Degeneration of skeletal and cardiac muscles in c-myb transgenic mice

In order to reveal cellular processes sensitive to abnormal c-myb expression in vivo, transgenic mice were produced by introducing the c-myb nuclear proto-oncogene under the ubiquitous transcriptional regulatory unit of the cytoplasmic beta-actin gene. Expression of c-myb in thymus did not cause apparent abnormality, but the mice unexpectedly developed degenerative abnormalities in skeletal and cardiac muscles; this occurred predominantly in males. Expression of c-myb in skeletal muscle was correlated with an inflammation of muscle and was accompanied by vacuolar degeneration of muscle fibres, their regeneration, and lymphocyte infiltration. The identical pathological progression in cardiac muscle was associated with cardiomegaly.

MDS-like experimental myelodysplasia: multilineage abnormal hematopoiesis in transgenic mice harboring the SV40 large T antigen under an immunoglobulin enhancer

The SV40 large T gene under the control of immunoglobulin enhancer induced hyperproliferation of multilineage hematopoiesis in transgenic mice. Huge splenomegaly was the major gross abnormality; mice were rather anemic, and neither leukoerythroblastosis nor invasion into tissues such as liver, kidneys or lymph nodes was common. In the latter phases of the disease, the proliferating cell type tended to shift to a variety of single-lineage hematopoiesis, but the majority of mice still showed the presence of multilineage hematopoiesis; such cells were somewhat dysplastic but low in neoplastic potential. A long-term observation by transplantation of the hematopoietic cells into lethally irradiated C57BL/6 mice resulted in a variety of neoplastic growths in the recipients; not only was myelodysplastic hypercellularity seen, but also single-lineage hematopoietic malignancies such as B cell lymphomas/leukemias, histiocytic malignancies and even myeloid leukemias. The disease bore the proliferative feature solely in the spleen and bone marrow, and the transition from multilineage myelodysplasia into single-lineage hematopoiesis at some frequency is reminiscent of myelodysplastic syndromes (MDS) in humans. The results that the SV40 large T antigen was expressed in every proliferating cell, and that there was no apparent increase in any colony-stimulating cytokine(s), together with the results of the transplantation assays, suggested that the hyperproliferation of the hematopoietic cells was a direct consequence of the expression of SV40 large T antigen in these cells themselves.

Genetic polymorphisms of α- and β-amylase isozymes in wild emmer wheat, Triticum dicoccoides, in Israel

α- and β-amylase isozyme diversity was studied electrophoretically by thin-layer polyacrylamide gel isoelectrofocusing in the tetraploid wild emmer wheat, Triticum dicoccoides, the progenitor of all cultivated wheats. We analyzed 225 plants from 23 populations encompassing the ecological spectrum of T. dicoccoides in Israel. The results were as follows: (a) Band and multilocus genotype polymorphisms abound and vary within and between the four amylase components: malt, green (α-amylases), and dry and germinating seeds (β-amylases). (b) The number of bands of malt, green, and dry and germinating seeds were 20, 6, 11 and 13, respectively, generating 40, 6, 51, and 51 patterns or multilocus genotypes (MGP), respectively. The MGPs vary drastically within and between populations, from monomorphic in some populations with a single pattern to highly polymorphic ones, (c) Mean H e values for malt, green, and germinating and dry seeds are 0.053, 0.055, 0.088, and 0.077, respectively; mean number of bands per individual was 11.8, 4.4, 7.6, and 4.0, respectively, (d) The percentages of 50 bands and 148 multilocus genotype patterns (MGP) (in parenthesis) were classified into widespread, sporadic, and localized: 84.4 (10.8), 8.9 (12.2), 6.7 (77.0), respectively. Notably, 89.2% of the patterns were not widespread, but sporadic and localized, (e) The mean value of genetic distances among populations (Nei's D) for the four amylase groups is D = 0.136, 0.175, 0.288 and 0.307, respectively, not displaying geographical correlates. (f) Most of the α- and β-amylase diversity is between populations (G st = 68-75%). (g) Significant environmental correlates occur between either bands or patterns and climatic diversity (water and primarily temperature factors). (h) Significant associations of multilocus amylase bands occur across Israel. Like-wise, significant gametic phase disequilibria, D, occur within populations and are positively correlated with climatic variables, primarily that of temperature, (i) Discriminant analyses correctly classified (95-100%) the 23 wild emmer populations into their ecogeographical region and soil type. (j) Autocorrelation analysis showed that there is no correlation between bands and geographic distance and excluded migration as a major factor of amylase differentiation.These results suggest that diversifying climatic and edaphic natural selection rather than stochastisity or migration is the major evolutionary force driving amylase differentiation at both the single and multilocus levels. Furthermore, wild emmer harbors high levels of α- and β-amylase diversity both as single bands and as multilocus adaptive genetic patterns. These are exploitable both as genetic markers for quantitative loci (QTLs) and as adaptive genetic resources to improve wheat germination and growth through classical breeding and/or biotechnology.

