[Effect of PCBs on mouse lung tumorigenesis induced by 1-nitropyrene: a preliminary report]

We have analyzed the effect of polychlorinated biphenyls (PCB, Kanechlor-400) on 1-nitropyrene (1-NP) induced lung tumor. Male A/J mice (6 weeks old) were used for the experiment. A total of 2.5 mg/kg PCB was administered intraperitoneally (PCB group), a total of 0.38 mmol/kg 1-NP was administered intraperitoneally for 17 times (1-NP group), PCB was administered followed by i.p. injection of 1-NP (PCB + 1-NP group), and only vehicle was administered (control group). The lung lesions induced were examined 18 weeks after the final treatment with 1-NP or vehicle. In control group, no neoplastic lesion in the lung was induced. In PCB group, only one lesion with adenoma was induced. In 1-NP group, various kinds of lung neoplastic lesions including hyperplasia, adenoma and adenocarcinoma were induced. In PCB + 1-NP group, both the number and size of tumors induced were significantly more than those in 1-NP group. In addition, the number of adenocarcinoma formed was more in PCB + 1-NP group than in 1-NP group. Each lesion was microdissected to collect and analyze DNA of the targeted tissue. K-ras gene mutation was detected in part of adenoma lesions and all the carcinoma lesions. The mutation was found in either 1-NP or PCB + 1-NP group, but not in control and PCB group. The pattern of K-ras mutation was CAA to CGA in codon 61 or GGT to GAT in codon 12. There was no difference in the pattern of K-ras mutation despite of the pretreatment with PCB. Although the present data are from small sample size, it was suggested that PCB may promote (but not initiate) 1-NP induced lung tumorigenesis, and may not induce K-ras mutation directly in the experimental system.

Isolation and characterization of a second subunit of molecular chaperonin from Pyrococcus kodakaraensis KOD1: analysis of an ATPase-deficient mutant enzyme

The cpkA gene encoding a second (alpha) subunit of archaeal chaperonin from Pyrococcus kodakaraensis KOD1 was cloned, sequenced, and expressed in Escherichia coli. Recombinant CpkA was studied for chaperonin functions in comparison with CpkB (beta subunit). The effect on decreasing the insoluble form of proteins was examined by coexpressing CpkA or CpkB with CobQ (cobyric acid synthase from P. kodakaraensis) in E. coli. The results indicate that both CpkA and CpkB effectively decrease the amount of the insoluble form of CobQ. Both CpkA and CpkB possessed the same ATPase activity as other bacterial and eukaryal chaperonins. The ATPase-deficient mutant proteins CpkA-D95K and CpkB-D95K were constructed by changing conserved Asp95 to Lys. Effect of the mutation on the ATPase activity and CobQ solubilization was examined. Neither mutant exhibited ATPase activity in vitro. Nevertheless, they decreased the amount of the insoluble form of CobQ by coexpression as did wild-type CpkA and CpkB. These results implied that both CpkA and CpkB could assist protein folding for nascent protein in E. coli without requiring energy from ATP hydrolysis.

Segmental gastrectomy for early cancer in the mid-stomach

BACKGROUND/AIMS

We modified the surgical procedure for segmental gastrectomy, which is normally used for peptic ulcers, to treat early gastric cancer of the mid-stomach. In this paper, we describe the surgical technique and its results.

METHODOLOGY

The location of the tumor was confirmed by intra-operative endoscopic examination. An area 2 cm proximal and distal to the tumor was marked with sutures. Firstly, the lymph nodes were dissected from around the perigastric and along the left gastric and common hepatic arteries. Then, a segmental gastrectomy was performed. The greater omentum, omental sac, and vagal nerve, including the hepatic, pyloric and celiac rami, were left intact. An end-to-end gastrogastrostomy was performed using Gambee's sutures and 4-0 monofilament polydioxanone. Gastric drainage was not necessary.

RESULTS

We performed segmental gastrectomies on 30 patients. Tumors less than 1 cm in diameter were found in 4 patients; 1.1-2 cm in 14, 2.1-5 cm in 11, and a tumor exceeding 5.1 cm in one patient. The cancer was confined to the mucosa in 23 patients; in the other 7, it had penetrated the submucosa. No lymph node metastases were found but 2 patients had microscopic invasion or permeation of the lymphatic vessels. One patient required post-operative balloon dilation of the pyloric sphincter for delayed gastric emptying. The remaining patients had no post-operative complications. To date, 29 patients, excluding one who died in a traffic accident, have survived disease-free for a mean of 30 months (range: 7-51). Their body weight and dietary volume returned to pre-operative levels within 12 months of surgery.

CONCLUSIONS

Patients who underwent segmental gastrectomy have had a reasonably good quality of life in the post-operative follow-up to date.

Asymmetric reduction of ethyl 2-methyl 3-oxobutanoate by Chlorella

Chlorella pyrenoidosa Chick reduced ethyl 2-methyl 3-oxobutanoate to the corresponding alcohols with the diastereomer (anti/syn) ratio of 53/47. The enantiomer excesses of anti-(2S, 3S)- and syn-(2S, 3R)-hydroxy esters were 89 and > 99ee% respectively. C. vulgaris and C. regularis afforded predominantly the syn-isomer, contrary to C. pyrenoidosa. The differences in the activity of reducing ethyl 2-methyl 3-oxobutanoate were observed among three strains of Chlorella. Addition of 2% metal salts slightly increased the chemical yield of the hydroxy ester.

Sublingual gland: MR features of normal and diseased states

OBJECTIVE

We describe the MR features of the sublingual gland in normal and diseased states.

SUBJECTS AND METHODS

We used MR imaging to assess age-related changes in size and signal intensity of normal sublingual glands in 60 control subjects. The MR features of sublingual glands were also studied in 70 patients with cancer, cellulitis of the sublingual space, Sjögren's syndrome, or ranula.

RESULTS

MR imaging efficiently revealed normal sublingual glands. On T1-weighted images, the MR signal intensity of the sublingual gland was lower than that of the surrounding fat but higher than that of muscle. The sublingual glands showed age-related decreases in size, with approximately 25% of the thickness present in the second decade of life being lost by the seventh decade. T1-weighted signal intensity of the parotid gland increased with age, but the signal intensity of the sublingual and submandibular glands did not. T1-weighted signal intensity of carcinomas in and near the sublingual space was lower than that of the sublingual glands, but T2-weighted signal intensity of carcinomas exceeded that of the glands. Gadolinium enhancement occasionally diminished the contrast between invading carcinomas and the glands. T1-weighted MR imaging showed that sublingual glands affected by Sjögren's syndrome exhibit features analogous to those of the other major salivary glands; however, the sublingual glands seemed to be less severely involved overall in this syndrome than the other major glands. We found that using fat suppression and short inversion time inversion recovery may be useful for assessment of sialadenitis of the gland.

CONCLUSION

MR imaging is useful in depicting normal and diseased states of the sublingual gland.

