatic secretion was enhanced after they were fed a casein, fat-free diet. This demonstrates that the pancreatic secretion is stimulated by dietary protein with a pancreatic protease-independent pathway. To examine the chemical structure of casein responsible for the enhancement of pancreatic secretion, we prepared chemically modified casein in which lysine residues were guanidinated. Secretion of protein, amylase, and chymotrypsin in the chronic BPJ-diverted rat was increased much more after the rats were fed a diet containing guanidinated casein (250 g/kg diet) than after they were fed a diet containing intact casein (250 g/kg diet). In normal rats whose diverted BPJ was returned to the duodenum, the increases in the pancreatic secretion after consuming the guanidinated casein diet were comparable to those after consuming the intact casein diet. In vitro digestibility of guanidinated casein by trypsin and chymotrypsin was much lower than that of intact casein. Also, guanidinated casein inhibited tryptic hydrolysis of benzoyl-L-arginine p-nitroanilide to a lesser extent than did intact casein as determined by an in vitro assay. These results demonstrate that guanidinated casein is less sensitive to trypsin than is intact casein and that the structure that is sensitive to trypsin is not involved in the stimulation of pancreatic secretion in diverted rats. The results evidence that masking luminal trypsin activity does not predominantly contribute to the enhancement of pancreatic secretion in 7-day BPJ-diverted rats. Also, in normal rats, the luminal protease-independent mechanism may play a role partly in increasing the pancreatic secretion by dietary protein.

[Ultrastructural changes in the lamina cribrosa in experimental monkey glaucoma]

We examined the ultrastructural changes in the lamina cribrosa in monkeys with experimental chronic glaucoma. In normal monkey eyes, the extracellular matrix consists of tightly packed collagen fibers, elastic fibers and less ground substance in the beams, and basement membranes associated with vascular cells and astrocytes in the lamina cribrosa. In the experimental glaucomatous eyes there was a marked destruction of collagenous bundles. The empty spaces were expanded and filled with fine fibrillar materials. There were normal by appearing parts and clearly destroyed parts mixed in the same region. Elastic fibers looked isolated from the collagenous bundles around them. Basement membranes were generally thick, multi-laminated, and bent. In addition, basement membrane-like materials, separated from the cells, were often seen in the laminar beams. The lamina cribrosa in experimental chronic glaucoma showed evidence of both destruction and healing or remodeling. These changes might have a influence to the worse for the tissue characterization of the lamina cribrosa, such as resistence to intraocular pressure changes. In conclusion, this may be a factor related with the progression of glaucomatous optic nerve damage.

Proliferative activity in breast carcinoma evaluated by BrdU and PCNA. Correlation with expression of p53, c-erbB-2, estrogen receptor and P-glycoprotein

The proliferative activity in 35 cases of breast carcinoma was evaluated by bromodeoxyuridine (BrdU) and proliferating cell nuclear antigen (PCNA) and was compared with benign breast lesion. Overexpression of p53 and c-erbB-2 oncoprotein, presence of estrogen receptor (ER) and cellular localization of multidrug resistance gene product P-glycoprotein (P-gp) were immunohistochemically examined to investigate the relation with the proliferative activity and clinicopathologic characteristics. The mean BrdU labeling index (LI) was 12.6% and PCNA labeling rate (LR) was 33.5% in breast carcinomas, and good correlation was found between them. The proliferative activity of breast carcinomas was significantly higher than that of benign lesions. The BrdU LI correlated positively with tumor size, histologic grade, TNM stage and p53 immunoreactivity, and negatively with the presence of ER. PCNA LR correlated with histologic grade and expression of p53. p53 protein was demonstrated in 43% of the breast carcinomas and correlated with proliferative activity. The extent of p53 immunoreactivity on carcinoma cells was also related to BrdU LI. c-erbB-2 oncoprotein was demonstrated in 51% of the breast carcinomas and correlated with histologic grade. ER was found in 34% of the breast carcinomas and correlated negatively with histologic grade, lymph node metastasis and TNM stage. P-gp was observed in 49% of the breast carcinomas and no correlation was found with clinicopathologic characteristics. None of the benign lesions expressed p53 protein, c-erbB-2 oncoprotein and P-gp. BrdU is a reliable standard and a more useful tool for the evaluation of proliferative activity of breast tumors. High proliferative activity, overexpression of p53 protein and the absence of ER are considered as a high grade malignancy of breast carcinoma. Expression of c-erbB-2 oncoprotein and P-gp may be related to malignant transformation of breast tumors.

Intracoronary stenting of a coronary occlusion resulting from an aortic dissection

Acute myocardial infarction secondary to aortic dissection may occur due to compression of the coronary arteries by a hematoma or extension of the dissection into the coronary arterial wall. We report a patient with this condition who was successfully treated by Palmaz-Schatz stenting, providing an alternative to thrombolysis or angioplasty.

Oral air pressure and nasal air flow rate on levator veli palatini muscle activity in patients wearing a speech appliance

This study was designed to determine if levator veli palatini muscle activity can be elicited by simultaneous changes in oral air pressure and nasal air flow when a speech appliance is in place. The speech appliances routinely worn by 15 subjects were each modified experimentally by drilling a hole in the vertical center of the pharyngeal bulb. The air flow rate into the nasal cavity through the opening in the bulb was altered by changing the circular area of the opening in the bulb from the occluded condition (Condition I), to circular area of 12.6 mm2 (4 mm in diameter; Condition II), and then to 38.5 mm2 (7 mm in diameter; Condition III). Electromyographic activity was measured from the levator veli palatini muscle with changes in nasal air flow rate and oral air pressure. Levator veli palatini muscle activity was correlated with changes in nasal air flow and oral air pressure. Increases in levator veli palatini muscle activity were associated with increases in nasal air flow rate compared to oral air pressure changes. The results indicated that aerodynamic variables of nasal air flow and oral air pressure might be involved in the neural control of speech production in individuals wearing a speech appliance, even if the subjects exhibit velopharyngeal incompetence without using a speech appliance. Also, the stimulating effect of bulb reduction therapy on velopharyngeal function might be achieved through the change in aerodynamic variables in association with the bulb reduction.