Subfamily-specific posttranscriptional mechanism underlies K(+) channel expression in a developing neuronal blastomere

Na(+) and K(+) channels are the two key proteins that shape the action potentials in neurons. However, little is known about how the expression of these two channels is coordinated. To address this issue, we cloned a Shab-related K(+) channel gene from ascidian Halocynthia roretzi (TuKv2). In this animal, a blastomere of neuronal lineage isolated from the 8-cell embryo expresses single Na(+) channel and K(+) channel genes after neural induction. Expression of a dominant negative form of TuKv2 eliminated the native delayed rectifier K(+) currents, indicating that the entire delayed rectifier K(+) current of the neuronal blastomere is exclusively encoded by TuKv2. TuKv2 transcripts are expressed more broadly than Na(+) channel transcripts, which are restricted to the neuronal lineages. There is also a temporal mismatch in the expression of TuKv2 transcript and the K(+) current; TuKv2 transcripts are present throughout development, whereas delayed rectifier K(+) currents only appear after the tailbud stage, suggesting that the functional expression of the TuKv2 transcript is suppressed during the early embryonic stages. To test if this suppression occurs by a mechanism specific to the TuKv2 channel protein, an ascidian Shaker-related gene, TuKv1, was misexpressed in neural blastomeres. A TuKv1-encoded current was expressed earlier than the TuKv2 current. Furthermore, the introduction of the TuKv2-expressing plasmid into noninduced cells did not lead to the current expression. These results raise the possibility that the expression of TuKv2 is post-transcriptionally controlled through a mechanism that is dependent on neural induction.

Splenectomy attenuates superoxide anion release into the hepatic sinusoids after lipopolysaccharide challenge

BACKGROUND/AIMS

The aim of this study was to determine whether the spleen contributes to superoxide anion release into the hepatic sinusoids and subsequent damage to endothelial cells of the hepatic sinusoids after lipopolysaccharide challenge.

METHODS

Rats were given 2 mg/kg body weight lipopolysaccharide. Three hours after the treatment, superoxide anion release into the hepatic sinusoids was examined in a liver perfusion model using the cytochrome C method. Damage to endothelial cells of the hepatic sinusoids was assessed from the purine nucleoside phosphorylase/glutamic-pyruvic transaminase ratio in the liver perfusate. To further characterize the mechanisms behind these changes, these studies were done in rats given superoxide dismutase or an anti-TNFalpha antibody. To study whether the spleen plays a role in the mechanisms, experiments with splenectomized rats were performed.

RESULTS

Lipopolysaccharide challenge resulted in superoxide anion release into the hepatic sinusoids and damage to endothelial cells of the hepatic sinusoids. These changes were significantly attenuated by the treatments with superoxide dismutase or an antibody against TNFalpha, as well as by splenectomy. The hepatic macrophage and Kupffer cell populations after lipopolysaccharide challenge were significantly smaller in the rats given splenectomy than in those given a sham operation. There were no significant differences in the neutrophil populations between the two groups. Levels of TNFalpha were significantly lower in the former than the latter, whereas there were no significant differences in levels of Interleukin-8 between the two groups.

CONCLUSIONS

Splenectomy reduced the superoxide anion release into the hepatic sinusoids caused by the lipopolysaccharide challenge and subsequent damage to endothelial cells of the hepatic sinusoids. This supports the view that splenectomy has a protective effect in lipopolysaccharide-induced liver injury.

[Indication and outcome in emergent coronary artery bypass graft for acute coronary syndrome]

Among 462 cases receiving coronary artery bypass graft (CABG) during the period from November 1991 to January 1999, emergency operation was performed within 24 hours for 27 cases. Male-to-female ratio was 21:6, and age of patients ranged from 50 to 83 years (average age: 65.9 years). Intra aortic balloon pumping (IABP) was used from preoperative period for 25 cases, and PCPS was used for one case. Operation was performed under cardiac arrest in 25 cases and under ventricular fibrillation in 2. Average number of grafts was 2.4 +/- 1.0 and perioperative mortality was 25.9%. The results of emergency cases were extremely low compared with mortality of palliative operation of 3.4%, whereas mortality has been improved to 12.5% (2/16) in the last two years. These results suggest that it is important for the improvement of the outcome in emergency CABG to prevent aggravation of circulatory dynamics and to shift to operation under stable conditions.