Left colon substitution with His' angle following total gastrectomy. Surgical technique using stapling devices

To resolve the disadvantages of jejunal Roux-en-Y reconstruction following total gastrectomy, we attempted the use of left colon substitution with all anastomoses conducted using mechanical stapling devices. A His' angle was formed to reduce regurgitation esophagitis. About 25 cm of the left colon with the ascending branch of the left colic artery with an adequate blood supply was brought up to the remnant esophagus without tension on the mesentery. The colon graft was interposed between the esophagus and duodenum in an isoperistaltic fashion. Three anastomoses, esophagocolic, duodenocolic and colocolic, were completed with a circular stapling device. An end-to-side esophagocolonostomy was positioned about 3 cm distal from the blind end of the proximal colon stump. The proximal end of the left colon was pexied to the esophagus using 3-4 stitches to make a new His' angle. Gastrointestinal continuity was restored by a side-to-end colonoduodenostomy and an end-to-end colonocolonostomy. Fifteen gastric cancer patients underwent left colon substitution following total gastrectomy. The circular staple used for esophagocolonostomy and colonoduodenostomy was 25 mm in all patients, and for colonocolonostomy was 29 mm in 9 patients and 33 mm in 6 patients. No problems were encountered in any steps of the procedure, and faulty stapling was avoided. Neither anastomotic leakage nor necrosis of the interposed colon segment was seen, nor was late anastomotic stricture, in any patient. Barium radiograms of the interposed colon segment showed that the capacity and passage of the interposed colon were adequate, and regurgitation did not occur. Diet volume was satisfactory and weight loss minimal.

Plasma brain natriuretic peptide as a biochemical marker for atrioventricular sequence in patients with pacemakers

We hypothesized that plasma brain natriuretic peptide, like plasma atrial natriuretic peptide, may reflect hemodynamic changes elicited by different cardiac pacing modes. The aim of this study was to investigate whether plasma brain natriuretic peptide could be influenced by different pacing modes or electrical stimulation. The subjects consisted of 164 patients with permanent pacemakers (52 VVI, 30 AAI, 82 DDD pacemakers) and unimpaired heart function. Patients with atrial fibrillation or spontaneous beats were excluded. Plasma atrial natriuretic peptide and brain natriuretic peptide levels were measured at a rate of 70 beats/min after 45 minutes in the supine position. Under ECG monitoring, the pacing mode was switched from DDD to VVI in 12 patients and from DDD to AAI in 4 patients with a dual chamber pacemaker. Plasma atrial natriuretic peptide and brain natriuretic peptide levels were also measured 30 minutes, 60 minutes, and 1 week after mode switching. Plasma atrial natriuretic peptide and brain natriuretic peptide levels were significantly higher in the nonphysiological pacing group than in the physiological pacing group, whereas these values were similar in the DDD and AAI pacing groups. One week after switching from DDD to VVI, plasma atrial natriuretic peptide and brain natriuretic peptide levels were significantly increased, however no significant changes were observed after switching to AAI. Based on a multivariate regression analysis of noninvasive clinical parameters, only a low plasma brain natriuretic peptide was significantly correlated with physiological pacing. We conclude that: (1) plasma brain natriuretic peptide, like atrial natriuretic peptide, is influenced by the pacing mode, but is not influenced by electrical stimulation; and (2) low plasma brain natriuretic peptide is important in relation to physiological pacing.

Effects of 5'-DFUR and lentinan on cytokines and PyNPase against AH66 ascites hepatoma in rats

Pyrimidine nucleoside phosphorylase (PyNPase) is an enzyme which converts 5'-deoxy-5-fluorouridine (5'-DFUR) to 5-fluorouracil (5-FU), and is induced by various cytokines in tumor cells. We evaluated a combination of 5'-DFUR and lentinan which is widely used as a biological response modifier (BRM), to verify antitumor effects, the induction of cytokines such as tumor necrosis factor (TNF)-alpha and latent transforming growth factor (TGF)-beta, and PyNPase activity against AH66 ascites hepatoma cells in rats. AH66 ascites hepatoma cells were subcutaneously injected into the backs of Donryu rats. Rats were randomly assigned to a group receiving either 5'-DFUR or lentinan alone, to a group receiving both 5'-DFUR and lentinan, or to a control group. 5'-DFUR was administered orally, and lentinan was administered intraperitoneally. The tumor size, PyNPase activity in the tumor and spleen, and TNF-alpha and TGF-beta in the tumor were examined. The results were as follows. a) Tumor growth was significantly (P < 0.05) inhibited in both the 5'-DFUR group and the 5'-DFUR + Lentinan group when compared to the control group. Tumor growth in the 5'-DFUR + Lentinan group was significantly (P < 0.01) inhibited compared to that in both the 5'-DFUR group and the Lentinan group. b) PyNPase activity in the tumor was significantly (P < 0.01) higher in each group than in the spleen. In the tumor, PyNPase activity was significantly (P < 0.01) higher in the Lentinan group compared to the control group. In the 5'-DFUR + Lentinan group PyNPase activity in the tumor was significantly (P < 0.01) lower compared to the Lentinan group. c) Levels of TNF-alpha and TGF-beta production in the tumor were significantly (P < 0.05) lower in the 5'-DFUR + Lentinan group compared to the control group. These findings suggested that PyNPase activity in the tumor was induced by lentinan but not so in the spleen, and lentinan increased the susceptibility of tumor cells to 5'-DFUR.

Long-term beneficial effect of late reperfusion for acute anterior myocardial infarction with percutaneous transluminal coronary angioplasty

BACKGROUND

Although the short-term and long-term beneficial effects of early coronary revascularization by primary PTCA or thrombolytic therapy have been established for acute myocardial infarction, thrombolytic therapy >24 hours after the onset of acute myocardial infarction has not been shown to improve clinical outcome. The purpose of this study was to assess the effect of late revascularization by primary PTCA over a 5-year period.

METHODS AND RESULTS

Eighty-three patients with initial Q-wave anterior myocardial infarction >24 hours after onset were randomized into a PTCA group (n=44) and a no-PTCA group (n=39). Long-term follow-up was conducted with regard to end points, which included cardiac death, nonfatal recurrence of myocardial infarction, and development of congestive heart failure. Left ventricular ejection fraction and regional wall motion at 6 months after myocardial infarction were similar in the 2 groups. Left ventricular end-diastolic and end-systolic volume indexes were significantly smaller in the PTCA group than in the no-PTCA group (P<0.0001). With cardiac events as end points, a 5-year Kaplan-Meier event-free survival analysis revealed that the no-PTCA group had a worse prognosis than the PTCA group (P<0.0001). Patency of the infarct-related artery, left ventricular ejection fraction, end-diastolic volume index, and end-systolic volume index were significantly associated with cardiac events by a Cox proportional hazards analysis (hazard ratios 0.120, 0.845, 1.065, and 1.164, respectively).

