[Cooley operation for hypertrophic obstructive cardiomyopathy associated with Noonan Syndrome following Morrow operation--a case report]

A 21-year-old female underwent ventricular septoplasty (Cooley operation) for severe left ventricular outflow tract obstruction (LVOTO), which had developed after performance of a Morrow operation at the age of 14. Diagnosis of Noonan syndrome and hypertrophic obstructive cardiomyopathy had been already established by clinical manifestations and a myocardial biopsy. The septoplasty technique and valve replacement could be successfully used to repair the residual LVOTO and aortic regurgitation. We found that this approach was one of the most convenient and provided effective management of LVOTO. Post-operative course has been uneventful and the patient remains completely well as of the 18th months after surgery.

A novel antitumor antibiotic, KW-2189 is activated by carboxyl esterase and induces DNA strand breaks in human small cell lung cancer cells

KW-2189 has been selected as a lead compound for clinical trial among duocarmycin derivatives with structural similarity to CC-1065, a cyclopropylpyrroloindole. The purpose of this study was to examine the DNA-binding potency and the mechanisms of cytotoxicity of KW-2189. In order to analyze DNA-binding activity of KW-2189, plasmid pBR322 was treated with KW-2189 with or without pretreatment with carboxyl esterase, which we demonstrated to be an activating enzyme, and the products were examined by agarose gel electrophoresis and restriction enzyme analysis. Cytotoxic activity was examined by exposing a human small cell lung cancer cell line, NCI-H69 to KW-2189 with or without carboxyl esterase. Alkaline elution was performed to examine whether KW-2189 induces DNA strand breaks. DNA treated with KW-2189 and carboxyl esterase migrated faster than KW-2189-treated DNA, which migrated at the same rate as untreated DNA. In addition DNA treated with esterase-activated KW-2189 was protected from digestion by some restriction enzymes. KW-2189 showed concentration- and time-dependent growth inhibitory effect with IC50 values (drug concentration required for 50% growth inhibition) of 58 nM (96 h) to 1900 nM (1 h) in H69 cells. The IC50 values of 4-h exposure of H69 to KW-2189 with 0, 26, 130, 650 mU/ml carboxyl esterase were 460, 120, 30, and 7 nM, respectively. Time-dependent enhancement of cytotoxicity by carboxyl esterase was also observed. KW-2189 induced DNA strand breaks in H69 cells in a concentration-dependent manner around the IC50 value. We conclude that 1) KW-2189 is activated by carboxyl esterase to its active form(s), 2) activated KW-2189 has a stronger DNA-binding activity and cytotoxicity than KW-2189, 3) DNA cleavage is one of the major mechanisms of KW-2189-mediated cytotoxicity.

Biomechanical function of the human anterior cruciate ligament

Knowledge about the biomechanical function of the anterior cruciate ligament (ACL) is very important in the treatment of the ACL deficient knee. This article presents an overview of the biomechanical function of the ACL, including its structural and mechanical properties as well as its role in knee stabilization and normal kinematics. Tensile properties of the prospective biological grafts and future directions in ACL research are also discussed.

Vibrio mimicus with multiple toxin types isolated from human and environmental sources

A collection of 13 strains of Vibrio mimicus, including both clinical and environmental isolates from different geographic regions, was examined for various toxins. One strain of environmental origin produced cholera-like toxin (CT) which was completely absorbed with anti-CT immunoglobulin G, five strains produced a haemolysin that cross-reacted with the thermostable direct haemolysin of V. parahaemolyticus and DNA from two strains hybridised with a DNA probe specific for the heat-stable enterotoxin of V. cholerae non-O1. Culture supernates of all strains produced a factor that was cytotoxic to Vero and Chinese hamster ovary cells. In this study, we were able to identify strains of V. mimicus that produced, or had the genetic potential to produce, several toxin types simultaneously. The role of these strains as genetic reservoirs is discussed.