Establishment and characterization of human immature teratoma cell line (TES-1)

A new human immature teratoma cell line, TES-1, was established from a surgical specimen from a 12-year old male with third ventricular immature teratoma. TES-1 shows polygonal morphology rich in neurites, and proliferated as adherent monolayer, with an approximate population doubling time of 48 hours. Electron microscopic analysis revealed the presence of swollen rough endoplasmic reticulum, and prominent lipid droplets, lysosomes and microfilaments. The chromosome numbers were between 41 and 160 (mode 78), including abnormal karyotypes 1p-, 5q-, 12p+ and 17p+ (G-band analysis). Hetero-transplantation of TES-1 into BALB/c nude mice produced no visible tumors. Multipotential differentiation was not induced in TES-1 monolayer culture, but significant neuron specific enolase activity was expressed in both extracellular (by RIA method) and intracellular fractions (by immunohistochemical method), suggesting the differentiation toward neurocytes. This cell line provides a useful in vitro model for the pathophysiological analysis of immature teratoma.

Iodine-impregnated drapes enable recording of precordial electrocardiogram

Although we believed that the use of a polyester film drape for primary elective open sternum with delayed sternal closure made it impossible to record precordial electrocardiograms on the drape, we confirmed that it is possible to record electrocardiograms on an iodine-impregnated drape due to the iodine anion electrical conductibility.

Evidence for ethanol oxidation by Kupffer cells

Ethanol oxidation in Kupffer cells was investigated by measuring 14C-acetate formation from 14C-ethanol, and the role of aldehyde dehydrogenase 2 (ALDH2) in this process was also examined. Formation of 14C-acetate from 20 mM of 14C-ethanol was significantly increased in medium-containing Kupffer cells (9,003 +/- 2,066 cpm/5 x 10(6) cells), compared with medium containing no cells (1,826 +/- 46 cpm, p < 0.01), or containing acid-killed Kupffer cells (1,629 +/- 210 cpm, p < 0.01). Ethanol formation was significantly attenuated when 20 and 200 microM cyanamide or 2 microM disulfiram were given. Reverse transcriptase-polymerase chain reaction demonstrated that Kupffer cells carry mRNA for ALDH2. These findings indicate that Kupffer cells can oxidize ethanol to acetate. ALDH2 may participate in this process, especially in the conversion of acetaldehyde to acetate.

A new instrument for hemostatic vascular management in endoscopic surgery: diode laser (STATLase-SDL) and its handpiece (dual hook)

OBJECTIVE

The authors described experimental data in hemostatic vascular transection using a STATLase-SDL with a 780-865 nm GaA/As diode wavelength and its handpiece, Dual Hook (DH).

SUMMARY BACKGROUND DATA

The STATLase-SDL and DH are newly developed devices for endoscopic surgery. It seems that the device has improved hemostatic cutting ability.

METHODS

The DH was applied to the abdominal aorta (< 2 mm) of Japanese white rabbits (n = 15) under general anesthesia. Tissue temperature during laser transection and interluminal bursting pressures were measured. Histopathological examinations at the cut end were carried out by hematoxylin-eosin (H&E) and elastica Van Gleson's (EVG) stainings. To investigate short-term effects 11 days postoperatively, the cut ends of the vessels were examined histologically in the heminephrectomy group.

RESULTS

The DH hemostatistically cut through arteries up to 2 mm in diameter. Temperatures at the inner hook and in adjunct tissue were higher than 160 degrees C, while that at the outer hook was lower than 80 degrees C. The bursting pressures immediately after transection was 307.2 +/- 35.2 mm Hg at a laser power of 8 W (n = 5), and 295.6 +/- 28.7 mm Hg at 10 W (n = 5). Histological examination of the transected sites on the vessels revealed well-opposed tissue welding of the vascular wall. Absence of fragmentation in the welding of the internal elastic lamina is crucial for closure of the vessel stump. Up to 11 days postoperatively, there were no direct complications related to the use of the DH.

CONCLUSIONS

The STATLase-SDL and DH have good hemostatic cutting ability and might be suitable for endoscopic surgery.