CONCLUSIONS

In initial Q-wave anterior myocardial infarction, we conclude that even with late reperfusion, PTCA had beneficial effects on cardiac events over the 5-year period after myocardial infarction, with the prevention of left ventricular dilation after myocardial infarction being a possible mechanism.

[Cerebral infarction associated with nephrotic syndrome in a young adult: a case report]

We report a 19-year-old man who developed a cerebral infarction in the territory of the anterior choroidal artery and showed a hypercoagulable state and nephrotic syndrome after diarrhea and appetite loss. He had suffered from nephrotic syndrome from the age of three and had been treated for five years. MR-angiography showed an occlusion originating in the right internal carotid artery. The right anterior and middle cerebral arteries were imaged from the left internal carotid artery via the anterior communication artery. He showed symptoms of left hemiparesis, agnosia, loss of activity, anasarca and left hypacusis following his clinical course, but had recovered from all but left hemiparesis following medical treatments including steroid therapy. The histologic finding by a renal biopsy revealed focal glomerulosclerosis. In this case, we considered that when he was in a hypercoagulable state and had a second attack of nephrotic syndrome because of inflammation and dehydration due to diarrhea and appetite loss, his hypercoagulable state grew worse, and he then developed a cerebral infarction. When one see a patient with nephrotic syndrome, one should be attentive to the possibility of a complication of cerebral infarction.

The organization of the ipsilateral corticocortical projections of the middle sylvian gyrus (AII) in the cat cerebral cortex: an anterograde and retrograde tracing study

The primary auditory area and surrounding cortical areas including the secondary auditory area subserve auditory information processing. In this study, corticocortical ipsilateral connections of the secondary auditory area were investigated in the cat by injections of axonally transported tracers into this area. Retrogradely labeled cells and anterogradely labeled terminals were observed within the secondary auditory area itself, and the primary, posterior, and ventroposterior auditory areas, in the insular cortex and in the temporal auditory area. These labeled terminals appeared in patches or bands. In the ventroposterior auditory area, a transverse band of anterograde and retrograde labeling, which extended from the posterior ectosylvian sulcus to the surface of the posterior ectosylvian gyrus was observed. In addition, scattered labeling was detected in the posterior auditory area. Although different parts of the secondary auditory area were found to send axons to different zones within the temporal cortex, no precise topographical arrangement was detected. When two different tracers were injected into the secondary auditory area and the anterior auditory area, respectively, some terminal aggregates anterogradely labeled from these two areas converged within the posterior auditory area. The organization of these connections is discussed in relationship to the functional role of the auditory cortical areas.

[Results of preoperative high-dose-rate intraluminal brachytherapy for resectable rectal cancer]

One hundred and fifteen patients with middle and lower rectal cancer were treated with preoperative High-dose-rate intraluminal brachytherapy (HDRIBT) and radical operation. Patients were divided into a middle-dose group (group A; 30-40 Gy; n = 94) and a high-dose group (group B; 60-80 Gy; n = 18). A control group of 115 rectal cancer patients who received no irradiation prior to radical surgery was used for comparison (group C). The rate of sphincter-saving resection was 71% in group A, 61% in group B, and 42% in group C (group A vs. group C; p < 0.0001). The local recurrence rate at 5 years was 10% in group A, 6% in group B, and 26% in group C (group A vs. group C; p = 0.005). The 5-year survival rate was similar among the three groups. These results suggest that preoperative HDRIBT contributed to the improvement of local control but not to survival after radical resection of rectal cancer. The application of HDRIBT might be useful to restore intestinal continuity for rectal cancer.

Corticosteroid irrigation of parotid gland for treatment of xerostomia in patients with Sjögren's syndrome

OBJECTIVE

To determine the efficacy of corticosteroid irrigation of the parotid gland in relieving salivary flow deficiency in patients with Sjögren's syndrome.

METHODS

The parotid glands of 31 patients with primary (24) or secondary (seven) Sjögren's syndrome were irrigated either with saline solution followed by corticosteroid solution, or with saline solution alone. Salivary function was assessed by Saxon test.

RESULTS

Corticosteroid irrigation significantly increased the salivary flow rate in patients with Sjögren's syndrome (p < 0.0001), with clinical improvement detectable 3.7 (2.4) weeks (mean (SD)) after initial corticosteroid irrigation. The extent of improvement in salivary function was reciprocal to the clinical severity of the disease, with patients at the early stages obtaining 1.20 (0.57) g net increase in salivary flow rate, and patients at the most advanced stages obtaining 0.20 (0.47) g net increase. Repeated corticosteroid irrigations did not evoke corticosteroid refractoriness of the salivary gland; similar levels of net increase in salivary flow rate were observed after the second to fourth challenge of the corticosteroid in these patients. The sustained period was 8.4 (3.5) months (mean (SD)).

CONCLUSION

These findings suggest the clinical usefulness of corticosteroid irrigation therapy in relieving xerostomia in patients with Sjögren's syndrome.

Transluminal percutaneous septal myocardial ablation in a patient with hypertrophic obstructive cardiomyopathy

Reduction of septal mass by inducing septal infarction using catheter techniques is a new therapy for hypertrophic obstructive cardiomyopathy (HOCM). We report a case of severe HOCM that was dramatically improved by this non-surgical treatment. A 60-year-old woman with HOCM had suffered dyspnea (NYHA class III) with syncopal attack despite medical treatment. Left heart catheterization showed a resting pressure gradient across the left ventricular outflow tract of 156 mmHg. Two proximal septal branches of the anterior descending coronary artery were catheterized with a balloon catheter by the usual percutaneous coronary angioplasty techniques and were completely blocked by injection of absolute alcohol. The pressure gradient decreased to 26 mmHg after the procedure. Symptoms were markedly improved (NYHA class I) without any medical treatment. The reduced pressure gradient was maintained at the 3-month follow-up catheterization (36 mmHg). Further long-term follow-up is needed, but this treatment would seem to to be a promising technique for reducing pressure gradient in symptomatic patients with HOCM.

MR features of the lacrimal gland in Sjögren's syndrome

OBJECTIVE

Our purpose was to investigate the MR features of the lacrimal glands in patients with Sjögren's syndrome.

SUBJECTS AND METHODS

Using MR imaging, we examined 58 lacrimal glands in 29 women with Sjögren's syndrome and 150 lacrimal glands in 75 female control subjects. The patients ranged in age from 21 to 76 years, and the control subjects ranged in age from 0 to 78 years. We analyzed the thicknesses and internal signal intensity patterns of the lacrimal glands and compared the results with lacrimal flow rates using Schirmer's test.