Analysis of effector T cells against the murine syngeneic tumor MethA in mice orally administered antitumor polysaccharide SPR-901

The growth of MethA tumor was significantly inhibited by oral administration of the alpha-glucan SPR-901 in BALB/c (+/+) mice but not in nude mice. Mice treated orally with SPR-901 exhibited an augmentation of antigen-specific resistance against rechallenge with the tumor cells. The tumor-neutralizing activity of regional lymph node cells from MethA-bearing mice against the tumor was augmented by oral administration of SPR-901. The tumor-neutralizing activity of lymph node cells from SPR-901-treated mice mainly appeared in Lyt2+ cells. Furthermore, lymphokine-activated killer activity of these cells was enhanced by administration of SPR-901. The antitumor effect of SPR-901 was abrogated in mice depleted of either L3T4+ or Lyt2+ cells, and in cyclosporin-A-treated mice. These results suggest that Lyt2+ cells are important effector cells in MethA-bearing mice orally administered SPR-901 and that functional exertion of both Lyt2+ and L3T4+ T cells is necessary for the antitumor effect of orally administered SPR-901 in vivo.

Effect of antitumor polysaccharide SPR-901 on antitumor activity in combination with 5-FU

We have examined the effects of the antitumor polysaccharide SPR-901 in combination with 5-fluorouracil (5-FU) on the antitumor activities against mouse syngeneic tumors. SPR-901 was administered p.o. from day 1 to day 10 at the dose rate of 30 mg/kg, and 5-FU was injected i.p. from day 1 to day 5 at the dose rate of 20 mg/kg after BALB/c mice were injected s.c. with 6 x 10(4) cells/mouse of Meth A on day 0. Tumor sizes of mice treated with both SPR-901 and 5-FU were significantly smaller than those from the untreated control group on days 10, 15 and 20. LAK activity of spleen cells from mice treated with both SPR-901 and 5-FU was higher than that from the untreated control group and either the SPR-901 or 5-FU treated group. Flow cytometrical analysis revealed that spleen cells from mice treated with both SPR-901 and 5-FU were much more abundant in both T-cell receptor alpha/beta+ and IL-2 receptor alpha+ T-cells. Furthermore, spleen cells from both the SPR-901- and 5-FU-treated groups exhibited higher growth responses to IL-2 than that from the untreated control group and either of the SPR-901- or 5-FU-treated groups. Therefore, the effects of the antitumor polysaccharide SPR-901 used in combination with 5-FU were augmented as compared with single drug use.

So-called "immature dentinoma": a case presentation and histological comparison with ameloblastic fibrodentinoma

The existence of the "dentinoma" as an independent entity has not been fully accepted, recently being regarded as an ameloblastic fibroma with formation of dentin and named an ameloblastic fibrodentinoma. However, there are histological differences between the several cases reported previously as "immature dentinoma" and the ameloblastic fibrodentinoma. This paper presents a case report of a dentin-forming intraosseous benign tumor without any histological features of ameloblastic fibroma. The patient was a 30-year-old woman with a rather well-circumscribed intraosseous lesion of the mandibular left premolar area. Histologically, the lesion consisted of dentin-like tissue with a tubular structure and globular calcifications, numerous epithelial strands and islands without enamel organ-like structure, and a cellular fibrous component without a primitive dental papilla-like appearance. The present case and a review of the literature suggest that epithelial elements in odontogenic fibroma-like lesions may occasionally have an inductive effect for dentin or dentin-like tissue formation.

Decomposition of the Modulated Waves in a Rotating Couette System

The time-dependent velocity field in a rotating Couette system has been decomposed. Successive instantaneous velocity profiles were obtained by an ultrasonic Doppler velocity profile method, and the spatiotemporal velocity field had been analyzed by two-dimensional Fourier transform. The Fourier spectrum is depicted by intrinsic peaks, and the velocity field cpan be reconstructed with these peak components only, indicating a successful decomposition of the velocity field. This method shows that the so-called broadband component, which is purely spatiotemporal and attributed to chaos, corresponds to a global motion of the wave propagating from roll to roll.

