Adenosarcomas originating from sites other than uterine endometrium

We report three cases of adenosarcomas arising from extraendometrium of the uterus: one arising from the ovary, one from the paracolpium and one from the endocervix of the uterus. Microscopically, they consisted of an admixture of benign-appearing epithelial and mesenchymal components with hypercellularity and minimal atypia. Two of the tumors were initially misdiagnosed as endometriosis and one was diagnosed as adenofibroma. One patient had several recurrences and died 7 years after the initial laparotomy and another patient had sarcomatous overgrowth which invaded the muscular tissues of the large intestine. Thus it appears that adenosarcoma occasionally shows grave clinical behavior, despite the benign or low-grade appearance of its microscopic features. Problems of diagnosis and management of this tumor are discussed. An aggressive therapeutic approach including wide surgical excision is recommended even in questionable cases.

nfxC-type quinolone resistance in a clinical isolate of Pseudomonas aeruginosa

Quinolone resistance gene nqr-T91 in a clinical isolate of Pseudomonas aeruginosa P1481 was cotransducible with catA1 in P. aeruginosa PAO. The nqr-T91 transductant, PKH-T91, was resistant to norfloxacin, imipenem, and chloramphenicol and showed less norfloxacin accumulation than the parent strain did. Loss of the 46-kDa outer membrane protein (D2) and an increase in the 50-kDa outer membrane protein in PKH-T91 were observed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Lipopolysaccharides in the transductant were also changed. These alterations were considered to be related to lower levels of norfloxacin accumulation in PKH-T91. These genetic and biochemical properties suggested that an nfxC type of quinolone-resistant mutation occurred in a clinical isolate of P. aeruginosa P1481.

Functional diversity of GABAA receptor ligand-gated chloride channels in rat synaptoneurosomes

Experiments were performed to examine neurochemically the functional diversity of GABAA receptors as measured by muscimol-, 5 alpha-pregnane-3 alpha,21-diol-20-one (THDOC)-, and pentobarbital-stimulated 36Cl- uptake, and region-specific changes in muscimol-, THDOC- and THDOC-induced potentiation of muscimol-stimulated 36Cl- uptake in rats treated acutely or subacutely with a subconvulsive dose of bicuculline. The data for stimulation of 36Cl- uptake by muscimol showed a single binding site interaction in the cerebral cortex, hippocampus and cerebellum. The concentration-response curves for muscimol in the cerebral cortex and hippocampus were steep and indicated an increase of approximately 130% at the maximum concentration. In contrast, the curve for the cerebellum was shallow and exhibited a smaller maximal response (approximately 60%). Apparent affinity for muscimol also differed among these brain regions. The regional differences in 36Cl- uptake induced by THDOC and pentobarbital were not as apparent as those induced by muscimol; however, the maximal modulatory effect of pentobarbital in the hippocampus was significantly higher than that in the cerebellum. In rats treated subacutely with a subconvulsive dose of bicuculline, a significant increase in muscimol-stimulated 36Cl- uptake was observed in the cerebellum but not in the frontal cortex or hippocampus. Analysis of the concentration-response curves for muscimol-stimulated 36Cl- uptake in the cerebellum revealed that the Vmax for muscimol in the subacutely treated group was significantly higher than those for muscimol in the control and acutely treated groups without any differences in the KD value.(ABSTRACT TRUNCATED AT 250 WORDS)

Measurement of arterial tracer concentrations from cardiac PET images

OBJECTIVE

Cardiac PET imaging offers the potential capability for the noninvasive measurement of arterial input function. This capability is somewhat limited, however, because of partial volume and spillover effects. The purpose of this study was to validate arterial tracer concentration measurements using PET images by assigning a region of interest (ROI) to the left ventricle, left atrium (LA), and ascending aorta.

MATERIALS AND METHODS

We selected [11C]CO and [13N]ammonia as tracers, because the activity of [11C]CO is primarily in the blood pool and that of [13N]ammonia primarily in myocardial tissue. Six [11C]CO and 11 [13N]ammonia PET scans were obtained in 17 subjects. Arterial tracer concentrations determined by PET were compared with those measured by well counting of arterial blood sampling obtained at the midpoint of each image acquisition.

