Morphological changes of human mandibular bone during fetal periods

Standardized photographs (lateral and basal view) of fetal mandibles (n = 80) were taken. Outline segments (from gnathion to condylion, on the coronoid process and from infradentale to gnathion in lateral view; and on the inferior margin in basal view) were analyzed into sine curves, according to Fourier series. Using the calculated Fourier coefficients, we statistically examined how mandibular shape changed with fetal growth. Materials were classified into four groups on the basis of the body length (BL): 100 < or = BL < 200 mm (BL1, n = 20); 200 < or = BL < 300 mm (BL2, n = 20); 300 < or = BL < 400 mm (BL3, n = 20); and 400 < or = BL < or = 500 mm (BL, 4 = 20). Statistical analyses were all done on these stature groups. On the outline from gnathion to condylion, the constant and the first term phase showed statistically greater values in BL4 than in the other groups, as assessed by t-test. The first term phase for the coronoid process significantly decreased with increments in stature in the canonical disciminant analysis. On the outline from infradentale to gnathion, although the cumulative contributions of the first two terms were constant (about 85%) in all four groups, the relative contributions with growing stature decreased in the first term and increased in the second term. The mean of the phase in the first term indicated slightly more than -90 degrees in BL1, and was less than -90 degrees in BL2 to BL4. The averages of the second term phases presented little change from BL1 to BL3, and were close to -100 degrees. From the canonical discriminant analysis, the constant was great and the first term amplitude was small in BL1 and BL4, and the constant was small and the first term amplitude was great in BL2 and BL3. Also, the second term amplitude in BL4 indicated a significantly bigger volume than in BL3. The constant for the inferior margin manifested statistically significant increments in BL2 to BL4, as assessed by t-test. We interpret the results as follows: 1. On the outline from gnathion to condylion, anteroinferior shift occurs in BL4, resulting in an acute gonial angle. The change of angle during the prenatal period precedes the postnatal findings that bring about a progressive decrease in the gonial angle. 2. The tip of the coronoid process indicates a forward shift with increasing fetal body stature.(ABSTRACT TRUNCATED AT 400 WORDS)

[The clinical manifestations of Sjögren's syndrome in children]

Sjögren's syndrome (SS) is thought to be uncommon in children. We studied the clinical manifestations and laboratory findings of 12 pediatric patients with SS, all of children did not have sicca symptoms but have lymphocytic infiltration of salivary glands, abnormal sialograms or abnormal results of scintigraphy compatible with typical SS. Seven cases had primary SS and five were secondary SS and had other autoimmune disorders (three cases with systemic lupus erythematosus, one case with dermatomyositis, and the other with mixed connective tissue disease). All patients were female. The mean age at onset of symptoms, including other autoimmune manifestations, was 12.2 years (range 9-15 years). The initial symptoms were some systemic manifestations (fever, exanthema, arthralgia, etc.) and various autoimmune phenomena (butterfly rash, Raynaud's phenomenon, proteinuria, weakness of muscles, etc.). On the other hand, no patients complained sicca symptoms. Laboratory studies in our patients revealed elevated levels of IgG (92%), antinuclear antibody (92%), rheumatoid factor (58%), anti-SS-A antibody (75%). These findings were similar to those found in adult patients with sicca symptoms previously reported in literature. From these studies, we suggest that lip biopsy, sialography and/or salivary gland's scintigraphy should be carried out in patients who had abnormal laboratory findings as mentioned above, irrespective of absence of sicca symptoms, in order to diagnose SS at early period.

