Comparative DNA analysis by image cytometry and flow cytometry in non-small cell lung cancer

To determine whether image cytometry (ICM) is advantageous for clinical DNA analyses of tumor cells, nuclear DNA contents measured by ICM were compared with those by flow cytometry (FCM), using 46 samples of non-small cell lung cancers. ICM was performed on smear specimens of fresh materials (f-ICM) and cell suspensions obtained from paraffin-embedded tumors (p-ICM). The same cell suspensions were also analyzed by FCM (p-FCM). Aneuploid rates/coefficient of variation (CV) of f-ICM, p-ICM, and p-FCM were 76.1/4.90, 71.7/5.01 and 60.9/5.31%, respectively. There was a high correlation in the DNA indices between p-ICM and p-FCM (r = 0.80). In the comparative DNA analysis, there were seven discordant samples. Six of them were estimated as aneuploid by p-ICM, but they were miscounted as diploid or undefinable (impossible) by p-FCM. This was caused by measuring condensed nuclei or debris. All "impossible" samples in p-FCM were squamous cell carcinoma with necrosis. In cell cycle analysis, the S and S+G2/M phase fractions in diploid samples were higher in p-ICM than those in p-FCM (P < 0.005), because the G0/G1 phase (2N) fraction presented by FCM was composed of cancer and non-malignant cells in diploid cancers. In ICM, they can be separately measured by means of morphological selection. These findings indicated that ICM is superior to FCM, especially for the practical DNA measurement of a few cancer cells and in the evaluation of the proliferation rates.

Histo-pathological study of a glass-ionomer/resin (Geristore) restoration system

The purpose of this experiment was to investigate histo-pathologically the pulpal reaction to a glass-ionomer/resin (Geristore) restoration system in human teeth. Black's class I cavities were prepared in 22 human teeth; these were divided into 2 groups, one with the Geristore after cavity was cleaned with 10% NaOCl solution and 3% H2O2 solution (Group G) and the other with the Geristore after the cavity was applied with Mirage-Bond (Group MG). The treated teeth were observed clinically over 90 days after operation. They were then extracted for histological examination. No unpleasant symptoms were noted. A few pathological changes were observed. No histo-pathological score differences were observed between groups G and MG. The average evaluation score of pathological results in both groups G and MG were excellent. Microorganisms observed in the cavity dentin of the group G was fewer than in group MG. In some cases, microorganisms were observed along the dentin walls. In conclusion, the pulpal injury due to this Geristore restoration system was slight, and the system was considered to be safe for the pulp and clinically useful.

Pleural dissemination in non-small cell lung cancer: results of radiological evaluation and surgical treatment

The aims of this study are to evaluate the diagnostic ability of chest computed tomography (CT) in the early detection of pleural disease and to analyze the results of surgical treatment for lung cancer with pleural dissemination. Twenty-three non-small cell lung cancer patients with pleural dissemination, but without distant metastasis, underwent pleuropulmonary resection during the past 15 years. Chest CT scans were obtained preoperatively in 21 of those patients. In eight patients without pleural effusion, small pleural nodules, about 3-5 mm in size, were found in their chest CT. However, during surgery, small nodules were more frequently observed on the parietal pleura than on the visceral pleura in five of them. Therefore, early detection of the dissemination by chest CT seemed limited to only those of the visceral pleura. In the survival curve after resection, there was no difference among the patients with n2 disease, but there was a significant difference between the patients without n2 disease and those with it (P < 0.05). The presence of n2 disease appeared to be a poor prognostic sign in this form of advanced lung cancer.

[Combined coronary artery bypass grafting and choledocholithotomy--a report of two cases]

A 74-year-old man and a 66-year-old woman were diagnosed as angina pectoris with choledocholithiasis. Combined coronary artery bypass grafting and choledocholithotomy were performed successfully in the two cases. For the prevention of cardiac complications and mediastinal infection, coronary artery bypass grafting was performed prior to choledocholithotomy. However, skin incisions were different in both cases. In the case with the biliary tract infection, both two surgical procedure were performed through a single skin incision in order to prepare the gastroepiploic artery as a graft. The combined operation is considered to be useful in selected cases with ischemic heart disease and choledocholithiasis.

[Surgically successful treatment of pleural empyema with multiple bronchial fistulae--a case report]

A 62-year-old man who had undergone left lingual segmentectomy for pulmonary tuberculosis developed left chronic localized pleural empyema with multiple bronchial fistulae in the region of surgical gauze left in the thoracic cavity. We surgically removed the gauze and fenestrated the empyema. After disinfection of the region of suppuration, small fistulae which were less than 2 mm in diameter were closed by fibrin-glue-packing and consolidation of the orifices using 40% silver nitrate solution. Two and one-half months later a second operation was performed. Residual large fistulae were closed by fibrin-glue-packing and suturing of their orifices, and the empyema space was then obliterated by muscle flap plombage. The patient's postoperative course was good and the empyema was completely cured with this treatment.

