An FH domain-containing Bnr1p is a multifunctional protein interacting with a variety of cytoskeletal proteins in Saccharomyces cerevisiae

Proteins containing formin homology domains, FH1 and FH2, are involved in cytokinesis or establishment of cell polarity in a variety of organisms. Bni1p and Bnr1p are FH proteins and potential targets of the Rho family small GTP-binding proteins in S. cerevisiae. We have shown that Bnr1p is localized at the bud neck to interact with Hof1p, involved in cytokinesis. We report here that the overexpression of BNR1 causes a cytokinesis deficiency which is similar to the phenotypes of the septin mutants, including cdc3, cdc10, cdc11, and cdc12. The region required for the septin mutant phenotypes was mapped to Bnr1p (35-500), which coincided with the region required for the bud-neck localization. To further isolate a gene interacting with BNI1 or BNR1, a multicopy suppressor of the bni1 bnr1 mutant was isolated. This gene encoded Smy1p, a kinesin-related protein. Bnr1p, but not Bni1p, directly interacted with the C-terminal region of Smy1p. The Smy1p-interacting region of Bnr1p was mapped to a region containing the FH2 domain. Bnr1p also directly interacted with Bud6p, a novel actin-binding protein. Bnr1p is thus a multifunctional protein which interacts with the septin system, a microtubule-dependent motor protein, and the actin system, to regulate cytoskeletal functions in S. cerevisiae.

nRap GEP: a novel neural GDP/GTP exchange protein for rap1 small G protein that interacts with synaptic scaffolding molecule (S-SCAM)

Synaptic scaffolding molecule (S-SCAM) has six PDZ domains through which it interacts with N-methyl-d-aspartate receptors and neuroligin at synaptic junctions. We isolated here a novel S-SCAM-binding protein. This protein has one PDZ, one Ras association, one Ras GDP/GTP exchange protein (Ras GEP) domain, and one C-terminal consensus motif for binding to PDZ domains. We named it nRap GEP (neural Rap GEP). nRap GEP moreover has an incomplete cyclic AMP (cAMP)-binding (CAB) domain. The domain organization of nRap GEP is similar to that of Epac/cAMP-guanine nucleotide exchange factor (GEF) I, except that Epac/cAMP-GEFI has complete CAB and Ras GEP domains but lacks the other two domains and the C-terminal motif. nRap GEP showed GEP activity for Rap1 but did not bind cAMP. nRap GEP was specifically expressed in rat brain. Immunohistochemical analysis revealed that nRap GEP and S-SCAM were localized at synaptic areas of the cerebellum. These results suggest that nRap GEP is a novel neural Rap1-specific GEP which is associated with S-SCAM.

Oxygen administration during hepatic DSA

The research presented in this article examined the role of oxygen in preventing diaphragmatic motion artifacts in delayed-phase hepatic digital subtraction angiography (DSA). The results demonstrate that administering oxygen to patients before the examination substantially reduces artifacts due to motion.

Age-dependent telomere shortening is slowed down by enrichment of intracellular vitamin C via suppression of oxidative stress

Telomeres in eukaryotic somatic cells are destined to the age-dependent shortening, which has not been demonstrated to correlate to direct lesion of telomeric DNA by reactive oxygen intermediates (ROI); still less explicable is the inhibitory effect of ROI-scavenging on telomere shortening. Here, we succeeded in artificial slowdown of age-dependent telomere shortening to 52-62% of the untreated control, in human vascular endothelial cells, by addition of the oxidation-resistant type of ascorbic acid (Asc), Asc-2-O-phosphate (Asc2P), which concurrently achieved both extension of cellular life-span and prevention of cell size enlargement indicative of cellular senescence. The results are attributable to a 3.9-fold more marked enrichment of intracellular Asc (Asc(in)) by addition of Asc2P, subsequently dephosphorylated before or during transmembrane influx, than by addition of Asc itself, and also attributed to diminution of intracellular ROI to 53% of the control level by Asc2P; telomerase activity was at a trace level and underwent an age-dependent decline, which was significantly decelerated by Asc2P. Thus, age-dependent telomere-shortening can be decelerated by suppression of intracellular oxidative stress and/or by telomerase retention, both of which are achieved by enriched Asc(in) but not by extracellular Asc overwhelmingly more abundant than Asc(in).