RESULTS

On the basis of the profile of normal age-related decreases in lacrimal gland thickness that we obtained from our control subjects, we categorized the lacrimal glands in the patients with Sjögren's syndrome as hypertrophic (7.8 +/- 0.8 mm), normal-sized (4.8 +/- 1.2 mm), or atrophic (2.4 +/- 0.5 mm). The patients had slower lacrimal flow rates than did the control subjects. Atrophic lacrimal glands had slower lacrimal flow rates (1.8 +/- 1.2 mm/5 min) than did normal-sized (5.2 +/- 2.8 mm/5 min) and hypertrophic (4.3 +/- 2.6 mm/5 min) glands. Normal-sized lacrimal glands with homogeneous MR features had faster lacrimal flow rates (7.6 +/- 2.2 mm/5 min) than did normal-sized glands with heterogeneous MR features (4.0 +/- 2.4 mm/5 min). Fat suppression studies showed that fat deposition was accelerated in the lacrimal glands of patients with Sjögren's syndrome.

CONCLUSION

These results suggest that change in size associated with accelerated fat deposition may be the characteristic MR feature of lacrimal glands affected by Sjögren's syndrome. Thus, MR imaging could be a useful tool for assessment of the extent of lacrimal gland involvement in patients with Sjögren's syndrome.

Random amplified polymorphic DNA observed in Eucalyptus by PCR study with random primers

A total DNA extracted from Eucalyptus globlus, E. citriodora, or a subspecies of E. gunnii (Maruha Yu-kari) being used as an template, Polymerase Chain Reaction (PCR) was performed with 40 kinds of commercially available random primers (Operon, OPA-01-20 and OPB-01-20). After electrophoresis of PCR-products on agarose gel, we analyzed the band pattern formed by DNA-fragments with 0.5-3.0 kbp as molecular weight. As a remuneration for the examination in which forty 10-mer arbitrary oligonucleotides were tried to be used as primers in PCR for each species, we found that 9 primers (for E. globlus) leads polymorphism, 6 primers for E. citriodora, and 6 primers for Maruha Yu-kari.

Novel primers designed for microsatellite loci in Eucalyptus and identification by PCR fingerprints

We found a novel PCR-primer which can be used for the identification on "elite-tree-selection". This primer was designed for selective hybridization at the both ends of microsatellite loci, which is well known as one of the most highpervariable region of DNA. After PCR-fingerprinting on five Eucalyptus species (E. globulus, E.citriodora, E.grandis, E. maidenii, E.bicostata), with our primer, DNA-polymorphism was observed all over the cases.

Enhanced glomerular expression of caldesmon in IgA nephropathy and its suppression by glucocorticoid-heparin therapy

BACKGROUND

Activation and consequent phenotypic modulation of mesangial cells is considered to play a crucial role in the process of glomerular disease progression. Caldesmon, a calmodulin and actin-binding protein, is a molecular marker of the phenotypic change in smooth-muscle cells.

SUBJECTS AND METHODS

We studied whether the expression of caldesmon in mesangial cells was enhanced in the process of IgA nephropathy and whether it would be a marker of mesangial activation indicating prognostic significance in specific disease states. We performed immunohistochemical staining with anticaldesmon and alpha-smooth-muscle actin (alpha-SMA) antibodies in 32 biopsy specimens from IgA nephropathy patients and analysed them quantitatively with a computer-aided manipulator.

RESULTS

The glomerular expression of caldesmon was enhanced in IgA nephropathy patients. We compared caldesmon expression with composite histological scores (cell score and matrix score), clinical parameters and expressions of alpha-SMA. There was a statistically significant correlation between the caldesmon score and the histological scores (cell score and matrix score, P<0.0001, P<0.01 respectively). Patients showing a high intensity of caldesmon expression (defined as caldesmon score > or = 35; H-group) had significantly higher urinary protein excretion than those showing a low intensity of caldesmon expression (defined as caldesmon score < 35; L-group) (1.2 +/- 1.2 g/24 h vs 0.41 +/- 0.53 g/24 h, P<0.05). Caldesmon and alpha-SMA expression had a statistically significant correlation (P<0.000). Next, 13 patients were treated with glucocorticoid-heparin for 4-8 weeks and re-biopsies were performed. After the therapy, the caldesmon and alpha-SMA scores were significantly lower than those before the therapy (P<0.01).

DISCUSSION

These results suggest that the expression of caldesmon in glomeruli is associated with the progression of IgA nephropathy, and that glucocorticoid heparin therapy may reverse the phenotype of mesangial cells during the disease process of glomerulonephritis.

Emergency coronary artery bypass grafting after left coronary artery rupture: a case report

Coronary artery rupture has been known as one of the complications of coronary balloon angioplasty. In this report, we describe a case of coronary artery rupture, who underwent emergency surgery for hemostasis and coronary revascularization. A 67-year-old-male with frequent angina attacks was admitted to our institution for possible coronary angioplasty. Coronary angiogram showed diffuse disease of the mid left anterior descending artery (LAD), with two 90% stenosis. Conventional balloon angioplasty was performed, however, coronary artery rupture occurred while the stent was expanded with a 3.5 mm balloon catheter. Though pericardial drainage improved his hemodynamic state, subsequent coronary angiogram revealed leakage of contrast medium. Emergency surgery was determined at this point for hemostasis and revascularization of the LAD. The revascularization was completed with the left internal thoracic artery (LITA) to the LAD. On the contrary, since the epicardial hemorrhage around the proximal LAD did not spread any further after systemic heparinization, the epicardial surface was covered with a piece of oxidazed cellulose and fibrin glue. After the surgery, the hemodynamic state improved gradually. Postoperative coronary angiogram revealed an aneurysm of the LAD, as well as excellent LITA-LAD patency.

Assessment of the angiotensin II-forming pathway in human atria

A cardiac angiotensin II-generating system is thought to be involved in cardiac fibrosis. Both angiotensin-converting enzyme (ACE) and human chymase can convert angiotensin I to angiotensin II. However, the relative contributions of these two enzymatic pathways to angiotensin II generation in vivo remain to be clarified. In 31 patients with heart diseases, we assessed the expression levels of mRNAs for collagen type I-alpha, ACE, and chymase in right atrial appendages by competitive reverse transcriptional polymerase chain reaction and Northern blot analyses. The expression level of the ACE mRNA was about 100 times higher than that of the chymase mRNA. The collagen type I-alpha mRNA concentration was significantly and positively correlated with both the mean pulmonary arterial pressure (r = 0.414; P = 0.020) and the ACE mRNA concentration (r = 0.548; P = 0.0014). However, the chymase mRNA concentration was not correlated with the collagen type I-alpha mRNA concentration. Multivariate regression analysis revealed that the collagen type I-alpha mRNA concentration was related to the ACE mRNA concentration (P = 0.0028) and to the mean pulmonary arterial pressure (P = 0.0386) [r = 0.633, P < 0.0008]. The present results suggest that ACE may affect tissue angiotensin II levels in human atria. However, we obtained no evidence that chymase is important in determining tissue angiotensin II level.

