[A case report of anomalous systemic arterial supply to the left basal lung]

A 38-year-old woman with a history of hemosputum once in a several years was admitted to our hospital because of a mass shadow in the left lower lung field on chest X-ray film. Physical examination revealed neither cardiac murmur nor any sign of heart failure. Chest X-ray film showed a tumorous shadow in the left posterior basal segment. Chest CT scan showed that this shadow was consisted of enhanced, dilated and torutuous vessel and was connected to the descending thoracic aorta. Angiographic examinations showed that there was no normal left basal trunk of the pulmonary artery, and revealed an anomalous arterial supply to the basal segments from the descending thoracic aorta, with an expanded left inferior pulmonary vein. Broncho-fiberscopy showed no abnormal findings in the bronchial tree except for mild stenosis of the left basal bronchus. This case was diagnosed as an anomalous systemic arterial supply to the left basal lung (Pryce type I). The left lower lobe without pulmonary sequestration and the anomalous systemic artery were resected. Microscopically, the anomalous artery showed an elastic type, and the peripheral lung areas showed congestion. The postoperative course was uneventful. We collected reports of 26 cases of the same anomalies in Japan and discussed the difference of this anomaly from pulmonary sequestration.

Effects of steroid 5alpha-reductase inhibitor ONO-9302 and anti-androgen allylestrenol on the prostatic growth, and plasma and prostatic hormone levels in rats

ONO-9302 [epristeride; (-)-17beta-(tert-butylcarbamoyl)androsta-3,5-diene-3-carboxy lic acid] is a novel inhibitor of steroid 5alpha-reductase. We studied in vitro and in vivo effects of ONO-9302 on the rat prostatic tissue in comparison with those of the anti-androgen allylestrenol. ONO-9302 inhibited the rat prostatic enzyme with an IC50 value of 11 nM, whereas allylestrenol was about 80,000-fold less potent. The growth of ventral prostate, which was induced by the subcutaneous injection of testosterone propionate in the castrated rats, was significantly reduced by ONO-9302 at oral doses of 1-100 mg/kg/day. Allylestrenol showed a significant effect only at a dose of 100 mg/kg/day. In mature male rats, ONO-9302 significantly reduced the ventral prostate weight at doses of 10-100 mg/kg/day and decreased prostatic 5alpha-dihydrotestosterone (DHT) content associated with a rise in testosterone (T) content at doses of 0.1-100 mg/kg/day. Plasma hormone levels (i.e., T, DHT, luteinizing hormone (LH) and follicle stimulating hormone (FSH)) were not altered significantly. Allylestrenol significantly reduced the ventral prostate weight at doses of 10-100 mg/kg/day. However, unlike ONO-9302, allylestrenol reduced both the prostatic DHT and T contents and also lowered plasma T, DHT, LH and FSH levels at a dose of 30 mg/kg/day. These results suggest that ONO-9302 reduces the prostatic growth by inhibiting the conversion of T to DHT in the prostate without lowering blood T level unlike anti-androgen drugs.

Lateral and medial olivocochlear neurons have distinct electrophysiological properties in the rat brain slice

Electrical properties of cochlear efferent (olivocochlear) neurons were investigated with the use of the whole cell patch recording technique in slice preparations of the neonatal rat (postnatal days 5-11). Lateral and medial olivocochlear (LOC and MOC, respectively) neurons were retrogradely labeled with a fluorescent tracer injected into the cochlea. Stained neurons were identified under a fluorescence microscope, and they were subjected to whole cell recording. LOC and MOC neurons showed different electrophysiological properties. Both showed spike trains of tonic pattern in response to injection of depolarizing current pulses at the resting membrane potential (-60 to -70 mV). However, when the membrane was slightly hyperpolarized (-72 to -76 mV), LOC neurons showed spike trains with a long first interspike interval (ISI), whereas MOC neurons showed spike trains with a long latency to the first spike. Extracellular application of 4-aminopyridine (4-AP; 0.5-2 mM) shortened these ISIs and latencies. In voltage-clamp experiments, two transient outward currents with different (fast and slow) decay kinetics were observed in LOC neurons. The fast outward current (I(A-LOC)) was inactivated by the preceding depolarization, and decayed with a time constant (tau) of 86 ms (at 0 mV). The preceding potential, which reduced the current size to the half-maximum (V1/2), was -72 mV. The slow current (I(KD)) decayed with a tau of 853 ms (at 0 mV). I(A-LOC) was sensitive to 4-AP (2 mM), and was less sensitive to tetraethylammonium chloride (TEA; 20 mM). I(KD) was partially blocked by TEA (20 mM), but was insensitive to 4-AP (2 mM). The recovery from inactivation of I(A-LOC) was time dependent with a time constant (tau(rec)) of 32 ms at -90 mV. MOC neurons also showed a transient outward current that consisted of a single transient component (I(A-MOC)) with a steady outward current. I(A-MOC) was inactivated by the preceding depolarization. Decay tau of I(A-MOC) was 33 ms (at 0 mV), and V1/2 was -75 mV. I(A-MOC) was sensitive to 4-AP (0.5-1 mM). The time-dependent recovery from inactivation of I(A-MOC) was faster than that of I(A-LOC), and tau(rec) was 15 ms at -90 mV. The different kinetics of transient outward currents between LOC and MOC neurons seems to be responsible for the difference in firing properties of these two neurons.