Indications for hepatectomy for hepatocellular carcinoma - what stage of the disease is the best indication for surgery?

To determine the clinical and tumor stage of hepatocellular carcinoma (HCC) that is the best indication for surgery, the postoperative long-term outcomes of patients who underwent hepatic resection were examined retrospectively. Of 975 patients with HCC who underwent regional therapy, 384 patients (39%) received hepatic resection (HR), 534 (55%) had transcatheter arterial chemoembolization (TACE), and the remaining 57 (6%) received percutaneous ethanol injection (PEI) into the tumor. The criteria defined by liver Cancer Study Group of Japan was used for staging and liver functional reserve (i.e., clinical staging). In the 133 patients with stage I HCC, there were no significant differences among the survivals of the HR, TACE, and PEI groups. In the 314 patients with stage II HCC, the 5- and 7-year survival rates were 51% and 46% in the HR group, 23% and 10% in the TACE group, and 0% and 0% in the PEI group. The survival of the HR group was significantly better than the survivals of the TACE and PEI groups (P < 0.001). The 5- and 10-year survivals of the stage II HCC patients who had HR were 64% and 47% in the clinical stage I (i.e., good liver function) group, significantly better than the 5; and 10-year survivals (32% and 23%) in the clinical stage II (i.e., bad liver function) group (P < 0.0001). Patients with good liver function in stage II are expected to have better survival and are considered to be the most suitable for HR.

Spiral CT during pharmacoangiography with angiotensin II in patients with pancreatic disease. Technique and diagnostic efficacy

PURPOSE

To compare the diagnostic efficacy of pancreatic pharmacoangiographic CT using angiotensin II with conventional angiographic CT.

MATERIAL AND METHODS

Eighteen patients with space-occupying pancreatic disease were examined in this study. Pharmacoangiographic CT was performed with a 1-3 micrograms/6-ml solution of angiotensin II injected through a catheter into the celiac artery during spiral CT.

RESULTS

In 17 of the 18 (94%) patients, the area of pancreatic parenchymal enhancement was the same or larger at pharmacoangiographic CT than at conventional angiographic CT. The attenuation value of the pancreatic parenchyma was significantly increased at pharmacoangiographic CT (p = 0.0010). Although the attenuation value of tumors was also increased on images obtained after the injection of angiotensin II, the tumor-to-pancreas contrast was significantly greater at pharmacoangiographic CT (p = 0.0479). The mean differences in attenuation between tumor and pancreas at angiographic CT with and without angiotensin II were respectively 182 HU and 115 HU.

CONCLUSION

Pharmacoangiographic CT with angiotensin II proved superior to conventional angiographic CT in the diagnosis of pancreatic disease. We therefore recommend it as a supplementary technique at the angiographic examination of patients with suspected pancreatic tumor.

[Our initial experience with SMANCS in TAE for liver cancer]

To evaluate the efficacy and adverse reaction of SMANCS, we reviewed 10 cases treated by TAE with SMANCS among 896 cases treated by TAE for liver cancer during the past three years at our institute. Our criteria for using SMANCS were as follows: a) reduced effectiveness of past TAE with Lipiodol, hydrophilic drugs and gelatin sponge; b) sufficient caliber and blood flow in the hepatic artery; and c) good hepatic function. The 1- and 2-year survival rates after treatment with SMANCS were 50% and 25%, respectively. The 3- and 5-year survival rates after initial treatment (first TAE, etc.) were 40% and 20%, respectively. There were no significant complications in clinical course, however, subsequent hepatic arteriogram often showed arterial change that may interfere with further regional therapy for the liver.