Superoxide anion release into the hepatic sinusoid after an acute ethanol challenge and its attenuation by Kupffer cell depletion

Superoxide anion release into the hepatic sinusoids and subsequent damage to the endothelial cells of the hepatic sinusoids after ethanol challenge was examined. A 250 mg/kg body weight/hr dose of ethanol was given to rats for 3 hr, and superoxide anion release into the hepatic sinusoids was examined in a liver perfusion model using the cytochrome c method. Ethanol treatment resulted in superoxide anion release into the hepatic sinusoids (0.20 +/- 0.01 vs. 0.12 +/- 0.02 o.d., p < 0.05) and an increase in the purine nucleoside phosphorylase/alanine aminotransferase ratio in the liver perfusate, a marker of damage to the endothelial cells of the hepatic sinusoids (0.003 +/- 0.002 vs. 0.008 +/- 0.002; p < 0.05). Tumor necrosis factor-alpha was not detectable in either group, and there were no significant differences in the population of hepatic macrophages, leukocytes, or Kupffer cells between the two groups. To clarify the role of Kupffer cells in the mechanism, 10 mg/kg of body weight of gadolinium chloride was given to rats twice, 24 hr apart, resulting in depletion of ED2-positive cells from the hepatic lobules. The superoxide anion release after the ethanol challenge was significantly attenuated in the Kupffer cell-depleted rats, compared with the controls (0.14 +/- 0.02; p < 0.05, compared with ethanol alone). The change was associated with a significant decrease in the purine nucleoside phosphorylase/alanine aminotransferase ratio in the liver perfusate (0.004 +/- 0.002; p < 0.05, compared with ethanol alone). Ethanol causes superoxide anion release into the hepatic sinusoid and subsequent damage to the sinusoidal endothelial cells. These changes were reduced by Kupffer cell depletion. This supports the view that Kupffer cell depletion has a protective effect on ethanol-induced liver injury.

Cross-coupling between voltage-dependent Ca2+ channels and ryanodine receptors in developing ascidian muscle blastomeres

1. Ascidian blastomeres of muscle lineage express voltage-dependent calcium channels (VDCCs) despite isolation and cleavage arrest. Taking advantage of these large developing cells, developmental changes in functional relations between VDCC currents and intracellular Ca2+ stores were studied. 2. Inactivation of ascidian VDCCs is Ca2+ dependent, as demonstrated by two pieces of evidence: (1) a bell-shaped relationship between prepulse voltage and amplitude during the test pulse in Ca2+, but not in Ba2+, and (2) the decay kinetics of Ca2+ currents (ICa) obtained as the size of tail currents. 3. During replacement in the external solution of Ca2+ with Ba2+, the inward current appeared biphasic: it showed rapid decay followed by recovery and slow decay. This current profile was most evident in the mixed bath solution (2 % Ca2+ and 98 % Ba2+, abbreviated to '2Ca/98Ba'). 4. The biphasic profile of I2Ca/98Ba was significantly attenuated in caffeine and in ryanodine, indicating that Ca2+ release is involved in shaping the current kinetics of VDCCs. After washing out the caffeine, the biphasic pattern was reproducibly restored by depolarizing the membrane in calcium-rich solution, which is expected to refill the internal Ca2+ stores. 5. The inhibitors of endoplasmic reticulum (ER) Ca2+-ATPase (SERCAs) cyclopiazonic acid (CPA) and thapsigargin facilitated elimination of the biphasic profile with repetitive depolarization. 6. At a stage earlier than 36 h after fertilization, the biphasic profile of I2Ca/98Ba was not observed. However, caffeine induced a remarkable decrease in the amplitude of I2Ca/98Ba and this suppression was blocked by microinjection of the Ca2+ chelator BAPTA, showing the presence of caffeine-sensitive Ca2+ stores at this stage. 7. Electron microscopic observation shows that sarcoplasmic membranes (SR) arrange closer to the sarcolemma with maturation, suggesting that the formation of the ultrastructural machinery underlies development of the cross-coupling between VDCCs and Ca2+ stores.