RESULTS

Arterial tracer concentrations as determined by LA-PET imaging correlated closely with those measured by blood sampling (r = 0.996, slope = 1.00 for [11C]CO; r = 0.841, slope = 0.974 for [13N]ammonia). Partial volume and spillover effects were minimized by assigning an ROI to the LA.

CONCLUSION

Arterial tracer concentrations can be measured noninvasively with cardiac PET.

Pseudolymphoma of the kidney: a case report

We report a case of pseudolymphoma of the kidney. Examination of a surgically resected specimen showed that the lesion was localized in the renal parenchyma. It was impossible to achieve an accurate preoperative diagnosis clinically or radiologically because there were no characteristic findings. To the best of our knowledge no previous case of a pseudolymphoma localized in the renal parenchyma has been reported.

[Diagnosis of accidental subdural block]

Accidental subdural block occurred in a 47-year-old man who underwent gastrectomy under nitrous oxide-sevoflurane anesthesia combined with continuous epidural block. The development of subdural block was suspected from unexpectedly severe hypotension with small doses of mepivacaine during operation and was confirmed by a characteristic X-ray photograph after operation. The subdural block should be suspected from abnormal changes in vital signs and by careful observation of X-ray photographs, because it is not always easy to determine the presence of contrast media either in the subdural space or in the epidural space.

[Patient's complaints preceding severe bradycardia and hypotension during spinal anesthesia]

We reported an episode of sudden bradycardia and hypotension during spinal anesthesia, in which the patient complained of nausea before the bradycardia and hypotension were recognized by the monitors, such as, intermittent measurement of arterial pressure, electrocardiography, pulse oxymetry and continuous arterial blood gas analysis. We emphasize the importance of strict vigilance during spinal anesthesia.

Flow cytometric analysis of nuclear DNA content in oral leukoplakia: relation to clinicopathologic findings

DNA ploidy of 50 biopsy specimens of oral leukoplakia was investigated by flow cytometry, and the results were compared with the clinicopathologic appearances. The aneuploidy rate of the leukoplakias was 17/50 (34%), and the mean DNA index (DI) of the aneuploid lesions was 1.22, with a range from 0.70 to 1.84. The incidence of the aneuploidy was significantly (P < 0.01) higher in nonhomogeneous leukoplakias (11/18) than in homogeneous lesions (6/32). The aneuploidy rate of the severely dysplastic leukoplakias (11/17) was significantly higher than those of the mildly dysplastic (4/22; P < 0.01) and the nondysplastic (2/11; P < 0.02) lesions. A significant (P < 0.01) difference in the aneuploidy rate was also observed between tongue (12/23) and gingival (2/18) leukoplakias.

[Relationship between regional flow reserve supplied by the great saphenous vein graft and regional left ventricular wall motion: a Doppler guide wire study]

The relationship between regional flow reserve supplied by a great saphenous vein graft and myocardial infarction and anterior wall motion assessed by left ventriculography was studied in 28 patients with no stenosis in the great saphenous vein graft and the peripheral site of the recipient left anterior descending coronary arteries. The proximal segment to the anastomosis was totally or subtotally occluded. The resting graft blood flow velocity was measured using a Doppler guide wire, then 0.56 mg/kg of dipyridamole was injected for 4 minutes intravenously and the resultant increase in graft blood flow velocity was recorded. The regional flow reserve of the anterior wall supplied by great saphenous vein grafts in 11 patients with anterior myocardial infarction (MI group) was significantly lower than that in 17 patients without myocardial infarction (non-MI group) (1.5 +/- 0.3 vs 2.6 +/- 0.7, p < 0.01). The flow reserve supplied by great saphenous vein grafts in 11 patients with normal anterior wall motion was 2.8 +/- 0.7, 10 with hypokinesis 1.9 +/- 0.3, and with akinesis 1.3 +/- 0.3. Reduced anterior wall motion induced a significant decrease in the flow reserve of the anterior wall supplied by the great saphenous vein graft (p < 0.01). The anterior wall motion score of four segments assessed by left ventriculography showed a significant correlation with the flow reserve of the anterior wall supplied by the great saphenous vein graft (y = -0.24 x + 3.7, r = 0.75, p < 0.001). The results show infarcted myocardium was an important influence on coronary flow reserve.