Transformation in Garnet from Orthorhombic Perovskite to LiNbO3 Phase on Release of Pressure

High-pressure in situ x-ray diffraction and transmission electron microscopy on quenched samples show that natural garnet transforms to orthorhombic perovskite (and minor coexisting phases) containing increasing amounts of aluminum with increasing pressure. This suggests that the perovskite is the dominant host mineral for aluminum in Earth's lower mantle. Orthorhombic perovskite is quenched from approximately 35 gigapascals but, because of the increased aluminum content, transforms to the LiNbO3 structure upon quenching from approximately 60 gigapascals.

[Patch clamp]

Patch clamp technique was applied to variety of cells for variety of purposes. There are several modifications made for the technique and we can now record not only from the single channel but also from the whole cell membrane. The application of the patch recording technique was expanded and recordings were made recently from brain slice preparations. We have summarized technical aspects and several applications of patch clamp in this short review.

Penetrating injury of the vertebral artery caused by a nail gun: preoperative embolization

We describe a penetrating injury of the vertebral artery caused by a nail gun. The artery was preoperatively embolized using mechanical detachable coils (MDC).

[The screening of hepatitis virus and its efficacy]

1. Infection of hepatitis A virus (HAV) was prevented with hepatitis A vaccine. High risk groups of HAV infection should be inoculated this vaccine because Japanese peoples less than 40 years old didn't have immunity for HAV. 2. Infection of hepatitis E virus (HEV) was scarcely observed in Japan. 3. Infection of hepatitis B virus (HBV) by blood transfusion was eradicated after the screening with anti-HBc antibody for blood donors. And maternal transmissions of HBV and infections of HBV in hospital were protected by HB-globulin and hepatitis B vaccine. 4. Infection of hepatitis D virus (HDV) was protected by HB-globulin and hepatitis B vaccine. 5. Infection of hepatitis C virus (HCV) by blood transfusion markedly decreased after the screening with anti-HCV for blood donors. We can't prevent a maternal transmission of HCV but its frequency is low (about 10%). And acute hepatitis C due to an infection of HCV in hospital can be prevented by the treatment with interferon in the Workmen's Accident Compensation Insurance.

Surgical difficulties and postoperative problems associated with cochlear implants

Since 1987 we have implanted 60 severely hearing-impaired adults with the Nucleus Minisystem-22 cochlear implant. In most cases, the surgical procedures were performed with satisfactory results and very few postoperative problems. The complications associated with cochlear implant surgery include difficulty in drilling the ossified cochlea, electrode displacement, and insufficient insertion of the electrode. Postoperative problems include dizziness, tinnitus, facial nerve spasm, receiver-stimulator migration or extrusion, infection of the scalp flap, and facial nerve palsy. In most cases, these complaints did not develop into serious conditions.