Identification of the disease-related T cell epitope of ovalbumin and epitope-targeted T cell inactivation in egg allergy

An ovalbumin (OVA)-specific T cell line (TCL) was established from a patient with hen egg allergy. The TCL was CD4+, expressed alpha beta T cell receptor, and recognized OVA presented by HLA-DR10. Based on the response of the TCL to synthetic OVA peptides, it was found that the TCL recognized OVA 323-339, which is a major T cell epitope presented by murine I-Ad. The TCL secreted high levels of IL-5, but undetectable amounts of IL-2, interferon-gamma, and IL-4 when stimulated with OVA or the OVA 323-339 peptide. Since IL-5 is an important growth and chemotactic factor for eosinophils, it is possible that these OVA 323-339-specific T cells can contribute to human egg allergy. To our knowledge, this is the first demonstration of food allergen-specific TCL establishment and identification of a T cell epitope possibly related to the allergic reaction to food antigens. An analog peptide of the OVA 323-339 which is known to strongly bind to I-Ad partially inhibited the response of the TCL to OVA 323-339 presented by HLA-DR10, raising the possibility of peptide-based immunotherapy of food allergy.

[Long-term follow-up in patients receiving anticoagulation therapy: potency of therapy and complications]

Many clinical trials have demonstrated the effectiveness of oral anticoagulation for the primary and secondary prevention of venous thromboembolism, myocardial infarction, systemic embolism and stroke. However, the relationship between potency and/or changes in anticoagulation therapy and frequency of complications is not clear. This study retrospectively investigated 157 patients (valvular heart disease 37, artificial valve replacement 19, atrial fibrillation 11, ischemic heart disease 55, post coronary artery bypass grafting 25, others 10: mean age 55 +/- 12 years) who received oral anticoagulation therapy for 4.9 +/- 3.2 years to investigate the development of complications. The thrombotest and prothrombin time were measured at follow-up examinations every month (mean interval 31 days). Target range of anticoagulation was 2.5 to 3.5 (international normalized ratio: INR). During the 770 patient-years of follow-up, seven major bleedings (cerebral, renal, gastrointestinal, etc.), 111 minor bleedings (subcutaneal, nasal, gum, etc. bleeding), 16 major thromboembolisms (cerebral, renal, etc. infarction) and 4 minor thromboembolisms (transient ischemic attack) were observed. INR at the onset of the complications was 2.93 +/- 0.41 in patients with bleeding and 1.81 +/- 0.46 in those with thromboembolism. INR was greater than 2.75 in all patients with major hemorrhage and less than 2.75 in those with major thromboembolism. Seventy-five percent of bleeding complications developed at the increasing phase of INR and 70% of thromboembolism at the decreasing phase. Cumulative rates free from bleeding complications with a mean INR of < or = 2.0, 2.0-2.5 and > 2.5 were 76.8, 62.8 and 45.5%, respectively, at 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Effective induction of human NK cells with OK-432 and further augmentation of their cytolytic function by rIL-2

Low concentrations of exogenously added recombinant interleukin 2 (rIL-2) were able to augment OK-432-induced natural killer (NK) cell activity. This kind of augmenting effect depended on the dose of rIL-2 and manifested itself only in PBMC stimulated with OK-432 (OK-MC) followed by rIL-2; augmentation did not happen in the reverse order. The existence of CD16+/CD25+ (IL-2 receptor positive; IL-2R+) and CD57+/CD25+ double positive cells which possess NK cell surface markers in OK-MC markedly increased in a long-term culture (12 days). A strong positive correlation was observed between the IL-2-dependent augmentation of NK activity and the quantitative changes in cell populations that possessed NK cell phenotypes. Treatment of the day-12-OK-MC with monoclonal anti-CD56 antibody plus complement could almost completely abrogate the augmented NK cytotoxicity. Furthermore, this augmenting effect was detectable within 4 hr after addition of rIL-2 at single cell level, suggesting that the effect did not require NK cell's DNA synthesis. Thus it was suggested that OK-432 could promote and upregulate the expression of IL-2 receptor (CD25) on CD56+ NK cell populations. Moreover, it was considered that the interaction of low concentration rIL-2 with IL-2 receptors on OK-432-activated NK cells could augment their lytic function.