Improvement of S-adenosylmethionine production by integration of the ethionine-resistance gene into chromosomes of the yeast Saccharomyces cerevisiae

An ethionine-resistance gene cloned from Saccharomyces cerevisiae DKD-5D-H was able to enhance S-adenosyl-L-methionine (AdoMet) accumulation when it was introduced into the yeast cells on multi-copy plasmid YEp13. In order to increase the AdoMet accumulation, the gene was integrated into the yeast chromosome by using a yeast transposon Ty element. When the YEp plasmid was used for the integration, the ethionine-resistance gene was efficiently inserted into the yeast chromosomes with a substantial increase in AdoMet productivity (about twofold) in comparison with that by the yeast cells carrying the gene on an extrachromosomal multi-copy plasmid.

A report on the perinatal diagnosis of 4 cases of cardiac tumors

Since 1973, we have identified 4 cardiac tumors by ultrasonography in fetal or early postnatal life. Tuberous sclerosis was diagnosed in three infants whose mother was also affected. The first infant died from acute cardiac failure after birth, and the second required cardiac surgery. The third infant had a cardiac tumor and a focal seizure at the age of 8 months. The cardiac tumor disappeared at the age of 2 years. The fourth cardiac rhabdomyoma may be the only sign of tuberous sclerosis.

[Lumbar epidurography with iohexol: the effect of aging on the leakage of contrast media from the intervertebral foramina]

The lateral and longitudinal spread of contrast media was investigated by lumbar epidurography with 8 ml of iohexol in 47 patients aged 25 yr to 86 yr. Iohexol was injected through the epidural catheter epidurally advanced by 5 cm cephalad from the L 1-4 interspace. A significant correlation was found between the longitudinal spread of iohexol and aging. No correlation was found between the leakage of iohexol from the intervertebral foramina and aging. This finding may deny the hypothesis that in elderly patients, the more extensive longitudinal spread of local anesthetics in the epidural space may be caused by its smaller leakage from the intervertebral foramina.

Potential usefulness of an artificial neural network for assessing ventricular size

An artificial neural network approach was applied to assess ventricular size from computed tomograms. Three layer, feed-forward neural networks with a back propagation algorithm were designed to distinguish between three degrees of enlargement of the ventricles on the basis of patient's age and six items of computed tomographic information. Data for training and testing the neural network were created with computed tomograms of the brains selected at random from daily examinations. Four radiologists decided by mutual consent subjectively based on their experience whether the ventricles were within normal limits, slightly enlarged, or enlarged for the patient's age. The data for training was obtained from 38 patients. The data for testing was obtained from 47 other patients. The performance of the neural network trained using the data for training was evaluated by the rate of correct answers to the data for testing. The valid solution ratio to response of the test data obtained from the trained neural networks was more than 90% for all conditions in this study. The solutions were completely valid in the neural networks with two or three units at the hidden layer with 2,200 learning iterations, and with two units at the hidden layer with 11,000 learning iterations. The squared error decreased remarkably in the range from 0 to 500 learning iterations, and was close to constant over two thousand learning iterations. The neural network with a hidden layer having two or three units showed high decision performance. The preliminary results strongly suggest that the neural network approach has potential utility in computer-aided estimation of enlargement of the ventricles.

Helicobacter pylori infection, serum pepsinogen level and gastric cancer: a case-control study in Japan

We conducted a case-control study to evaluate the effect of Helicobacter pylori (HP) infection on the risk of gastric cancer in Tokyo, Japan. The sera at the time of diagnosis from 282 gastric cancer cases and 767 sex- and age-matched cancer-free controls were tested for the presence of anti-HP IgG antibody (HM-CAP ELISA kit) and serum pepsinogen (PG) level (PG I and PG II Riabead). No significant association was observed in all sets [matched odds ratio (OR) = 1.04, 95% confidence interval: 0.73-1.49]. In subgroup analyses, however, an association was suggested in females [OR = 1.57], a younger population (< 50 years) [OR = 1.86], early cancer [OR = 1.53] and small cancer (< 40 mm) [OR = 1.55]. Furthermore, we observed a tendency for odds ratios to decrease with an increase in age or cancer growth (depth of tumor invasion and tumor size). Considering that the spontaneous disappearance of HP due to extended mucosal atrophy may lead to these decreasing odds ratios, we applied the conditional logistic model adjusted for the PG I/II ratio as a measure of atrophic gastritis. This analysis showed a positive association with HP infection in all sets [OR = 1.69; 1.01-2.81], distal cancer [OR = 1.88; 1.07-3.31] and intestinal-type cancer [OR = 3.76; 1.39-10.18]. We concluded that the risk of cancer associated with HP infection may be underestimated in studies with cross-sectional exposure because of spontaneous disappearance of HP due to extended mucosal atrophy.