Simple method of purification of Escherichia coli heat-labile enterotoxin and cholera toxin using immobilized galactose

A simple method for purification of heat-labile enterotoxin produced by enterotoxigenic Escherichia coli and for purification of cholera toxin using immobilized D-galactose column is described. A single run of column chromatography yielded homogeneous toxin as demonstrated by sodium dodecyl sulfate polyacrylamide slab gel electrophoresis.

Regulation and physiological role of insulin-like-growth-factor-binding protein-1 in human granulosa cells

The present study was undertaken to elucidate the physiological role and the regulation of insulin-like growth factor (IGF)-binding protein-1 (IGFBP-1) in human luteinizing granulosa cells. IGFBP-1 abolished IGF-I-stimulated estradiol production by luteinizing granulosa cells in a dose-dependent manner with a 50% inhibitory concentration (IC50) of 0.27 nM. Similarly, IGFBP-1 inhibited 125I-IGF-I binding to granulosa cells. IGFBP-1 was identified by Western immunoblot and specific enzyme immunoassay in the granulosa-cell-conditioned medium after 24 h culture. Immunoreactive IGFBP-1 released into the medium was inhibited by both IGF-I and follicle-stimulating hormone dose-dependently with an IC50 of 0.14 and 0.13 nM, respectively, while human chorionic gonadotropin-stimulated IGFBP-1 release with a 50% effective dose (ED50) of 0.6 nM. These results suggest that IGFBP-1 is involved in follicular development and granulosa cell differentiation in the human ovary and that gonadotropins may influence IGF-I action by modifying IGFBP-1 levels within the ovary.

Decreased activity of 11 beta-hydroxysteroid dehydrogenase in mesenteric arteries of Dahl salt-sensitive rats

11 beta-Hydroxysteroid dehydrogenase (11 beta-HSD) activity in mesenteric arteries of 4-week- and 8-week-old Dahl rats was determined to evaluate the relationship between glucocorticoids and norepinephrine in hypertension, 11 beta-HSD activity (expressed as the percentage conversion of 3H-corticosterone (B) to 3H-11-dehydrocorticosterone (A)) significantly decreased in 8-week-old Dahl salt-sensitive (DS) rats (11.4 +/- 1.4%) compared with Dahl salt-resistant (DR) rats (15.3 +/- 0.3%) (p < 0.05) when each group was fed a high-sodium chow (7%) for 4 weeks. There were no significant differences in 11 beta-HSD activity in the 4-week-old DS and DR rats. The enhanced response of mesenteric arteries to norepinephrine was observed only in 8-week-old DS rats. Our results suggest that a decreased 11 beta-HSD activity in the vascular walls contributes to the increased response of norepinephrine by local increment of glucocorticoids in DS hypertensive rats.

Characterization of an etoposide-resistant human ovarian cancer cell line

Etoposide (VP-16) is one of the most important anticancer agents available and is used in many chemotherapeutic regimens. To characterize resistance to this drug, we established a VP-16-resistant human ovarian cancer cell line, SKOV3/VP, by continuous stepwise exposure of SKOV3 cells to VP-16. The degree of resistance to VP-16 of SKOV3/VP was about 25 times that of the parent cell line (SKOV3), and SKOV3/VP showed cross-resistance to teniposide, adriamycin, CPT-11, and vincristine. The accumulation of [3H]-VP-16 observed in SKOV3/VP cells was about half that seen in SKOV3 cells, and the accumulation of Adriamycin by this resistant cell line was also lower than that of its parent. Overexpression of neither the multidrug resistance gene mdr-1, the multidrug-resistance-associated protein (mrp) gene, nor P-glycoprotein was detected using reverse transcriptase-polymerase chain reaction analysis and flow cytometry with MRK-16, a monoclonal antibody against P-glycoprotein. The topoisomerase II activity of nuclear extracts from SKOV3/VP cells was lower than that from the parental cells, as was the amount of DNA topoisomerase II, demonstrated by immunoblotting. These results suggest that the mechanism responsible for the multidrug resistance of this cell line may be attributable to changes on its DNA topoisomerase II and to its reduced accumulation of the drugs as compared with the parental line SKOV3.

