Two-dimensional pulsed Doppler echocardiographic technique for estimating pulmonary to systemic blood flow ratio in children with atrial septal defect and patent ductus arteriosus

A two-dimensional pulsed Doppler echocardiographic method was evaluated for quantifying the pulmonary (Qp) to systemic (Qs) blood flow ratio. Twenty six patients were studied, 15 with atrial septal defect (ASD) and 11 with patent ductus arteriosus (PDA). An apical four-chamber view was used to measure the maximal Doppler flow velocities in the right and left ventricular inflow regions (RVIR and LVIR) and the maximal diameters of the tricuspid and mitral anuli at diastole. The two-dimensional pulsed Doppler pulmonary to systemic blood flow ratio (Qp/Qs) estimation involved calculating the area of the Doppler flow velocity signal along the time scale multiplied by the diameter of either the tricuspid or mitral anulus as measured on the apical four-chamber view. In ASD patients, Qp was measured at RVIR and Qs at LVIR. In PDA patients, Qp was calculated at LVIR and Qs at RVIR. Twenty-six healthy children comprised the control group. The areas of the Doppler flow velocity signals along the time scales of RVIR and LVIR were also quantified and the diameters of the tricuspid and mitral anuli were measured. In the control group, the linear correlation of the trans-mitral M(d)*M(a) to trans-tricuspid T(d)*T(a) value was r = 0.909, n = 26. The correlations between Doppler Qp/Qs ratio estimates and those obtained at cardiac catheterization were r = 0.902, n = 15 in ASD and r = 0.967, n = 11 in PDA. These results suggest a clinical application of this Doppler echocardiographic method in the noninvasive estimation of the cardiac shunt in ASD and PDA.

Environment: peculiar pigment cell neoplasm in fish

Chromatophoroma in the croaker (Nibea mitsukurii) showed a unique geographic distribution. The contribution of environmental chemicals to the cause of chromatophoroma in the feral croaker is considered likely on the basis of the following results in our studies. 1) Chromatophoroma was induced in tank-reared N. mitsukurii by administration of certain kinds of known carcinogens such as 7,12-dimethyl-benz(a)anthracene, N-methyl-N'-nitro-N-nitrosoguanidine, and nifurpirinol. 2) Local accumulation of pigment-cell hyperplasia in the catfish (Protosus anguillaris) showed similar tendencies to those of chromatophoroma in N. mitsukurii. 3) Removal of contaminated sediment from the harbor and the river appeared to reduce the incidence from 47% in 1973-1983 to about 20% in 1985-1987. 4) Waste water from a factory located at the station where the incidence of the neoplasm was the highest contained mutagenic substances such as chloroacetones and glyoxals [5]. Exposure of catfish to the waste water induced pigment-cell hyperplasia on the skin.

Evaluation and comparison of the axis of the interventricular septum by two-dimensional echocardiography among the patients with congenital heart disease (ASD, VSD, PDA, PS, TOF) and the normal subjects

A two-dimensional echocardiographic method was applied to determine the axis of interventricular septum (IVS) in the horizontal plane. This study comprised 19 subjects with ASD, 15 subjects with VSD(I), 20 subjects with VSD(II), 13 subjects with PDA, 16 subjects with PS, 15 subjects with TOF and 99 normal children. Parasternal left ventricular short axis view was taken, and the IVS was recorded by using the polaroid prints. The axis of the IVS in the horizontal plane was measured from the recorded polaroid prints. The value of the angularity of IVS (IVS-A) expressed as means +/- one standard deviation (mean +/- 1S.D.) is 52.0 +/- 13.7 degrees in ASD, 42.2 +/- 9.7 degrees in VSD(I), 43.7 +/- 9.1 degrees in VSD(II), 41.6 +/- 11.4 degrees in PDA, 38.6 +/- 10.9 degrees in PS, 61.0 +/- 8.5 degrees in TOF and 40.1 +/- 8.2 degrees in normal controls. There was no significant difference among VSD(I), VSD(II), PDA, PS and normal controls but a highly significant difference was noted in ASD and TOF as compared to other groups. The correlation coefficient of the IVS-A with (1) the Qp/Qs ratio, (2) the magnitude of shunt (%), (3) the right ventricular pressure and (4) the hematocrits were evaluated among the patient groups. The IVS-A of ASD and VSD(II) had a good correlation with the shunt flow (r = 0.921 and 0.88 respectively) and/or the Qp/Qs ratio (r = 0.782 and 0.955 respectively); while that of VSD(I), PDA, and PS had a good correlation with the right ventricular pressure (r = 0.956, 0.953, 0.842 respectively) and that of TOF was mostly concerned with the hematocrits (r = 0.911). Besides, the IVS-A in each severe CHD subgroup was significantly (p less than 0.005 or a better value) higher than the normal control group. Thus an alternative method was validated for evaluating the severity of congenital heart disease by using a noninvasive two-dimensional echocardiographic technique.