Quantitative expression of thrombopoietin receptor on leukaemia cells from patients with acute myeloid leukaemia and acute lymphoblastic leukaemia

Using a non-isotopic ligand binding assay, we quantitatively examined the amount of human thrombopoietin (TPO) receptor (TPO-R) on leukaemia cells from 128 patients with acute myeloid leukaemia (AML) or acute lymphoblastic leukaemia (ALL). The TPO-R was expressed in 53 (47%) of 114 AML cases, and an in vitro treatment with TPO led to proliferation (stimulation index >1 5) of leukaemia cells in 13 (20%) of 66 AML cases examined. The TPO levels had no relation to the FAB classification except for FAB-M7 AML. All five FAB-M7 cases expressed TPO-R, and one of three FAB-M7 examined showed in vitro proliferative response to TPO. Although there was no significant correlation (r = 0.3125) between the amount of TPO-R and the proliferative response, all of the AML cases which showed the in vitro response had TPO-R expression. There was no relationship between TPO-R amount and CD phenotypes, or the amount of granulocyte-colony stimulating factor (G-CSF) receptor. TPO-R was also expressed in two (14%) of 14 cases of ALL, and only these two cases had in vitro proliferative response to TPO. One had only lymphoid antigens, and the other had both lymphoid and myeloid antigens. Our results suggest that some leukaemia cells express functionally active TPO-R.

Cicletanine-induced decreases in cytosolic Ca2+ level and contraction in vascular smooth muscle

The mechanism by which cicletanine (3-(4-chlorophenyl)-1,3-dihydro-7-hydroxy-6-methylfuro-[3,4-c]pyri dine) induces vasodilatation was examined in isolated vascular smooth muscle. Cicletanine inhibited the contraction induced by high K+, norepinephrine (NE) and prostaglandin F2alpha in a concentration-dependent manner in rat aorta. High K+ (15.8-72.7 mM) elicited elevation of cytosolic Ca2+ level ([Ca2+]i) and contraction in a concentration-dependent manner. Cicletanine (300 microM) inhibited the high K+-induced contractions without changing the [Ca2+]i/tension relationship. NE (3-300 nM) elicited greater contractions than high K+ at a given [Ca2+]i, suggesting that NE increased Ca2+ sensitivity of the contractile elements. Cicletanine inhibited the NE-induced contractions without changing the slope of the [Ca2+]i/tension relationship. Cicletanine inhibited the transient increases in both [Ca2+]i and muscle tension elicited by NE but not the transient increase in [Ca2+]i elicited by caffeine in Ca2+-free solution. Cicletanine did not inhibit contraction induced by Ca2+ in the permeabilized rabbit mesenteric artery with alpha-toxin. These results suggest that cicletanine inhibits vascular smooth muscle contraction by multiple mechanisms: 1) inhibition of Ca2+ influx via voltage-dependent Ca2+ channel and 2) inhibition of Ca2+ release mediated by the alpha-adrenoceptors, but not by caffeine.

Deep facial infections of odontogenic origin: CT assessment of pathways of space involvement

PURPOSE

We investigated the pathways of spread of odontogenic infection in the facial and neck spaces.

METHODS

CT scans of 45 patients with extensive spread of odontogenic infection into the facial and neck spaces were analyzed to document pathways of spread.

RESULTS

Odontogenic infections arising in the mandible first spread upward, into the masseter and/or medial pterygoid muscles in the masticator space, and downward, into the sublingual and/or submandibular spaces, and then spread into the spaces or muscles adjacent to one or more of these locations. Infections from the masseter muscle spread into the parotid space to involve the temporalis and lateral pterygoid muscles. Infections from the medial pterygoid muscle spread into the parapharyngeal space to involve the lateral pterygoid muscle. Infections in the maxilla did not spread downward; instead, they tended to spread upward and superficially into the temporal and/or masseter spaces and deeply involve the lateral and/or medial pterygoid muscles in the medial masticator space.

CONCLUSION

CT may be useful to depict the extent of infection and to plan treatment of extensive odontogenic infection, which can be life threatening when therapy is ineffective.

Amount of mpl on bone marrow haemopoietic precursor cells from healthy volunteers and patients with refractory anaemia

Using a non-isotopic ligand binding assay using multi-colour flow cytometry, we quantitatively examined the amount of mpl in megakaryocyte-platelet lineage cells. Firstly, we quantified the amount of mpl on cell lines. Mpl gene-transfected BaF3 cells expressed a large amount of mpl, whereas original BaF3, K562, HL-60 and NOMO-1 cells showed no mpl. In bone marrow cells from healthy volunteers, mpl was expressed on CD34+ cells from the very early stage of differentiation when they had no CD38 antigen. The amount of mpl increased with differentiation to CD34+ CD41+ cells, but decreased with further differentiation to CD34- CD41+ cells. In CD34+ CD41+ cells the amount of mpl varied according to cell size: abundant in large cells, moderate in medium-size cells and a little in small cells. In bone marrow cells from patients with refractory anaemia (RA), the amount of mpl was decreased compared with that in bone marrow cells from healthy volunteers. When analysed by the same CD phenotype and same cell size, the amount of mpl was less in RA patients compared with that in healthy volunteers in all phenotypes and sizes tested. The proportion of large CD34+ CD41+ cells was less in RA patients than in normal volunteers.

Molecular cloning of the cDNA for the catalytic subunit of plant DNA polymerase alpha and its cell-cycle dependent expression

BACKGROUND

DNA polymerase alpha has been studied in considerable detail in yeast and animals. Genetic and biochemical analyses reveal that this enzyme is composed of a heterotetramer and is necessary for replicon initiation and primer synthesis in lagging strand synthesis. In spite of the fact that modes of DNA replication in plants seem to be similar to those in other eukaryotes, very little is known about the biochemical components that participate in DNA replication of plants, including DNA polymerases.

RESULTS

Using a 561-base pair DNA fragment, obtained by polymerase chain reaction amplification from a rice cDNA library as a probe, we isolated and sequenced a cDNA homologous to the cDNA for the catalytic subunit of rice DNA polymerase alpha. The encoded polypeptide has extensive homology with the catalytic subunit of DNA polymerase alpha from several species. Furthermore, when the cDNA was expressed in eukaryotic transcription/translation systems, the protein products showed DNA polymerase activity which was inhibited by a monoclonal antibody specific for DNA polymerase alpha. Using RNA gel blot analysis, we found that the levels of mRNA of the catalytic subunit of this enzyme is regulated during the cell-cycle in plant cells.

CONCLUSION

This is the first report which describes the cDNA cloning of plant DNA polymerase. We conclude that the principal features of the DNA polymerase alpha catalytic subunit are conserved in plants.