Expression of 11 beta-hydroxysteroid dehydrogenase mRNA in rat vascular smooth muscle cells

The enzyme 11 beta-hydroxysteroid dehydrogenase (11-HSD) converts corticosterone to the inactive 11-dehydrocorticosterone in the rat. The bioactivity of 11-HSD, expressed as the percentage conversion of 3H-corticosterone to 3H-11-dehydrocorticosterone, was 13.7 +/- 0.4% in rat vascular smooth muscle cells (rVSMC). Cells treated with 100 nM dexamethasone (Dex) showed a 1.4-fold (p < 0.05) increase in 11-HSD activity. Insulin (100 microM) decreased 11-HSD activity by 0.8-fold (p < 0.05). Expression of 11-HSD mRNA was also confirmed in rVSMC by Northern blot analysis. Dexamethasone increased and insulin decreased the levels of 11-HSD mRNA in parallel with the increase in bioactivity. Vascular smooth muscle cells express 11-HSD activity; the access of corticosterone to vascular smooth muscle receptors may be modulated by the enzyme.

Spectroscopic characterization of SC-NTR: a subsidiary dye of allura red AC dye (FD&C red no. 40)

A major subsidiary dye in US certified Allura Red AC dye (FD&C Red No. 40) has been isolated by preparative high performance liquid chromatography. The paper chromatographic properties of the isolated dye indicate that it is the dye designated as SC-NTR in a previous paper (Marmion 1971). Spectroscopic analysis of the isolated dye is consistent with the disodium salt of 6-hydroxy-5-(2-methoxy-5-methyl-3-sulphophenylazo)-2-naphthalen esulphonic acid, which is an azo-coupling product between the meta-isomer of cresidine-p-sulphonic acid (CSA) and Schaeffer's salt (SS).

Plasma and leukemic cell pharmacokinetics of high-dose N4-behenoyl-1-beta-D-arabinofuranosylcytosine in acute leukemia patients

The pharmacokinetics of N4-behenoyl-1-beta-D-arabinofuranosylcytosine (BHAC), a lipophilic antitumor analog of 1-beta-D-arabinofuranosylcytosine (ara-C), was investigated, by assay of plasma and leukemic cells of ten acute leukemic patients receiving 60-minute intravenous (IV) infusion of 700 mg/m2 BHAC, for BHAC and 1-beta-D-arabinofuranosylcytosine 5'-triphosphate (ara-CTP) by high-performance liquid chromatography, ara-C by radioimmunoassay, and 1-beta-D-arabinofuranosyluracil (ara-U) by gas chromatography-mass fragmentography. The plasma concentration of BHAC reached a maximum (173.4 +/- 75.3 micrograms/mL) at the end of the infusion and then declined in a biphasic pattern with an initial-phase half-life (t1/2 alpha) of 1.00 +/- .36 hours and a second-phase half-life (t1/2 beta) of 4.28 +/- 2.35 hours. That of ara-C similarly reached a maximum (102.2 +/- 39.9 mg/mL) at the end of the infusion and then declined with t1/2 alpha of 1.37 +/- 1.11 hours and t1/2 beta of 11.2 +/- 4.31 hours. Intracellular ara-CTP concentration increased in a linear-accumulation manner for the first 4 hours after the infusion, reached a maximum of .081 +/- .112 micrograms/10(7) cells at approximately 7 hours, and then declined very slowly in accordance with a one-compartment model with t1/2 of 13.56 +/- 9.62 hours.