[Effects of 5-fluorouracil in shrinking residual gastric cancer: a case report]

The patient was a 79-year-old man who underwent extensive gastrectomy and Billroth-II reconstruction for gastric ulcer in 1974. He complained of heartburn in November, 1992, and endoscopy for the residual stomach revealed IIb + IIa-like lesion mainly in the posterior wall of the anastomosed site, which was diagnosed as well differentiated adenocarcinoma. As the patient refused to be operated, 150 mg/day of 5-FU was administered. For 4 months before he decided to undergo operation, 12.9 g of 5-FU was administered in total. After rehospitalization, endoscopy of the residual stomach showed shrinkage of the lesion, and biopsy revealed no malignant findings. The pathological examination after total resection of the residual stomach showed atypism, but no evidence to support malignancy. He has continued to be well without sign of recurrence for 1 year since the operation. The administration of 5-FU is widely used as preoperative adjuvant chemotherapy. This case it is rare for 5-FU to cause the disappearance or falling off of malignant cells.

[Cochlear implants in children]

A multichannel cochlear implant was performed in 8 children, and the following results were obtained. The surgical procedures were not as difficult as in adults, and there were few postoperative complications. The results of testing postoperative speech comprehension ability were examined in three children whose course was followed for more than one year postoperatively. Some patients had good speech comprehension ability postoperatively, and we expect to continue performing cochlear implant in children. Postoperative rehabilitation takes longer. The cooperation of physicians, audiologists, speech therapists, school teachers and family members is essential, and establishing a cochlear implant center for children would be desirable.

Detection of immunologically related Kunitz and Bowman-Birk proteinase inhibitors expressed during potato tuber development

Antiserum against a potato Kunitz-type proteinase inhibitor (PKPI) expressed in Escherichia coli was produced. In immunoblotting assays of proteins from potato tubers cultured in vitro, three proteins reacted to the antiserum, two of 20 kDa and one of 10 kDa. Their N-termini were sequenced. While the 20 kDa proteins showed 59 and 90% identity to PKPI, the 10 kDa one had 65% identity to soybean C-II proteinase inhibitor. Characterization of the temporal expression of these proteins showed that both could be detected from 10 days after induction of tuberization (DAI) in vitro, but the times when maximum amounts of PKPI and 10 kDa protein could be detected were different, corresponding to 22 and 32 DAI, respectively. The amounts of these proteins decreased in the following stages, and no positive reaction of the antiserum with mature tuber proteins could be found. The 20 kDa proteins were also detected in early stages of development of potato tubers grown in the field, indicating that these proteins are expressed during normal tuber development, and differ from the PKPIs reported previously.

[Cochlear implants for adult prelingually deaf patients]

We have performed cochlear implants on 6 adult prelingually deaf patients and obtained the following results. 1) The speech comprehension ability of the adult prelingually deaf patients was poorer than in postlingually deaf patients, but some patients showed better results than expected. 2) The adult prelingually deaf patients required a longer period of rehabilitation than the postlingually deaf patients. There were considerable variations in performance among the adult prelingually deaf patients.

Detection of alcohol-tolerant hiochi bacteria by PCR

We report a sensitive and rapid method for detection of hiochi bacteria by PCR. This method involves the electrophoresis of amplified DNA. Nucleotide sequences of the spacer region between 16S and 23S rRNA genes of 11 Lactobacillus strains were identified by analysis of PCR products. Five primers were designed by analysis of similarities among these sequences. A single cell of Lactobacillus casei subsp. casei could be detected when purified genomic DNA was used as the template. When various cell concentrations of L. casei subsp. casei were added to 50 ml of pasteurized sake and the cells were recovered, the detection limit was about one cell. No discrete band was observed in electrophoresis after PCR when human, Escherichia coli, mycoplasma, Acholeplasma, yeast, or mold DNA was used as the template.

Efferent vestibular fibers to otolith organs in guinea pigs

The origins of efferent vestibular fibers to the otolith organs in guinea pigs, examined with the use of retrograde transport of HRP were: i) the bilateral lateral portions of the facial genu and ii) the ipsilateral reticular nucleus at the level of the facial nucleus. These origins are almost the same as those of the efferent fibers to the three semicircular canals which we have previously identified in cats; however, they differ in certain respects.