Double phase CT arteriography of the whole liver in the evaluation of hepatic tumors

PURPOSE

Our goal was to evaluate the contribution of double phase CT arteriography (CTA) of the whole liver to differentiate hepatic tumors from false-positive areas on CT during arterial portography (CTAP).

METHODS

In 38 candidates for surgical resection of hepatic tumors, both CTAP and double phase CTA were performed. A total of 68 perfusion defects were identified at CTAP. Of 68 perfusion defects, 47 were found to represent hepatic tumors [hepatocellular carcinoma (HCC), n = 31; hepatic metastasis, n = 13; cholangiocarcinoma n = 2; focal nodular hyperplasia, n = 1]. The other 21 perfusion defects were defined as perfusion abnormalities in which focal hepatic masses had not been identified at surgery or pathologic analysis. The phase one CTA scanning started 12 s after the beginning of the injection of contrast material, and the phase two CTA scanning started 20 s after the end of the phase one CTA, with 60 ml of contrast agent (150 mg I/ml) injected at a rate of 2 ml/s.

RESULTS

On phase one CTA, only 1 lesion in 31 HCCs showed rim enhancement and 26 HCCs (84%) had rim enhancement on phase two CTA. Twelve lesions (80%) of the hepatic metastases and cholangiocarcinomas had rim enhancement on phase one CTA and 11 lesions (73%) showed rim enhancement on phase two CTA. Twenty-one perfusion abnormalities on CTAP did not show rim enhancement on either phase one or phase two CTA.

CONCLUSION

Double phase CT arteriography of the whole liver was useful to differentiate hepatic tumors from perfusion abnormalities on CTAP.

[Relationship between the experience of steroids side effects and noncompliance with oral steroids treatment in collagen disease patients]

PURPOSE

To analyze the relationship between the experience of side effect and the compliance with oral steroids drug treatment of the patients in Collagen Disease Clinic.

METHODS

A questionnaire survey through interview was conducted on 165 outpatients with various collagen disease at Saga Medical School Hospital.

RESULTS

94 patients (57%) had a history of noncompliance to the steroids drug. 49 patients (52.1%) adventitiously had forgotten to take the steroids as ordered and 45 patients (47.9%) intentionally had regulated their steroids dose or had discontinued the steroids drug treatment. Over 80% of the patients had experienced side effects of the steroids. The patients who experienced one or more of the following side effects, osteoporosis, bone fractures, menstrual disorders, moon face, central obesity, alopecia, acnelike eruption, manic-depressive state, and insomnia, intentionally regulated, or discontinued the steroids therapy. In addition, the patients who were not made cognizance about side effects of the steroids by their physicians and nurse tended to noncompliance group.

CONCLUSION

To increase the compliance rate with oral steroids drug treatment, we must make conscious efforts to inform the patients on the condition of their medical states, the efficacy of the prescribed drugs, and the side effects and risk concerning discontinuation of the steroids. It is Also necessary to establish "Drug information and counseling day" in outpatient Department.

Oral administration of lens homogenate suppresses antibody production in mice injected with beta-crystallin emulsified in CFA

Auto-antibodies (Abs) against lens antigens (Ags) are present in most patients with age-related cataract, and with complement they kill lens epithelial cells (LECs) in vitro. We studied, in an animal model, whether cytotoxic Abs against lens Ags can be suppressed by oral administration of the Ags. Mice were fed calf lens homogenate, 4 mg/mouse, every 4 days for 4-5 weeks, or bovine serum albumin (BSA) before and after immunisation with beta-crystallins emulsified in complete Freund's adjuvant (CFA). Sera from these animals were analysed for Abs to beta-crystallins by enzyme-linked immunosorbent assay (ELISA) and protein blot analysis. In addition, we studied the proliferative response of T-lymphocytes to beta-crystallins. The titer of anti-beta-crystallin Abs in the control animals fed BSA gradually increased to 1.5 x 10(-6) by the 5th week after the first injection. In contrast, the titer of anti-beta-crystallin Abs in animals fed calf lens homogenate was reduced to 30-70% of the control. Feeding lens homogenate prior to or concomitant with beta-crystallins immunization, was more effective than feeding after immunization (65% suppression vs. 30% suppression, respectively). Also the proliferative response of T-lymphocytes to beta-crystallins in mice fed homogenate was suppressed significantly. Thus, oral administration of lens homogenate is a specific and nontoxic method of suppressing anti-beta-crystallin Ab production in mice. We are exploring the therapeutic value of oral administration of lens proteins in age-related cataract.