[Chemical iodination of hormonogenic tyrosine residues of human thyroglobulin is critical for the production of anti-thyroglobulin autoantibody and for the induction of experimental autoimmune thyroiditis in mice]

There is evidence from animal models that the iodine content of thyroglobulin (Tg) may influence its antigenicity in thyroid autoimmunity. To elucidate the effect of iodination of hormonogenic sites of human Tg (hTg) on its autoantigenicity, a synthetic peptide (TB: hTg 2546-2571), containing two hormonogenic tyrosine residues of hTg, and a chemically-iodinated peptide (TB-I) were prepared. We immunized C3H/He (H-2k) mice, a high responder strain to Tg, and BALB/c (H-2d), a low responder strain, with TB or TB-I plus lipopolysaccharide. Lymph node cells from the two strains immunized with TB or TB-I proliferated in response to both TB and TB-I. Anti-Tg autoantibodies were detected in both strains when immunized with TB-I, while immunization with TB failed to produce anti-Tg antibodies. Furthermore, one of the C3H/He mice immunized with TB-I developed diffuse thyroiditis, but BALB/c mice did not. These findings indicate that the iodination of the hormonogenic tyrosine residues of hTg, in other words, the synthesis of mono- and di-iodotyrosine (MIT and DIT) residues, is necessary for the production of anti-Tg autoantibodies in high and low responder mice and for the induction of autoimmune thyroiditis in high responder mice.

Thyroglobulin-specific T cell line from a healthy individual does not produce proinflammatory cytokines on antigenic stimulation: an implication for possible fail-safe mechanism to avoid autoimmunity

In order to investigate the regulation of autoimmune response to thyroglobulin (Tg), one of the thyroid autoantigens, we established a Tg-specific T cell line by stimulation of peripheral blood mononuclear cells from a healthy volunteer with Tg and characterized its cytokine production pattern. The Tg-specific T cell line, designated DH5D1, obtained from a limiting dilution culture bore alpha beta T cell receptor and was CD4 and CD45RO positive. Upon stimulation with Tg, DH5D1 secreted little or no titers of IL-2, TNF-alpha, and IFN-gamma, whereas activation with combination of phorbol myristate acetate and calcium ionophore produced measurable levels of these cytokines. These results indicate that the Tg-specific T cell line is not defective in its capacity to produce proinflammatory cytokines and suggest that the inability of cytokine production by autoreactive T cells of healthy individuals is one fail-safe mechanism for preventing aggression of harmful autoimmune response.

An immunohistochemical study of sensory and autonomic innervation of the dog tongue with special reference to substance P- and calcitonin gene-related peptide-containing fibers in blood vessels and the intralingual ganglia

The distribution, pathways and origins of peptide-containing nerve fibers in the anterior two thirds of the dog tongue were investigated using immunohistochemistry combined with retrograde axonal tracing and denervation experiments. Within the epithelium of the fungiform papillae, varicose nerve fibers immunoreactive to substance P (SP) and calcitonin gene-related peptide (CGRP) were present. These disappeared completely after severance of the lingual nerve (LN) alone. Dense CGRP-immunoreactive varicose fibers surrounded cell bodies in the intralingual ganglia (ILG), which consisted of neurons immunoreactive to vasoactive intestinal polypeptide (VIP), neuropeptide Y (NPY) and SP. These CGRP-immunoreactive fibers disappeared following severance of the chorda tympani (CT) alone. SP-, CGRP-, VIP-, NPY- and tyrosine hydroxylase (TH)-immunoreactive nerve fibers were distributed around the walls of blood vessels, especially arteriovenous anastomoses (AVAs). None of these immunoreactive fibers completely disappeared after severance of the LN or CT alone, but SP- and CGRP-immunoreactive fibers disappeared following severance of both the LN and CT. TH-immunoreactive fibers disappeared after ganglionectomy of the superior cervical ganglion (SCG) or severance of the hypoglossal nerve (HGN). VIP- and NPY-immunoreactive fibers invariably remained after various denervation experiments. In tracing experiments, CGRP-immunoreactive as well as SP and CGRP-immunoreactive cells in the trigeminal ganglion were labelled from the LN, and those in the geniculate ganglion and jugular ganglion were labelled from the CT. A large number of neurons in the SCG were labelled from the HGN, with some of these being SP and CGRP-immunoreactive. These results demonstrate that SP- and CGRP-immunoreactive fibers from the trigeminal ganglion are distributed to the lingual epithelium; vascular walls receive SP- and CGRP-immunoreactive sensory fibers from the LN as well as CT, some SP and CGRP-immunoreactive fibers from the SCG in addition to catecholaminergic sympathetic fibers, and VIP- and NPY-immunoreactive parasympathetic fibers from the ILG. The ILG is also considered to be innervated by CGRP-immunoreactive sensory fibers from the CT.

