[Renal autotransplantation for dissecting aneurysm]

Out of twenty-five patients operated on for dissecting aneurysm in our institution since January 1991, four patients had autotransplantation of the kidney. The renal autotransplantation and the segmental replacement of the descending aorta with the prosthesis were done at the same time in three of them, and segmental replacement of the distal aortic arch was followed by autotransplantation because of the postoperative acute renal failure in the other one. Postoperative renal function of simultaneously operated patients was good whereas the patient who had been treated by two-staged operation needed hemodialysis for two weeks after the autotransplantation. Postoperative scintigraphy showed fully recovered function of the autotransplanted kidneys with enlargement. CT scan showed that the false lumen of the dissecting aorta was reduced in size with increased intraluminal clot formation. Renal autotransplantation with entry closure is easy and safe technique and assures successful operative results for the dissecting aneurysm, restoring impaired renal blood flow.

Evaluation of large intracranial aneurysm with three-dimensional MRI

OBJECTIVE

The purpose of this study was to evaluate large intracranial aneurysms by contrast-enhanced 3D MRI.

MATERIALS AND METHODS

Eleven patients, nine women and two men, were examined. The aneurysms involved the internal carotid artery in seven patients, the middle cerebral artery in one, the basilar artery in two, and the posterior cerebral artery in one. Contrast-enhanced 3D MR images were obtained using FLASH (fast low angle shot) on a 1.5 T system. We obtained axial images first, then sagittal and coronal images by multiplanar reconstruction. Those images were reviewed for comparison with conventional and MR angiography.

RESULTS

We could easily evaluate the true aneurysmal size, the intraaneurysmal constitution (patent lumen and intraluminal thrombus), and the detailed relationship of the aneurysm to the surrounding vascular and neural structures. Except for the cavernous internal carotid artery, we could identify the aneurysmal neck by carefully observing axial, sagittal, and coronal images. In addition, the progression of intraaneurysmal thrombosis and the patency of the parent arterial lumen after the endovascular treatment were well appreciated.

CONCLUSION

We consider that 3D MRI appears to be useful for evaluation of the large intracranial aneurysm.

Accumulation of mutant p53 and hsp72 by heat treatment, and their association in a human glioblastoma cell line

The cellular content of mutant p53 and hsp72 proteins following gamma-ray irradiation, UV irradiation, and heat treatment was studied in A-7 cells, a human glioblastoma cell line. A-7 was found to contain a mutant p53 gene in which the arginine codon at position 175 was substituted by a histidine codon. Although the p53 gene was mutant, the phenotype of the p53 protein appeared wild-type since the cellular content of the p53 protein was limited under normal culturing conditions. The quantity of mutant p53 and hsp72 proteins in A-7 was increased by heat treatment as well as gamma-ray and UV irradiation. Furthermore, the mutant p53 protein was coimmunoprecipitated with anti-hsp72/hsc73 antibody. Additionally, hsp72 and hsc73 were coimmunoprecipitated with anti-p53 antibody. These results suggest that in A-7, p53 protein accumulation may be caused as a result of response to stressors, such as gamma-ray, UV and heat and that mutant p53 protein and hsp72/hsc73 may manage biological functions cooperatively after gamma-ray, UV and also heat treatments.

Compensation of multi-dimensional selective excitation pulses using measured k-space trajectories

Multidimensional spatially selective excitation pulses rely on the accuracy of gradient waveforms to achieve desired excitation volumes. Unfortunately, the high gradient slew-rates and magnitudes required by these pulses often lead to distortion of the waveforms produced by imaging systems resulting in poor selection profiles. In this paper, a k-space calibration procedure, used to determine the actual trajectory produced by the scanner's field gradients, is extended to two spatial dimensions. This measured information is then incorporated in a selective excitation design technique for correcting the RF pulse envelopes to compensate for gradient waveform induced distortion of the excitation volumes.