Dating sonographic endometrial images in the normal ovulatory cycle

Pelvic sonograms were obtained from 5 fertile volunteers and 150 infertile patients with normal ovulatory cycles, using real-time ultrasound. The existence of a linear cavity echo (C), thick hypoechoic layer (H) and increased echogenicity (E) were chosen as the parameters of sonographic endometrial images to be studied for dating the ovulatory cycle. In 109 serial sonograms from the fertile volunteers, H was observed from 3 days before ovulation (day -3) to ovulation day (day 0). E was observed from day +1 to day +8, and C, from day -10 to day +3. Studies on 189 sonograms from the infertile patients revealed a similar pattern for these parameters. We tested the accuracy of sonographic images of the endometrium, using sonograms from five patients who underwent hysterectomy. The measurements of endometrial thickness, in vivo, and in vitro, showed little difference. Sonographic endometrial images are considered indicative of histological changes, under the influence of estradiol and progesterone. Therefore, observation of the combined quantitative changes in C, H and E facilitates dating of the sonographic endometrial images in a normal ovulatory cycle.

Sonographic study of the endometrial responses to ovarian hormones in patients receiving ovarian stimulation

A total of 486 endometrial sonograms from 60 cases were reviewed to study the endometrial responses. There was a significant change in the proportion of each sonographic criterion between the pre- and post-ovulatory phases. After ovulation endometrial image showed distinct changes, and its thickness increased. These results suggest that classification of endometrial sonograms according to criteria and thickness measurements provides useful information.

Epitope mapping of the human immunodeficiency virus type 1 gp120 with monoclonal antibodies

A soluble form of recombinant gp120 of human immunodeficiency virus type 1 was used as an immunogen for production of murine monoclonal antibodies. These monoclonal antibodies were characterized for their ability to block the interaction between gp120 and the acquired immunodeficiency syndrome virus receptor, CD4. Three of the monoclonal antibodies were found to inhibit this interaction, whereas the other antibodies were found to be ineffective at blocking binding. The gp120 epitopes which are recognized by these monoclonal antibodies were mapped by using a combination of Western blot (immunoblot) analysis of gp120 proteolytic fragments, immunoaffinity purification of fragments of gp120, and antibody screening of a random gp120 gene fragment expression library produced in the lambda gt11 expression system. Two monoclonal antibodies which blocked gp120-CD4 interaction were found to map to adjacent sites in the carboxy-terminal region of the glycoprotein, suggesting that this area is important in the interaction between gp120 and CD4. One nonblocking antibody was found to map to a position that was C terminal to this CD4 blocking region. Interestingly, the other nonblocking monoclonal antibodies were found to map either to a highly conserved region in the central part of the gp120 polypeptide or to a highly conserved region near the N terminus of the glycoprotein. N-terminal deletion mutants of the soluble envelope glycoprotein which lack these highly conserved domains but maintain the C-terminal CD4 interaction sites were unable to bind tightly to the CD4 receptor. These results suggest that although the N-terminal and central conserved domains of intact gp120 do not appear to be directly required for CD4 binding, they may contain information that allows other parts of the molecule to form the appropriate structure for CD4 interaction.

The influence of carbohydrate structure on the clearance of recombinant tissue-type plasminogen activator

Modification of the carbohydrate structures of recombinant tissue-type plasminogen activator (rt-PA) can increase or decrease its rate of clearance in rabbits. When rt-PA was treated with sodium periodate to oxidize carbohydrate residues, the rate of clearance was decreased from 9.6 +/- 1.9 ml min-1 kg-1 to 3.5 +/- 0.6 ml min-1 kg-1 (mean +/- SD, n = 5). A similar change in the clearance of rt-PA was introduced by the use of endo-beta-N-acetyl-glucosaminidase H (Endo-H), which selectively removes high mannose asparagine-linked oligosaccharides; the clearance of Endo-H-treated rt-PA was 5.0 +/- 0.5 ml min-1 kg-1. A mutant of rt-PA was produced with an amino acid substitution at position 117 (Asn replaced with Gln) to remove a potential glycosylation site that normally contains a high mannose structure. The clearance of this material was also decreased, similar to the periodate and Endo-H-treated rt-PA. Conversely, when rt-PA was produced in the CHO 15B cell line, which can produce only high mannose oligosaccharide structures on glycoproteins, the clearance was increased by a factor of 1.8. These results demonstrate that the removal of rt-PA from the blood depends significantly upon the nature of its oligosaccharide structures.

