Prediction of incontinence following low anterior resection for rectal carcinoma

PURPOSE

This study was performed to predict incontinence following low anterior resection for rectal cancer.

METHODS

Preoperatively, 21 patients were evaluated via patient history and a physical examination that included anal manometric studies. Six months postoperatively, repeat manometric studies and clinical evaluations were performed to assess the level of continence. Degree of continence was graded based on severity of the dysfunction and grade of the continence score.

RESULTS

The formula used for predicted postoperative resting pressure is as follows: predicted postoperative resting pressure = 0.42 x preoperative resting pressure +1.56 x length of remaining rectum +12.37 (R2 = 0.58; P < 0.001). It was demonstrated that patients with low predicted postoperative resting pressures (< 30 mmHg) had incontinence, and those with high predicted postoperative resting pressures (> 35 mmHg) were continent. There were significant correlations between length of the remaining rectum and ratio of the decrease in maximum resting pressure (postoperative/preoperative maximum resting pressure; r = 0.63; P < 0.01).

CONCLUSIONS

Continence following low anterior resection may be influenced by maximum resting pressure function of the internal anal sphincter; if it is injured during surgery, incontinence will occur. We may be able to foretell incontinence by using the predicted postoperative resting pressure formula, which is calculated by using preoperative resting pressure measurements and then determining the length of the remaining rectum.

A possible role of endogenous inhibitor for nitric oxide synthesis in the bovine ciliary muscle

The present experiments were designed to investigate the possible role of endogenous methylarginine derivatives such as NG-monomethyl-L-arginine, asymmetrical NG,NG-dimethyl-L-arginine and symmetrical NG,N'G-dimethyl-L-arginine for the nitric oxide synthesis in the bovine ciliary muscle. The contents of asymmetrical NG,NG-dimethyl-L-arginine and symmetrical NG,N'G-dimethyl-L-arginine in the bovine ciliary muscle were determined to be 370.2 +/- 27.6 (n = 5) and 182.4 +/- 22.9 (n = 5) pmoles g-1 wet weight, respectively by means of the automated high-performance liquid chromatography. NG-Monomethyl-L-arginine was below the assay limits. On the basis of the total tissue water content (0.792 +/- 0.006 ml g-1 wet weight, n = 14), the concentrations of asymmetrical NG,NG-dimethyl-L-arginine and symmetrical NG,N'G-dimethyl-L-arginine were tentatively estimated to be (4.7 +/- 0.3) x 10(-7) M (n = 5) and (2.3 +/- 0.3) x 10(-7) M (n = 5), respectively. A23187 (10(-7)-3 x 10(-4) M) produced a concentration-dependent relaxation of the ciliary muscle strips which had been contracted with 10(-5) M carbachol. Authentic asymmetrical NG,NG-dimethyl-L-arginine (3 x 10(-6)-3 x 10(-4) M), but not symmetrical NG,N'G-dimethyl-L-arginine (3 x 10(-4) M), inhibited the 10(-6) M A23187-induced relaxation in a concentration-dependent manner. The inhibition with asymmetrical NG,NG-dimethyl-L-arginine (10(-4) M) was reversed by an addition of 3 x 10(-3) M L-arginine, but not by 3 x 10(-3) M D-arginine. The A23187 (10(-6) M)-induced relaxation was enhanced by 3 x 10(-3) M L-arginine or superoxide dismutase (50 U ml-1), whereas it was inhibited by carboxy-PTIO (3 x 10(-4) M), a scavenger of nitric oxide, or methylene blue (10(-5) M), an inhibitor of guanylate cyclase. The carbachol-induced contraction was enhanced by asymmetrical, NG,NG-dimethyl-L-arginine (10(-5) M) and inhibited by 3 x 10(-3) M L-arginine. Any effect of prostanoid formation during the A23187-induced relaxation was ruled out by using indomethacin (10(-5) M). Sodium nitroprusside (10(-5) M), a donor of nitric oxide, also produced a relaxation, which was inhibited by methylene blue (10(-5) M) or carboxy-PTIO (3 x 10(-4) M) and was augmented by superoxide dismutase (50 U ml-1), but unaffected by asymmetrical NG,NG-dimethyl-L-arginine (3 x 10(-4) M) or L-arginine (3 x 10(-3) M). These results lead us to speculate that the nitric oxide synthesized endogenously from L-arginine may play a role for mediating relaxation of the bovine ciliary muscle and that the endogenous asymmetrical NG,NG-dimethyl-L-arginine may be involved in inhibiting the biosynthesis of nitric oxide when there are increased intracellular concentrations of the methylarginine under certain circumstances.