Thyroplasty type I with ceramic shim

To improve hoarseness or misswallowing caused by unilateral recurrent laryngeal nerve paralysis, medialization of paralyzed vocal cord has frequently been performed. This method includes such techniques as injection method, insertion method, and arytenoid adduction, each presenting its merits and demerits. The insertion method which can be done while monitoring the patient's voice seems advantageous in that the technique is easy to perform and generally guarantees the voice improvement. Among insertion methods, Isshiki thyroplasty type I is the one most representative as well as popularized. However, since a silicone shim is inserted in this operation, it may be accompanied by the risks of carcinogenicity, foreign body reaction, and induction of collagen disease of silicone. Therefore we planned to use a ceramic as a safe substitute instead of silicone. There has been no article reporting the use of ceramic in this type of surgery. We used a fibrin glue to fix the ceramic shim and for hemostasis, which was found very useful. Hitherto, 2 cases of unilateral recurrent laryngeal nerve paralysis underwent Isshiki thyroplasty type I using ceramic shim with satisfactory results.

Latent herpes simplex virus type 1 in human vestibular ganglia

Viral infection has been considered to be a possible pathogenesis of vestibular neuronitis, and reactivation of the herpes simplex virus (HSV) is one of the most likely causes. However, it remains unknown whether the human vestibular ganglia contain latent HSV. We examined 26 vestibular ganglia from autopsied adults in search of HSV type 1 (HSV-1). To detect HSV-1, we used polymerase chain reaction (PCR), in situ hybridization and immunohistochemical staining. HSV DNA was detected in 6 of 10 vestibular ganglia using the PCR method. However, the latency-associated transcript (LAT) of HSV-1 was negative in all of the 16 vestibular ganglia examined. No HSV antigen was detected in any of the ganglia. These results indicate that HSV-1 is latently infected in the human vestibular ganglia, and that LAT is transcribed weakly or not at all.

[Contribution of proliferating cell nuclear antigen to prognostic evaluation of carcinomas of the maxillary sinus]

Proliferating cell nuclear antigen (PCNA) is a nuclear protein, synthesized in the late G1 and S phases of the cell cycle. Therefore, it is considered to be closely related to cell proliferation. The contribution of PCNA to prognostic evaluation of the disease was investigated in 42 squamous cell carcinomas of the maxillary sinuses, retrospectively. Histological sections were prepared by formalin-fixation, paraffin-embedding and staining with monoclonal antibody to PCNA (DAKO, PC10) using the Avidin-biotin peroxidase complex method. The percentage of tumor cells with positive staining for PCNA ranged from 26.3 to 92.3% (average; 61.7%). In order to evaluate PCNA in terms of prognosis, five-year survival rates in the following two groups were compared. One included cases with a PCNA positive rate above the mean level and the other, those below the mean level. Five year survival rate was 30.4% in the group with a higher positive rate, but 42.1% in the group with the lower rate. However, the difference in survival rate between the two groups was not statistically significant. In addition, no correlations either between the rate of PCNA positivity and T-classification of tumors or between the degree of tumor cell differentiation and metastasis to neck lymph nodes were obtained. Further study is necessary to evaluate PCNA as a prognostic marker in human malignancy.

Detection of varicella-zoster virus DNA in human geniculate ganglia by polymerase chain reaction

Latent varicella-zoster virus (VZV) has been demonstrated in the human trigeminal and thoracic ganglia by means of nucleic acid hybridization. However, the human geniculate ganglia in VZV latency have not been examined. Tissue DNA extracted from the trigeminal and geniculate ganglia of a newborn and 7 adults was examined by polymerase chain reaction with a pair of VZV-specific primers. None had symptoms of recent infection with VZV (chickenpox or shingles). VZV DNA was detected in 11 (79%) of 14 trigeminal ganglia and in 9 (69%) of 13 geniculate ganglia of the adults. VZV DNA was not detected in either type of ganglion from the newborn or from 1 adult who was seronegative for VZV antibodies. These findings indicate that VZV becomes latent in human geniculate ganglia after primary infection and suggest the possibility that reactivation of the virus from the geniculate ganglia may cause Ramsay Hunt syndrome.