Healing of the intimal dissection of the internal thoracic artery graft

We report healing of the intimal dissection of an internal thoracic artery graft. Triple coronary artery bypass grafting was performed using left internal thoracic artery and saphenous vein grafts. One month after operation, the intimal dissection of the internal thoracic artery graft was clearly visible by coronary angiography; however, after 1 year of only medical treatment consisting of warfarin, ticlopidine, and nitrate, the intimal dissection was undetectable by coronary angiography.

[Coronary artery bypass grafting technique to minimize the usage of metallic materials]

Some metallic materials are widely used for coronary artery bypass surgery. There is no problem using the metallic materials themselves. However, metallic artifact interferes with the interpretation and reduces the sensitivity of the MRI. To minimize the utilization of metallic materials, we applied absorbable nonmetallic clips and used an ultrasonically activated scalpel to harvest the arterial grafts. We also applied polyester suture instead of the stainless steel sternal wire. We believe this technique will allow increased MRI usage for patients who undergo coronary artery bypass surgery.

Basic fibroblast growth factor induction of neuronal ion channel expression in ascidian ectodermal blastomeres

1. Cleavage-arrested anterior animal (a4-2) blastomeres isolated from eight-cell embryos of Halocynthia aurantium differentiated into neuronal type cells expressing neuron-specific ion channels when they were treated with basic fibroblast growth factor (bFGF). This induction process was very similar to that when a4-2 blastomeres were cultured in contact with anterior vegetal (A4-1) blastomeres from the same embryos or when treated with subtilisin, a serine protease. 2. Other growth factors, transforming growth factor (TGF) beta1, activin A, epidermal growth factor (EGF) and nerve growth factor (NGF), had no effect on the default epidermal differentiation of cleavage-arrested a4-2 blastomeres. 3. Messenger RNA of the ascidian neuronal Na+ channel, TuNa I, was detected using RT-PCR in a4-2-derived partial embryos of Halocynthia aurantium as well as in the cleavage-arrested a4-2 blastomeres treated with bFGF, confirming the neural inducer activity of bFGF during ascidian embryogenesis. 4. bFGF was effective at concentrations as low as 1 ng ml-1 in inducing neuronal ion channels in cleavage-arrested a4-2 blastomeres. EC50 for neuronal differentiation was estimated to be around 8 ng ml-1, and the maximum effect of 90 % neuronalization was obtained with above 100 ng ml-1. 5. For induction of neuronal differentiation, bFGF was required to be continuously present 8 to 14 h after fertilization. A similar time window was required for cell-contact induction, but it was considerably shorter for subtilisin induction. 6. We discuss whether activation of receptor tyrosine kinase is a common pathway for neural induction by bFGF, subtilisin, and cell-contact with A4-1 blastomeres.

Interleukin-6 and "complex" cardiac myxoma

A rare case of "complex" cardiac myxoma is reported. Complex cardiac myxoma manifests with more constitutional signs than the sporadic type. These constitutional signs are known to be associated with the overproduction of interleukin-6 by cardiac myxomas. In our study, immunohistochemical staining of the myxoma for interleukin-6 was strongly positive. The serum interleukin-6 level decreased after surgical removal of the tumor and has remained undetectable for the past 2 years.

Formation of superoxide anion in the hepatic sinusoid after lipopolysaccharide challenge

Using the cytochrome c method, superoxide anion that is released into the hepatic sinusoid was measured after a lipopolysaccharide challenge in a liver perfusion system. Moreover, damages of epithelial cells of the hepatic sinusoid were estimated with scanning electron microscopic analysis and levels of purine nucleoside phosphorylase/GPT ratio. Lipopolysaccharide administration increased the conversion of oxidized cytochrome c into reduced cytochrome c in the perfusate, indicating that superoxide anion was formed in the hepatic sinusoid. This change was associated with increase in levels of portal tumor necrosis factor-alpha and attenuated by the simultaneous administration of superoxide dismutase. Scanning electron microscope analysis revealed that diameters of sinusoidal fenestrae increased in rats treated with lipopolysaccharide, compared with controls. Moreover, levels of purine nucleoside phosphorylase/GPT ratio was significantly increased in the liver perfusate in lipopolysaccharide-treated rats, compared with controls. Superoxide anion in hepatic sinusoid may be one of the pathogenic factors behind damages of epithelial cells of the hepatic sinusoid caused by lipopolysaccharide.