Isolation and characterization of melanotropins from lamprey pituitary glands

Three peptides containing the melanotropin-core amino-acid sequence, YXMXHFRWG, were isolated from the pituitary glands of a modern representative of the most primitive vertebrates, the sea lamprey, Petromyzon marinus. MSH-A, a nonadecapeptide (NPELYQMNHFRWGQPPTHF), is free at both ends. MSH-B, an eicosapeptide (VQESADGYRMQHFRWGQPLP), is free at the N-terminus and amidated at the C-terminus. They differ strikingly from gnathostome MSHs in structure. The third peptide, with an apparent molecular weight of 15 kDa, was tentatively designated lamprey ACTH, based on a structural feature: the N-terminal 22-residue-MSH (SVSSPKYAMGHFRWGSPDKATI) is followed by four consecutive basic amino acids (RKRR) and a ACTH-like sequence (PVRPNTSDSPEIPDYAF--). MSH-B is 10 and 100 times more potent than alpha-MSH and MSH-A, respectively, in a frog skin assay in vitro, whereas the lamprey ACTH showed no melanotropic activity. Lamprey ACTH did, however, show corticotropic activity on the lamprey pronephric and mesonephric tissue.

Activation induces dephosphorylation of cofilin and its translocation to plasma membranes in neutrophil-like differentiated HL-60 cells

We suggested that a cytosolic 21-kDa phosphoprotein played an important role in opsonized zymosan-trigered activation of superoxide-generating enzyme in neutrophil-like HL-60 cells through dephosphorylation (Suzuki, K., Yamaguchi, T., Oshizawa, T., Yamamoto, Y., Nishimaki-Mogami, T., Hayakawa, T., and Takahashi, A (1995) Biochim. Biophys. Acta 1266, 261-267). In the present study, we characterized the phosphoprotein and studied changes in it localization upon activation of phagocytes. The 21-kDa phosphoprotein was rapidly dephosphorylated upon activation not only wit opsonized zymosan but also with formyl-Met-Leu-Phe and arachidonic acid. The peptide fragments derived from the 21-kDa phosphoprotein were found to have the same amino acid sequences as those of cofilin, an actin-binding protein. The phosphoprotein reacted exclusively with anti-cofilin antibody on two dimensional immunoblots. Accordingly, together with its apparent molecular weight, isoelectric point, and detection of phosphoserine as a phosphoamino acid, we concluded that the 21-kDa phosphoprotein was a phosphorylated form of cofilin. The amount of cofilin in membranous fractions was increased upon activation. Furthermore, confocal laser scanning microscopy showed that cofilin existed diffusely in the cytosol and nuclear region of the resting cells, while in the activated cells, it was accumulated at the plasma membrane area, forming ruffles or endocytic vesicles on which O2.- should be produced. These results suggested that in resting cells cofilin exists as a soluble phosphoprotein in the cytosol and nuclei, while upon stimulation a large portion of cofilin is dephosphorylated and translocated to the plasma membrane regions.

Melanotropin and corticotropin are encoded on two distinct genes in the lamprey, the earliest evolved extant vertebrate

In the lamprey, which is a member of the oldest extant class of vertebrates, the agnathans, melanotropins (MSH) and corticotropin (ACTH) were found to be encoded on two distinct genes. In all other vertebrates, a single precursor gene, proopiomelanocortin (POMC), encodes MSH and ACTH, as well as beta-endorphin (END). Two different cDNAs were cloned from a lamprey pituitary lambda gt11 cDNA library using antisera against lamprey MSH-B and ACTH(1-16). One cDNA encoded MSH-B, MSH-A and beta-END, while the other cDNA encoded nasohypophysial factor (NHF), ACTH and a different beta-END, but not MSH-A and MSH-B. Northern blot analysis demonstrated that in the adult lamprey pituitary, genes for MSH and ACTH are expressed in the pars intermedia (PI) and pars distalis (PD), respectively.

Compressive and bone-bonding strength of hydroxyapatite thermal decomposition product implanted in the femur of rabbit as a bioactive ceramic bone cement

Hydroxyapatite thermal decomposition product (HATDP) after mixing with water was injected into the femur of rabbits, and its biocompatibility, compressive strength and bone-bonding strength were investigated. The compressive strength of a block of HATDP was 56.0 MPa 4 weeks after injection, which was about 60% of that of poly(methyl methacrylate) (PMMA) cement. The bone-bonding strength was 8.2 MPa 4 weeks after injection, which was significantly higher than that of PMMA cement. HATDP seems to be useful as a cement material because of its good bone-bonding property and relatively high mechanical strength.