Establishment and evaluation of a new chemiluminescent enzyme immunoassay for carcinoembryonic antigen adapted to the fully automated ACCESS system

We have established a new chemiluminescent enzyme immunoassay for carcinoembryonic antigen (CEA), designated ACCESS CEA, which is adapted to the fully automated ACCESS immunoassay analyzer. The assay is based on a one step sandwich-type method using two monoclonal antibodies, one of which is immobilized on micrometer-size paramagnetic particles and the other is conjugated to alkaline phosphatase. Ten microliters of calibrators or sera are incubated for 5 minutes at 37 degrees C with the particles and with the alkaline phosphatase conjugate. The particles are then magnetically separated and washed to remove unbound components. Time needed to obtain the first result is less than 15 minutes. The assay range was 0.04-1000 micrograms/l of CEA, and the possible high-dose hook effect was prevented at CEA concentrations up to 100000 micrograms/l in this working range. The coefficient of variation (CV) for intra-assay precision was 3.0 to 4.7%, and inter-assay CV was 3.4 to 5.6%. The sample carryover was less than 0.001%. The analytical recovery ranged from 98 to 104% and a dilution linearity was demonstrated. No interference was detected in any sample with levels up to 300 mg/l for bilirubin, 12000 mg/l for haemoglobin, 50000 mg/l for human serum albumin, 8500 mg/l for triacylglycerol, and 500000 IU/l for rheumatoid factor. The ACCESS CEA assay also showed very homogeneous reactivity with purified CEA preparations from different tumours and could discriminate CEA from four CEA-related normal antigens tested. Serum samples (n = 362) from patients with malignant or non-malignant disease, as well as from healthy individuals, were analyzed by the ACCESS CEA assay and by the established IMx CEA assay. The CEA values determined by the ACCESS CEA assay were in good agreement with those determined by the IMx CEA assay, and the ACCESS CEA assay significantly increased the sensitivity and specificity of tumour diagnosis as compared with the IMx CEA assay.

Gastric lesions in 76 patients with adult T-cell leukemia/lymphoma. Endoscopic evaluation

BACKGROUND

Adult T-cell leukemia/lymphoma (ATLL) is caused by human T-lymphotropic virus type I. Gastric lesions in ATLL have not been described precisely, whereas the clinical features of ATLL have been well documented. The goal of the present study was to review gastric lesions, including gastric involvement, of patients with ATLL who were admitted to our hospital.

METHODS

Endoscopic examination of the upper gastrointestinal tract was performed on 76 of 110 patients who were admitted to our hospital between 1981 and 1994. Gastric involvement was diagnosed by histologic examination of biopsy specimens of gastric lesions. Types of gastric lesions, histologic features, and survival periods in patients with ATLL were summarized.

RESULTS

Of the 76 patients with ATLL who underwent an endoscopic examination, 23 had gastric involvement (30.3%). Twenty-seven patients had other gastric lesions: 10 with peptic ulcers (13.2%), 8 with gastric erosions (10.5%), 3 with submucosal tumors (3.9%), 2 with hyperplastic polyps (2.6%), 1 with gastric adenoma (1.3%), and 3 with gastric carcinomas (3.9%). The most frequent endoscopic configuration of gastric involvement with ATLL was the diffuse type with ulceration, and the most common histology was large cell type. Among those with the acute type ATLL, the survival period of those patients with gastric involvement was less than that of the patients without gastric involvement. In contrast, the survival period for lymphoma type ATLL did not differ among the groups regardless of gastric involvement.