Detection of latent herpes simplex virus DNA and RNA in human geniculate ganglia by the polymerase chain reaction

By using the polymerase chain reaction (PCR) we detected latent herpes simplex virus type 1 (HSV-1) in human geniculate and trigeminal ganglia obtained from autopsy cases. A pair of primers which were specific for a part of the HSV-1 thymidine kinase domain were used for detection of HSV DNA. We also examined the latency-associated transcript (LAT), known as latency-specific RNA, by means of reverse transcription-PCR with a pair of LAT-specific primers. HSV-1 DNA was detected in 16 of 17 (94%) trigeminal ganglia and in 15 to 17 (88%) geniculate ganglia of adults. We also demonstrated HSV-1 RNA derived from the LAT in both types of ganglia. These findings suggest that HSV-1 latently infects the majority of geniculate and trigeminal ganglia of adults, and that PCR and reverse transcription-PCR are useful tools for analysis of HSV latency.

Expression of the angiotensinogen gene and localization of its protein in the human heart

BACKGROUND

There have been no reports on the presence of the tissue renin-angiotensin system in the human heart, although the presence of angiotensinogen has been described in the animal heart.

METHODS AND RESULTS

To determine whether angiotensinogen is synthesized in the human heart, we examined angiotensinogen messenger RNA (mRNA) synthesis in autopsy hearts by using ribonuclease protection assay. As a result, angiotensinogen mRNA was detected in the atrial muscle, muscles of the conduction system, and the left ventricular wall. In the left ventricular wall, mRNA expression was more prominent in the subendocardial muscles than in the midcardial or epicardial muscles. Using a monoclonal antibody to human angiotensinogen in immunoblotting experiments, we detected two closely spaced bands at approximately 70 kd in the heart, which was quite consistent with the human angiotensinogen molecule. Immunohistochemical studies with this monoclonal antibody demonstrated intense immunoreactivity in the atrial muscles, the muscles of the conduction system, and those of the subendocardial layers.

CONCLUSIONS

We conclude that angiotensinogen was synthesized in the human heart. It was evident that the localization of angiotensinogen was not ubiquitous in the cardiac muscles, showing its predilection for the atrial muscles, muscles of the conduction system, and subendocardial layer of the left ventricle.

Triple cancers in the urogenital area of a patient with aplastic anemia

Three epithelial neoplastic lesions, perineal Bowenoid papulosis, uterine cervical carcinoma, and bladder transitional cell carcinoma, which occurred in a mildly immunosuppressed patient who had aplastic anemia were studied for human papillomavirus (HPV) infection. In the Bowenoid papulosis, HPV type 16 DNA was identified by polymerase chain reaction (PCR) and by in situ hybridization (ISH). In contrast, in the uterine cervical carcinoma, HPV 16 was not detected, although possibly another unidentified type of HPV in the lesion was suggested by the ISH findings. In the bladder transitional cell carcinoma, neither papillomavirus genus-specific (PGS) antigen nor HPV DNA was found.

Clinical significance of the epidermal growth factor receptor gene in squamous cell carcinomas of the nasal cavities and paranasal sinuses

The authors retrospectively analyzed epidermal growth factor receptor (EGFR) gene amplification in 49 cases of squamous cell carcinoma (SCC) arising from the nasal cavities (NC) and paranasal sinuses (PS) by using slot-blot analysis of DNA extracted from formalin-fixed, paraffin-embedded tissues. Also, the relationship between the results of gene analysis and the clinical features of the patients was studied to investigate the clinical significance of the EGFR in SCC of the NC and PS. Amplification of the EGFR gene was detected in 5 of the 49 cases (10%). No significant difference was observed between EGFR gene amplification and the presence of lymph node metastases, local recurrence, or prognosis. This suggests that EGFR gene amplification is not related to the local progression or metastasis of the SCC in the NC and PS. In addition, it appears that amplification of the EGFR gene is not a prognostic indicator for SCC in the NC and PS.