Properties of Ca(2+)-dependent K+ channels of human gingival fibroblasts

Cells in the oral cavity are normally exposed to different temperatures. Ion transport systems are influenced by temperature in other tissues: In particular, changes in intracellular K+ ion can affect cell growth and synthesis of macromolecules. The purpose of this investigation was to identify K+ channels in human gingival fibroblast cells and analyze the effect of temperature on their K+ conduction properties. Ca(2+)-dependent K+ channels with a large conductance (125 pS in symmetrical K(+)-rich solutions) were identified in human gingival fibroblasts and studied by the patch-clamp technique. The open probability of the channels varied with membrane potential between +40 and -100 mV. When the bath temperature was decreased from 40 to 4 degrees C, channel conductance was reduced, but the mean open time of the channels was increased. The activation energies for the conductance and the reciprocal of the mean open time were estimated to be 9.1 and 22.9 kJ/mol, respectively. These values are lower than those reported for these and other types of channels in cells from other tissues. The open probability of the channels was nearly constant in the temperature range studied. These results suggest that the properties of Ca(2+)-dependent K+ channels of gingival fibroblasts remain relatively unchanged when the cells are exposed to a wide range of temperatures.

A case with quadruple primary cancers of head and neck

Despite progress in techniques for early detection and treatment of cancers, cases of multiple primary cancers are apparently increasing. This paper reported quadruple primary cancers of stomach, lung, hypopharynx and maxillary sinus in a 63-year-old male. He finally died of brain metastasis and pneumonia by MRSA (Me Resistant S. aureus).

[A neonate case of dural arteriovenous shunt presenting with cerebellar hemorrhage]

A rare case of dural arteriovenous shunt (dAVS) manifested as cerebellar hemorrhage in a neonate is reported. Seven days after birth, a neonate was referred to our hospital because of consciousness disturbance. CT scan revealed cerebellar hemorrhage, subarachnoid hemorrhage, subdural hematoma, and a high density mass lesion at the torcular herophili. Retrograde brachial angiogram failed to show any vascular lesions. He underwent an evacuation of the cerebellar hematoma. Postoperative course was uneventful. However, at the age of four months, he was admitted again because of consciousness disturbance and cardiac failure. CT scan revealed hydrocephalus and an enlarged mass lesion at the torcular herophili. Angiogram disclosed dural AVS. Its feeding arteries were as follows; the bilateral middle meningeal arteries (MMA), the occipital arteries (OA), dural branches of the bilateral posterior inferior cerebellar arteries, arteries consisting of transdural anastomosis from the left posterior cerebral artery. The arterial flow from these feeding arteries was shunting directly to the torcular herophili, the posterior part of the superior sagittal sinus, and the straight sinus. He underwent a venticulo-peritoneal shunting. Then, after treatment for cardiac failure, superselective embolization of the bilateral MMAs and the OAs resulted in diminution of shunting flow. The initial onset of this case was at seven days after his birth. Dural AVS is very rare in the pediatric population, particularly in the neonate. The clinical features, pathogenesis, and the treatment for this rare entity are discussed.

Percutaneous transluminal angioplasty in a canine model of cerebral vasospasm: angiographic, histologic, and pharmacologic evaluation

BACKGROUND

Cerebral vasospasm following subarachnoid hemorrhage (SAH) is one of the leading factors that deteriorate the clinical outcome after aneurysmal surgery. Percutaneous transluminal angioplasty (PTA) is a method to directly dilate the constricted vessel using the intravascular neurosurgical technique.

METHODS

Angiographic, histologic, and pharmacologic evaluations related to PTA are presented, using a canine double-injection model of SAH. In angiographic evaluation, we studied the effect of PTA performed on day 1, 4, or 7 of SAH. We performed sequential histologic study by light microscopy using the same for the angiographic evaluation. In pharmacologic evaluation, we measured in vitro isotonic constrictive force using two vasoconstrictors immediately after PTA on normal basilar arteries (control group) and basilar arteries on day 7 of SAH.

RESULTS

In angiographic evaluation, we observed the effective dilation of spastic artery immediately after PTA and saw no recurrence of vessel constriction when PTA was performed on day 7 of SAH. However, the preventive effect of PTA was inconsistent when it was performed earlier after SAH (days 1, 4). In histologic evaluation, PTA segments immediately after PTA showed denuding of endothelial cells and stretching of the internal elastic lamina without disruption of the muscle layer. In pharmacologic evaluation, there was no difference in isotonic constrictive force created by vasoconstrictors between the PTA and non-PTA segments without SAH. However, there was a statistically significant reduction of isotonic constrictive force on the PTA segment with SAH.

CONCLUSIONS

We suggest that the mechanism of PTA vasodilation in vasospasm after SAH may result from mild functional changes in the vascular wall when PTA was applied on day 7 of SAH. The functional changes would not be adequately induced to prevent recurrence of vasoconstriction when PTA was applied soon after SAH.