Fibroblasts spread on immobilized fibrin monomer by mobilizing a beta1-class integrin, together with a vitronectin receptor alphavbeta3 on their surface

Human and murine fibroblasts were found to spread far more avidly on fibrin monomer monolayers than on immobilized fibrinogen, indicating that removal of fibrinopeptides by thrombin is a prerequisite for the fibrin-mediated augmentation of cell spreading. In fact, cell spreading was not efficiently augmented on monolayers of a thrombin-treated dysfibrinogen lacking the release of fibrinopeptide A due to an Aalpha Arg-16 --> Cys substitution. Since a synthetic Arg-Gly-Asp (RGD)-containing peptide inhibited the fibrin-mediated cell spreading, subsequent dissociation of the carboxyl-terminal globular domain of the Aalpha-chains appears to render the RGD segments accessible to the cell-surface integrins. In support of this, fibrin-augmented cell spreading was inhibited by an antibody recognizing a 12-kDa peptide segment with gamma Met-89 at its amino terminus, which is located in close association with the RGD segment at Aalpha 95-97 in the helical coiled-coil interdomainal connector. The fibrin-mediated augmentation of cell spreading was inhibited not only by an antibody against human vitronectin receptor (LM 609) but also by an antibody against the beta1 subunit of integrin (mAb13), suggesting that the beta1-class integrin together with a vitronectin receptor, alphavbeta3, is mobilized onto the surface of fibroblasts upon contact with the fibrin monomer monolayer.

Stage-specific requirement of phosphate for development of rat 1-cell embryos in a chemically defined medium

Rat 1-cell embryos, recovered from naturally mated females, were cultured in a chemically defined medium (mR1ECM). When examined after 24, 56, 64 and 80 h of culture, embryos developed to the 2-cell (100%), 4-cell (93%), 4-cell to 8-cell (97%) and > or = 8-cell (95%) stages, respectively. When 0.4 M phosphate (NaH2PO4) was added to the medium after 0, 24, 56 and 64 h of culture, percentages (0-67%) of embryos that developed to the blastocyst stage after 115 h of culture were lower than that (86%) in the medium without phosphate. However, addition of phosphate after 80 h of culture accelerated blastocyst formation; a significantly higher percentage (94%) of blastocysts was obtained after 110 h of culture in this medium compared with when phosphate was not added (67%). When phosphate was added to the medium after 64 h, almost all (97%) 8-cell embryos developed to the blastocyst stage by 100 h of culture but development of 4-cell to 7-cell embryos was inhibited (22-63%). Acceleration of blastocyst formation was caused by addition of phosphate rather than by the exchange of the medium. The stimulatory effect of phosphate on embryo development was observed at concentrations of 0.1-1.2 mM. The mean numbers of cells (54.5-60.9 cells) in blastocysts examined after 115 h of culture were increased by the addition of 0.4-1.6 mM phosphate at 80 h as compared with blastocysts from cultures without phosphate (46.6 cells).

Immunohistochemical expressions of estrogen and progesterone receptors in human epididymis at different ages--a preliminary study

OBJECTIVE

To explore the biological significance of sex steroidal actions in human epididymis at various stages.

PATIENTS AND METHODS

Human epididymides were obtained from 20 males aged from 2 days to 81 years at autopsy. Immunohistochemical staining for estrogen receptor (ER) and progesterone receptor (PR) was conducted using formalin-fixed paraffin-embedded sections of epididymides, by the avidinbiotin-peroxidase complex method.

RESULTS

Positive immunohistochemical staining of ER was detected in the nucleus of epididymal epithelia in 14- to 64-year-old men, while in males aged from neonatal to 12 years, and over 65 years, ER was not detected in epididymides. On the other hand, PR was not detected in epididymis in any cases.