[A radiological analysis of the position of lumbar epidural catheters: a comparison between median and paramedian approach]

The position of lumbar epidural catheters was confirmed by radiography in 71 patients. Catheters were advanced by 5 cm cephalad in the lumbar epidural space by paramedian approach (Group P: n = 28) or median one (Group M: n = 43) and contrast media was injected through the catheters. If the contrast media was present in the paravertebral regions, the catheter was considered to be in the abnormal position. The incidence of the abnormal position of the catheters was higher in group M than in group P significantly. To advance an epidural catheter longer into the lumbar epidural space, paramedian approach may be superior to median one.

Pharmacology of descending noradrenergic systems in relation to motor function

The function of descending noradrenergic systems in the spinal ventral horn has not been fully elucidated. We have reviewed our own findings and those of others relating to motor function of these noradrenergic systems. We studied the effects of adrenergic drugs on spinal reflexes, decerebrate rigidity, and noradrenaline release from the spinal cord in rats, and motoneuron activity in spinal cord slices isolated from adult rats. It was shown that the descending noradrenergic systems were facilitatory to the motor system, and that alpha 1-antagonistic action at the spinal cord and alpha 2-agonistic action at the brainstem inhibited spinal motor activity by blocking spinal alpha 1-receptors and by reducing the release of noradrenaline in the spinal cord, respectively.

Spread of subarachnoid hyperbaric amethocaine in adolescents

We have compared the spread of subarachnoid hyperbaric amethocaine in adolescents with that in adults. Amethocaine 8 mg in 2 ml of 10% glucose was injected through a 25-gauge spinal needle inserted at the L3-4 interspace in 21 adolescents aged 12-16 yr and in 111 adults aged 17-82 yr. Although we found no differences in height, weight or body mass index between the adolescents and adults, maximum spread of analgesia was significantly higher in the adolescents (median T3 (range T4-C5) than in the adults (T4 (T9-C7)). We conclude that subarachnoid injection of hyperbaric amethocaine produces an unexpectedly higher level of analgesia in adolescents than in adults.

[Severe bradycardia and hypotension during epidural anesthesia in a patient undergoing hemorrhoidectomy]

Severe bradycardia and hypotension developed suddenly in two patients undergoing hemorrhoidectomy under lumbar epidural anesthesia in the jackknife position, about 5 to 10 min after epidural administration of buprenorphine. Severe vago-vagal reflex was supposed to have been induced with buprenorphine in a situation where venous return was decreased by epidural anesthesia and the jackknife position.

Isolation and characterization of homeobox-containing genes of carrot

Homeodomains (HDs) are DNA-binding domains that have been well characterized in animals, and HD proteins are thought to be regulators of transcription. To investigate the regulation of gene expression during somatic embryogenesis in carrot, an attempt was made to isolate cDNA clones that encode HD proteins. A cDNA library from carrot somatic embryos was screened with a degenerate oligonucleotide probe that corresponded to a conserved amino acid sequence of HDs, and one cDNA clone (CHB1) encoding an HD protein was isolated. The amino acid sequence deduced from the nucleotide sequence of this clone contained a putative leucine zipper motif adjacent to the anticipated HD. The homeodomain/leucine zipper (HD-Zip) sequence of this cDNA was used for further screening, and five additional independent clones (CHB2 through CHB6) were isolated. Although the HD-Zip sequences encoded by these clones were similar to each other, the sequences beyond the HD-Zip regions varied greatly. Transcripts corresponding to CHB1 through CHB6 were expressed at different times during somatic embryogenesis. In particular, transcripts corresponding to CHB2 were expressed in close association with the early development of embryos.