Sjögren's syndrome with pleural effusion

Sjögren's syndrome (Sjs) can cause many organic changes, but is rarely accompanied by pleuritis. We report here a 62-year-old patient with subclinical Sjs who developed unilateral pleuritis with moderate effusion. He was diagnosed to have subclinical Sjs based on the positivity of anti SS-A/SS-B antibodies and the biopsy findings of minor salivary glands which revealed lymphocyte infiltration around the duct. In the pleural effusion, both increased lymphocytes and anti SS-A/SS-B antibodies were observed. He showed no signs of infection nor malignancy. There was no direct evidence that he had other collagen diseases which cause pleuritis. We conclude that the pleuritis was caused by Sjs. In patients with Sjs, activated polyclonal B lymphocytes and autoantibodies are considered to cause systemic tissue damage. This case indicates that these factors can cause pleuritis in Sjs patients.

Detection of superoxide free radicals in rats with acute pancreatitis

To study the importance of oxygen-derived free radicals in acute pancreatitis, an experimental study of in vivo detection of superoxide free radicals (O2-) was performed using rats. Using a new chemiluminescence probe (2-methyl-6-[p-methoxyphenyl]-3,7-dihydro-imidazol[1,2-1]pyrazin- 3-one; MCLA; a Cypridina luciferin analogue) and a highly sensitive photon counting system, O2- from the pancreatic surface of rats with experimental acute pancreatitis induced by 180 micrograms cerulein/kg was detected. The time course of MCLA-dependent luminescence suggested that O2- production began 2-3 h after cerulein injection and then decreased gradually. Superoxide free radical production in the pancreas of rats with cerulein-induced acute pancreatitis was confirmed using MCLA-dependent chemiluminescence. This new method allows direct observation of the behavior of oxygen-derived free radicals.

Treatment of a stage I testicular yolk sac tumor with vascular invasion

There is controversy concerning the treatment of stage I yolk sac tumor of the testis, particularly of those with histological factors that indicate a high risk of relapse. Usually orchiectomy alone is sufficient and adjuvant chemotherapy is unnecessary. Retroperitoneal lymphadenectomy is indicated for patients with persistently high alpha-fetoprotein. Once recurred, treatment at that time is thought to be curative. However, postoperative chemotherapy may be necessary for patients with a tumor expressing histological factors that predict possible relapse. In this paper we report on a case of a 2 year old boy whose tumor invaded the testicular veins. The patient suffered from recurrent disease but was successfully treated by chemotherapeutic regimens including cisplatin and retroperitoneal lymphadenectomy. The importance of the histological factors in making a decision on the treatment strategy for stage I testicular yolk sac tumor is discussed.

Positive and negative regulation of granulocyte-macrophage colony-stimulating factor promoter activity by AML1-related transcription factor, PEBP2

The granulocyte-macrophage colony-stimulating factor (GM-CSF) gene promoter contains a consensus sequence for the polyomavirus enhancer binding-protein 2 (PEBP2) transcription factor, which consists of alpha and beta subunits. There are at least two genes, alpha A and alpha B, encoding the alpha subunit. alpha B is the mouse homologue of human AML1 gene detected at the breakpoints of t(8;21) and t(3;21) myeloid leukemias. We examined alpha A1 (an alpha A-gene product) and alpha B1 and alpha B2 (two alpha B-encoded isomers) for their effects on the GM-CSF promoter. PEBP2 alpha A1, alpha B1, and alpha B2 proteins bound the PEBP2 site within the mouse GM-CSF promoter. PEBP2 alpha A1 and alpha B1 enhanced the expression of the GM-CSF promoter-driven reporter plasmid in unstimulated and 12-O-tetradecanoylphorbol 13-acetate/phytohemagglutinin-stimulated human Jurkat T cells. In contrast, the promoter activity was suppressed by alpha B2. Coexpression of alpha B1 and alpha B2 showed that the promoter activity could be determined by the alpha B1/alpha B2 ratio. Jurkat cell extract contained PEBP2 site-binding protein(s) that cross-reacted with antimouse alpha A1 antibodies. Northern blot analysis indicated the expression of human PEBP2 alpha A, alpha B (AML1), and beta genes in Jurkat cells. Although further studies are required to determine the precise role of PEBP2 in the GM-CSF promoter activity, the present findings suggested the importance of the relative ratio of different PEBP2 isoforms in regulating the levels of the promoter activity.