CONCLUSION

Estrogen might contribute to reproductive epididymal functions after puberty and during maturity via estrogen-ER cascades.

Stage-dependent development of rat 1-cell embryos in a chemically defined medium after fertilization in vivo and in vitro

The present study was conducted to examine the development of rat 1-cell embryos cultured in a chemically defined medium (mR1ECM) soon after penetration of eggs in vivo or in vitro. When eggs were recovered from naturally mated females at 0600-0900 h on the following day, no penetrated eggs with male pronuclei were observed. However, the percentage of pronuclear eggs had increased significantly at 1000-1100 h (17%) and 1200-1300 h (65%). When penetrated eggs recovered at 0600-0900 h were cultured in mR1ECM, blastocyst formation (22-46%) was significantly less frequent than in those (79-93%) recovered at 1000-1300 h. After collection at 0600-0800 h, preculture of penetrated eggs in modified Krebs-Ringer bicarbonate solution (mKRB) for up to 1200-1300 h improved their development to the blastocyst stage from 42% to 78%. Pronuclei were formed in almost all (98-100%) of the penetrated eggs examined after 6-20 h of insemination in mKRB. When penetrated eggs were transferred from mKRB into mR1ECM after 4-30 h of insemination, the percentages (47-64%) of blastocyst formation were significantly higher than those (1-20%) for eggs transferred after 1-3 h or after 40 h of insemination. When a total of 70 morulae or early blastocysts that had been produced by in vitro fertilization and developed in vitro were transferred to 7 pseudopregnant rats, 5 recipients into which 48 embryos had been transferred maintained their pregnancies and 25% of the embryos developed into late fetuses or pups. The results of the present study indicate that rat 1-cell embryos recovered from oviducts before pronuclear formation, or produced by in vitro fertilization, can develop to the blastocyst stage in vitro and that one or more factors in mKRB are necessary to maintain their development in mR1ECM.

[A case of myeloradiculoneuropathy associated with persistent high titers of anti-GM1 and anti-GD1b antibodies]

A 60-year-old woman was admitted to our hospital with bilateral weakness of the lower limbs. She had been suffering from spastic paraparesis of unknown origin for 12 years since she was 48. Myelopathy with the Th6 level appeared when she was 52 and underwent gradual deterioration. On admission, she showed spastic paraparesis and myelopathy with the Th6 level. A thoracic spinal MRI examination revealed a wholly thin spinal cord. EMG demonstrated that the conduction velocity of the peroneal nerve was 37.8m/sec, and F waves were not evoked on stimulation of the peroneal nerve. Although the anti-GM1 and anti-GD1b antibody titers in the serum were increased on admission, their values decreased transiently after whole plasmapheresis. There was accompanying impairment of the radiculoneuropathy and myelopathy. It is important to measure the titers of anti-ganglioside antibodies in patients with myeloradiculoneuropathy of unknown origin, and whole plasmapheresis is considered to represent a useful treatment for this type of illness.

Validation of the proximal isovelocity surface area method for assessing mitral regurgitation in children