Detection of human papillomavirus DNA in carcinomas of the nasal cavities and paranasal sinuses by polymerase chain reaction

The authors retrospectively searched for human papillomavirus (HPV) types 16 and 18 in 60 cases of carcinoma arising from the nasal cavities (NC) and paranasal sinuses (PS) by using the polymerase chain reaction (PCR) on DNA extracted from formalin-fixed, paraffin-embedded tissues. In cases of SCC (n = 49), the authors also compared the clinical features of patients with HPV-positive and HPV-negative results to determine the clinical significance of HPV. HPV 16 and 18 were detected in 7 of the 49 cases (14%) of SCC. In the other histologic types of carcinoma (n = 11), neither HPV 16 nor HPV 18 was detected. No significant differences in the clinical features were observed between patients with SCC with HPV-positive and HPV-negative results. The results suggest that HPV 16 and 18 are implicated in the pathogenesis of SCC arising from the NC and PS. However, the presence of HPV is not related to local progression, occurrence of metastases, or the prognosis of the patients.

Latent herpes simplex virus type 1 in human geniculate ganglia

Viral infection, especially by reactivation of herpes simplex virus (HSV) has been considered to be a possible explanation for the pathogenesis of idiopathic peripheral facial nerve palsy (Bell's palsy). We investigated whether the geniculate ganglia of man contain latent HSV type 1 (HSV-1), and compared the frequency of HSV-infected ganglia and that of latently infected neurons in human geniculate ganglia and in trigeminal ganglia. From autopsy specimens of eight adults 15 geniculate ganglia and 16 trigeminal ganglia were examined by means of in situ hybridization and immunohistochemical staining. The HSV-1 genome was detected in 11 of the 15 (71%) geniculate ganglia and in 13 of the 16 (81%) trigeminal ganglia. No HSV antigen was noted in any of the ganglia. The incidence of latently infected neurons was 0.9% in the trigeminal ganglia and 5.3% in the geniculate ganglia. The difference in percentages between the two types of ganglia was significant. Our results suggest that reactivation of latent HSV in the geniculate ganglia is a probable cause of some cases of herpetic stomatitis and of idiopathic peripheral facial nerve palsy.

Molecular characterization of a JC virus (Sap-1) clone derived from a cerebellar form of progressive multifocal leukoencephalopathy

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by polyomavirus JC (JCV). In the majority of cases of PML the cerebrum is mainly affected (cerebral PML) but on rare occasions lesions are restricted to the cerebellum and brain stem (cerebellar PML). We report a rare cerebellar PML case which occurred in a Japanese patient undergoing prolonged hemodialysis treatment. To understand the molecular basis of the viral tissue tropism, we molecularly cloned JCV DNA and compared it with those of cerebral PML. Of ten clones analyzed nine showed identical fragment patterns after digestion with various restriction endonucleases, and we designated these clones Sap-1. It could be shown that the basic structures of the regulatory regions are similar between Sap-1 and isolates from cerebral PML. Restriction endonuclease mapping analysis was used to examine the genetic relationship between Sap-1 and urine-derived isolates containing the archetypal regulatory sequence. We found that Sap-1 was genetically related to an archetypal JCV isolate in Japan.

[Treatment of malignant gliomas by selective intraarterial infusion chemotherapy with high-dose ACNU and autologous bone marrow transplantation--preliminary report]

Six patients with malignant gliomas were treated by selective intracarotid infusion of ACNU at 15 mg/kg (about 600 mg per m2) or 10 mg/kg with or without radiotherapy and rescue of autologous bone marrow transplantation after surgery. These high doses of ACNU were well tolerated if bone marrow rescue was performed and granulocyte colony stimulating factor was used. With the development of microcatheters for use in selective intraarterial infusion, it has become possible to cannulate the major artery and infuse drugs at high dose into the artery feeding the tumor. The complication of ocular toxicity can be avoided by using the Tracker-18 or Balt (Magic) angiographic catheter. On the other hand, drug dosage and infusion rate must be chosen carefully, because of the increased likelihood of local arteritis and local necrosis caused by high dosage of ACNU. In the present study, local arteritis or cerebral infarction in the area of the middle cerebral artery was considered to have been prevented by extending the infusion time to 80 minutes. When combined with radiotherapy, 10 mg/kg of ACNU and 80 min. of infusion time were found to be optimal in relation to brain tolerance.