Isolation and characterization of [Pro2]somatostatin-14 and melanotropins from Russian sturgeon, Acipenser gueldenstaedti Brandt

A new form of somatostatin (SRIH), along with melanotropins (MSHs), was isolated from pituitaries of the Russian sturgeon Acipenser gueldenstaedti Brandt by gel filtration, ion exchange, and reversed-phase HPLC following acid-acetone extraction. The sturgeon SRIH consists of 14 amino acid residues and differs from mammalian SRIH-14 by the substitution Pro for Gly at position 2. Synthetic [Pro2]SRIH-14 was as potent as mammalian SRIH-14 in inhibiting release of growth hormone into medium from the organ-cultured pituitary of rainbow trout. Sturgeon alpha-MSH has the same amino acid sequence as those found in mammals. Sturgeon beta-MSH is composed of 17 amino acid residues, and its amino acid sequence is identical to the N-terminal 15 residues of salmon beta-MSH I and to the C-terminal 2 residues of mammalian beta-MSH.

[Restenosis after percutaneous transluminal coronary angioplasty in the elderly--risk factor analysis]

Utilization of percutaneous transluminal coronary angioplasty (PTCA) has dramatically expanded even in the management of elderly patients with coronary artery disease. However, restenosis after successful PTCA remains the major problem limiting the long-term efficacy of the procedure. Reported restenosis rates vary from 25 to 43%. In order to determine the relationship of restenosis to coronary risk factors in the elderly, we analyzed the data in 87 patients who had undergone PTCA and angiography before and 3 to 6 months after PTCA. Of these, 29 patients were 65 years of age or older (elderly group) and 58 were less than 65 years of age (younger group). Restenosis, defined as a luminal narrowing of greater than 50% at follow-up time, was found in 20 of the elderly group (69.0%), and in 26 (44.8%) of younger group (p < 0.0001). Total cholesterol, LDL cholesterol, apolipoprotein B (apo B), and the ratio of apoB/apoA1 in the elderly group were significantly lower than those in the younger group. HDL cholesterol levels were lower than 40 mg/dl in both groups (not significant). Each group was subdivided into two types; restenosis type and non-restenosis type. There were no significant differences in serum lipid, apolipoprotein, and lipoprotein(a) levels between the 2 subtypes in each group. The degree of coronary atherosclerosis calculated by Gensini's method, the number of damaged coronary vessels, diabetes mellitus, hypertension, and smoking did not appear to affect the rate of restenosis in either group.(ABSTRACT TRUNCATED AT 250 WORDS)

Elevated cerebrospinal fluid levels of manganese superoxide dismutase in bacterial meningitis

We examined the mechanism of increase of manganese superoxide dismutase (Mn SOD) in the cerebrospinal fluid (CSF) in bacterial meningitis (BM). The elevated levels of Mn SOD in the CSF in BM, measured with an enzyme immunoassay method, were more prominent than those in aseptic meningitis (AM) and encephalitis (EN). In AM and EN Mn SOD levels well correlated with levels of neuron-specific enolase and S-100b protein, which are markers of damages to nervous tissues, but did not with any of them in BM. CSF concentrations of tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 alpha (IL-1 alpha) were higher in BM than in AM and EN. From the serial measurements in BM, the peak values of these cytokines chronologically preceded or corresponded to those of Mn SOD. Immunohistochemically, a large number of the glial cells were stained for Mn SOD in the cerebral cortex from a patient with BM. By contrast, in the normal cerebral cortex, the glial cells were negative for Mn SOD staining. These results suggest that the marked increase of Mn SOD in the CSF in BM may be related to the increase of such cytokines as TNF-alpha and IL-1 alpha and that these cytokines may play a role in the induction of Mn SOD in nervous tissues.

Undifferentiated carcinoma in the cardioesophageal junction which produces parathyroid hormone related protein

A 68-year-old man with undifferentiated carcinoma occurring in the cardioesophageal junction accompanied by hypercalcemia is reported. The serum level of parathyroid hormone-related protein (PTHrP) was remarkably elevated. Serum calcium and PTHrP levels decreased following chemotherapy, but this amelioration was temporary. He died of hypercalcemia. On autopsy, a significant amount of immunoreactive PTHrP was detected in the tumor tissue extract, and the tumor cells were stained strongly positive for PTHrP by immunohistochemistry. This is the first case of undifferentiated carcinoma in the gastrointestinal tract which demonstrated hypercalcemia due to PTHrP produced by the malignant tumor.