The proximal isovelocity surface area (PISA) method for calculating volume flow through the regurgitant orifice has attracted significant attention. A number of in vitro studies and clinical studies in adults suggest that the method is accurate. However, when applying the method to children it must be noted that the absolute regurgitation volume is small, and the range of body sizes is wide. This study investigated the accuracy of the PISA method for quantitative assessment of the severity of mitral regurgitation in children. Twenty children aged 7 months to 12 years (average 4.7 years) with mitral regurgitation but without interventricular shunt or aortic stenosis were selected for this study. Underlying cardiac diseases included atrioventricular septal defects in nine, isolated mitral regurgitation in five, and association with other heart defects in six. The PISA radius (r) and the duration of regurgitation (T) were measured on color M-mode recordings, with the M line passing through the center of the PISA. Assuming that the PISA is a hemisphere, maximal regurgitant flow rate (MFR: ml/s) was calculated as MFR = 2pi x r2 x V (r = maximal radius, V = aliasing velocity), and regurgitant stroke volume (RSVpisa) as RSVpisa = 2pi x MSR x V x T (MSR = mean square of the PISA radius during regurgitation). As a validating standard, total stroke volume (TSV) using two-dimensional echocardiography determined by the area-length volumetry method and forward stroke volume (FSV) by the pulsed Doppler method were measured, and regurgitant stroke volume (RSVD: RSVD = TSV - FSV) and regurgitant fraction (RF: RF = RSVD/TSV) were calculated. A linear correlation was found between MFR, RSVpisa, and RSVD (X) (MFR = 4.2X + 54.0, r = 0.84. RSVpisa = 1. 0X + 9.8, r = 0.90), and both RSVpisa and MFR divided by body surface area (BSA: m2) revealed a significant correlation with regurgitant fraction (X) by nonlinear regression analysis (RSVpisa/BSA = 26.2 x X/(1 - X) + 16.8, r = 0.85. MFR/BSA = 121.8 x X/(1 - X) + 92.2, r = 0.79). It is concluded that maximal regurgitant flow rate, regurgitant stroke volume, and regurgitant fraction can be accurately predicted in children using the PISA method by Doppler echocardiography.

Silver-stained nucleolar organizer regions in the uterine myomatous tumors

The numbers of silver-stained nucleolar organizer regions (AgNORs) were counted in uterine myomatous tumors, and compared with those in corresponding normal myometria. The mean number of AgNORs in myomatous tumors tended to increase according to the neoplastic changes. The mean number of AgNORs in leiomyosarcoma (6.4 +/- 0.9) was significantly higher than that in cellular leiomyoma (4.5 +/- 0.7, P < 0.01). or leiomyoma (3.0 +/- 0.5, P < 0.001). In the normal myometria, the mean number of AgNORs (3.3 +/- 0.4) in the premenopausal women showed a higher tendency than that in the post-menopausal women (2.4 +/- 0.5). These results therefore suggest that AgNOR counts may be useful for diagnosis of cellular activity in uterine myomatous tumors.

Characterization of the ATP-dependent LTC4 transporter in cisplatin-resistant human KB cells

An active efflux pump for cis-diamminedichloroplatinum(II) (cisplatin) has been identified in cisplatin-resistant KCP-4 cells isolated from human epidermoid carcinoma KB-3-1 cells. The adenosine triphosphate(ATP)-dependent transport of leukotriene C4 (LTC4), an endogenous substrate for the glutathione S-conjugate export pump(GS-X pump), has been found in membrane vesicles prepared from KCP-4 cells. Multidrug resistance-associated protein (MRP) has also been identified as an ATP-dependent LTC4 transporter. To examine whether the GS-X pump expressed in KCP-4 cells in MRP, we investigated the expression of MRP in KCP-4 cells and compared the LTC4 transporting activity of GS-X pump expressed in KCP-4 cells with that of MRP. The level of MRP gene expression in KCP-4 cells was low and similar to that in KB-3-1 cells. MRP was not detected in membrane vesicles prepared from KB-3-1 and KCP-4 cells by immunoblot analysis. The ATP-dependent transport of LTC4 in KCP-4 and C-A120 vesicles showed saturable kinetics with an apparent Km of 0.18 microM and 0.25 microM, respectively. [3H]LTC4 transport in KCP-4 vesicles was more inhibited by 2,4-dinitrophenyl-S-glutathione(DNP-SG), bis-(glutathionato)-platinum(II) (GS-platinum) complex and glutathione disulfide(GS-SG) and less by LTD4 compared with that in C-A120 vesicles. The character of the LTC4 transporter expressed in KCP-4 vesicles is similar but not identical to that of MRP. Our results suggest that a glutathione S-conjugate export pump which is different from MRP exists in cisplatin-resistant KCP-4 cells.

Effects of tinted intraocular lens on contrast sensitivity

We evaluated contrast sensitivity and glare in 64 pseudophakic eyes. An ultraviolet-absorbing intraocular lens (IOL) was implanted in 32 eyes and a noncyanopsia yellow-tinted IOL was implanted in 32 eyes. The latter lens was designed to effectively absorb light below a wave-length of 500 nm. Contrast sensitivity was measured at a pupil diameter of 3 mm using an artificial pupil. The implanted yellow-tinted IOL showed improved contrast sensitivity in the middle spatial frequencies of 6 and 12 c/deg in photopic and mesopic vision. In addition, the yellow-tinted IOL decreased the effect of central glare on the contrast sensitivity.