Hepatocarcinogenesis in transgenic mice carrying albumin-promoted SV40 T antigen gene

We have developed transgenic mice that inherit albumin promoter-regulated simian virus 40 (SV40) large T antigen gene, expressed specifically in hepatocytes. These mice all develop multifocal hepatocellular carcinomas at around 5 months and die of liver insufficiency by 7 months. Sequential morphological observation of hepatocarcinogenesis revealed 5 distinct stages: (I) newborn to 2 weeks of age, neither recognizable histological changes nor cellular replication in spite of T antigen expression; (II) between 3 and 7 weeks, diffuse cytomegalic change of hepatocytes with numerous abnormal mitoses, usually resulting in cell death; (III) from 7 weeks onwards, quasi-regenerative small hepatocyte foci with a decreased tendency for cytomegaly in spite of T antigen expression, rapidly replacing the hepatic tissue; (IV) 11 weeks of age and thereafter, neoplastic foci and nodules with enzymatic alteration; (V) 20 weeks of age and thereafter, gross hepatocellular carcinomas with occasional pulmonary metastases. Considerable variation existed both in morphological and enzymatic features and T antigen expression among neoplastic lesions, including carcinomas. Thus, these transgenic mice clearly show a multistep process in hepatocarcinogenesis with remarkable synchrony and provide a promising model for analyzing the essential events of carcinogenesis at different stages.

Morphological and cytogenetic characterization and N-myc oncogene analysis of a newly established neuroblastoma cell line

A permanent cell line established from a xenograft of neuroblastoma which occurred in a 5-year-old girl was investigated for its morphological and biological characteristics. The cultured cells were tumorigenic in nude mice. Microscopically, each tumor consisted of small round to polygonal cells with irregular nuclei and prominent nucleoli, corresponding to the features of the primary and xenografted tumor cells. Electron microscopic examination revealed that both the transplanted tumor cells and the cultured cells contained scanty microtubules and dense-core neurosecretory granules. Chromosome analysis of this cell line showed monosomy for chromosomes 1, 10, 19 and X, and structural rearrangements involving chromosomes 8, 17 and 20, in addition to numerous double minutes. The N-myc oncogene was found to be amplified 40- to 80-fold in the transplanted and cultured tumor cells, as well as in the primary tumor cells. In situ hybridization with a digoxigenin-labeled uridine-triphosphate N-myc RNA probe detected abundant mRNA in the tumor cells. This neuroblastoma line may become a valuable in vitro experimental model system for studies aimed at better characterization of neuroblastoma.

Multiple cerebral infarcts caused by emboli from carotid atheroma--a case confirmed by indium-111 platelet scintigraphy

A 47-year-old male presented with frequent transient ischemic attacks (TIAs) of weakness of the left upper extremity. Computed tomography demonstrated multiple infarcts in the right cerebral hemisphere. Cerebral angiography showed marked atheromatous changes at the siphon of the right internal carotid artery, characterized by wall irregularities and heterogeneous filling. Indium-111-labeled platelet scintigraphy demonstrated abnormal tracer accumulation at the right carotid siphon. Following right carotid artery ligation, this abnormal platelet deposition was resolved and no further TIA was experienced. This suggests that the release of microthrombi from thrombogenic carotid atheroma contributes to embolic stroke.

Pathological features of virus infections of the central nervous system (CNS) in the acquired immunodeficiency syndrome (AIDS)

Neurological disorders are a common cause of morbidity and mortality in the acquired immunodeficiency syndrome (AIDS). In this report we describe the neuropathological changes associated with both human immunodeficiency virus (HIV) infection and with the major opportunistic virus infections, cytomegalovirus (CMV), JC papovavirus (JCV) and herpes simplex virus (HSV) seen in AIDS. In addition "in situ" hybridization studies have been employed for the detection of virus genomic material in each case and the usefulness of this method in supporting the pathological diagnosis is demonstrated. Mechanisms whereby HIV infection results in leukoencephalopathy and the possible contributing roles of the three opportunistic virus infections are discussed.