CONCLUSIONS

This study demonstrated that 30.3% of patients with ATLL had gastric involvement and 13.2% had peptic ulcers. Gastric involvement of ATLL was one of the prognostic factors in acute type ATLL, whereas it had no influence on the prognosis of lymphoma type ATLL.

Genomic factors controlling the lethality exhibited in the hybrid between Nicotiana suaveolens Lehm. and N. tabacum L

Interspecific hybrid plants between Nicotiana suaveolens and N. tabacum exhibit lethal symptoms at the seedling stage and cannot grow to maturity. In this investigation, an attempt was made to clarify the genomic factors responsible for this lethality. N. suaveolens was crossed to N. sylvestris (genomic constitution: SS) and N. tomentosiformis (TT), these latter two species being the progenitors of N. tabacum (SSTT). From the cross N. suaveolens x N. tomentosiformis, many seedlings were obtained through ovule culture, and these subsequently grew to maturity without exhibiting any lethality. In the reciprocal crossing between N. sauvelons and N. sylvestris, only a few hybrid seedlings were obtained through ovlue culture and all died after unfolding their cotyledons when cultured at 28 °C. This lethality could be avoided by culturing the ovules at 36 °C. These features of hybrid lethality resembled those observed in the interspecific hybrid between N. suaveolens and N. tabacum. These findings suggest that the S genome in N. tabacum is responsible for the lethality exhibited in the hybrid between N. suaveolens and N. tabacum.

Contrast enhancement with Gd-EOB-DTPA in MR imaging of hepatocellular carcinoma in mice: a comparison with superparamagnetic iron oxide

The purpose of this study was to evaluate the ability of the new liver-specific magnetic resonance contrast agent gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (Gd-EOB-DTPA) to detect hepatocellular carcinoma (HCC). Seventeen mice with 66 chemically induced HCCs underwent magnetic resonance imaging with both Gd-EOB-DTPA (30 mumol/kg) and superparamagnetic iron oxide (SPIO; 10 mumol/kg). After enhancement, lesion-to-liver contrast-to-noise ratios (CNRs) of 47 detected HCCs increased negatively from 3.7 +/- 10.7 (mean +/- SD) to -55.1 +/- 25.8 with Gd-EOB-DTPA (P < .001) and increased positively from 10.4 +/- 10.4 to 26.1 +/- 16.3 with SPIO (P < .001). The improvement of CNR after administration of SPIO was less in smaller lesions (< 4 mm), whereas that after administration of Gd-EOB-DTPA was independent of lesion size. However, Gd-EOB-DTPA positively enhanced four HCCs (8.5%), both highly differentiated (grade 1) and moderately differentiated (grade 2). Gd-EOB-DTPA allows the conspicuous detection of small HCCs; however, moderately differentiated HCCs occasionally may be positively enhanced.

[Antibacterial activity of sulopenem, a new parenteral penem antibiotic]

Sulopenem, a new penem antibiotic, was compared with other antibiotics with regard to in vitro antibacterial and bactericidal activities, stabilization against beta-lactamases, and effect on the release of lipopolysaccharide from Gram-negative bacteria. The results are summarized as follows. 1. Sulopenem showed more potent activities than other antibiotics against both Gram-positive and Gram-negative bacteria except Pseudomonas aeruginosa. 2. Sulopenem showed potent bactericidal activities (MIC/MBC) against both Gram-positive and Gram-negative bacteria. Time kill studies against Staphylococcus aureus, Escherichia coli, Enterobacter cloacae and Citrobacter freundii showed potent bactericidal activities of sulopenem. 3. Sulopenem was found to possess a stronger activity than other antibiotics against beta-lactamase-producing strains except P. aeruginosa and Stenotrophomonas maltophilia. 4. In particular, sulopenem was found to be more stable to the hydrolysis by various beta-lactamases produced by Gram-negative bacteria than any other antibiotics tested. Vmax/Km values of sulopenem were smaller than those of cefotiam for all tested beta-lactamases, which reflected a broad antibacterial spectrum of sulopenem. 5. E. coli ML4707 exposed to sulopenem and imipenem released less endotoxin than did controls at all concentration ranges tested. In contrast, the strain exposed to ceftazidime at bacteriostatic concentrations released a large amount of endotoxin.