Chronological observation of mouse endometrial carcinogenesis induced by N-methyl-N-nitrosourea and 17 beta-estradiol

Chronological observation of the neoplastic endometrial lesions induced by N-methyl-N-nitrosourea (MNU) and 17 beta-estradiol (E2) were studied. E2 induced cystic glandular hyperplasia, but adenomatous hyperplasia was induced predominantly by MNU. Atypical hyperplasia and adenocarcinoma were induced cooperatively by E2 and MNU, and first found at week 12; the incidence of adenocarcinoma increased in accordance with the week-course. Some atypical hyperplasia might be changed to adenocarcinoma. Mean AgNORs numbers in (pre)neoplastic lesions increased in accordance with neoplastic changes. This model was useful for clarifying histogenesis of human endometrial carcinogenesis.

[Effect of preoperative oral 5-fluorouracil on cell cycle of advanced cervical squamous cell carcinoma]

Using flow cytometry, we examined the correlations between the tumor stage and the cell cycle in subjects with advanced cervical squamous cell carcinoma as well as between the changes of cell cycle caused by 5-FU and their prognoses. Before 5-FU treatment, 75.9 +/- 9.6% of the patients were at G1 phase, 16.8 +/- 3.9% at S and 7.3 +/- 4.5% at G2/M. The change of cell cycle was not accompanied by the progression of tumor stage. Sixteen patients received oral 5-FU (300 mg/day) for at least 2 weeks before operation. In the patients at stage I, the cell cycle was not changed even after 5-FU treatment. They have been cancer-free for 3 postoperative years. While early recurrence was found in 4 of 5 cases at stage II or III showing progression at G1, all 6 cases who had regressed or remained unchanged at G1 were free from recurrence (p = 0.0152). These results suggested that the cell cycle is not necessarily correlated with the progression of tumor stage in patients with this kind of carcinoma, and that the change of cell cycle due to preoperative oral 5-FU could be a predictive indicator for their prognoses. Especially for those with poor prognoses who had shown progression at G1, more potent adjuvant chemotherapy should be planned.

A gamma Gly-268 to Glu substitution is responsible for impaired fibrin assembly in a homozygous dysfibrinogen Kurashiki I

A new type of gamma Gly-268 (GGA) to Glu (GAA) substitution has been identified in a homozygous dysfibrinogen by analyses of the affected polypeptide and its encoding gene derived from a 58 year-old man manifesting no major bleeding or thrombosis. The functional abnormality was characterized by impaired fibrin assembly most likely due to failure to construct properly aligned double-stranded fibrin protofibrils. This presumption was deduced from the following findings: (1) Factor XIIIa-catalyzed cross-linking of the fibrin gamma-chains progressed in a normal fashion, indicating that the contact between the central E domain of one fibrin monomer and the D domain of another took place normally; (2) Nevertheless, factor XIIIa-catalyzed cross-linking of the fibrinogen gamma-chains was obviously delayed, suggesting that longitudinal association of D domains of different fibrin monomers, ie, D:D association was perturbed; (3) Plasminogen activation catalyzed by tissue-type plasminogen activator was not as efficiently facilitated by polymerizing fibrin monomer derived from the patient as by the normal counterpart. Therefore, gamma Gly-268 would not be involved in the 'a' site residing in the D domain, which functions as a complementary binding site with the thrombin-activated 'A' site in the central E domain, but would be rather involved in the D:D self association sites recently proposed for human fibrinogen. Thus, the gamma Glu-268 substitution newly identified in this homozygous dysfibrinogen seems to impair proper alignment of adjacent D domains of neighboring fibrin molecules in the double-stranded fibrin protofibril, resulting in delayed fibrin gel formation.