Magnetic resonance imaging of oral and maxillofacial angiomas

Eleven patients with oral and maxillofacial angiomas (seven hemangiomas and four lymphangiomas) were evaluated with magnetic resonance imaging using a 0.2-T permanent system and spin-echo pulse sequences. These lesions typically had signal intensities that were iso T1-weighted, similar to muscle, and high T2-weighted, greater than subcutaneous fat. Nine tumors had well- or relatively well-defined margins, and seven cases had curvilinear structures of low signal intensities in the masses on T2-weighted images. It was impossible to distinguish hemangiomas from lymphangiomas on MR images. Our experience suggested that most angiomas of oral and maxillofacial regions present special characteristics on magnetic resonance images. It is thought that information obtained with magnetic resonance images can contribute significantly to the evaluation of the extent of these lesions.

Multimodality imaging of cervicofacial actinomycosis

Actinomycosis is an uncommon chronic disease usually caused by Actinomyces israelii. It affects the soft tissue mainly but sometimes spreads to involve salivary glands, bone, or even the skin of the face and neck. Five cases have been seen in our department. Several imaging modalities were used to assist in making the diagnosis. The cases are presented and the literature reviewed. Ultrasonography was found to be a useful diagnostic tool especially in developing the differential diagnosis.

[Multivariate analysis of mandibular morphology with fetal growth by means of the soft standardized radiographs]

Mandibular growth of the fetus is a great matter of importance to anatomy, anthropology and also oral and Maxillofacial surgery. The postnatal changes of the mandible that have occurred with growth have been reported by numerous investigators. However, a few researchers have investigated the prenatal growth of the mandible. The purposes of this study were discussed how to change in size and shape of the mandible during the fetal period. The materials consisted of 162 human fetuses from the body length (BL) of 95 mm, to 500 mm. They were divided into four groups: 95-199 mm (BL1, N = 40), 200-299 mm (BL2, N = 76), 300-399 mm (BL3, N = 26), 400-500 mm (BL4, N = 20). All specimens were stored in formalin, and only those free from gross deformation were selected for study. The heads were removed by decapitation at the level of the hyoid bone. The soft standardized radiographs were taken of the frontal, lateral, basal aspects. They were used for tracing and angular and linear measurements (total thirty). The data were used to evaluate the mandibular form by multivariate analysis. They were supported the univariate analysis. The findings leads to the following conclusions: 1) Cluster analysis and principal component analysis were applied to the data to make clear the correlation between 30 variables. Four clusters were constructed at the level ninety similarities in cluster analysis. They were corresponded to four factors were obtained in principal component analysis. 2) The data were subjected to a stepwise discriminant function analysis using the seventeen of original 30 variables. Nine variables, mandibular length (Go-Me), mandibular ramus height (Col-Go), Symphyseal height (Id-Me), mandibular body height (Kr'-beta), gonial angle (< Co2, Go, Me), mental angle (< Id, Pog, Go), gonial width (BGo), alveolar width (BKr'), basal angle of mandible (< RGo, Me, LGo), were selected as the best discriminators. The incidence of correctly classified cases 88.68%. 3) As a result of the first discriminant function of the discriminant analysis and one-way analysis of variance (ANOVA) and t-test, mandibular length (Go-Me), gonial width (BGo), alveolar width (BKr'), Symphyseal height (Id-Me) were longer in tall group that short group (BL4 > BL3 > BL2 > BL1). Therefore, the first discriminant function was accounted for the size factor. 4) In consequence of the second discriminant function of the discriminant analysis and regression analysis, gonial width (BGo) was grown broader than alveolar width (BKr') from BL1 to BL2.(ABSTRACT TRUNCATED AT 400 WORDS)