[Changes in the blood flow in celiac artery and superior mesenteric artery after stellate ganglion block]

We evaluated the effect of stellate ganglion block (SGB) on the blood flow of celiac artery (CA) and superior mesenteric artery (SMA) by using the ultrasonic pulse Doppler technique. The subjects were 15 healthy volunteers (14 males, one female; average 26 years old; 22-38). Right C7-SGB was performed using 5 ml of 1% mepivacaine at the 7th cervical process. Blood pressure, heart rate, mean blood flow velocity and diameter in CA and SMA, were measured after 5 minute rest, before and after SGB. To measure the flow velocity and the diameter of vessels, ultrasonic diagnostic equipment SSA-270A or SSA-260A (Thoshiba CO, Ltd.) with convex electric-phased 3.75 MHz, probe was used. Doppler shiftgrams of the CA and SMA were recorded. Then, we calculated their flow volume and sectional area of vessels. In CA mean blood flow velocity tended to decrease (P < 0.05) and both flow volume and sectional area of vessels tended to increase (P < 0.001). In SMA, mean flow velocity tended to decrease (P < 0.05) and sectional area increased (P < 0.001). But flow volume did not show significant change. Our results indicate that right C7-SGB leads to an increase in the blood flow of CA.

Human T cell clones reactive against U-small nuclear ribonucleoprotein autoantigens from connective tissue disease patients and healthy individuals

SLE and mixed connective tissue disease (MCTD) are characterized by the presence of high titers of autoantibodies against uridine-rich RNA-small nuclear ribonucleoprotein (snRNP) Ag. Because the presence of such snRNP-reactive autoantibodies has recently been shown to be associated with polymorphisms of HLA, this study was undertaken to determine whether snRNP-reactive T cells could be identified and characterized from patients. PBMC were stimulated with affinity-purified snRNP Ag and cloned by limiting dilution in the presence of rIL-2 and rIL-4, snRNP-reactive human T cell clones were generated from three patients and two healthy blood donors who possessed disease-associated HLA genotypes. The cell surface phenotype of clones determined by flow cytometry was CD3+, CD4+, CD45RO+, TCR V alpha beta+. TCR V beta analysis, performed using V beta-specific primers and polymerase chain reaction, revealed that the T cell lines generated were clonal; a limited number of TCR V beta genes were expressed among the clones tested. All clones tested by mAb blocking of Ag-induced proliferation were restricted by HLA-DR. Several T cell clones were identified that were specific for B'/B or D polypeptides. These results demonstrate that snRNP-reactive T cells can be isolated from SLE and MCTD patients in vitro, and that Ag-driven expansion of such T cells could play a role in the immunopathogenesis of these diseases in vivo.

[Early and long-term results of sternocostal elevation combined with bridge external traction for funnel chest in children]

The purpose of the present study is to evaluate the effects of addition of a bridge external traction to our conventional sternocostal elevation technique in the surgical management of funnel chest in children. During the period from 1970 to 1979, a total of 29 children with funnel chest were treated surgically using sternocostal elevation technique (Group I). Operative technique consisted of total subperichondral resection of deformed costal cartilages (usually 3rd to 8th, bilaterally), transection of deformed portion of the sternum in 2-3 points and fixation of the sternum in elevated position using 2 Kirschner wires, and shortening resuturing of the opened perichondrium. Since 1980, an addition of the bridge external traction to our conventional sternocostal elevation technique was applied for about 10 days after operation in 82 consecutive children (Group II). The vertebral index (B/A = sagittal diameter of vertebral body/minimum sternovertebral distance), D/C ratio (maximum sagittal depth of depression of sternum/distance from anterior surface of the vertebral body to the sternum at Louis's angle) and E/C ratio (E = minimal sagittal distance from anterior surface of the vertebral body to the sternum) were measured in all cases and compared before and after operation and also between the two Groups. Preoperatively, there was no significant difference in all 3 indices between the two Groups. Postoperative B/A, D/C and E/C ratio in Group I were 0.28 +/- 0.06, 0.14 +/- 0.19, 1.09 +/- 0.32 (mean +/- SD), respectively. There were a significant drop in D/C ratio and a significant elevation in E/C ratio after operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Human T cell clones reactive against U-small nuclear ribonucleoprotein autoantigens from connective tissue disease patients and healthy individuals