Expression of the multidrug-resistance-associated protein (MRP) gene in human colorectal, gastric and non-small-cell lung carcinomas

MRP has been identified as another multidrug-resistance (MDR) gene and may be involved in an alternative MDR mechanism in some solid tumors. We investigated the expression of MRP mRNA in multidrug-resistance KB sublines (KB-8-5, KB-C2, C-A40 and C-A120), human non-small-cell lung carcinomas (NSCLC), gastric and colorectal carcinomas, and compared it with that in drug-sensitive human KB cells. MRP gene expression was elevated in 8 of 9 (89%) squamous-cell carcinomas of the lung. Furthermore, MRP expression in 4 squamous-cell carcinomas (L13, 18, 19 and 20) was more than 3.6 times higher than in KB-3-1 cells, and the average MRP mRNA expression level of all squamous-cell carcinomas was significantly higher than that of adenocarcinoma of the lung and of colorectal and gastric carcinomas. These results suggested that the MRP is responsible, at least in part, for drug resistance in some squamous-cell carcinomas of the lung.

Expression of the multidrug-resistance-associated protein (MRP) gene in human colorectal, gastric and non-small-cell lung carcinomas

MRP has been identified as another multidrug-resistance (MDR) gene and may be involved in an alternative MDR mechanism in some solid tumors. We investigated the expression of MRP mRNA in multidrug-resistance KB sublines (KB-8-5, KB-C2, C-A40 and C-A120), human non-small-cell lung carcinomas (NSCLC), gastric and colorectal carcinomas, and compared it with that in drug-sensitive human KB cells. MRP gene expression was elevated in 8 of 9 (89%) squamous-cell carcinomas of the lung. Furthermore, MRP expression in 4 squamous-cell carcinomas (L13, 18, 19 and 20) was more than 3.6 times higher than in KB-3-1 cells, and the average MRP mRNA expression level of all squamous-cell carcinomas was significantly higher than that of adenocarcinoma of the lung and of colorectal and gastric carcinomas. These results suggested that the MRP is responsible, at least in part, for drug resistance in some squamous-cell carcinomas of the lung.

Measurement of ventricular volumes by cine magnetic resonance imaging in complex congenital heart disease with morphologically abnormal ventricles

This study assessed the validity of cine magnetic resonance imaging (MRI) for measuring right and left ventricular volumes by using Simpson's rule in children with complex congenital heart disease. Forty-five patients with complex congenital heart disease (average age 2.6 years) and 10 controls (average age 2.3 years) were evaluated. The whole heart was encompassed by contiguous transverse sections. Ventricular volumes were calculated by adding luminal areas determined in each section at end diastole and end systole. End-diastolic and end-systolic volumes by MRI in both groups correlated well with those by ventriculography (r>0.89). Comparison of the ejection fraction in both ventricles in both groups yielded a good correlation between MRI and ventriculography (r>0.67). MRI technique in both groups had low intraobserver and interobserver variation (<6%). Cine MRI provides a suitable noninvasive means of quantifying ventricular volume in children with complex congenital heart disease.

[Oligospermia improved by switching an anticonvulsant from phenytoin to valproate]

We report a case of 30-year-old man with generalized seizure, who had received phenytoin (PHT) for more than 6 years, but developed decrease in sperm count and motility. After PHT had been discontinued and valproate (VPA) had been administered for 3 months, his sperm activity became normalized. The decrease in sperm motility was the most important cause of his infertility. Sperm motility has been reported to be inversely correlated with the ratio of the concentrations of antiepileptic drugs in the plasma and semen. In our case, the ratio was 0.21 for PHT and 0.08 for VPA. We wish to emphasize the importance of measuring the concentration of antiepileptic drugs in the semen of infertile young males if they are on anticonvulsants.