The GTS1 gene, which contains a Gly-Thr repeat, affects the timing of budding and cell size of the yeast Saccharomyces cerevisiae

A gene with an open reading frame encoding a protein of 417 amino acid residues with a Gly-Thr repeat was isolated from the yeast Saccharomyces cerevisiae by using synthetic oligonucleotides encoding three Gly-Thr dimers as probes. The deduced amino acid sequence showed partial homology to the clock-affecting gene, per, of Drosophila melanogaster in the regions including the GT repeat. The function of the gene, named GTS1, was examined by characterizing the phenotypes of transformants with different copy numbers of the GTS1 gene produced either by inactivating the GTS1 gene by gene disruption (TM delta gts1) or by transformation with multicopy plasmid pPER119 (TMpGTS1). They grew at similar rates during the exponential growth phase, but the lag phases were shorter for TM delta gts1 and longer for TMpGTS1 cells than that for the wild type. Analyses of their cell cycle parameters using synchronized cells revealed that the unbudding period changed as a function of gene dosage; that is, the periods of TM delta gts1 and TMpGTS1 were about 20% shorter and longer, respectively, than that of the wild-type. Another significant change in the transformants was detected in the distribution of the cell size. The mean cell volume of the TM delta gts1 cells in the unbudded period (single cells) was 27% smaller than that of single wild-type cells, whereas that of single TMpGTS1 cells was 48% larger. Furthermore, in the temperature-sensitive cdc4 mutant, the GTS1 gene affected the timing of budding at the restrictive temperature. Thus, the GTS1 gene product appears to modulate the timing of budding to obtain an appropriate cell size independent of the DNA replication cycle.

Aftereffects of high-intensity DC stimulation on the electromechanical performance of ventricular muscle

To clarify the mechanisms underlying cardiac dysfunction after electrical defibrillation, we investigated the effects of direct current field stimulation (10 ms, 1-80 V/cm) on isolated guinea pig papillary muscles. Shocks (S2) > 15 V/cm lowered the plateau height of the S2-induced action potential and inhibited its terminal repolarization. Subsequent responses to basic stimuli (S1, 1.0 Hz) for 1-3 min were characterized by a decrease in the maximum diastolic potential, a shortening of action potential duration, and an increase of the developed tension. With S2 > 30 V/cm, a marked delay in repolarization of the S2-induced action potential was followed by oscillation of membrane potential, resulting in repetitive spontaneous activity and often refractoriness to S1 stimulation. The aftereffects were independent of the phase of S2 application. Most of the aftereffects were preserved in the presence of nifedipine (1 microM) or ryanodine (1 microM). Only sodium channel blockade by tetrodotoxin (10 microM) modified the aftereffects by depressing the generation of spontaneous activity. These findings suggest that strong shocks (> 15 V/cm) will produce abnormal arrhythmogenic responses probably through a transient rupture of sarcolemmal membrane (electroporation) leading to a disturbance of the ionic equilibrium of the myocyte.

[New endoscopic laser treatment for unilateral vocal cord paralysis after pulmonary resection]

In two patients who had developed aspiration due to left recurrent laryngeal nerve injury during radical resection for lung cancer, low power Nd:YAG laser irradiation of the paralyzed vocal cord was performed through a bronchofiberscope. With irradiation, the paralyzed vocal cords of both patients swelled and became fixed at the median portion of the glottis. Thereafter, aspiration disappeared. Thus, this new application of Nd:YAG laser irradiation is apparently quite useful in treating aspiration due to unilateral vocal cord paralysis immediately after pulmonary resection.

[A study of prostatic tissue levels of cefodizime (CDZM)]

Twenty-four patients suffering from prostate hyperplasia were given venous injections of CDZM of either 1 or 2 g at specific intervals (30 min, 1, 2 and 4 hr) before surgery. Blood samples from the injected vein and tissue samples from the prostate were subsequently taken. In this study, the concentrations of CDZM in the prostate tissue (P) and in serum (S), as well as the ratio of the tissue to serum concentrations (P/S) were determined. In patients given 1 g injections, P ranged from 5.26-48.10 micrograms/g, while S ranged from 25.40-130.00 micrograms/ml and P/S ranged from 12.6-37.0%. In the patients given 2 g injections, P ranged from 9.40-49.20 micrograms/g, S ranged from 62.30-234.00 micrograms/ml and P/S ranged from 9.3-29.1%. CDZM exhibited excellent transmigration to the prostate tissue. Inflammatory bacteria present in prostatitis and urinary tract infections are generally those of E. coli, Proteus sp., but because the P range was much higher than the ratio of MIC, CDZM is expected to be useful against infections in the field of urology.