Proposal of a risk score for recurrence in patients with curatively resected gastric cancer

In this study, 168 patients who underwent curative resection for gastric cancer with prognostic serosal invasion [ps(+)] and 150 without prognostic serosal invasion [ps(-)] were analyzed separately to determine the prognostic importance of clinicopathological factors, and identify which patients were at high risk of recurrence. A multivariate analysis of survival time using Cox's proportional hazard model revealed the important prognostic factors to be: Lymph node involvement, the classification of gross appearance, macroscopic serosal invasion, and interstitial connective tissue in the ps(+) group; and lymph node involvement, macroscopic serosal invasion, and venous invasion in the ps(-) group. We proposed a risk score of recurrence based on the results of a further multivariate analysis called Hayashi's Quantification Analysis II, in which recurrence was chosen as an objective variable and the above prognostic factors were chosen as explanatory variables. Eighty-four percent of the patients with a score of 0 or higher in the ps(+) group and 83% of those with a score of +6 or higher in the ps(-) group showed recurrence. Thus, we believe that this score is useful for identifying those patients at high risk of recurrence, who should receive intensive chemotherapy even after curative resection.

Synthesis of rat brain natriuretic peptide 45 using tetrafluoroboric acid deprotection and silyl chloride disulfide formation

A newly isolated rat brain natriuretic peptide 45 (rBNP45) was synthesized using the 9-fluorenylmethyloxycarbonyl (Fmoc)-based solid-phase method. Tetrafluoroboric acid (HBF4) deprotection was successfully applied for this synthesis, while the conventional trifluoroacetic acid (TFA)-thioanisole method gave unsatisfactory results. The disulfide bond of rBNP45 was constructed by using the silyl chloride method within 10 min, which was extremely advantageous to avoid the formation of Met(O)-rBNP45. The chick rectum relaxant activity of the synthetic rBNP45 was three times as potent as that of alpha-rat atrial natriuretic peptide (alpha-rANP).

Jasmonic acid-inducible gene expression of a Kunitz-type proteinase inhibitor in potato tuber disks

Messenger RNAs of a potato (Solanum tuberosum L.) Kunitz-type proteinase inhibitor(s) (PKPI) were present in potato disks excised from tubers stored for 14 months (old tubers) or 2 months (young tubers) after harvest, and disappeared during the aseptic culture. The PKPI mRNA accumulation was found to be induced in potato disks from the old tubers by the addition of jasmonic acid (JA) [3-oxo-2-(2'-cis-pentenyl)-cyclopentane-1-acetic acid].

Clinical studies of oral quinolone once daily in the treatment of lower respiratory tract infections

The efficacy and safety of oral ofloxacin, 400 mg once daily, for the treatment of patients with lower respiratory tract infections were studied. The most common species recovered from the sputum specimens of these patients were Haemophilus influenzae, followed by Streptococcus pneumoniae (S. pneumoniae), Staphylococcus aureus (S. aureus), Gram positive cocci unidentified, Pseudomonas aeruginosa (P. aeruginosa), Morexella catarrhalis, Streptococcus epidermidis, and another Haemophilus species in this order. All these bacteria were susceptible to ofloxacin except for one strain of methicillin resistant S. aureus. A satisfactory clinical outcome was achieved in 34 of 40 patients (85%). It is concluded that ofloxacin, 400 mg once daily, is useful for patients with respiratory tract infections.

Paraganglioma associated with hypoglycemia

A 63-year-old female had frequent attacks of palpitations with sweating and occasional loss of consciousness for 7 years before admission. These symptoms and documented hypoglycemia (blood glucose: 46 mg/dl) suggested insulinoma, but computed tomography demonstrated a retroperitoneal tumor which was diagnosed as a paraganglioma by histological examination of the resected specimen.

[Development of automated lactate analyzer with continuous blood sampling for monitoring blood lactate and its application for the testing of physical exercise]

The anaerobic threshold is useful for estimating the intensity of physical exercise. It is shown as either an increase in blood concentrations of lactate or a disproportionate increase in ventilation. We developed a lactate analyzer based on an electroenzymatic method with a continuous blood sampling system through a double-lumen catheter. Ascorbic acid, bilirubin, hemoglobin, creatinine, uric acid, and glucose did not interfere the results. The lactate concentrations in blood samples from healthy subjects during physical exercise correlated well (r = 0.993) with results measured by the conventional enzymatic method. We measured the concentrations of blood lactate with a use of this lactate analyzer to see the anaerobic threshold in nine healthy volunteers during exercise on a treadmill with an increasing workload. The point at which lactate concentrations started to increase was detected easily. The anaerobic threshold identified as a disproportionate increase in ventilation was seen at almost the same time. We conclude that the lactate analyzer, with a continuous blood sampling system, can measure precisely concentrations of lactate in blood and can detect the anaerobic threshold during physical exercise.