Growth kinetics of animal cells immobilized within porous support particles in a perfusion culture

The growth kinetics of anchorage-independent animal cells [mouse myeloma MPC-11 (ATCC CCL 167)] immobilized within porous polyvinyl formal resin biomass support particles (BSPs; 3 x 3 x 3 mm cubes; mean pore diameter, 60 microns) was analyzed by measuring intracellular and extracellular lactate dehydrogenase (LDH) activities in a perfusion culture. First, the intracellular LDH content of cells immobilized within the BSPs was assayed in a shake-flask culture and found to remain almost comparable to that of non-immobilized cells in the exponential growth phase under static culture. Then, cells inoculated in the BSPs were grown in a continuous stirred-tank bioreactor. Using the LDH content of non-immobilized cells, the density of immobilized cells and the numbers of leaked and dead cells were evaluated, respectively, by the intracellular LDH activity of immobilized and leaked cells and the LDH activity in cell-free culture supernatant. In the initial period, immobilized cells exhibited exponential growth at a constant apparent specific growth rate; however, the actual specific growth rate, which takes into consideration cell death and cell leakage, decreased significantly. In the stationary phase, the actual specific growth rate maintained a constant but markedly lower value than during exponential growth.

Imipramine stimulates phospholipase C activity in rat brain

We previously demonstrated that antidepressant drugs (ADs) cause Ca2+ release from inositol 1,4,5-trisphosphate-sensitive Ca2+ stores in cultured neurons of rat frontal cortex. The present study examines the mechanism by which tricyclic ADs activate phospholipase C (PLC) in rat frontal cortex. Using an exogenous substrate to measure PLC activity, we demonstrated that a tricyclic AD, imipramine, stimulated PLC activity of the frontal cortex membrane in a concentration-dependent manner. Two tricyclic ADs, desipramine and amitriptyline, also stimulated PLC activity, while Li+ or pargyline had no effect on PLC activity. Although imipramine did not activate PLC in the membrane in the absence of Ca2+, imipramine synergistically activated PLC in the presence of Ca2+. This result indicates that the mechanism of PLC activation by imipramine is different from its activation by Ca2+. Imipramine stimulated PLC activity in the cytosol of rat frontal cortex as well as in the membrane. Preincubation of the cytosol with anti-PLC-beta 1 antibody prevented the imipramine-mediated activation of PLC. However, preincubation with anti-PLC-gamma 1 or anti-PLC-delta 1 did not prevent activation of PLC. These results suggest that imipramine activates PLC-beta 1 directly without receptor or guanine nucleotide binding protein mediation.

Methylmethacrylate bone cement does not release histamine in patients undergoing prosthetic replacement of the femoral head

This study was designed to see if methylmethacrylate monomer bone cement released histamine in 13 patients undergoing total hip replacement surgery with a cemented prosthesis, compared with seven control patients receiving a cementless porous-coated prosthesis. Blood samples for plasma concentrations of histamine were obtained before the start of anaesthesia, immediately before insertion of methylmethacrylate bone cement into the shaft of the femur in the cemented fixation group or before insertion of the femoral component of the prosthesis in the cementless fixation group, and 15, 30 and 60 min after the start of implantation of the prosthesis. In both groups, changes in plasma histamine did not differ significantly from baseline before implantation of cement. There were no significant differences between groups. We conclude that methylmethacrylate bone cement does not release histamine during total hip replacement surgery.

The effects of patients' sera with sperm-immobilizing antibodies on sperm of the Japanese monkey

In order to study the interspecies cross-reactivity of sperm-immobilizing antibodies found in sera of women who were infertile for unknown reasons, we used the sperm-immobilization test to examine the effects of patients' sera with or without sperm-immobilizing antibodies on the sperm of the Japanese monkey (Macaca fuscata). Fourteen of 17 antibody-positive sera and 7 of 14 antibody-negative sera showed sperm-immobilizing activity with regard to monkey sperm. The sperm-immobilizing antibody that was active against both human and monkey sperm could be absorbed only by sperm from each corresponding species. The periodate treatment of human or monkey sperm markedly diminished their antibody-absorbing capabilities. Human and mouse monoclonal antibodies having sperm-immobilizing activity with regard to human sperm showed no sperm-immobilizing activity with regard to monkey sperm. These results indicate that the sperm-immobilizing activity of the sera of infertile women against human and monkey sperm might be due to antibodies with different specificities, which recognize a unique carbohydrate antigen epitope expressed in the sperm of each species.