[Analysis of ovalbumin-specific T cell lines established from patients with hen egg allergy]

Ten ovalbumin (OVA)-specific T cell lines (TCLs) were established from peripheral blood mononuclear cells of 6 patients with hen egg allergy, and the antigen recognition of these TCLs was characterized. Two OVA epitopes were determined by use of 3 synthetic OVA peptides which have been known as murine T cell epitopes. Blocking of antigen-specific T cell proliferation by anti-HLA class II monoclonal antibodies suggest that all 3 HLA class II molecules could act as restriction elements for T cell recognition of OVA. This is the first demonstration of OVA epitopes recognized by T cells in patients with hen egg allergy, as far as we know.

Locoregional immunotherapy of head and neck cancers utilizing allogeneic spleen cells--a report of 2 cases

Frozen-stored human spleen cells (SC) cultured with streptococcus preparation OK-432 acquired direct cytotoxicity to autologous as well as allogeneic tumor cells. The activated cells started to produce cytocidal cytokine TGIF, which is distinct from previously known cytokines. We examined the possibility of allogeneic adoptive immunotherapy (AIT) using these OK-432-stimulated spleen cells (OK-SC) in two cancer patients. Rapid necrosis of cancer tissue and remarkable decreases of tumor markers in tumor effusion were observed. There were no severe side effects.

[International normalized ratio (INR) for optimal anticoagulant therapy]

Optimal therapeutic ranges for an oral anticoagulant therapy has been discussed for many years. Prothrombin time, prothrombin time ratios (PTR) and thrombotest have been employed so far, but, recently, International Normalized Ratio of prothrombin time (PT-INR or INR) has been introduced. We investigated paying special interest to INR, the effectiveness of oral anticoagulant therapy in 170 prosthetic valve patients and in 157 patients with various cardiovascular diseases who received warfarin at two different centers. The thrombotest, prothrombin time and INR were measured at follow-up visits every month. Regarding the 170 patients with prosthetic valves with a mean follow-up period of 2.44 years, 9 thromboembolisms (TE) were reported. The average TT and INR values in TE-free patients among 101 in whom coagulability could be measured, were 21.1% and 1.73 respectively. The average TT and INR values in 5 patients with TE were 26.4% and 1.53 respectively and this was significantly (p < 0.01) higher (smaller) than in TE-free patients. 157 patients (mean age 55 +/- 12 y.o.) with various cardiovascular diseases (Table 2) were followed up for a mean of 4.9 +/- 3.2 years. As is seen in figure 4, mean INR values in TE patients were 1.28, in patients with bleeding complications 4.1, and in event free patients 2.07 respectively. In conclusion, with INR greater than 2.75, no thromboembolic complication occurred, but several hemorrhagic complications occurred at INR greater than 3. Therefore INR therapeutic ranges between 2.0-3.0 are recommendable both for the prevention of TE and bleeding complications.

A common T-cell epitope between human thyroglobulin and human thyroid peroxidase is related to murine experimental autoimmune thyroiditis

We have investigated functional common T-cell epitopes between human thyroglobulin (hTg) and human thyroid peroxidase (hTPO) in mice. Four hTg peptides, Tg-P1, Tg-P2, Tg-P3 and Tg-P4, in which 5 amino acid residues are identical to those of hTPO, and 1 hTPO peptide, TPO-P4 relevant to Tg-P4, were prepared. Among these peptides, only Tg-P4 (residues 2730-2743) and TPO-P4 (residues 118-131) were highly antigenic and both peptides shared the common T-cell epitope. In addition, when the spleen cells from mice immunized with mouse Tg (mTg) were restimulated in vitro by Tg-P4 or TPO-P4 as well as by mTg, these cells transferred thyroiditis to naive recipient mice. These findings indicate that this common T-cell epitope between hTg and hTPO is immunogenic and related to the development of murine experimental autoimmune thyroiditis.