Temperature dependence of processes proximal and distal to the glucose-induced [Ca2+]i rise in stimulus-secretion coupling in rat pancreatic islets

Cooling is known to inhibit glucose-induced insulin secretion from pancreatic islets, but temperature-dependent processes in stimulus-secretion coupling remain unclear. In the present study, we examined the effects of cooling on the glucose-induced increase in cytoplasmic Ca2+ concentration ([Ca2+]i) and concomitant insulin secretion in rat pancreatic islets to analyze the temperature dependence of processes proximal and distal to the Ca2+ signal in stimulus-secretion coupling. Rat pancreatic islets were isolated and perifused. [Ca2+]i was measured using fura-2. Glucose (15 mM) caused a triphasic [Ca2+]i response in single islets at 35 degrees C: an initial decrease and a transient increase followed by a gradual increase, on which series of Ca2+ transients were frequently superimposed. Cooling to 30 and 25 degrees C caused slower and smaller [Ca2+]i responses with a Q10 (temperature coefficient) of 1.8. Glucose caused biphasic insulin secretion at 35 degrees C, which was inhibited by cooling, with a Q10 of 11.6. The ratio of glucose-induced insulin secretion to [Ca2+]i rise (IS/Ca) was calculated to represent the efficiency of Ca2+ to cause exocytosis. The Q10 value of the ratio of IS/Ca was 6.6. The Q10 values of the ratio of IS/Ca in the responses to high K+ (30 mM), carbamylcholine (100 microM) and glibenclamide (2 microM) were 5.6, 3.8, and 13.0, respectively. These values were greater than the Q10 values of corresponding [Ca2+]i responses: 1.2, 1.4, and 1.8, respectively. From these results, we conclude that cooling inhibits not only the glucose-induced [Ca2+]i rise but also Ca(2+)-activated exocytosis, and that the latter is much more sensitive to cooling than the former.

Successful pregnancy in a patient with pseudomyxoma peritonei arising from ovarian mucinous cystadenocarcinoma treated with cisplatin

A 24-year-old Japanese woman clinically showing pseudomyxoma peritonei arising from ovarian mucinous cystadenocarcinoma FIGO stage Ic is reported. She received intra-abdominal administrations of cisplatin five times following left oophorectomy. After being free of disease for 6 months, she conceived and carried two pregnancies to successful deliveries at 34 and 37 weeks, respectively. At the Cesarean sections, there were no abnormal findings except for right ovarian mucinous cystadenoma. She has had no evidence of recurrence by the time of the 60-month postoperative examination.

Perfusion imaging of the brain by B-mode ultrasonography. An experimental study in rabbits

BACKGROUND AND PURPOSE

The purpose of this study was to assess the ultrasonic imaging of normal rabbit brain by using echocontrast enhancer to identify the brain tissue perfusion.

METHODS

A solution of SH/TA-508 (containing microbubbles of mean size 2 to 4 microns; n = 4) was used for contrast enhancement of rabbit brain tissue and was administered through the left internal carotid artery. Contrast enhancement in the ipsilateral parietal area was examined by placing a 7.5-MHz transducer on the dura after a craniectomy. Throughout the experiment, we measured parameters including arterial blood pressure, arterial blood gases, and serum glucose and hematocrit levels. We investigated whether the administration of an echocontrast enhancer would be safe for the brain tissue (n = 4).

RESULTS

After injection of 100 mg/mL SH/TA-508, contrast enhancement was clearly observed within approximately 1 second in the left hemisphere (especially in the left cerebral cortex) in all animals and disappeared within 3 seconds after the end of injection. All physiological parameters remained within the normal range throughout the experiment. No focal abnormalities were observed on hematoxylin-eosin staining of the brain tissue.

CONCLUSIONS

Contrast enhancement was observed in the ipsilateral hemisphere with the administration of SH/TA-508. Contrast enhancement on B-mode brain imaging would be useful for real-time identification of brain tissue perfusion and should become a promising method for bedside clinical assessment of brain tissue perfusion.

Overexpressions of c-fos/jun mRNA and their oncoproteins (Fos/Jun) in the mouse uterus treated with three natural estrogens

To further understand hormonal carcinogenesis of natural estrogens (estrone, 17 beta-estradiol (E2) and estriol), we determined the expressions of c-fos/jun mRNA, and their oncoproteins (Fos/Jun) with intracellular localization in the uterus of ovarectomized mice treated with these estrogens. Mid-term chronic, as well as short-term assays were examined. Of three estrogens examined, mid-term chronic E2-treatment significantly increased the expression of c-fos/jun mRNA, and their oncoproteins (Fos/Jun). These were most prominently expressed in glandular cells of E2-treated mouse endometrium. Therefore, mid-term chronic E2-treatment might partially induce glandular cell transformation of uterine endometrium via overexpression of Fos/Jun.