Effect of chronic ethanol feeding on endotoxin-induced hepatic injury: role of adhesion molecules on leukocytes and hepatic sinusoid

Endotoxin is postulated to be an important aggravating factor for alcoholic liver disease. We have previously reported that rats fed ethanol are more vulnerable to endotoxin-induced liver damage, and hepatic microcirculatory disturbance plays an important role for this liver damage by observation with an intravital microscopy. In this study, we have investigated the role of adhesion molecules in endotoxin-induced microcirculatory disturbance in chronic ethanol-fed rats. Male Wistar rats were pair-fed with ethanol liquid diet (ethanol group) or an isocaloric control diet (control group) for 6 weeks. Leukocyte adherence to the hepatic sinusoid by stimulation with lipopolysaccharides (1 mg/kg of body weight) was observed by an inverted fluorescence microscopy equipped with a silicon-intensified target camera and was found to be enhanced in ethanol-fed rats. Tumor necrosis factor-alpha and GRO/CINC-1 (rat counterpart of interleukin-8) was increased in the blood in these animals. Subsequent expression of adhesion molecules, LFA-1 beta-chain on leukocytes were demonstrated by flow cytometry, which suggests a possible involvement of leukocyte adherence to the hepatic damage in ethanol-fed animals. Preadministration of anti-rat LFA-1 beta-chain monoclonal antibody effectively suppressed leukocyte adherence to the hepatic sinusoid. These results suggest that the enhanced sequestration of neutrophils to the liver with these adhesion molecules may play a significant role in the pathogenesis of alcoholic liver disease.

[A case report of recurrent self inserted needle in heart]

A 17-year-old female who had, on two occasions, inserted a total of 7 needles into her heart and chest wall, resulting in autolesion on both occasions, was examined. On the first occasion, because the needle end was recognizably protruding from the right ventricle, we successfully removed the needle without using ECC. No complications arose prior to discharge, after which she regularly visited the psychiatric department for treatment. Two months after discharge, she again inserted needles into her chest wall and was admitted to hospital. At that time, five needles were evident in the chest wall. During preparation for removal of the needles under local anesthetic, she escaped from the room. When found in a ward several hours later, six needles were embedded in her chest wall, the sixth, most recently inserted needle was an injection needle. Due to the depth to which the needle had been inserted in the heart, neither the point nor end were visible, and thus the needle had to be removed using ECC and fluoroscopy.

[A case of MIDCAB to the left circumflex via the left posterolateral thoracotomy]

There have been many reports of MIDCAB to left anterior descending artery via a small dissection utilizing the left anterolateral thoracotomy. We report here a case of CABG reoperation to the circumflex artery by MIDCAB via the left posterolateral thoracotomy. A 66-year-old male patient had received a 3 branch bypass graft on the LITA-LAD and the SVG-OM-4 PD at another institution. Postoperative angiography revealed a SVG occlusion. Since repeated intervention was unsuccessful, reoperation was necessary. To preserve the patency of the LITA, the 4th left intercostal posterolateral thoracotomy was selected. We utilized a commercially available rib retractor for MIDCAB, as well as a stabilizer and a CO2 blower to obtain a nearly perfect bloodless stabilized view. A new SVG was used to connect the left circumflex artery. The operation was successful without any postoperative complications or need for transfusion. After a two week hospital stay, the graft patency was confirmed and the patient was discharged.

Ion channels and early development of neural cells

In this review we underscore the merits of using voltage-dependent ion channels as markers for neuronal differentiation from the early stages of uncommitted embryonic blastomeres. Furthermore, a fairly large part of the review is devoted to the descriptions of the establishment of a simple model system for neural induction derived from the cleavage-arrested eight-cell ascidian embryo by pairing a single ectodermal with a single vegetal blastomere as a competent and an inducer cell, respectively. The descriptions are focused particularly on the early developmental processes of various ion channels in neuronal and other excitable membranes observed in this extraordinarily simple system, and we compare these results with those in other significant and definable systems for neural differentiation. It is stressed that this simple system, for which most of the electronic and optical methods and various injection experiments are applicable, may be useful for future molecular physiological studies on the intracellular process of differentiation of the early embryonic cells. We have also highlighted the importance of suppressive mechanisms for cellular differentiation from the experimental results, such as epidermal commitment of the cleavage-arrested one-cell Halocynthia embryos or suppression of epidermal-specific transcription of inward rectifier channels by neural induction signals. It was suggested that reciprocal suppressive mechanisms at the transcriptional level may be one of the key processes for cellular differentiation, by which exclusivity of cell types is maintained.