Bilateral oculomotor nerve palsies due to posterior cerebral arterial compression relieved by microvascular decompression--case report

A 59-year-old male developed peripheral oculomotor nerve paresis due to compression by the left posterior cerebral artery (PCA), which was successfully treated by microvascular decompression. Two months later, a similar oculomotor nerve paralysis due to the same mechanism occurred contralaterally and was also treated by microvascular decompression. The previous condition was probably caused by arteriosclerotic changes in the PCA, and the following condition by postsurgical adhesion of the arachnoid membrane. The possibility of vascular compression should be considered when oculomotor nerve palsy rapidly develops, although not proven by angiography.

Molecular pathologic study of human papillomavirus infection in inverted papilloma and squamous cell carcinoma of the nasal cavities and paranasal sinuses

Nasal inverted papilloma is a rare benign tumor occasionally associated with squamous cell carcinoma. To determine the etiological role of human papillomavirus in inverted papilloma, and to clarify the relationship between human papillomavirus and malignant transformation of this benign tumor, we retrospectively analyzed inverted papillomas from 26 patients, 7 of whom had squamous cell carcinoma. We used an immunohistochemical method and molecular pathologic techniques, or dot-blot hybridization of DNA extracted from paraffin-embedded tissues, in situ hybridization, and polymerase chain reaction. Human papillomavirus was detected in 5 of 26 patients (19%), 3 patients with human papillomavirus 11 and 2 patients with human papillomavirus 16. The latter 2 patients had inverted papillomas associated with squamous cell carcinoma. We speculate that human papillomavirus may be related to the malignant transformation of inverted papillomas.

[Early diagnosis of acute mesenteric artery occlusion--clinical and experimental study]

This study was undertaken for the purpose of making early diagnosis of acute superior mesenteric artery occlusion (SMAO). (Clinical Study) This study included 16 patients with SMAO. The early diagnoses by clinical, laboratory, echographic and radiologic findings which were commonly obtained in the cases of abdominal emergency, were difficult. Angiography was useful method for its diagnosis. But in its early stage, we could hardly determine which patient was subject to angiography, therefore non-invasive and simple screening modelity is needed for its early diagnosis. (Experimental Study) Portal blood flow (PVF) is considered to decrease when superior mesenteric artery (SMA) is occluded, because SMA is a main feeder of portal vein. If SMAO has specific portal hemodynamics, its early diagnosis will be possible by non-invasive PVF measurement using an ultrasonic duplex system (PD). We investigated the portal hemodynamic changes in experimental SMAO, peritonitis and ileus using 24 mongrel dogs. Our results showed that PVF to cardiac output ratios (PCR) of SMAO models were under 10% and in contrast, those of others were over 10%. So SMAO models were distinguishable from others. These suggested that PCR measured by PD and echocardiography was an useful indicator of early diagnosis of SMAO.

Histological study of atelocollagen infused into the human vocal cords

There have been only three case reports of histological study on injection of atelocollagen into the human vocal cords, and none of these have indicated foreign body reaction. We histologically examined the larynx of a 70-year-old man, which had to be excised 44 days after infusion of atelocollagen into the vocal cords. The atelocollagen infused was found to have been replaced with the collagen of host cells, but no foreign body reaction was observed. As in conventional reports, the histoaffinity of atelocollagen was confirmed.

Postoperative angiographic evaluation of gastroepiploic artery grafts: technical considerations and short-term patency

Follow-up angiography was performed in 37 patients with right gastroepiploic artery (GEA) grafts at 27 +/- 32 days postoperatively. By the femoral approach, a 5F cobra or twist catheter was advanced selectively into the gastroduodenal artery (GDA) over a plastic-coated guidewire. In 29 patients, the GDA was successfully catheterized, and the GEA grafts were clearly visualized by the injection of 3-7 ml of contrast medium. GDA catheterization was unsuccessful in 8 patients, but in 4 of them the grafts were well visualized when 15-20 ml of contrast was injected. In the other 4 patients, visualization of the GEA grafts was poor, but the distal portions were outlined by retrograde perfusion from the native right coronary arteries. A total of 34 GEA grafts were patent (92%), and the diameters of these grafts were adequate when compared with respective recipient coronary arteries (2.8 +/- 0.9 and 2.3 +/- 0.6 mm, respectively; P less than .05). No complications were noted except for transient vasospasm (3 patients) in the GEA, hepatic artery, or both, which was relieved by the intra-arterial injection of isosorbide dinitrate (2.5 mg). Thus, the over-the-wire technique allows simple and safe GDA catheterization, which is essential for obtaining good visualization of GEA grafts.