Prevalence of goiter and urinary iodine excretion levels in children around Chernobyl

The prevalence of goiter among children living in areas affected by the Chernobyl accident was investigated by analysis of data on approximately 120,000 children examined at five medical diagnostic centers in Belarus, Russia, and the Ukraine. Examinations of thyroid gland were conducted with an arch-automatic ultrasonographic instrument at the five centers under the same protocol. The diagnosis of goiter was established when the thyroid volume exceeded a limit calculated from age, height, and body weight of a child. A considerable variation by region was noted in the prevalence of goiter. Highest in the Kiev region, the prevalence in the five regions was 54% in Kiev, 38% in the Zhitomir regions of the Ukraine, 18% in Gomel, 22% in the Mogilev regions of Belarus, and 41% in the Bryansk region of Russia. Urinary iodine content was measured in approximately 5700 children, and an endemic iodine deficient zone was confirmed in the Bryansk, Kiev, and Zhitomir regions. A significant negative correlation was observed between the prevalence of goiter and the median level of urinary iodine content (Spearman's rank correlation coefficient was -0.35, P = 0.025).

Central facial weakness due to medial medullary infarction: the course of facial corticobulbar fibres

Two patients are reported with contralateral hemiparesis including a face of supranuclear type, caused by an infarct of the unilateral ventromedial part of the upper medulla. Data from these patients support the hypothesis that part of the corticobulbar fibres supplying the lower facial muscles descend ipsilaterally in the ventromedial part of the upper medulla and then, after decussation, ascend rostrally to the contralateral facial nucleus.

A remote conference system for image diagnosis on the World-Wide Web

OBJECTIVE

The World-Wide Web on the Internet enables an exchange of multimedia information among remote desktop computers. Therefore, a teleradiology system using the Web would allow remote consultation with expert radiologists. Our objective was to establish a Web-based prototype system for image interpretation.

CONCLUSION

Our system allows a physician to transmit clinically useful images to an expert radiologist at a different location, who can see them on a Web browser and discuss diagnoses with the physician.

Effects of gamma-butyric acid on the release of thyrotropin-releasing hormone from the rat retina in vitro

Effects of gamma-butyric acid (GABA) on the release of thyrotropin-releasing hormone (TRH) from the rat retina in vitro were studied. The rat retina was incubated in medium 199 (pH 7.4) with 1.0 mg/ml of bacitracin and 100 micrograms/ml of ascorbic acid (medium). The amount of TRH release into the medium was measured by radioimmunoassay. The TRH release from the rat retina was inhibited significantly in a dose-related manner with the addition of GABA, but not with bicuculline. The inhibitory effect of GABA on TRH release from the retina was blocked by adding bicuculline to the medium. The findings suggest that the GABAergic system inhibits TRH release from the rat retina in vitro.

[Moderately differentiated adenocarcinoma of the rectum: a case report of remarkable response to preoperative administration of FT suppository]

A 50-year-old man with moderately differentiated adenocarcinoma of the rectum was operated upon following preoperative administration of FT suppository. Digital examination, colonoscopy, and barium enema showed an elevated lesion with central ulcer of the rectum. Microscopically, the biopsy specimen demonstrated moderately differentiated adenocarcinoma. FT suppository (1,500 mg/day for 52 days, total 78 g) was administered on an outpatient basis. Rectal amputation including lymph node dissection was performed. The tumor markedly reduced in size and changed into a small ulcer in the resected specimen. Microscopically, the tumor degenerated and changed into xanthogranulomatous tissue with foamy histiocytes. Only two tubules of degenerated adenocarcinoma remained. FT suppository for rectal cancer is considered to be safe and effective.

Necrotizing granulomatous vasculitis of transverse colon and gallbladder

A 52-year-old man suffering neither from allergies or asthma, with necrotizing granulomatous vasculitis (allergic granulomatosis) of the transverse colon and gallbladder is presented. During an emergency laparotomy, segmental necrosis of the mesenteric side of the mid-transverse colon, and a bulky enlarged gallbladder were found. The affected colon was resected and cholecystectomy was performed. Histological findings included necrotizing granulomatous vasculitis of the small- and medium-sized muscular arteries and adjacent veins with tissue infiltration by eosinophils and extravascular eosinophilic granulomas. These histological features were compatible with allergic granulomatous angitis described by Churg and Strauss (CSS). The patient had neither asthma nor involvement of two or more extra-pulmonary organs which is a key clinical criteria of CSS and fulfilled the criteria of eosinophilia alone. Although pulmonary vasculitis was not confirmed in this patient, the histological diagnosis of this patient was definitive CSS. Localised PAN with allergic granulomatosis or an isolated or limited form of CSS based on these clinical features may be an alternative entity.

Association of an acute reduction in lipoprotein(a) with coronary artery restenosis after percutaneous transluminal coronary angioplasty

BACKGROUND

Lipoprotein(a) [Lp(a)], which structurally resembles-tissue-type plasminogen, is reported to be associated with coronary atherosclerosis. We examined whether the acute change in Lp(a) by percutaneous transluminal coronary angioplasty (PTCA) is related to restenosis after PTCA.

METHODS AND RESULTS

We measured serum Lp(a) and other lipid parameters (triglycerides and total, LDL, and HDL cholesterol) before and 1 day after PTCA in 143 procedures and 3 days after and 4 months after PTCA in 62 procedures. Quantitative coronary angiography was performed, and restenosis was defined according to three criteria: (1) clinical recurrence of ischemic symptoms, (2) a final stenosis > 50%, and (3) an absolute decrease in minimal lumen diameter > 1/2 of the acute gain in the dilated segment. Restenosis was recognized in 25.9%, 35.7%, and 38.5% of the cases 4 months after PTCA for each criterion, respectively. Although triglyceride and LDL, HDL, and total cholesterol levels were similar in the restenosis and no-restenosis groups before PTCA, Lp(a) was significantly higher in the restenosis group. We found a significant reduction in Lp(a) in the restenosis but not the no-restenosis group 1 day after PTCA. At 3 days after and 4 months after PTCA, Lp(a) was similar in the two groups. A multivariate-analysis revealed that the absolute change in Lp(a) (before versus 1 day after PTCA) to be the sole significant predictor of restenosis among the clinical, angiographic, and plasma lipid parameters examined.

CONCLUSIONS

Lp(a) levels were significantly higher in the restenosis group, and they fell significantly after PTCA in the restenosis group.

CP2289, a new 5-HT3 receptor ligand: agonistic activities on gastroenteric motility

A new 5-HT3 receptor ligand, CP2289, was synthesized and pharmacologically tested. Although CP2289 inhibited the Bezold-Jarisch reflex, it contracted the excised ileal muscle of mice, rats and guinea pigs. This response may reflect a partial agonist character of CP2289 in the gut. In vivo antiemetic and gastric emptying tests gave similar results.

Genetic mutations of butyrylcholine esterase identified from phenotypic abnormalities in Japan

We have identified 12 kinds of genetic mutations of butyrylcholine esterase (BCHE) from phenotypic abnormalities, showing that BCHE activities were deficient or diminished in sera. These genetic mutations, detected by PCR-single-strand conformation polymorphism analysis and direct sequencing, consisted of one deletion (BCHE*FS4), nine missense (BCHE*24 M, *1005, *250P, *267R, *330I, *365R, *418S, *515C, *539T), and two nonsense mutations (BCHE*119STOP, *465STOP). All of the individuals deficient in serum BCHE activity were homozygous for silent genes (6 of 6). Fifty-eight percent of the individuals (31 of 53) with slightly reduced serum BCHE activity were heterozygous for silent genes. They also showed a higher frequency (47% as allele frequency) of the K-variant than the general population (17.5%). Finally, we confirmed low serum BCHE activity in 10 of 23 individuals heterozygous for silent genes.