Synergetic effects of epidermal growth factor and gonadotropins on the cytoplasmic maturation of pig oocytes in a serum-free medium

Cumulus-enclosed or cumulus-free pig oocytes were cultured for 48 h in a serum-free maturation medium, TCM-199B containing 1 mg/ml polyvinylalcohol, supplemented with gonadotropins (PMSG + hCG) and/ or epidermal growth factor (EGF), and inseminated with frozen-thawed ejaculated spermatozoa. Fourteen hours after insemination, the ability of oocytes to form male pronucleus (MPN) was examined. EGF significantly increased the ability of cumulus-enclosed oocytes to form MPN irrespective of the concentrations (1-100 ng/ml) tested. Gonadotropins had a greater effect than EGF on MPN formation in cumulus-enclosed oocytes, and a synergetic effect was observed when EGF and gonadotropins were added together. However, neither EGF nor gonadotropins exhibited a stimulatory effect on MPN formation in cumulus-free oocytes. These results indicate that the role(s) of both EGF and gonadotropins in stimulating cytoplasmic maturation of pig oocytes is mediated by cumulus.

Thrombocytopenia: a risk factor for acute myocardial infarction during the acute phase of Kawasaki disease

BACKGROUND

We report on 10 patients with Kawasaki disease and thrombocytopenia who were found to have a high incidence of coronary artery aneurysm and acute myocardial infarction. The clinical features of these patients, the cause of their thrombocytopenia and the relationship between cardiovascular pathology and thrombocytopenia were analyzed.

METHODS

The clinical features of 10 patients with Kawasaki disease found to have thrombocytopenia (group A: mean age 8.0 +/- 7.0 months) and those of 293 patients with Kawasaki disease (group B, controls: mean age 13 +/- 20 months) were analyzed. Coagulation studies and bone marrow aspiration were performed to ascertain the cause of the thrombocytopenia in nine out of 10 subjects in group A.

RESULTS

The minimum platelet count was 4-12 x 10(4)/mm3 (average day of illness, 10.3) and platelet counts were elevated to the baseline value within 1-2 weeks of onset of the illness. Low fibrinogen concentrations, high levels of fibrin degradation products, and low erythrocyte sedimentation rates with high C-reactive protein levels were observed in seven patients. In two other patients, immature megakaryocytes with normal coagulation values were observed. The differences in the incidence of coronary artery aneurysm and acute myocardial infarction between groups A and B were highly significant (coronary artery aneurysm: 60% in group A, 8.9% in group B; acute myocardial infarction: 40% in group A, 0.3% in group B).

CONCLUSIONS

In many patients with Kawasaki disease and thrombocytopenia, the thrombocytopenia appears to be a result of intravascular coagulation, and to be one of the risk factors for acute myocardial infarction.

[Relationship between kinetic visual acuity and visual acuity with limited exposure]

Using a kinetic vision tester which we developed, kinetic visual acuity (KVA) at target velocity of 0-100 km/h was measured at background luminance of 0.1-200 cd/m2 in 19 eyes of 10 normal volunteers ranging in age from 20 to 31 years. The decrease in KVA was slow at a target velocity of 30 km/h or more as reported before. KVA was best at background luminance of 100 cd/m2. In 3 eyes of 2 normal subjects, 3 eyes of 2 patients with tonic accommodation and 1 eye of 1 patient with central serous chorioretinopathy, visual acuity at limited exposure times was also measured. In patients with tonic accommodation, visual acuity at limited exposure times was good, but KVA was poor as compared to normal eyes. In the eyes of patients with central serous chorioretinopathy, results were poor for both. The quantity of light required to obtain the same visual acuity was similar for both normal eyes and eyes with central serous chorioretinopathy in terms of both KVA and visual acuity at limited exposure times. In eyes with tonic accommodation, difference was seen in the required quantity of light. We conclude that functions of accommodation are involved in kinetic vision and that higher visual functions are required than those for visual acuity at limited exposure times.