[A case report of thoracic outlet syndrome with acute arterial obstruction caused by abnormal first rib]

A 33-year-old male was transferred to our hospital because of coldness, numbness and pain in his right arm. Chest X-ray showed abnormal first ribs on both sides that were attached to the second ribs below the clavicles. Angiogram revealed an aneurysm of right subclavian artery, thrombus in the aneurysm and embolism to the brachial artery. Thrombectomy using a Fogarty catheter was done and the radial pulse recovered. Surgical resection of the abnormal first rib and thrombectomy was performed, because ischemic symptoms recurred in spite of anticoagulation and antiplatelet therapy. Acute arterial occlusion in patients with thoracic outlet syndrome is rare. The literature on arterial complications of thoracic outlet syndrome is reviewed.

[A case of impending rupture of coronary aneurysm after rapid growth within a month]

A case of successful surgery for a rapidly growing aneurysm is described. The patient, a 47-year-old woman, had suffered from recurrent aphtous and genital ulcers for 17 years and hyperthyroidism for two years. One month after myocardial infarction, follow-up coronary angiography showed total obstruction at the distal part of the aneurysm in the left anterior descending artery with rapid dilation to 37 mm. Echocardiography revealed gradually increasing pericardial effusion. Urgent surgery was performed on January 11, 1995. Because Behçet's disease was suspected and since the vascular wall was suspected to have become fragile, surgery was performed using the aortic-no-touch technique. Under ventricular fibrillation, the proximal and distal part of the left anterior descending artery of the coronary aneurysm was ligated and bypass grafting was achieved at the distal part of the left anterior descending artery with the left internal thoracic artery. Low dose steroid treatment was started from nine days after surgery. The post operative course was satisfactory and coronary angiography during the first month showed no abnormal signs.

Distinct neuronal lineages of the ascidian embryo revealed by expression of a sodium channel gene

The ascidian larva contains tubular neural tissue, one of the prominent anatomical features of the chordates. The cell-cleavage pattern and cell maps of the nervous system have been described in the ascidian larva in great detail. Cell types in the neural tube, however, have not yet been defined due to the lack of a suitable molecular marker. In the present work, we identified neuronal cells in the caudal neural tube of the Halocynthia embryo by utilizing a voltage-gated Na+ channel gene, TuNa I, as a molecular marker. Microinjection of a lineage tracer revealed that TuNa I-positive neurons in the brain and in the trunk epidermis are derived from the a-line of the eight-cell embryo, which includes cell fates to epidermal and neural tissue. On the other hand, TuNa I-positive cells in the more caudal part of the neural tissue were not stained by microinjection into the a-line. These neurons are derived from the A-line, which contains fates of notochord and muscle, but not of epidermis. Electron microscopic observation confirmed that A-line-derived neurons consist of motor neurons innervating the dorsal and ventral muscle cells. Isolated A-line blastomeres have active membrane excitability distinct from those of the a-line-derived neuronal cells after culture under cleavage arrest, suggesting that the A-line gives rise to a neuronal cell distinct from that of the a-lineage. TuNa I expression in the a-line requires signals from another cell lineage, whereas that in the A-line occurs without tight cell contact. Thus, there are at least two distinct neuronal lineages with distinct cellular behaviors in the ascidian larva: the a-line gives rise to numerous neuronal cells, including sensory cells, controlled by a mechanism similar to vertebrate neural induction, whereas A-line cells give rise to motor neurons and ependymal cells in the caudal neural tube that develop in close association with the notochord or muscle lineage, but not with the epidermal lineage.