High Critical-Current Density in the Heavily Pb-Doped Bi2Sr2CaCu2O8+delta Superconductor: Generation of Efficient Pinning Centers

Critical-current density (Jc) is a parameter of primary importance for potential applications of high-temperature copper oxide superconductors. It is limited principally by the breakdown of zero-resistive current due to thermally activated flux flow at high temperatures and high magnetic fields. One promising method to overcome this limitation is to introduce efficient pinning centers into crystals that can suppress the flux flow. A marked increase in Jc was observed in Bi2Sr2CaCu2O8+delta (Bi-2212) single crystals doped with a large amount of Pb. By electron microscopy, characteristic microstructures were revealed that probably underlie the observed enhancement in Jc: thin (10 to 50 nanometers), platelike domains having a modulation-free structure appeared with spacings of 50 to 100 nanometers along the b axis.

Effects of 5'-DFUR and OK-432 on cytokines and thymidine phosphorylase in tumor tissue of gastric cancer patients

BACKGROUND

The purpose of the study was to verify whether OK-432 in combination with 5'-DFUR induced thymidine phosphorylase (TdR Pase) and cytokines in gastric cancer patients as well as in vitro.

MATERIALS AND METHODS

Fifty patients with invasive gastric cancer were randomly assigned, upon admission using by a closed-envelope technique, to either a group receiving 5'DFUR or OK-432 alone, to a group receiving both 5'DFUR and OK-432, or to a non- treated group up. Surgical specimens of the tumor and normal tissues were taken soon after gastrectomy to evaluate TdR Pase activity, IL-1 alpha and TNF-production.

RESULTS

TdR Pase activities were several times higher in tumor than in normal tissues. In normal tissues, TdR Pase activities in the 5'-DFUR + OK-432 group were significantly higher than in the OK-432 group. TdR Pase activity in tumors, however, showed no significant difference between treated group. In the 5'-DFUR + OK-432 group, the level of IL-1 alpha production in tumor was significantly higher compared to the control group. In the 5'-DFUR + OK-432 group, the level of TNF alpha production in tumor was significantly higher than in normal tissue. TNF alpha production in tumor showed no significant difference in each treated group compared to the control. There was a significant correlation between TdR Pase activity and IL-1 alpha production levels in tumor.

CONCLUSIONS

TdR Pase was induced by IL-1 alpha in tumor tissues of gastric cancer patients. OK-432 in combination with 5'-DFUR, however, did not induce TNF alpha and IL-1 alpha, and increase TdR Pase activity in gastric cancer tumors.

Premature fat deposition in the salivary glands associated with Sjögren syndrome: MR and CT evidence

PURPOSE

To investigate abnormal fat deposition in the major salivary glands associated with Sjögren syndrome.

METHODS

We analyzed the fat deposition in the parotid and submandibular glands of 33 patients with Sjögren syndrome by using short-inversion-time inversion recovery (STIR) and fat-saturation MR sequences and CT values.

RESULTS

All three in vivo techniques substantially confirmed premature deposition of fat in the major salivary glands in association with Sjögren syndrome. Furthermore, this change was characteristic of Sjögren syndrome, and the severity of fat deposition correlated well with the impaired rates of salivary flow in these patients.

CONCLUSION

Monitoring of fat deposition might be useful for diagnosing Sjögren syndrome and assessing its progress in patients whose clinical and serologic findings are suggestive of the disease.

Effect of genotype on the angiotensin-converting enzyme mRNA level in human atria

1. To clarify the mechanism of the association between I/D polymorphism of the angiotensin-converting enzyme (ACE) gene and various cardiovascular disease, ACE mRNA levels in human atrial appendages were assessed in relation to the genotype of the ACE gene. 2. Angiotensin-converting enzyme mRNA levels were positively correlated with age and tended to show a positive correlation with mean pulmonary pressure (mPA). Multiple regression analysis indicated that age and mPA, but not the genotype of the ACE gene, were predictors of ACE mRNA levels in human atrial appendages. 3. The present study indicates that I/D polymorphism of the ACE gene is not simply reflected in ACE mRNA levels and that further study is needed to determine the mechanism of the association between this polymorphism and various cardiovascular diseases.

Induction of renin in medial smooth muscle cells by balloon injury

We studied the expression of each component of the renin-angiotensin system (renin, angiotensin I-converting enzyme, angiotensinogen, and angiotensin II type I receptor) in balloon-injured rat carotid artery. We assessed the expression levels of the respective mRNAs by competitive polymerase chain reaction. Renin mRNA concentration was markedly increased 24 hours after balloon injury and remained higher than that in the control at 7 days after balloon injury. Angiotensin-converting enzyme mRNA concentration was decreased 24 hours after balloon injury and was increased at 14 days after balloon injury. No significant change in angiotensinogen mRNA concentration was observed throughout the study period. Angiotensin type I receptor mRNA concentration was increased beginning 3 days after balloon injury and remained higher than that in the control at 14 days after balloon injury. Immunohistochemical analysis showed that renin was transiently expressed in medial smooth muscle cells after balloon injury. Administration of quinapril markedly reduced neointimal formation and was accompanied by an attenuation of the increase in the concentrations of angiotensin type I receptor and angiotensin-converting enzyme mRNAs. The upregulation of renin mRNA in balloon-injured rat carotid artery preceded and may play a role in neointimal formation.

Identification of Eucalyptus citriodora clones micropropagated in tissue culture

The extent of genetic identity observed in the young individuals which were micropropagated from a single Eucalyptus individual was analyzed by using DNA-fingerprinting. Among 40,000 tissue-cultured-seedings of E.citriodora, 200 plants were randomly chosen so that each total DNA might be extracted from their leaves. Using these DNAs as template, PCR was performed with some primers we found in advance that leads polymorphism for DNA of E. citriodora. In this study, all over the 200 cases, the band pattern formed cDNA fragment on a gel after electrophoresis was the identical one mutually.

A young man with acute renal failure and severe loin pain

The first case of exercise-induced acute renal failure (EIARF) is reported measuring the blood flow and arterial resistance in the kidney by pulsed Doppler ultrasound. A 20-year-old Japanese male suffered from severe loin pain and non-oliguric acute renal failure after strenuous exercise. Serum myoglobin and creatine phosphokinase were normal and urinary myoglobin was not detectable. The Doppler pattern in several segmental arteries showed a slow end-diastolic velocity (EV) and a high resistance index (RI), indicating increased renal vascular resistance, which suggested severe renal vasoconstriction. Three days later, the EV had apparently increased and the RI normalized in accordance with improvement of renal function. The ultrasound Doppler technique is useful for the detection of a decrease in arterial blood flow on real time and for the diagnosis of EIARF.