Transient ST elevation and left ventricular asynergy associated with normal coronary artery in aneurysmal subarachnoid hemorrhage

A 62-year-old woman presented with transient ST segment elevation and left ventricular asynergy in an acute phase of subarachnoid hemorrhage (SAH). A coronary arteriogram during ongoing ST elevation showed no fixed stenoses or spasm. These findings refute epicardial coronary vasospasm as a cause of transient ST elevation and left ventricular asynergy in patients with SAH.

Preoperative in vitro chemosensitivity test of esophageal cancer with endoscopic specimens

BACKGROUND

From January 1990 to June 1991, the authors tested in vitro chemosensitivity before surgery with endoscopic biopsy specimens from 23 patients with intrathoracic esophageal cancer.

METHODS

The authors tested eight anticancer agents using the dye exclusion method, and all 23 patients received chemotherapy with the most sensitive three drugs according to the results of the chemosensitivity test.

RESULTS

Ten patients (43.5%) had a tumor reduction of more than 50% on radiologic studies, and 4 patients (17.4%) had a good histologic effect.

CONCLUSIONS

The chemosensitivity test is useful in selecting preoperative chemotherapeutic agents for patients with esophageal cancer.

Tumoricidal effect of human PBMC following stimulation with OK-432 and its application for locoregional immunotherapy in head and neck cancer patients

Both cell-mediated and cytokine-mediated antitumor activities were induced in peripheral blood mononuclear cells (PBMC) in short-term culture with streptococcal preparation, OK-432. Kinetic analysis of OK-432-activated killer activity (OKAK) showed that it reached a plateau level much faster (by 48 h of culture) than that detected in PBMC stimulated with recombinant interleukin 2 (rIL-2) (lymphokine-activated killer: LAK). We also found that the tumor growth inhibitory factor (TGIF) activity was produced in the culture supernatant (CSN) of the OK-432-activated PBMC (OK-MC) and the activity synchronously increased with augmentation of OKAK activity. The TGIF activity was rarely found in the CSN of rIL-2-stimulated PBMC. The TGIF activity detected in CSN of OK-MC was further characterized as derived from a cytokine different from interferon gamma (IFN gamma), tumor necrosis factor (TNF), or lymphotoxin (LT) by a neutralization test using monoclonal antibodies to these cytokines. These 48-h-cultured-OK-MC were adoptively transferred (adoptive immunotherapy: AIT) into 19 head and neck cancer patients either alone or in combination with chemotherapy and/or radiation therapy, and their therapeutic effects were examined. AIT was performed by intra-arterial or intratumoral administration of OK-MC. There were no significant side effects observed in this treatment. In these patients, approximately 1-10 x 10(7) cells were transferred into the tumor burden. Of the 19 patients, 17 had primary cancer, and in 6 (6/17;35%) of them complete remission (CR) of the tumor was obtained. Partial remission (PR) was attained in 9 of the 17 patients (9/17; 53%), giving the overall response rate of 88%.(ABSTRACT TRUNCATED AT 250 WORDS)

The possible use of spleen cells for the adoptive immunotherapy of cancer patients

The possible use of spleen-derived mononuclear cells (SPMC) for the intentional and economical adoptive immunotherapy of cancer patients was studied. SPMC were obtained from spleens resected surgically from patients with gastric cancer or idiopathic thrombocytopenic purpura (ITP). When SPMC were cultured in recombinant interleukin 2 (rIL2), SPMC, in the form of interleukin-activated killer spleen cells (IL-SP) proliferated in six of eight cases. CD8+ lymphocytes were the major expanding cell population in most SPMC cultures and IL-SP showed a significant cytolytic activity against cultured tumor cells during cell proliferation. When cultured with a streptococcal preparation, OK-432, for 24 to 48 h, SPMC showed cytotoxic activity against tumor cells and were expressed as OK-432 activated killer spleen cells (OK-SP). The effects of supernatants from IL-SP and OK-SP on tumor cell growth were also examined. The supernatants from IL-SP and OK-SP significantly inhibited cell growth in 3 and 10 out of 11 cases, respectively, while those from OK-SP showed higher growth inhibitory activity than those from IL-SP. The results of this study indicate the potential of SPMC as effector cells for the adoptive immunotherapy of cancer patients.