Km mutant of acid alpha-glucosidase in a case of cardiomyopathy without signs of skeletal muscle involvement

A male patient is reported with a mutation of acid alpha-glucosidase causing an altered Km toward natural substrates. Cardiac arrhythmia was found at 12 years of age, and he died of heart failure at 15 years. No skeletal muscle involvement was observed either clinically or histologically. Acid alpha-glucosidase activity in fibroblasts was moderately low (43% of the control mean) with normal Km for 4-methylumbelliferyl alpha-D-glucoside. The hydrolysis of glycogen was markedly decreased (14% of the control mean), and the Km for maltose was increased 4-fold and for glycogen 5-fold. The biosynthesis and the posttranslational processing of the mutant enzyme appeared normal, but the total amount of the enzyme was lower than normal. This mutant enzyme comigrated with normal acid alpha-glucosidase on starch gel electrophoresis, and not with the rare isozyme, acid alpha-glucosidase 2. A possible role of this mutant enzyme in the pathogenesis of this disease and the relationship to glycogenesis II are discussed.

[Study on relationships between sonographic endometrial images and ovarian hormone levels]

Sixty-seven and 109 sonographic endometrial images obtained from 67 infertile patients and 5 healthy volunteers with normal ovulatory cycles, respectively, were investigated with regard to serum estradiol (E2) and progesterone (P) levels. The ultrasound devices used were sector electronic scanners (3.5 MHz). 1) Endometrial images were able to be classified into four pattern types, according to the criteria reported by Sakamoto (1985), using a gray-scale contact compound scan. Pattern 1: linear cavity echo, pattern 2: thick hypoechoic endometrium surrounded by thin border echo, pattern 3: thickened border echo, pattern 4: entire echogenic endometrium. 2) Both E2 and P levels were low in pattern 1. The E2 level was significantly higher in pattern 2 than in pattern 1 (p less than 0.01), indicating pattern 2 reflects E2 surges prior to ovulation. The P level was high in pattern 3; and in pattern 4, it was significantly higher than in patterns 1 and 2 (p less than 0.01), indicating that patterns 3 and 4 are in the early and mid-luteal phase, respectively. 3) Sonograms obtained from 12 cases with suspicious luteal phase defects showed an abnormal pattern in the mid-luteal phase. These results indicate that the sonographic endometrial images reflect respective ovarian hormone levels.

Delineation of a region of the human immunodeficiency virus type 1 gp120 glycoprotein critical for interaction with the CD4 receptor

The primary event in the infection of cells by HIV is the interaction between the viral envelope glycoprotein, gp120, and its cellular receptor, CD4. A recombinant form of gp120 was found to bind to a recombinant CD4 antigen with high affinity. Two gp120-specific murine monoclonal antibodies were able to block the interaction between gp120 and CD4. The gp120 epitope of one of these antibodies was isolated by immunoaffinity chromatography of acid-cleaved gp120 and shown to be contained within amino acids 397-439. Using in vitro mutagenesis, we have found that deletion of 12 amino acids from this region of gp120 leads to a complete loss of binding. In addition, a single amino acid substitution in this region results in significantly decreased binding, suggesting that sequences within this region are directly involved in the binding of gp120 to the CD4 receptor.