SLE and mixed connective tissue disease (MCTD) are characterized by the presence of high titers of autoantibodies against uridine-rich RNA-small nuclear ribonucleoprotein (snRNP) Ag. Because the presence of such snRNP-reactive autoantibodies has recently been shown to be associated with polymorphisms of HLA, this study was undertaken to determine whether snRNP-reactive T cells could be identified and characterized from patients. PBMC were stimulated with affinity-purified snRNP Ag and cloned by limiting dilution in the presence of rIL-2 and rIL-4, snRNP-reactive human T cell clones were generated from three patients and two healthy blood donors who possessed disease-associated HLA genotypes. The cell surface phenotype of clones determined by flow cytometry was CD3+, CD4+, CD45RO+, TCR V alpha beta+. TCR V beta analysis, performed using V beta-specific primers and polymerase chain reaction, revealed that the T cell lines generated were clonal; a limited number of TCR V beta genes were expressed among the clones tested. All clones tested by mAb blocking of Ag-induced proliferation were restricted by HLA-DR. Several T cell clones were identified that were specific for B'/B or D polypeptides. These results demonstrate that snRNP-reactive T cells can be isolated from SLE and MCTD patients in vitro, and that Ag-driven expansion of such T cells could play a role in the immunopathogenesis of these diseases in vivo.

Voltage-dependent modulation of L-type Ca2+ current by manidipine in guinea-pig heart cells

Effects of manidipine, a dihydropyridine derivative, on L-type Ca2+ currents were examined in guinea-pig ventricular cells, using the whole-cell patch-clamp method. At a holding potential of -37 mV, manidipine decreased the Ca2+ current at concentrations above 0.1 nM, and abolished it at 100 nM (IC50 = 2.6 nM). At a holding potential of -78 mV, manidipine did not suppress the Ca2+ current at concentrations less than 100 nM, but increased the Ca2+ current slightly at a concentration of 10 nM. The antagonistic effect of manidipine was significant at concentrations above 100 nM (IC50 = 400 nM). The voltage-dependent effect of manidipine on the Ca2+ current may explain the weak negative inotropism of manidipine in ventricular muscles, and provide an electrophysiological basis for its vascular selectivity.

Antithrombin III producing hepatocellular carcinoma

A case of primary hepatocellular carcinoma with an abnormal increase in the antigenic quantity and activity of Antithrombin III (AT-III) is reported. The patient was a 53-year-old man. The liver was palpated for a five fingerbreadths, but no jaundice or ascites was noted. Computed tomogram (CT) revealed the presence of many nodules of various sizes in the right hepatic lobe. Both viral markers of HBV and HCV were negative. For tumor markers, PIVKA-II was high (27.7 AU/ml) but AFP was normal. Among coagulation and fibrinolytic factors, the activity and antigenic levels of AT-III were abnormally high (290% and 81.6 mg/dl). An US guided needle biopsy of the tumor revealed hepatocellular carcinoma, Edmondson I. The cellularity was high and the tumor cells were small, well differentiated. The tumor cells were positively stained in immunohistochemical staining using the anti-AT-III antibody. It was believed that AT-III produced by the tumor cells was responsible for this exaggerated level.

The successful surgical management of perforation after endoscopic sphincterotomy: report of two cases

Retroperitoneal perforation following endoscopic sphincterotomy (EST) is an infrequent but serious complication with a high mortality rate in patients who do not receive prompt treatment. We report herein two cases of perforation, diagnosed 3 and 7 days after EST, one of whom was treated by choledochojejunostomy (Roux-en-Y) and suturing of the perforation site with jejunal patching, and the other by pancreatoduodenectomy. Both operations were successful as emergency treatments and therefore we consider that radical surgery should be attempted for cases of perforation after endoscopic sphincterotomy with a delayed diagnosis.