Clear cell odontogenic carcinoma. A case report with massive invasion of neighboring organs and lymph node metastasis

Clear cell odontogenic carcinoma is a rare and unusual tumor that occurs in the jaws. This tumor is generally considered to be of a low grade of malignancy. We describe a patient with a huge clear cell odontogenic carcinoma that originated in the mandible and exhibited massive invasion into the adjacent tissues and metastases to the submandibular lymph nodes. The ultrastructural and immunohistochemical details are described.

[A case of adult pulmonary supravalvular membranous stenosis which was successfully treated by percutaneous transluminal balloon dilatation]

We report a case of adult pulmonary supravalvular stenosis which was successfully treated with percutaneous transluminal balloon dilatation (PTBD). A 42-year-old man was admitted for a heart murmur and abnormal findings in the screening chest roentgenogram. Having no symptoms on admission, his physical activity was evaluated as Class I according to the classification of the New York Heart Association. A systolic murmur (Levine III/VI) with split second sound was audible at the left sternal border in the 3rd intercostal space. Chest roentgenogram revealed 57% of the cardio-thoracic ratio and no signs of increased pulmonary vascular markings. ECG showed incomplete right bundle branch block. Echocardiography and right ventriculography visualized the supravalvular membranous structured stenosed pulmonary artery 1cm above the pulmonic valve. Systolic pressure gradient between the right ventricle and the distal main pulmonary trunk was 54mmHg. The patient was diagnosed as having pulmonary supravalvular membranous stenosis. PTBD was applied using Inoue balloon catheter, where inflation was initiated from approximately 120% of pulmonary arterial diameter and terminated at 150%. This procedure decreased systolic pressure gradient from 54mmHg to 36mmHg without complication. After PTBD right ventriculography demonstrated that a part of the membranous structure had become floppy and movable. Pulmonary arterial diameter was unchanged. We considered that PTBD tore the membranous structure, which consequently resulted in the decrease of systolic pressure gradient. Systolic murmur diminished to Levine II/VI. Six months later, cardiac catheterization showed no change in systolic pressure gradient compared with that immediately after PTBD. This is the first report on pulmonary supravalvular membranous stenosis successfully treated with PTBD.(ABSTRACT TRUNCATED AT 250 WORDS)

High correlation between lipid peroxide radical and tumor-promoter effect: suppression of tumor promotion in the Epstein-Barr virus/B-lymphocyte system and scavenging of alkyl peroxide radicals by various vegetable extracts

We examined the ability of hot-water extracts of 66 vegetables and plants to suppress tumor promotion, as well as to scavenge lipid peroxide radicals in vitro. To assess the effect against tumor promotion (transformation) in vitro, we used the phorbol myristate acetate/Epstein-Barr virus/B-lymphocyte system. To assess the lipid radical-scavenging effect, the luminol-enhanced chemiluminescence method using the tert-butyl hydroperoxide/heme system was used, which generates more alkyl peroxide radical (ROO.) than alkyl (R.) and alkoxyl (RO.) radicals. The results showed a significant correlation between the anti-tumor-promoting effect and the lipid radical-scavenging effect (r = 0.82). We found that boiled extracts of green leaves of carrot, crucifers, and beans (black bean, red bean, mung bean, and soybean) had the greatest anti-tumor-promoter and radical-scavenging activities. Cold-water extracts of vegetables generally exhibited only about 10% or less of the activity of the hot-water extracts.