[Simultaneous operations for ischemic heart disease and lung cancer]

Two cases were operated on simultaneously for coronary revascularization and lung resections for cancer. Case 1 was a 79 year-old man, diagnosed with two vessels coronary artery disease and squamous cell carcinoma of left lower lobe. At the end of aortocoronary bypass grafting to LAD and first diagonal branch using saphenous vein, median sternotomy was closed, and lower lobectomy was performed through left posterolateral standard thoracotomy. Case 2 was a 65 year-old man who underwent aortocoronary bypass grafting to LAD first and left lingular segmentectomy via median sternotomy simultaneously. We concluded that a simultaneous operation was definitively and ideally a preferable method in most selected cases. The order of two operations for coronary artery and lung was also discussed.

[A case of multicentric Castleman lymphoma in the left pulmonary hilum and mediastinum]

A 29-year-old female who complained of low grade fever was detected an abnormal shadow in the left pulmonary hilum on a chest roentgenogram. Thoracotomy revealed that the tumorous lesion originated from left hilar lymph node. Left hilar and mediastinal lymph nodes were extirpated. Histopathologically, three of all the resected lymph nodes were diagnosed as Castleman lymphoma (plasma cell type). Therefore, not only the main lymph node but also the associating lymph nodes should be completely extirpated, since, in this disease, especially plasma cell type, the lesions are often multicentric.

Membrane disorganization induced by perfringolysin O (theta-toxin) of Clostridium perfringens--effect of toxin binding and self-assembly on liposomes

theta-Toxin (perfringolysin O) of Clostridium perfringens binds to membrane cholesterol with high (Kd approximately 10(-9) M) and low (Kd approximately 10(-7) M) affinities and causes membrane lysis of intact cells and liposomes. In order to understand the lytic process at the molecular level, the lysis of liposomes was investigated in comparison with that of intact cells. The toxin dose required to cause 50% lysis (RD50) of phosphatidylcholine/phosphatidylglycerol (82:18, mol/mol) liposomes containing 36-40 mol% cholesterol was 300-1400-times higher than the RD50 value for sheep or human erythrocytes when samples with the same cholesterol concentration were compared. However, the average number of toxin molecules bound per liposome vesicle at 50% lysis was estimated as 10-18 from the RD50 values, close to the number on erythrocytes at 50% lysis, suggesting that the number of toxin molecules adsorbed per vesicle is important for lysis. As to the toxin dose required for membrane lysis, no significant difference was observed between liposomes containing both high- and low-affinity toxin-binding sites and those containing only low-affinity sites, suggesting that theta-toxin molecules bound to low-affinity sites can assemble and cause membrane lysis as well as those bound to high-affinity sites. theta-Toxin assembles on liposomal membranes, as on erythrocytes, in a high-molecular-weight polymeric form as judged from sedimentation patterns in sucrose density-gradient centrifugation. The high-molecular-weight polymers were detected only under conditions where cell or liposome lysis occurred. At low toxin doses, slower sedimenting toxin oligomers and monomers were predominant on liposomal membranes. These results indicate that toxin assembly on membranes is essential for liposome lysis as it is for cell lysis and that assembly occurs on membranes without membrane proteins.

Phosphorylation inhibits the DNA-binding activity of MyoD homodimers but not MyoD-E12 heterodimers

MyoD is a member of the basic helix-loop-helix (bHLH) family of muscle gene regulatory proteins that includes myogenin, myf-5, and MRF4. These proteins have been shown to heterodimerize with E2A bHLH proteins, E12/E47, and to bind to a consensus sequence known as an E-box, CANNTG, the target for transcriptional activation by these myogenic regulators. MyoD is also a phosphorylated nuclear protein that is present in muscle cells prior to the transcriptional activation of the muscle-specific genes, many of which contain E-box elements in their regulatory regions. Here we report that phosphorylated chicken MyoD, called CMD1, produced in sf9 cells using the baculovirus system, is qualitatively similar to CMD1 isolated by immunoaffinity purification from primary cultures of embryonic chick breast muscle. Functional analysis of phosphorylated and dephosphorylated CMD1 produced in sf9 cells indicates that, in the presence of magnesium, DNA binding of phosphorylated CMD1 is inhibited whereas binding in association with E12 is not affected. However, CMD1 binding alone is equally efficient when either EDTA is added in excess or dephosphorylated or bacterially expressed CMD1 is used in the assay. Our results suggest that cellular phosphorylation changes the CMD1 homodimer-heterodimer equilibrium which, in turn, modulates and/or eliminates binding site competition between CMD1 homodimers and CMD1/E-protein heterodimers in the cell.