[Preliminary evaluation of the apparent diffusion coefficient of the kidney with a spiral IVIM sequence]

We examined the usefulness of the spiral intravoxel incoherent motion (IVIM) sequence in measuring the apparent diffusion coefficient (ADC) of the kidneys. Five volunteers and five patients with chronic renal failure underwent diffusion-sensitive magnetic resonance imaging of the kidneys with the spiral IVIM sequence. The ADC values in patients with chronic renal failure were significantly lower than those in the renal cortex of volunteers. The mean value of ADC in patients with chronic renal failure was lower than that in volunteers, although there was no statistically significant difference. In volunteers, the ADC of the renal cortex was significantly higher than that of the renal medulla. The phantom study indicated that the accuracy of ADC depended on the signal to noise ratio. A spiral IVIM sequence with a high enough signal to noise ratio may be useful in evaluating renal function especially that of the cortex.

[Central facial weakness due to medullary pyramidal infarction; a case report]

We reported a hypertensive 40-year-old man who developed sudden right hemiparesis, deep sensory disturbance, left hypoglossal nerve palsy, and mild right central facial weakness. MRI of the brain showed an infarct located in the left upper medullary pyramid. Course and connection of the corticobulbar pathway are not well known in human. Recently Cavazos (1996) described a hypothesis that some facial corticobulbar fibers descend caudally ipsilaterally as low as the upper medulla, making a loop before decussating and ascending to the contralateral facial nucleus Contralateral central facial weakness may result from interruption of these descending fibers.

Identification of the nuclear localization signal of mouse DNA primase: nuclear transport of p46 subunit is facilitated by interaction with p54 subunit

DNA polymerase alpha-primase is a replication enzyme necessary for DNA replication in all eukaryotes. Mouse DNA primase is composed of two subunits: a 46 kDa protein (p46), which is the catalytic subunit capable of RNA primer synthesis, and a 54 kDa protein (p54), whose physiological role is not clear. To understand the structure-function relationship of DNA primase, we set out to characterize these two subunits individually or in combination using a cDNA expression system in mammalian cultured cells, and determined the subcellular distribution of ectopically expressed DNA primase. The p54 expressed in COS-1 cells after transfection was predominantly localized in the nucleus, whereas p46 was retained in the cytoplasm as shown by indirect immunofluorescence analysis. Using several mutant proteins with deletions or substitutions as well as chimeric constructs, we identified the nuclear localization signal of p54 as RIRKKLR, encoded near the amino terminus (residues 6–12). Furthermore, co-expression of both p46 and p54 subunits markedly altered the subcellular distribution of p46; co-expressed p46 was transported into the nucleus as efficiently as p54. These results demonstrate that p54 has a nuclear localization signal and is able to be translocated into the nucleus independently of DNA polymerase alpha subunits. In contrast, p46 lacks a nuclear localization signal, and its nuclear translocation is facilitated by interaction with p54. We present here first evidence for a novel role of p54 in the nuclear translocation process, and a piggy-back binding transport mechanism of mouse DNA primase.

Short segment of left colon substitution following proximal gastrectomy

For improved quality of life, limited surgery for early gastric cancer has been preferred over the standard operation with lymph node dissection. Therefore, we have developed a modified technique: the proximal gastrectomy is reconstructed with a short segment of the left colon. The anastomoses of both esophagocolonostomy and colono-gastric remnantstomy are made using stapling devices. A His' angle is formed to reduce reflux esophagitis. We described here the detail of an operative technique.

MR imaging of the lacrimal gland. Age-related and gender-dependent changes in size and structure

PURPOSE

The subject of this study was to define age-related and gender-dependent changes in MR features of the lacrimal gland.

MATERIAL AND METHODS

MR images were retrospectively analyzed in 104 normal subjects aged 2-79 years to measure thickness and area of the lacrimal gland, its MR signal intensity ratio, and SD of the MR signal intensity profile.

RESULTS

Thickness and area of the lacrimal gland decreased with age in women (p < 0.001), but not in men. Furthermore, MR signal intensity ratio of the lacrimal gland showed an age-related increase in women (p < 0.001), but not in men. On the other hand, SD of the MR signal intensity increased with age in both women and men (p < 0.001).

CONCLUSION

These findings demonstrate that gender has a significant influence on lacrimal gland structure during development and aging.

Infarction of superior cerebellar artery presenting as cerebellar symptoms

BACKGROUND

MRI of the brain has facilitated the diagnosis of cerebellar infarction in the territory of the superior cerebellar artery (SCA). We analyzed the data on patients with SCA infarction who presented with only cerebellar symptoms in an attempt to define its underlying pathophysiology.

SUMMARY OF REPORT

Ten patients with SCA infarction who presented with cerebellar symptoms were studied by brain MRI, angiography, and underlying pathology. Brain MRI demonstrated an infarct in the SCA territory in the anterior rostral cerebellum of all patients. None had abnormalities in the brain stem. In four patients, a hemorrhagic infarct was present in the same region. Cerebral angiography revealed no obvious SCA occlusion or atherosclerotic vascular disease in any patient. Eight of the 10 patients had heart disease, such as atrial fibrillation or old myocardial infarction. The presumed diagnosis was occlusion of the SCA in its periphery due to cardiogenic embolism.

CONCLUSIONS

When a patient presents with only cerebellar symptoms and has cerebellar infarction demonstrated by brain MRI, the SCA branch is probably occluded by cardiogenic embolism.

MR imaging of the parotid gland in Sjögren's syndrome: a proposal for new diagnostic criteria

OBJECTIVE

Because classic diagnostic techniques for sjögren's syndrome (SS) are invasive and require radiation exposure, a noninvasive diagnostic method might benefit patients with SS. The purpose of this study was to determine whether quantitative analysis of MR images of the parotid gland can differentiate patients with SS from normal subjects.

SUBJECTS AND METHODS

We performed quantitative analysis of MR images of the parotid gland for 40 patients with definite and probable SS, for 30 normal subjects matched by age and sex to the SS patients, and for 10 patients with parotid inflammation. MR images of teh parotid gland were assessed by calculating standard deviations (SD) of signal intensity.

RESULTS

SD of signal intensity exclusively (p < .0001) separated MR images of the parotid glands of patients with definite SS from those of normal subjects. SD of signal intensity for the parotid glands of patients with probable SS also were significantly higher (p < .001) than those of normal subjects. Changes in signal intensity were specific for SS and did not occur with parotid inflammation. Tentative categorization on the basis of signal intensity patterns on MR images of the parotid glands of SS patients showed a high correlation with the results of labial gland biopsy (r = .834) and sialography (r = .936).

CONCLUSION

Taken together, these results conclusively indicate that quantitative analysis of MR images for SD of signal intensity is useful method for diagnosing SS and can replace classic methods, which are invasive.