[Maternal beta-endorphin secretion during pregnancy--measurement of immunoreactive beta-endorphin in urine]

Gestational variations in maternal beta-endorphin (beta-end) secretion were investigated by simultaneous measurements of plasma and urinary immunoreactive beta-endorphin (ir-beta-end). Urinary ir-beta-end was extracted by using a Sep-Pak C18 column and was found to be stable for at least 24 hours at room temperature. Plasma and urine (2 hour collection) samples were obtained from 41 pregnant women and 7 non-pregnant women. Almost parallel increases in plasma and urinary ir-beta-end were observed during the course of pregnancy and there was a good correlation between them. Compared with non-pregnant values, significant increases (p less than 0.001) were observed after 36 weeks of gestation. We also studied chromatographic patterns of urinary extracts of non-pregnant and pregnant women. Both of them consist of 4 peaks and resemble each other. They were essentially similar to those of plasma extracts except for the third peak which appeared between the elution position of beta-lipotropin (beta-LPH) and beta-end. In conclusion, maternal beta-end secretions increase in late gestation not only in plasma but also in urine.

A novel macromolecular antibiotic, SN-07. Taxonomy of producing organism, isolation, characterization and biological activities

A novel macromolecular antibiotic SN-07 was obtained from the cultural supernatant of Actinomadura roseoviolacea var. miuraensis nov. var. The antibiotic was soluble in water, had a molecular weight of 18,000-22,000 daltons in 50 mM Tris-HCl buffer, pH 7.0, containing 2.0 M KCl as compared with authentic proteins. Its major constituents were nucleic acids. The substance had antibacterial activity against Gram-positive bacteria. It was also effective against lymphocytic leukemia P388 in vivo.

A new species of Actinomadura producing a polyether antibiotic, cationomycin

Taxonomic studies on the new species, Actinomadura azurea are presented. A significant property of this species is the production of a new polyether antibiotic, cationomycin.

[Studies on the classification of endometriosis]

A new classification system of endometriosis proposed by the American Fertility Society (AFS classification) was utilized to categorize patients with endometriosis after surgical treatment and the following results were obtained. 1. AFS classification system was useful to categorize patients with endometriosis, because of a simple and objective point system. 2. There were discrepancies in categorized patients between AFS system and a system proposed by Acosta et al. (Acosta's system). One-third of patients categorized as "Severe" by Acosta's system was classified to be "Moderate" by AFS system. These discrepancies occurred when lesion of endometriosis was just restricted within ovaries. 3. Conception was reduced once ovaries were involved and fecundability rate was significantly reduced if ovarian endometrioma was greater than 3cm in diameter. 4. Acosta's system revealed differences among fecundability rate among the different categories, however, AFS system could not demonstrate a direct correlation between the categories of endometriosis and fecundability rate.

Effects of storage of jaws in saline and of velocity of loading on the force required to extract the rat mandibular first molar

Storage of jaws in cold saline for up to 32 h did not cause significant changes in the ultimate loads required to extract the rat mandibular first molar. The mean ultimate loads were 33.05, 34.91 and 36.38 newtons at the extension rates 1, 5 and 25 mm/min respectively, though the differences were not significant between groups. The force required to extract the tooth would be fairly constant even after the storage of the dissected jaws in cold saline for longer periods of time. Changes in the force required were not detectable within the range of the velocities of loading employed.

[Studies on the ovarian pathophysiology by exogenous gonadotropin stimulation in combination with adrenal suppression (author's transl)]

In order to investigate the steroidogenesis of dysfunctional ovaries, adrenal suppression and ovarian stimulation tests were performed on 32 patients with ovulatory defect and 3 volunteers with normal menstrual cycles. The protocol of this study was as follows; 3 mg of dexamethasone (DXM) was given daily for 11 days. From 5th day of DXM, 225 IU of human menopausal gonadotropin (hMG) was injected for 3 days, followed by 5,000 IU of human chorionic gonadotropin (hCG). Serum estrone (E1), estradiol (E2), androstenedione (A), dehydroepiandrosterone (DHA), testosterone (T) and dihydrotestosterone (DHT) were measured by radioimmunoassay. In the patients with polycystic ovaries (PCO) which was confirmed under laparotomy and biopsy, serum E2 levels were markedly elevated by hMG stimulation. The E1 levels were similarly elevated by hMG stimulation and increased further by hCG stimulation. The A levels were significantly high (p less than 0.05), and increased remarkably by hCG. The T levels were very high. And they decreased to 2/3 of the basal level following DXM administration, and they increased again by hCG stimulation. Similar secretion patterns of these steroids in PCO patients were also seen in controls and in some patients with moderately atrophic ovaries (MA). THe secretion pattern of DHA suggested that DHA was also secreted from the PCO, normal ovary and MA ovary. From these results it is presumed that excessive production of androgens is not specific in PCO, but it is the result of continuous intrinsic LH stimulation.