Clinical features of small hepatocellular carcinomas as assessed by histologic grades

BACKGROUND

Ninety-seven patients with small hepatocellular carcinomas (HCCs) measuring 3 cm or less in size and three patients with adenomatous hyperplasia who underwent radical hepatic resection were examined in this study.

METHODS

The lesions were classified into four groups according to the following histologic grading criteria: group A, adenomatous hyperplasia (n = 3); group B, early HCC (n = 6); group C, well-differentiated HCC (wHCC) (n = 32); and group D, moderately or poorly differentiated HCC (n = 59). The involvement factors that seemed to be important or to characterize the progression of HCC and the survival rates were compared among the four histologic groups.

RESULTS

The frequency of patients with tumors larger than 2.0 cm in size and that of patients with 200 or more ng/ml serum alpha-fetoprotein increased with the progression of histologic malignancy. Tumor staining on the angiogram, capsular formation, and extranodular invasion were never seen in groups A and B, but they began to appear in group C and increased remarkably in group D. The 5-year survival rates of the patients in groups B, C, and D were 100%, 60%, and 27%, respectively, and statistically significant differences were seen among them. In comparative evaluation of the group C patients the lesions that showed no tumor staining had no capsule, and those that had no capsule had no extranodular invasion. The 5-year survival rate of patients with wHCC without extranodular invasion (81%) was significantly higher than that of patients with extranodular invasion (35%) (p < 0.05).

CONCLUSIONS

It may be recommended to provide the category of wHCC without extranodular invasion for pathologic classification of clinically early HCC (i.e., HCC of high curability).

[Usefulness of spiral CT in the detection of hypovascular, well-differentiated hepatocellular carcinoma]

Whole liver scanning during artery-dominant phase using spiral CT was performed in 14 patients with 17 histologically proven well-differentiated HCCs, which were not depicted by hepatic digital subtraction angiography but by CT during arterial portography. The density of HCC relative to the liver was evaluated with conventional precontrast CT, spiral CT, and following conventional CT during the equilibrium phase. Comparison between spiral CT and magnetic resonance (MR) imaging of dynamic contrast studies was also investigated. Four tumors of 17 HCCs (24%) were shown as a high-density area by the artery-dominant phase using spiral CT. Consequently, the total sensitivity of these three kinds of CT techniques was elevated to 82%. The sensitivity of dynamic MR imaging was slightly greater than that of spiral CT. However, spiral CT sometimes made the diagnosis more conspicuous by it's good spatial resolution. Our results indicate that spiral CT has a potential benefit in the detection of hypovascular well-differentiated HCC, and MR imaging and spiral CT may be complement each other.

[Double lumen--coaxial catheter system for combined CT during arterial portography and CT hepatic angiography]

The high sensitivity of CT during arterial portography (CTAP) for hepatic lesions is accompanied with a lack of specificity for diagnosis. Combined CTAP and CT hepatic angiograpy (CTHA) had been proved to improves lesion detection and heightens confidence in interpreting perfusion abnormalities. We describe a new double lumen - coaxial catheter system for performing combined CTAP and CTHA without the need for repeated transfer of the patient or bilateral arterial punctures. This technique was employed in eight patients with liver neoplasms. In all eight patients, CTAP and CTA images were obtained successfully. We concluded that this method was useful for the evaluation of liver tumors.