A scintigraphical qualitative analysis of peripheral vascular sympathetic function with meta-[123I]iodobenzylguanidine in neurological patients with autonomic failure

In order to assess qualitatively the sympathetic functions of the peripheral vessels, we performed a scintigraphical study of the entire body with meta-[123I]iodobenzylguanidine (MIBG) in 13 patients with autonomic failure and 11 healthy subjects as control. The patients comprised seven with multiple system atrophy (MSA), two with pure autonomic failure (PAF), three with Parkinson's disease with autonomic failure (PD with AF) and one with familial amyloid polyneuropathy (FAP). No clinical evidence of vascular disease was noted in any of the patients and the control subjects. We investigated their autonomic functions using the head up tilt test as well as norepinephrine and isoproterenol infusion tests. We found that: (i) All of the control subjects showed satisfactory MIBG uptake; (ii) all of the patients with PAF and FAP, most of whom had postganglionic sympathetic lesions, showed supersensitivity and low MIBG uptake; (iii) almost all the patients with MSA, who were considered to have mainly preganglionic sympathetic lesions, showed supersensitivity and diminished MIBG uptake, although the patients with olivopontocerebellar atrophy showed supersensitivity but not diminished MIBG uptake. In conclusion, these results suggest that peripheral vascular scintigraphy using MIBG is useful in detecting peripheral adrenergic dysfunction.

Synergistic effects of insulin-like growth factor II (IGF-II) with leukemia inhibiting factor (LIF) on establishment of rat pluripotential cell lines

To examine effects of IGF-II on establishment of pluripotential diploid cells from rat embryos, we cultured blastocysts in medium containing mouse LIF with or without IGF-II. Combination of mouse LIF (5,000 units/ml) and rat IGF-II (100 ng/ml) promoted growth of inner cell mass (ICM) and was effective for establishment of pluripotential cell lines derived from the ICM. The cell lines indicated colony forms different from the rat ES cell lines. However, they showed morphological alteration to adult-like tissue cells, formed embryoid body in suspension culture, and thus, seemed to retain a pluripotent characteristics. The rat IGF-II is useful for establishing of pluripotential cells efficiently.

Prolonged inhibition of an antigen-specific IgE response in vivo by monoclonal antibody against lymphocyte function-associated antigen-1

Intraperitoneal injection of ovalbumin (OVA) into BALB/c mice caused the induction of OVA-specific IgE production in vivo. However, administration of monoclonal antibody against lymphocyte function-associated antigen-1 (anti-LFA-1 mAb) at days 0 and 1 after OVA immunization resulted in an inhibition of OVA-specific primary and secondary IgE production in a dose-dependent manner. The inhibition of the antigen-specific IgE response due to anti-LFA-1 mAb was seen up to 8 weeks after anti-LFA-1 mAb administration. The OVA-specific IgG1 response was also blocked by anti-LFA-1 mAb. The spleen cells obtained from OVA-immunized mice showed enhanced proliferation against secondary stimulation with OVA in vitro. However, the spleen cells obtained from the mice treated with both OVA and anti-LFA-1 mAb revealed a markedly decreased proliferative responses to OVA, while they showed no reduced responses against keyhole limpet hemocyanin stimulation, indicating that anti-LFA-1 mAb might induce antigen-specific anergy in vivo. It was also demonstrated that treatment of the mice with anti-LFA-1 mAb significantly inhibited the interleukin-4-producing ability of OVA-immunized mouse spleen cells. These results demonstrated that LFA-1-dependent cell-cell interaction is essential for the production of IgE in vivo and may be important in IgE-dependent allergic disease.

Gastrointestinal manometry findings in a case with dilated small bowel and disturbed transit treated successfully with bowel plication

We report the manometric findings in a case of dilated small bowel and disturbed transit successfully treated with plication of the dilated small bowel. The female newborn infant required total parenteral nutrition following an operation for small bowel atresia. X-ray showed a dilated proximal small bowel. Jejunal manometry showed normal phase 3 migration but persistently low-amplitude contractions in the dilated segment. After plication of the dilated intestine, symptoms of bowel obstruction disappeared. A second manometry two weeks after the operation showed contractions with normal amplitude. These findings indicate that: (1) disturbed transit in the dilated intestine proximal to small intestinal atresia is associated with persistently low contraction amplitude, and (2) the amplitude can be increased by the plication of the dilated loop.