Clear cell carcinoma of the lung: a case report and review of the literature

Clear cell carcinoma of the lung is an extremely rare type of lung cancer with doubtful etiology. This present case showed that the tumor cells contained abundant cytoplasmic glycogen with a diffusely distributed pattern and intracellular glandular structure electron microscopically. Immunohistochemical study revealed that the tumor cells expressed not only epithelial marker including cytokeratin and epithelial membrane antigen, but also Ley, one of stage-specific embryonic carbohydrate antigens. The diagnosis of pulmonary clear cell carcinoma should be done carefully, because benign clear cell tumor and secondary renal cell carcinoma show similarities in a histologic appearance but not in their management and prognosis.

[Cardiac hemangioma of the interventricular septum and right ventricle: a case report]

A 52-year-old man who had been pointed out cardiac tumor on echocardiography, CT, MRI and coronary angiography was admitted to our hospital. He was asymptomatic. The surgical excision of the tumor was performed under extracorporal circulation and the postoperative period was free of event. It was not certain whether it originated from interventricular septum or right ventricle. The histology was mixed hemangioma composed of capillary and cavernous type.

[A case report of graft replacement of the ascending and transverse aorta without homologous red blood cell transfusion]

A 28-year-old man of DeBakey type I dissecting aneurysm was received graft replacement of the ascending and transverse aorta under the deep hypothermic circulatory arrest and continuous retrograde cerebral perfusion for cerebral protection during circulatory arrest. From 3 weeks before operation, autologous blood was collected from the patient with the intravenous administration of a recombinant human erythropoietin (rHuEPO) and was subsequently used in the operation. As result, the graft replacement of the ascending and transverse aorta was performed without homologous red blood cell transfusion and postoperative neurological complications. We believe autologous blood transfusion with rHuEPO and circulatory arrest with CRCP contributes operations of aortic aneurysms without homologous blood transfusion.

Increased hepatic arterial blood flow in acute viral hepatitis: assessment by color Doppler sonography

To evaluate the effect of acute viral hepatitis on hepatic arterial blood flow, we performed color Doppler sonography with point-spectral analysis in 15 patients with acute viral hepatitis and compared the results with those in 15 normal volunteers. During the acute phase of hepatitis, the peak-systolic and end-diastolic velocity of the hepatic artery were significantly larger than those in normal arteries (p < 0.01). During the recovery phase, these indexes of the hepatic artery decreased significantly to the control levels (p < 0.01). The resistive indexes related to vascular resistance in the hepatic artery during the acute phase were significantly less than those in normal arteries (p < 0.01), and they increased significantly to the control levels during the recovery phase (p < 0.01). No significant correlation was found between these indexes of the hepatic artery and conventional liver function parameters. However, the interval between the acute phase and the recovery phase did correlate negatively with the peak-systolic velocity of the hepatic artery in the acute phase (r = -0.630, p < 0.05) and with the end-diastolic velocity (r = -0.514, p < 0.05). We conclude that color Doppler sonography is useful for imaging increased hepatic arterial blood flow in patients with acute viral hepatitis. We believe that increased hepatic arterial blood flow during the acute phase may provide a marker for earlier recovery from hepatitis-induced damage.

Pulmonary dirofilariasis cytologically mimicking lung cancer. A case report

A case report on a 64-year-old male with pulmonary dirofilariasis cytologically mimicking lung cancer is presented. By transbronchial brushing cytology, several suspect cells with a papillary arrangement showing a high nuclear/cytoplasmic ratio, irregularity of nuclear shape, nuclear enlargement and a macronucleolus were obtained. These cells seemed to originate in the reparative process of the bronchiolar epithelium around the infarcted lesion containing Dirofilaria immitis.

[A case of right ventricular outflow reconstruction surgery using an autologous pericardial non-valved conduit to treat pulmonary atresia with uncommon systemic-pulmonary collateral artery]

A 11-year-old girl diagnosed as having pulmonary atresia with uncommon systemic-pulmonary artery underwent on March 6, 1991. The collateral artery was derived from the left subclavian artery and divided from the descending aorta. Right ventricular outflow reconstruction was performed using a non-valved conduit of the autologous pericardium, and anastomosis of the conduit and pulmonary artery was successfully performed prior to extracorporeal circulation, because of the conduit's flexibility. Thus, we could reduce extracorporeal circulation time. Postoperative course was excellent, and patient is free from the morbidity associated with prosthetic valve. It is considered that a non-valved conduit of the autologous pericardium may be effective, but will require a long term follow-up.