In vitro antibacterial activities of FK037: a new parenteral cephalosporin

The antibacterial and bactericidal activities and the stability of FK037 to beta-lactamases were investigated and compared with those of cefpirome, flomoxef, ceftazidime, ceftizoxime, and vancomycin. Against clinical isolates of methicillin-sensitive and methicillin-resistant Staphylococcus aureus, FK037 was less active than vancomycin but more potent than the other drugs tested. Among highly methicillin-resistant staphylococci (MIC for methicillin: 200 mg/l or higher), none of the strains were highly resistant to FK037 (MIC > or = 100 mg/l) unlike the other cephalosporins. With the exception of Enterococcus faecalis, FK037 had an activity equipotent to that of cefpirome and far superior to those of flomoxef, ceftazidime and ceftizoxime against other gram-positive clinical isolates. The activity of FK037 against Pseudomonas aeruginosa and Pseudomonas cepacia was equipotent to that of cefpirome but 2- to 4-fold less active than that of ceftazidime. FK037 inhibited 90% of Enterobacter cloacae and Citrobacter freundii growth at a concentration of 6.25 mg/l; it was as active as cefpirome and much more active than ceftazidime. Against the other gram-negative bacteria tested, FK037 was equipotent to cefpirome and ceftazidime and was more effective than flomoxef. FK037, like cefpirome, portrayed a high stability to various beta-lactamases except type II penicillinase and oxyimino-cephalosporinase (CXase). FK037 scored an MIC range of 0.013-6.25 mg/l against numerous beta-lactamase-producing bacterial strains with the exception of some CXase-producing strains and a cephalosporinase-producing C. freundii; and against strains other than P. aeruginosa FK037 was as active as cefpirome and 2- to 32-fold more active than ceftazidime. FK037 displayed highly potent activities against cephalosporinase-producing E. cloacae, C. freundii and Serratia marcescens which were resistant to flomoxef and ceftizoxime. FK037 was highly bactericidal against S. aureus and Escherichia coli at its MIC or higher.

New concept of spinal orthosis for weakened back muscles

An anterior bending posture of the trunk during walking is often seen among the elderly commonly due to weakened thoraco-lumbar and gluteal muscles. For the management of this debilitating condition, the authors have developed a modified design of thoraco-lumbosacral orthosis (TLSO). Incorporated in this device are pockets for the accommodation of lead weights, which are located posteriorly at the level of the lumbar region and an elasticated anterior abdominal band. The results and level of patient acceptance achieved with the use of this brace have both been excellent.

Proteolysis by calpain is an underlying mechanism for formation of sugar cataract in rat lens

To confirm the effect of a new aldose reductase inhibitor (ARI), rat lenses were cultured with xylose. ARI prevented opacities and reduced lens hydration caused by xylose. Next, cataract was produced by feeding a diet containing 50% galactose. ARI was tested for amelioration of cataract. On day 19 after feeding of galactose, nuclear cataracts were visible in 75% of the animals receiving only galactose, while nuclear cataracts were not observed in animals treated with ARI. In galactose cataract, lens hydration and calcium were significantly increased. Calpain in soluble and insoluble fractions was decreased. Alpha- and beta-crystallins were proteolyzed. These changes were inhibited by administration of ARI. These results suggested that proteolysis by calpain is an underlying mechanism in formation of sugar cataract in rat lens.

Dye-injection method for placement of an infusion catheter in regional hepatic chemotherapy

PURPOSE

To evaluate the usefulness of a dye-injection method in the placement of an infusion catheter and port via proximal branches of the axillary artery for hepatic infusion chemotherapy.

MATERIALS AND METHODS

Sixteen patients with surgically unresectable hepatic cancer underwent transfemoral hepatic arteriography. Then a 3-F coaxial catheter was inserted into a proximal branch of the left axillary artery. Dye injected through the coaxial catheter during the surgical procedure improved the visualization of the target branch. The coaxial catheter was also used as a guide for retrograde insertion through the target branch of an infusion catheter into the descending aorta.

RESULTS

In 13 of 16 patients (81%), catheterization was successful without exposure of the axillary artery. In these patients, the acromial-deltoid branch of the thoracoacromial artery was chosen as the target.

CONCLUSION

Injection of dye simplifies the surgical procedure for placement of a hepatic infusion catheter via proximal branches of the axillary artery. The depth and extent of incisions, as well as the risk of nerve injury, are reduced.