[A case of aortic valve replacement 3 years after coronary artery bypass grafting]

A rare case of aortic valve replacement (AVR) with poor left ventricular function, following coronary artery bypass grafting, was reported. The patient was 57-year-old man who received urgent CABG with 2 saphenous vein grafts 3 years ago. At that time, aortic regurgitation (AR) was grade 2. He suffered acute myocardial infarction 1 year after CABG because of the occlusion the saphenous vein graft to the obtuse marginal branch. Percutaneous transluminal angioplasty was successfully performed for occluded graft. Since then, however, AR increased gradually and the left ventricular function decreased. Three years after the initial operation, he was admitted again with congestive heart failure. Heart catheterization revealed grade 3 AR and 17% left ventricular ejection faction (LVEF). AVR was performed through a median sternotomy and 2 saphenous vein grafts were preserved. He showed uneventful postoperative recovery and is now very well with 40% LVEF.

[A case of thymic epidermoid carcinoma recurred in the pericardial cavity]

A 61-year-old woman with cough and sputum and right scapular pain was referred to our hospital with a suspected anterior mediastinal tumor by Chest X-rays and CT-scan. The tumor was diagnosed as thymic cancer cytologically by fine needle biopsy. At the the thoracotomy via median sternotomy, the tumor adhered to left brachial vein, superior vena cava and pericardium and it was dissected by maneuver. It was diagnosed as moderately differentiated epidermoid carcinoma by histology of the surgical specimen and involvement of the pericardium was histologically presumed. The patient received postoperative radiation therapy. A year after operation, the tumor recurred in the pericardial cavity. Inspite of resection of the recurred tumor and an anticancer chemotherapy, the patient died of cardiac failure due to the proliferated tumor around the heart. There are some reports that epidermoid carcinoma of the thymus may have different responses to radiation therapy according to histologic tumor differentiations. At resection of epidermoid carcinoma of thymus, therefore, intraoperative pathologic examination of the adhesive part of excised specimen and additional resection were essential to resect thymic cancer radically.

Monoclonal antibodies against pig ovarian follicular granulosa cells induce apoptotic cell death in cultured granulosa cells

Two monoclonal antibodies capable of inducing granulosa cell apoptosis were produced against granulosa cells prepared from antral follicles of pig ovaries. The healthy follicles, 4-5 mm in diameter, were dissected from the ovaries of gilts, and then granulosa cells were isolated. BALB/c female mice were immunized with the isolated granulosa cells. Antibodies against the granulosa cells were detected by immunofluorescent staining using frozen ovarian sections. The isolated spleen cells prepared from immunized mice producing antibodies against the granulosa cells were fused with Sp2/O-Ag 14 mouse myeloma cells by standard hybridization techniques. Two hybridoma clones, PFG-1 and PFG-2, which produced specific IgM antibodies against granulosa cells were selected. Western blotting analysis revealed that PFG-1 and PFG-2 antibodies specifically recognized cell-membrane proteins with molecular weights of 55 and 70 kD and isoelectric points of 5.9 and 5.4, respectively. The monoclonal antibodies immunohistochemically reacted with granulosa cells of healthy follicles. When the isolated granulosa cells prepared from healthy follicles were cultured in medium containing 0.1 or 10 micrograms/m/PFG-1 or PFG-2 antibodies, respectively, the cells underwent apoptosis as determined by nuclear morphology, DNA electrophoresis and flow cytometric analysis. In conclusion, these two monoclonal antibodies against granulosa cells have cell-killing activity in cultured granulosa cells.

[Coronary bypass surgery in the elderly: characteristics and quality of life]

From November 1991 to December 1996, 66 patients aged 70 years or more underwent coronary artery bypass grafting (CABG). They were compared with a group of 200 consecutive patients aged less than 70 years of age who underwent CABG during the same period. The elderly patients had a higher incidence of female gender, smaller body structure, left main trunk disease, calcification of ascending aorta and emergency operation. However, there were no significant differences between two groups in hospital mortality, IABP insertion or length of stay in intensive care unit. Quality of life (QOL) of the elderly patients was evaluated for all the 58 survivors by means of Specific Activity Scale Questionnaires. Forty of the 58 patients (69%) had functional capacity of 5 METs or more. All the 43 patients who worked before CABG were able return to work, although some patients reduced their workload. We conclude that CABG in elderly patients can be performed with mortality and morbidity similar to those in younger patients. QOL is generally maintained.